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180,772 | cba582e8-b343-4363-a06c-fd9f9fd0a4ff | Age was found to be a factor affecting the relation of diabetes mellitus and periodontics | Sampling Bias | Selection Bias | Confounding Bias | Information Bias | 2 | single | null | Dental | null |
180,818 | 69d34d76-8d26-492e-a0d1-50a9c22a7a6f | Complication which commonly accompanies acute prostatitis - | Epididymitis | Orchitis | Seminal vesiculitis | Sterility | 2 | single | • Acute inflammation of prostate associated with UTI
• Caused by ascending urethral infection or reflux of infected urine into prostatic ducts
• MC organism: E. coli
• Patients present with sudden onset high grade fever with chills and rigors, severe irritative symptoms and enlarged, tender and boggy prostate
• Catheterization and prostatic massage is contraindicated
• MC used antibiotics are: TMP-SMX and Ciprofloxacin (Both are having better concentration in prostatic tissue)
• Around 4-6 weeks of antibiotic therapy is used to avert chronic bacterial prostatitis.
Chronic Bacterial Prostatitis
• Due to persistent bacterial infection of prostate
• Insidious in onset, characterized by relapsing or recurrent UTI caused by persistence of pathogen in prostatic fluid despite of antibiotic therapy
• Diagnosis is made by microscopic examination and culture of prostatic expressate and culture of urine obtained before and after prostatic massage.
• Treated by chronic antibiotic suppression (3–4 months)
Prostatic Abscess
• Most cases result from complications of acute bacterial prostatitis
• Fluctuation is a very late sign
• Predisposing factors: Diabetes, renal insufficiency, immunosuppression, urethral instrumentation, chronic indwelling catheter
• Diagnosis: TRUS or pelvic CT scan is crucial for diagnosis and treatment
• Treated by transurethral drainage and antibiotics | Surgery | null |
180,901 | 3601e6a4-5888-49f2-9cb6-67b4589a2efb | World diabetes day is celebrated on - | 8th may | 8th march | 14th November | 1st december | 2 | single | Ans. is 'c' i.e., 14th November* 8th may - world red cross day* 8th march - international womens day* 14th november - world diabetes day* 1st december - world AIDS day | Social & Preventive Medicine | Non-Communicable Diseases |
181,050 | 69e2ab08-f073-459b-a56e-070bb451a9f0 | Several of the older patients in your practice intend to pursue exercise programs. They have no cardiac symptoms, but some do have vascular risk factors such as diabetes or hypertension. In these patients, which of the following is true about exercise electrocardiography? | it is an invasive procedure | it is contraindicated in patients over 65 years of age | it detects latent disease | it has a morbidity of approximately 5% | 2 | multi | Exercise electrocardiography represents an increasingly popular noninvasive method for early detection of latent ischemic heart disease. As with other diagnostic tests, the exercise ECG is of most clinical value when the pretest probability of disease is moderate (i.e., 30-70%). In men over 40 and women over 50 who plan to start vigorous exercise, use of exercise ECG is possibly, but not definitely, supported by the evidence (class IIb). | Medicine | C.V.S. |
181,058 | dd65a265-9e6f-43fd-92da-1ccc13ebb5d1 | Asthma is which type of hypersensitivity? | Type -1 hypersensitivity | Type -2 hypersensitivity | Type -3 hypersensitivity | Type -4 hypersensitivity | 0 | single | Ans. is 'a' i.e., Type -1 hypersensitivity HypersensitivityType I (IgE mediated)Type II (IgG IgM and complement mediated)o Eczemao Blood transfusion reactionso Hay fevero Erythroblastosis fetaliso Asthmao Autoimmune hemolytic anemia or thrombocytopenia or agmulocytosiso Atopyo Pemphigus vulgariso Urticariao Good pasture syndromeo Anaphylactic shocko Bullous pemphigoido Acute dermatitiso Pernicious anemiao Theobald smith phenomenono Acute rheumatic fevero Prausnitz Kusnter (PK) reactiono Diabetes mellituso Casonistesto Graves diseaseo Schultz-Dale phenomenono Myasthenia gravisType III (IgG IeM. complement and leucocyte mediated)Tvpe IV (Cell mediated)o Local-Arthus reactiono Tuberculin testo Systemic-serum sicknesso Lepromin testo Schick testo Sarcoidosiso Polyarteritis nodosa (PANo Tuberculosiso Rheumatoid arthritiso Contact dermatitiso SLEo Granulomatous inflammationo Acute viral hepatitiso Type I lepra reactiono Penicillamine toxicityo Patch testo Hyperacute graft rejectiono Temporal arteritiso Type 2 lepra reaction (ENL)o Jones mote reaction (cutaneous basophilic HSN)o Hypersensitivity pneumonitiso Graft rejectiono R.Ao Fairleys testo Infective endocarditiso Frie's testo Henoch schonlein purpura o Glomerulonephritis | Pathology | Hypersensitivity Reactions: Immune-Mediated Injury |
