Horseshoe Kidney

Fascinating specimen of a horseshoe kidney!!
This is the most common renal anomaly, occurs in one of every 400. 
Horseshoe kidney is a rental fusion anomaly that consists of two distinct functioning kidneys on each side of the midline, connected at the lower poles by an isthmus (the fused part) of functioning renal parenchyma or fibrous tissue that crosses the midline of the body.
Fusion is thought to occur before the kidneys ascend from the pelvis to their normal dorsolumbar position. This is usually between the 5th and 9th weeks of gestation.
It often presents together with other congenital anomalies, particularly ureteral and collecting system abnormalities. 
Horseshoe kidneys are, in themselves, asymptomatic and thus they are usually identified incidentally (eg, routine ultrasound).
They are however prone to a number of complications as a result of poor drainage, which may lead to clinical presentation such as pain and/or hematuria due to obstruction or infection. They are at increased risk for infection because of the increased likelihood of urinary stasis. 
Also susceptibility of trauma and risk of development of renal calculi and transitional cell carcinoma of the renal pelvis.
The majority of patients have an excellent prognosis without any therapeutic intervention.
It is however important to recognise their presence prior to abdominal surgery or renal intervention for one of their many complications.

Mcq part:6

MCQs By Mnemonicsmed Group

.Carboluria is seen in acute poisoning with
A.Nitric acid
B.Phenol
C.Oxalic acid
D.Sulphuric acid

ANS : B

Q.Causes of iron deficiency anemia EXCEPT
A.CRF
B.Young male
C.Celiac sprue
D.Hook worm
E.Carcinoma cecum

ANS: B

Q.Which of the following is the type of joint present b/w stapes and incus
A.Primary cartilaginous
B.Saddle synovial
C.Secondary cartilaginous
D.Ball and socket synovial

ANS: D

Q. Rapid urease positive test is done in
A.Helicobacter pylori
B.Staphylococcus aureus
C.Klebsiella
D.Streptococcus

ANS: A

Q.Most common pattern of fingerprint is
A.Whorls
B.Loops
C.Composite
D.Arches

ANS: B

Q.The auricle develops from
A.1st branchial cleft
B.1st branchial arch
C.1st & 2nd branchial arch
D.1st,2nd,3rd branchial arch

ANS: C

Q.Absence of lacrimation is seen in which nerve injury
A.Nasociliary nerve
B.Greater petrosal nerve
C.Supraorbital nerve

ANS: B

Q.Which of the following is developed from the mesogastrium of stomach
A.Liver
B.Pancreas
C.Spleen
D.Kidney

ANS: C

Q. What is the Neutrophil count of moderate neutropenia
A.<500/mm3
B.100/mm3
C.500-1000/mm3
D.>1000/mm3

ANS: C

Q.Side effects of erythropoietin
A.Hypertension
B.Increased ferritin
C.Increased potassium ion
D.Thrombocytosis
E.Decreased phosphate ion

ANS: A

Q.Aliskiren is
A.Renin antagonist
B.Renin synthesis inhibitor
C.Renin modulator
D.Renin releaser

ANS: B

Q.Most common cause of antibiotic induced colitis is due to
A.E.coli
B.Clostridium difficile
C.Salmonella
D.Campylobacter jejuni

ANS: B

Q.NADPH is required for
A.Gluconeogenesis
B.Fatty acid synthesis
C.Glycogenolysis
D.Glycolysis

ANS: D

Q.In a foetus,the insulin secretion begins by
A.3rd month
B.5th month
C.7 th month
D.9 th month

ANS: A

Q.Hanging drop preparation used for ?
A.Trichomonas vaginalis
B.Gardenella vaginalis
C.Candida albicans
D.Mobilincus

ANS: A

Q.Ion which is needed for conversion of prothrombin to thrombin is ?
A. Sodium
B. Potassium
C. Magnesium
D. Calcium

ANS: D

Q.Which of the following is not a bronchodilater ?
A.β2 agonist
B.Methylxanthines
C.Steroids
D.Anticholinergic

ANS: D

Q.Which drug can cause thyroid dysfunction is ?
A.Amiodarone
B.Ampicillin
C.Ibutilide
D.Acyclovir

ANS: A

Q.A woman assaulted by neighbour was brought to you in the emergency department with fractures of middle tooth. Injury was extended medially to the mouth and there was also contusion to bilateral leg. What is the nature of this injury?
A.Grievous injury
B.Simple injury
C.Dangerous injury
D.Assault

ANS: A

Q. A child develops blisters on exposure to sunlight.irregular dark spots on the skin are also found. He is very likely to have a defect in which of the following mechanism?
A. Nucleotide excision repair
B. Mismatch repair
C. Recombination repair
D. Thymine dimers

ANS: A

Q.Which of the following is a Rho-kinase inhibitor-
A.Fasudil
B.Nicorandil
C.Amiloride
D.Ranolazine

ANS: A 

Q. Recommended oral dose of vitamin A in postpartum female is-
A. 50,000 IU
B. 1,00,000 IU
C. 2,00,000 IU
D. 3,00,000 IU

ANS: C

Q.Staining characteristic used for demonstration of Amyloid is?
A. Apple green with congo red under ordinary light
B. Apple green with congo red under polaried light
C. Pink with congo red under ordinary light
D. None