181,071 | 344c4767-4ee1-4ab1-a7f0-090cdc83730e | Nodular glomerulosclerosis is pathognomic for: September 2009 | Antiphospholipid syndrome | Goodpasture's syndrome | Renal amyloidosis | Diabetic nephropathy | 3 | single | Ans. D: Diabetic nephropathy The constellation of renal changes attributed to Diabetes mellitus are- Armanni-Ebstein lesion, aerionephrosclerosis, aeriolonephrosclerosis, chronic interstitial nephritis, diabetic glomerulosclerosis, fatty changes in renal tubules, glomerulonephritis, Kimmelstiel-Wilson disease--focal and segmental glomerulosclerosis, nephrotic syndrome, papillary necrosis, and pyelonephritis. | Medicine | null |
181,129 | 8c79bc07-60d8-415c-8595-b24fbb91aa5a | A-65 years alcoholic suffering from diabetes has a flexion deformity at the right little finger over the metacarpophalangeal joint of around 15 degrees. The ideal management for him would be - | Observation | Percutaneous fasciotomy | Subtotal fasciectomy | Total fasciectomy | 0 | single | The information in this question are:-
Patient is alcoholic and diabetic (both are risk factors for Dupuytren's contracture).
Flexion deformity at MCP joint of little finger.
Patient is old (65 years).
The Diagnosis is Dupuytren's contracture.
The only effective treatment is by operation; however, operation is not necessary in every case; a contracture that is not progressing rapidly is often better left alone, especially in an elderly patient.
Primary indication for surgery is fixed contracture of > 30° at metacarpophalangeal joint or > 15° at proximal interphalangeal joint. | Orthopaedics | null |
181,135 | ba0a5e39-38ce-4ab6-81f6-43ed1f44b192 | Childhood-obesity prevention is an example of which of the following types of prevention? (E. REPEAT 2007) | Primordial | Primary | Secondary | Tertiary | 0 | single | Ref: Park's Textbook of Preventive and Social Medicine, 22nd edition, Pages 39, 40 Explanation: Preventing childhood obesity becomes primordial prevention for most of the non-communicable diseases. This is because the risk factor for other diseases is prevented, which means primordial prevention. Level of prevention Phase of disease Interventions Examples Primordial Prevention of risk factors Health education * School health education Health promotion * Lite style modification * Stop smoking * Stop alcoholism Primary Prevention of disease * Chemoprophylaxis * Condom usage * Wearing helmet * Seat belt Specific protection Secondary Prevention of spread of disease and complications Early diagnosis and prompt treatment * Screening lor any disease * Two weeks cough with sputum in ease of tuberculosis * Any fever case treated as malaria * MCR slipper in diabetes before complication Tertiary Limiting the occurred complication and rehabilitation Disability limitation * Appropriate tool cure in diabetes and leprosy Rehabilitation * Artificial limbafter road traffic accidents | Unknown | null |
181,152 | 23ef563d-5d23-4b2f-be48-bfe36a1c9ac0 | Which type of anemia is seen in Rheumatoid ahritis? | Normocytic, normochromic | Hyperchromic, Normocytic | Hypochromic, normocytic | Hypochromic, leucopenia | 0 | single | Anemia of chronic illness traditionally encompassed any inflammatory, infectious, or malignant disease of a long-standing nature. Includes rheumatoid ahritis, severe trauma, hea disease, or diabetes mellitus. There is primarily a decreased availability of iron, relatively decreased levels of erythropoietin, and a mild decrease in the lifespan of RBCs to 70-80 days. Early onset rheumatoid ahritis with positive rheumatoid factor is more likely to have normocytic normochromic anemia. | Medicine | Rheumatoid Ahritis |
181,158 | c20bbd0f-1974-4e26-b2e7-30e35a2ca00e | A 59-vear-old man with type 2 diabetes goes for a screening eve examination. The ophthalmologist reports that the patient has developed non-proliferative retinopathy. (List the findings.)For the above patient with a complication of diabetes, select the most likely diagnosis or findings. | microaneurysms and hemorrhage (dot and blot) | vitreal hemorrhage | dilated veins | open-angle glaucoma | 0 | multi | Background retinopathy is present in about 90% of diabetes after 25-30 years of disease. Microaneurysms, dilated veins, dot and blot hemorrhages, cotton-wool spots, and hard exudates are common findings. | Medicine | Endocrinology |
181,168 | 0a4629cd-b72e-4aef-a801-bffd2d95a47c | Sq. cell tumor of urinary bladder is due to -a) Stoneb) Schistosomiasisc) Chr. cystitisd) Diabetes mellitus | ab | bc | abc | bcd | 2 | single | Risk factors for squamous cell ca of bladder
Schistosoma haematobium
it's a risk factor for both TCC & sq. cell ca, but more for sq. cell ca.
Chronic irritation from urinary calculi, long term indwelling catheters, chronic urinary infections
Bladder diverticula | Surgery | null |
181,327 | 294fbabf-d326-4fae-9372-857bb5c197f9 | FK 506 is a type of: | Immunoglobulin antibody | Non-depolarizing muscle relaxant | Macrolide antibiotic | Opioid anaesthetic | 2 | single | Tacrolimus (FK506)- structurally a macrolide antibiotic which is a newer immunosuppressant chemically different from cyclosporine, but having the same mechanism of action, and is -100 times more potent. It binds to a different cytoplasmic immunophilin protein labeled 'FKBP', but the subsequent steps are the same, i.e. inhibition of helper T cells calcineurin. Tacrolimus is administered orally as well as by i.v. infusion. Oral absorption is variable and decreased by food. It is metabolized by CYP3A4 Section 14 and excreted in bile with a longer tlh of 12 hour. Therapeutic application, clinical efficacy as well as toxicity profile are similar to cyclosporine. It is paicularly valuable in liver transplantation because its absorption is not dependent on bile. Because of more potent action, itis also suitable for suppressing acute rejection that has set in. Hypeension, hirsutism and gum hyperplasia are less marked than cyclosporine, but tacrolimus is more likely to precipitate diabetes, cause neurotoxicity, alopecia, and diarrhea. Dose-limiting toxicity is renal. ESSENTIALS of MEDICAL PHARMACOLOGY SIXTH EDITION -K. D TRIPATHI Page:853 T | Pharmacology | Immunomodulators |
181,362 | e117ceba-9d46-4320-beba-73675089ee32 | Propranolol is contraindicated in diabetes mellitus because it: | Causes hyperglycemia | Causes seizures | Masks the hypoglycemic symptoms | Causes hypotension | 2 | single | null | Pharmacology | null |
181,422 | 55a55d2f-2795-4614-b35e-d8335ef0fa92 | Which of the following is not a cause for the development of carpal tunnel syndrome? | Alcoholism | Sarcoidosis | Gout | Menorrhagia | 3 | single | Ans. is 'd' i.e., Menorrhagia * There are many causes of carpal tunnel syndrome: -1) Idiopathic: - This is the most common cause.2) Pregnancy and menopause3) Metabolic: - Gout, Diabetes mellitus4) Endocrine: - Hypothyroidism, Myxedema, Acromegaly, Hyperparathyroidism.5) Deposition disorder:- Amyloidosis, Sarcoidosis, Rheumatid arthritis, Leukemia, CRF, Mucopoly-saccharoidosis.6) Alcoholism7) Local causes: - Malunited colie's fracture, osteo-arthritis of the carpal bones, synovitits of flexor tendon sheath, hematoma. | Orthopaedics | Miscellaneous |
181,461 | b0343895-cf99-47fd-b6eb-bc34ed101ca0 | Most common association with Acanthosis nigricans ? | Hypeension | DM | Obesity | Hypothyroidism | 2 | single | Ans. is 'c' i.e., Obesity Acanthosis nigricans is a brown to black, velvety hyperpigmentation of the skin. It is usually found in body folds, such as posterior & lateral folds of neck, axilla, groin, umblicus, forehead. It typically occurs in individuals younger than 40 years of age. Histopathologically papillomatosis is characteristically seen; however, there is no hypermelanosis and there is only mild acanthosis, if present. It is associated with : Obesity (most common) Endocrinopathies --> Hypothyroidism, hypehyroidism, insuline resistance diabetes, Cushing's disease, PCOD, Bloom syndrome. Internal malignancy --> Gastric adenocarcinoma. | Skin | null |
181,516 | 06277027-48a9-4e9f-b9d5-a20e6513633e | In which of the following intensive management of diabetes needed except - | Autonomic neuropathy causing postural hypotension | Pregnancy | Post kidney transplant in diabetic nephropathy | DM with acute MI | 0 | multi | null | Medicine | null |
181,525 | 8331f967-1fc5-479b-8af9-ae34f153e0de | A 1-year-old girl is brought to the emergency room by her parents who report she has had a fever and diarrhea for 3 days. Her temperature is 38degC (101degF). The CBC shows a normal WBC count and increased hematocrit (48 g/dL). Which of the following is the most likely cause of increased hematocrit in this patient? | Acute phase response | Dehydration | Diabetes insipidus | Malabsorption | 1 | single | Increased hematocrit in this patient reflects hemoconcentration caused by dehydration, secondary to diarrhea. This hematologic condition, termed relative polycythemia, is characterized by decreased plasma volume with a normal red cell mass. When patients suffer from burns, vomiting, excessive sweating, or diarrhea, they not only lose fluid but also suffer electrolyte disturbances. Systemic blood pressure falls with continuous dehydration, and declining perfusion eventually leads to death. Diabetes insipidus (choice C) may cause dehydration but is an unlikely choice because the patient has a history of diarrhea. None of the other choices cause relative polycythemia.Diagnosis: Dehydration, relative polycythemia | Pathology | Hemodynamics |
181,671 | 6950df0d-d379-48a9-896a-e8c02f6fb9b2 | Most common cause of neuropathic joint - | Leprosy | Tabes dorsalis | Diabetes | Nerve injury | 2 | single | Ans. is 'c' i.e., DiabetesNeuropathic joint (Charcot's joint)o It is a progressive destructive arthritis associated with loss of pain sensationx, proprioception or both, in addition normal muscular reflexes that modulate joint movements are decreased.o Without these protective mechanisms, joints are subjected to repeated trauma, resulting in progressive cartilage and bone damage.o It is most commonly caused by diabetes mellitus.Causes of Neuropathic joint disease (Charcoat's joint)o Diabetes mellitus {most common) o Amyloidosiso Tabes Dorsalis o Leprosyo Meningomyelocele o Congenital indifference to paino Syringomyelia o Peroneal muscular atrophy | Orthopaedics | Neuropathic Joints |
181,715 | d1e3de35-3e36-4bc5-b0a5-8f750dacadf6 | A 90-year-old woman with mild diabetes and Alzheimer's disease die in her sleep. At autopsy, hepatocytes are noted to contain golden cytoplasmic granules that do not stain with Prussian blue. Which of the following best accounts for pigment accumulation in the liver of this patient? | Advanced age | Alzheimer disease | Congestive hea failure | Diabetic ketoacidosis | 0 | single | The answer is A: Advanced age. Substances that cannot be metabolized accumulate in cells. Examples include:- (1) endogenous substrates that are not processed because a key enzyme is missing (lysosomal storage diseases) (2) insoluble endogenous pigments (lipofuscin and melanin) (3) exogenous paiculates (silica and carbon) Lipofuscin is a "wear and tear" pigment of aging that accumulates in organs such as the brain, hea, and liver. None of the other choices are associated with lipofuscin accumulation.Diagnosis: Aging, lipofuscin | Pathology | Pigmentation |
181,804 | fe94a1f7-2fa1-416b-b5cd-a3f044b8057b | Multifactorial inheritance is most likely to play a role in | Cleft lip | Marfan's syndrome | Down's syndrome | Erythroblastosis fetalis | 0 | single | Cleft lip and cleft palate, also known as orofacial cleft, is a group of conditions that includes cleft lip (CL), cleft palate (CP), and both together (CLP).] A cleft lip contains an opening in the upper lip that may extend into the nose. The opening may be on one side, both sides, or in the middle. A cleft palate is when the roof of the mouth contains an opening into the nose. These disorders can result in feeding problems, speech problems, hearing problems, and frequent ear infections. Less than half the time the condition is associated with other disordersMultifacorial inheritance is the type of inheritance followed by traits that are determined by multiple factors both environmental and genetic. Environmental factors interact with many genes to generate a normally distributed susceptibiity.Some diseases for example myocardial infarction, congenital bih defects, cancer, diabetes, mental illnesses and Alzheimer diseases cause along with morbidity, premature moality in two out of three individuals during their lifetime. Many show clustering among families. However their inheritance pattern does not follow that of single gene disorders (Mendelian pattern of inheritance). These kind of diseases are thought to result from complex interactions between genetic and environmental factors, i.e. multifactorial inheritance pattern. | Pathology | General pathology |
181,865 | d9a4bfd2-ea44-4fdc-9517-bd11a2c73820 | All are true regarding Klinefelter's syndrome except: | Small Testes | Webbing of neck | Gynecomastia | Increased FSH levels | 1 | multi | Ans: B (Webbing of neck) Ref: Robbins Pathologic Basis of Disease, 8th edition.Explanation:Webbing of neck is characteristically seen in Turner's syndromeKlinefelter SyndromeMale hypogonadism that occurs when there are two or more X chromosomes and one or more Y chromosomes.MC genetic disease involving the sex chromosomesMost common cause of hypogonadism in the male.Incidence 1 in 660 live male birthsIt can rarely he diagnosed before puberty because the testicular abnormality develop late.Distinctive body habitus -Increase in length between the soles and the pubic bone ->> elongated bodyEunuchoid body habitusLong legsSmall atrophic testesSmall penisLack of secondary male characteristics as deep voice, beard & pubic hair.GynecomastiaThere is increased incidence ofType 2 diabetesThe metabolic syndromeMitral valve prolapse in 50%.Autoimmune diseases (SLE)Breast cancer (20 times more common than in normal males)Extragonadal germ cell tumors||Plasma gonadotropin concentrations (FSH) & || testosterone levelsT Plasma estradiol levels (Unknown mechanism)The ratio of estrogens and testosterone determines the degree of feminization in individual cases.Reduced spermatogenesis and male infertilityTesticular tubules are totally atrophied and replaced by pink, hyaline, collagenous ghosts.Sometimes, apparently normal tubules are interspersed with atrophic tubules.In some patients all tuhules are primitive and appear embryonic, consisting of cords of cells that never developed a lumen or progressed to mature spermatogenesis.Leydig cells appear prominent, as a result of the atrophy and crowding of tubules and elevation of gonadotropin concentrations.The classic pattern of Klinefelter syndrome is associated with a 47, XXY karyotype (90% of cases).This complement of chromosomes results from nondisjunction during the meiotic divisions in one of the parents.15%' of patients w ith Klinefelter syndrome have been found to have a variety of mosaic patterns, most of them being 46, XY/47, XX\r (Other patterns are 47, XXY/48, XXXY )Turner SyndromeTurner syndrome results from complete or partial monosomy of the X chromosome and is characterized primarily by hypogonadism in phenotypic femalesIt is the most common sex chromosome abnormality in females.Three types of karyotypic abnormalities are seen in Turner syndrome.Entire X chromosome is absent (57%), resulting in a 45 XO karyotype.Structural abnormalities of the X chromosomes (14%)Mosaics (29%).Examples of karyotypes that mosaic Turner females may have are the following: (1) 45,X/ 46, XX; (2) 45. X/46. XY; (3) 45, X/47, XXX; or (4) 45, X/46. X. i(X)(ql0).The mosaics with a Y chromosome-containing population (e.g., 45. X/46, XY karyotype) may be at risk of developing GonadoblastomaClassical Features of Turners syndromePresent durings infancy with edema of the dorsum of the hand and foot due to lymph stasis. Swelling of the nape of the neck (due markedly distended lymphatic channels leading on to cystic hygroma)Bilateral neck webbingPersistent looseness of skin on the back of the neck.Congenitat heart disease (esp preductal coarctation of the aorta and bicuspid aortic valve)Failure to develop normal secondary sex characteristics.Turner syndrome is the single most important cause of primary amenorrheaApproximately 50% of patients develop autoantibodies to thyroid gland, and can develop hypothyroidism.Glucose intolerance, obesity, and insulin resistance in minority of patients | Pathology | Mendelian Disorders: Single-Gene Defects |
182,145 | 9181ca89-36cf-4bbb-9201-261520d3227a | A 67-year-old man with an 18-year history of type 2 diabetes mellitus presents for a routine physical examination. His temperature is 36.9 C (98.5 F), his blood pressure is 158/98 mm Hg and his pulse is 82/minute and regular. On examination, the physician notes a non tender, pulsatile, mass in the mid-abdomen. A plain abdominal x-ray film with the patient in the lateral position reveals spotty calcification of a markedly dilated abdominal aoic walI. Which of the following physiologic observations helps to account for the fact that 75% of the aneurysms of this patient's type are found in the abdomen and only 25% principally involve the thorax? | Diastolic pressure is greater in the abdominal aoa in the supine position | Negative intrathoracic pressure reduces aoic wall tension in the thorax | The average blood flow in the abdominal aoa is greater than that in the thoracic aoa | The average blood pressure in the abdominal aoa is higher than that in the thoracic aoa | 3 | multi | Increased blood pressure is a strong risk factor for atherosclerosis, and humans pay a price for their erect sitting and standing postures. In these postures, the abdominal aoa experiences the weight of a column of blood added to the pressure produced by the hea. In the supine posture, the pressures in the thoracic and abdominal aoa are similar. So, if an average daily pressure is taken, the abdominal aoa tends to have a significantly higher pressure than does the thoracic aoa. Diastolic pressure is actually greater in the thoracic aoa compared to the abdominal aoa in the supine position. However, the systolic blood pressure is greater in the abdominal aoa. A negative intrathoracic pressure would tend to increase transmural pressure across the wall of the thoracic aoa, and thereby increase wall tension and promote the development of aneurysms. Blood flow in the abdominal aoa is less than that in the thoracic aoa, because some blood leaves the aoa through its thoracic branches. Ref: Creager M.A., Loscalzo J. (2012). Chapter 248. Diseases of the Aoa. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds),Harrison's Principles of Internal Medicine, 18e. | Physiology | null |
182,260 | f31a85eb-1839-4c41-af04-3b1bb83c9b82 | False about trans fatty acid | Increase risk of cardiovascular disease | Fried foods have high content of TFA | Hydrogenation increases TFA | Hydrogenation decreases TFA | 3 | multi | Trans fatty acids (TFA) are atherogenic. They lower HDL level and elevate LDL level. TFA is present in dairy products and hydrogenated edible oils. It is widely used in the food industry since it increases the shelf life of fried food. Cooking media containing PUFA and fast food preparations have a high content of trans fatty acids. Trans fatty acids adversely affect endothelial function and aggravate insulin resistance and diabetes. It is high in processed foods and bakery products, where hydrogenated vegetable oils are used for cooking.Ref: DM Vasudevan - Textbook of Biochemistry, 6th edition, page no: 437 | Biochemistry | Metabolism of lipid |
182,267 | 54c576d7-cd4c-49c8-b29b-f46b9f35e68a | Risk factors for coronary aery disease (CAD) - | High HDL | LowLDL | Increased homocysteine levels | Decreased fibrinogen levels | 2 | single | Ref: R Alagappan - Manual of Practical Medicine 4th Edition.pg no:182 Risk Factors Category I (For which interventions have been proved to lower CVD risks) 1. Raised LDL cholesterol 2. Reduced HDL cholesterol 3. Atherogenic diet 4. Cigarette smoking 5. Hypeension 6. LVH 7. Thrombogenic factors Category II (For which interventions are likely to lower CVD risks) 1. Diabetes mellitus 2. Physical inactivity 3. Increased triglycerides 4. Small dense LDL 5. Obesity Category III (Associated with increased CVD risk that, if modified, might lower risk) 1. Psychosocial factors 2. Increased Lipoprotein a (normal level--0-3 mg/dl) 3. Hyperhomocysteinemias 4. No alcohol consumption 5. Oxidative stress 6. Post-menopausal status Category IV (Associated with increased CVD risk which cannot be modified) 1. Age 2. Male gender 3. Low socio-economic status 4. Family history of early onset CVD | Medicine | C.V.S |
182,283 | 8f8318b1-f44f-488a-af3b-05fe570988ae | Not a common cause of meningitis in a child of age 8 years is: | S. pneumococci | H. influenza | S. aureus | Meningococci | 2 | single | S. aureus REF: Nelson 17th edition page 863, "Meningitis due to S. aureus is not common; it is associated with cranial trauma and neurosurgical procedures ( e.g. craniotomy, cerebrospinal fluid shunt placement) and less frequently with endocarditis, parameningeal foci (e.g., epidural or brain abscess), diabetes mellitus, or malignancy. The CSF profile in S. aureus meningitis is indistinguishable from that in other bacterial causes of meningitis" Causes of bacterial meningitis vary by age group and comorbid conditions: Age Group & conditions Causes Premature babies & New- horns up to 3 month Group B Streptococci (mc), Streptococcus pneumoniae, Escherichia coli (carrying K1 antigen), Listeria monocytogenes Infants Neisseria meningitidis, Haemophilus influenzae, Streptococcus pneumoniae Children (2-29 years) N. meningitidis (mc), S. pneumoniae Adult S. pneumoniae (mc), N. meningitidis, Mycobacteria Impaired cellular immunity L monocytogenes, gram-negative bacilli, S pneumoniae Postsurgical or posttraumatic Staphylococcus aureus, S pneumoniae, gram-negative bacilli | Pediatrics | null |
182,421 | e4453f82-0320-4fc3-a8d5-0771184b6f21 | Vulvar carcinoma accounts for what percentage of genital tract malignancies? | 0.5 - 1% | 3 - 5% | 7 - 11% | 13 - 15% | 1 | single | Ans. is 'b' i.e.,3 - 5%Vulval CarcinomaIt occurs in 17/100,000 females.It accounts for 3 - 5% of the genital tract malignanciesIt usually occurs in post menopausal females with median age of 60 years.It has increased association with obesity, hypeension, diabetes and multiparity. | Gynaecology & Obstetrics | null |
182,487 | ca357e08-beb9-4ef8-b31e-81740da2ac57 | Placental enlargement is seen in which of the following infections except? | Toxoplasma | CMV | Parvovirus | Plasmodium | 3 | multi | Ans. D.PlasmodiumMaternalMaternal diabetesRh incompatibilityAnemiaChronic intrauterine infection: TORCH (Toxoplasmosis, rubella, CMV, herpes), syphilis, VZV, Parvovirus B-19.Alpha - thalassemiaFetalHigh output hea failureUmbilical vein obstructionHydrops fetalis (all causes)Sacrococcygeal teratomaBeckwith - Wiedemann syndromePlacental :Choriocarcinoma, Hemorrhage, hydatidiform moleFinnish type nephrotic syndrome | Gynaecology & Obstetrics | null |
182,609 | a44dd2df-8836-4fb1-9ec2-97e74c8e8f33 | All have chances of DVT except - | Hip fracture & resting | Young < 25yrs age | Decreased protein C & S | Factor V defect | 1 | multi | Ans. is 'b' i.e., Young <25 yrs. Risk factors for DVT -o Advanced Age# Major abdominal.''orthopedic surgery/major trauma# Prolonged immobilisation (>3 days)# HRT and OCP use# Pregnancy and puerperium# Malignancy# Obesity/Diabetes/CHF/Shock# Nephrotic syndrome# Varicose veins# Antiphospholipid antibody syndrome# Myeloproliferative disease# Tobacco Smoking | Unknown | null |
182,670 | 45d47097-ba83-4b1e-89ef-584737a309b5 | A child with alopecia, hyperpigmentation, hypogonadism and rash of genital area and mouth is likely to suffer from: | Iron deficiency | Zinc deficiency | Calcium deficiency | Copper deficiency | 1 | single | Ans. (b) Zinc deficiencyRef. Harrison's 19th ed. / 96e-9* Zinc is an essential trace nutrient required for the proper function of more than 100 enzymes and plays a crucial role in nucleic acid metabolism.* Acrodermatitis enteropathica is an autosomal recessive disorder postulated to occur as a result of mutations in the SLC39A4 gene located on band 8q24.3.* This protein is highly expressed in the enterocytes in the duodenum and jejunum. Therefore, affected individuals have a decreased ability to absorb zinc from dietary sources. Absence of a binding ligand needed to transport zinc may further contribute to zinc malabsorption.* Clinical manifestations include diarrhea, alopecia, muscle wasting, depression, irritability, and a rash involving the extremities, face, and perineum. The rash is characterized by vesicular and pustular crusting with scaling and erythema.* Features of acrodermatitis enteropathica start appearing in the first few months of life, if mother discontinues breast milk.Deficiency and toxicity of several metalsPhosphorus ElementDeficiencyToxicityTolerable Upper (Dietary) Intake LevelBoronNo biologic function determinedDevelopmental defects, male sterility, testicular atrophy20mg/d (extrapolated from animal data)CalciumReduced bone mass, osteoporosisRenal insufficiency (milk-alkali syndrome) nephrolithiasis, impaired iron absorption, thiazide diuretics.2500 mg/d (milk alkali)CopperAnemia, growth retardation, defective keratinization and pigmentation of hair, hypothermia, degenerative changes in aortic elastin, osteopenia, mental deterioration.Nausea, vomiting, diarrhea, hepatic failure, tremor, mental deterioration, hemolytc anemia, renal dysfunction10 mg/d (liver toxicity)ChromiumImpaired glucose toleranceOccupational',Renal failure, dermatitis, pulmonary cancerNot determinedFluoride|Dental cariesDental and skeletal flurosis, osteosclerosis10 mg/d (Blurosis)IodineThyroid enlargement, |T4 cretinismThyroid dysfunction, acne-like eruptions.1100 mg/d (thyroid dysfunction)IronMuscle abnormalities, koilonychia, pica anemia, |work performance, impaired cognitive development, premature labor, |perinatal maternal deathGastrointestinal effects, (nausea, vomiting, diarrhea, constipation), iron overload with organ damage, acute and chronic systemic toxicity, increased susceptibility to malaria, increased risk association with certain chronic diseases (e.g. diabetes)45 mg/d of elemental Iron (gastrointestinal side effects)ManganeseImpaired growth and skeletal development reproduction, lipid and carbohydrate metabolism, upper body rashGeneral: Neurotoxicity, Parkinson-like symptoms Occupational: Encephalitis like syndrome, Parkinson like syndrome, psychosis, pneumoconiosis.11 mg/d (neurotoxicity)MolybdenumSevere neurologic abnormalitiesReproductive and fetal abnormalities2mg/d (extrapolated from animal data)SeleniumCardiomyopathy, heart failure, striated muscle degenerationGeneral: Alopecia , nausea, vomiting, abnormal nails, emotional400 pg/d (hair, nail changes)PhosphorusRickets (osteomalacia) proximal muscle weakness, rhabdomyolysis, paresthesia, ataxia, seizure confusion, heart failure, hemolysis acidosis.Hyperphosphatemia4000 mg/dZincGrowth retardation, |taste and smell alopecia, dermatitis, diarrhea, immune dysfunction, failure to thrive, gonasal atrophy, congenital malfomations.General: Reduced copper, absorption, gastritis, sweating fever,nausea, vomitingOccupational; Respiratory distress, pulmonary fibrosis40 mg/d (impaired copper metabolism) | Biochemistry | Micronutrient Metabolism |
182,692 | 935d46c0-448d-4005-8891-f953a4b43af0 | Which of the following condition masks low serum haptoglobin in hemolysis? | Bile duct obstruction | Liver disease | Malnutrition | Pregnancy | 0 | single | Haptoglobin is a glycoprotein synthesized in the liver that binds free hemoglobin. Its scavenging function counteracts the potentially harmful oxidative and nitric oxide-scavenging effects associated with "free" hemoglobin. Low haptoglobin is considered an indicator of hemolysis. But it is increased in biliary obstruction, hence it will mask the effect of hemolysis on haptoglobin. Increased in: Acute and chronic infection (acute-phase reactant) Malignancy Biliary obstruction Ulcerative colitis Myocardial infarction Diabetes mellitus Decreased in: Newborns and children Pregnancy Malnutrition Posttransfusion Intravascular hemolysis Autoimmune hemolytic anemia Liver disease Ref: Nicoll D., Lu C.M., Pignone M., McPhee S.J. (2012). Chapter 3. Common Laboratory Tests: Selection and Interpretation. In D. Nicoll, C.M. Lu, M. Pignone, S.J. McPhee (Eds), Pocket Guide to Diagnostic Tests, 6e. | Pathology | null |
182,714 | 1605273f-c03c-4cca-8f11-1b7adb6c0da3 | Which is a immunological marker of type I diabetes? | Anti-endothelial antibody | GAD | Anti-saccharomyces antibody | None of the above | 1 | multi | Ans. B. GADImmunologic markers in type 1 DM:a. Islet cell autoantibodies (ICAs)b. Antibody to insulin (IAA)c. Glutamic acid decarboxylase, (GAD)d. Tyrosine phosphatase (IA-2 & IA- 2B)e. Beta cell specific zing transporter (ZnT - 8) | Medicine | Miscellaneous |
182,771 | 203f7cd2-2c38-4fe2-85eb-d8683f81673a | Which of the following has highest potential to cause metabolic syndrome? | Clozapine | Risperidone | Quetiapine | Aripiprazole | 0 | single | Metabolic complication like weight gain, hyperlipidemia and precipitation of diabetes is a major limitation. Other given drugs donot cause metabolic syndrome. Ref KD TRIPATI 8TH ED. | Pharmacology | Central Nervous system |
182,784 | 6f7305c1-d81a-4a85-ad66-b7adf46e8a38 | Which of the following maternal complication during pregnancy result in giving bih to a large baby? | Anaemia | Cardiac disease | Gestational diabetes | Gestational hypeension | 2 | single | Maternal development of gestational diabetes result in fetal macrosomia. The pathophysiology of fetal macrosomia is not very clear but it seems clear that fetal hyperinsulinemia is one driving force. The insulin like growth factor, as well as fibroblast growth factor, also are involved, so a hyperinsulinemic state with increased levels of some growth factors, with increased expression of GLUT proteins in syncytiotrophoblast, may promote excessive fetal growth. It could also be due to elevated levels of maternal free fatty acid which leads to its increased transfer to the fetus accelerating triglyceride synthesis and resulting in adiposity. Ref: Williams Obstetrics 22nd Edition, Page 59, 689 ; Textbook of Obstetrics By D. C Dutta, 6th Edition, Page 286-7 | Gynaecology & Obstetrics | null |
182,815 | ca769633-3650-4209-8d22-b81a2e171d25 | Organism that causes emphysematous cholecystitis is: | Salmonella typhi | Cytomegalovirus | Clostridium perfringens | Bacteroides | 2 | single | Ref: Harrison's 18th editionExplanation:Emphysematous CholecystitisIt is thought to begin with acute cholecystitis (calculous or acalculous) followed by ischemia or gangrene of the gallbladder wall and infection by gas-producing organisms.Bacteria most frequently cultured in this setting includeAnaerobes, such as C. welchii or C. perfringensAerobes, such as E. coli.This condition occurs most frequently in elderly men and in patients with diabetes mellitus.The clinical manifestations are essentially indistinguishable from those of nongaseous cholecystitis.The diagnosis is usually made on plain abdominal film by finding gas within the gallbladder lumen, dissecting within the gallbladder w all to form a gaseous ring, or in the pericholecvstic tissues.The morbidity and mortality rates with emphysematous cholecystitis are considerable.Prompt surgical intervention coupled with appropriate antibiotics is mandatory. | Medicine | Gall Bladder |
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