ANS: B

Q.A 55 year old male presents with renal failure. He gives a history of mild bone pains for the last 7 years. X-ray pelvis shows osteolytic lesion.serum electrophoresis reveals is M spike. Peripheral blood evalution showd a rouleaux formation of RBCs with 35% plasma cells. Bone marrow examination showed a increase in plasma cells with aberrant expression. The most likekly diagnosis is-
A. Monoclonal gamopathy of undetermined significance
B. Multiple myeloma
C. Smoldering multiple myeloma
D. Plasma

Ans:D

Raynaud's Phenomenon

Raynaud’s phenomenon!
This phenomenon is essentially a vasospastic disorder (blood vessels tighten or close) causing discoloration of the fingers, toes, and occasionally other extremities.
The cause of the phenomenon is unknown, but it is a disorder characterized by cold or stress-induced hyperreactivity of the digital arterial smooth muscle, leading to episodic vasospasm in the fingers and toes, the body parts that are usually most susceptible to cold injury. 
Subsequently, it is the cause of finger ischemia that typically progresses from pallor (due to vasoconstriction) to cyanosis to erythema (red due to rapid blood reflow), and accompanied by pain.
In the image, a clear line of demarcation exists between the ischemic and unaffected areas.
These effects are reversible, and they must be distinguished from irreversible causes of ischemia such as vasculitis or thrombosis. Rarely, tissue necrosis occurs distal to the affected vessel, usually in the periphery of the vasculature.
Drug treatment is normally with a calcium channel blocker, frequently nifedipine to prevent arterioconstriction.
Patient education is the cornerstone of management, with patients being advised to avoid cold exposure, maintain the warmth of the whole body (i.e. not just wearing gloves and socks), cease smoking, avoid sympathomimetic medications, and avoid emotional stress where possib

Aorta

The aorta is the largest artery in the body, initially being an inch wide in diameter. It receives the cardiac output from the left ventricle and supplies the body with oxygenated blood via the systemic circulation.

The aorta can be divided into four sections: the ascending aorta, the aortic arch, the thoracic (descending) aorta and the abdominal aorta. It terminates at the level of L4 by bifurcating into the left and right common iliac arteries. The aorta classified as a large elastic artery, and more information on its internal structure can be found 

In this article we will look at the anatomy of the aorta – its anatomical course, branches and clinical correlation

Ascending Aorta

The ascending aorta arises from the aortic orifice from the left ventricle and ascends to become the aortic arch. It is 2 inches long in length and travels with the pulmonary trunk in the pericardial sheath.

Branches

The left and right aortic sinuses are dilations in the ascending aorta, located at the level of the aortic valve. They give rise to the left and right coronary arteries that supply the myocardium.

Aortic Arch

The aortic arch is a continuation of the ascending aorta and begins at the level of the second sternocostal joint. It arches superiorly, posteriorly and to the left before moving inferiorly.

The aortic arch ends at the level of the T4 vertebra. The arch is still connected to the pulmonary trunk by the ligamentum arteriosum (remnant of the foetal ductus arteriosus).

Branches

There are three major branches arising from the aortic arch. Proximal to distal:

• Brachiocephalic trunk: The first and largest branch that ascends laterally to split into the right common carotid and right subclavian arteries. These arteries supply the right side of the head and neck, and the right upper limb.

• Left common carotid artery: Supplies the left side of the head and neck.

• Left subclavian artery: Supplies the left upper limb.

Thoracic Aorta

The thoracic (descending) aorta spans from the level of T4 to T12. Continuing from the aortic arch, it initially begins to the left of the vertebral column but approaches the midline as it descends. It leaves the thorax via the aortic hiatus in the diaphragm, and becomes the abdominal aorta.

Branches

In descending order:

• Bronchial arteries: Paired visceral branches arising laterally to supply bronchial and peribronchial tissue and visceral pleura. However, most commonly, only the paired left bronchial artery arises directly from the aorta whilst the right branches off usually from the third posterior intercostal artery.

• Mediastinal arteries: Small arteries that supply the lymph glands and loose areolar tissue in the posterior mediastinum.

• Oesophageal arteries: Unpaired visceral branches arising anteriorly to supply the oesophagus.

• Pericardial arteries: Small unpaired arteries that arise anteriorly to supply the dorsal portion of the pericardium.

• Superior phrenic arteries: Paired parietal branches that supply the superior portion of the diaphragm.

• Intercostal and subcostal arteries: Small paired arteries that branch off throughout the length of the posterior thoracic aorta. The 9 pairs of intercostal arteries supply the intercostal spaces, with the exception of the first and second (they are supplied by a branch from the subclavian artery). The subcostal arteries supply the flat abdominal wall muscle

  Abdominal Aorta

  The abdominal aorta is a continuation of the thoracic aorta beginning at the level of the T12 vertebrae. It is approximately 13cm long and ends at the level of the L4 vertebra. At this level, the aorta terminates by bifurcating into the right and left common iliac arteries that supply the lower body.
  Branches
  In descending order:
  • Inferior phrenic arteries: Paired parietal arteries arising posteriorly at the level of T12. They supply the diaphragm.
  • Coeliac artery: A large, unpaired visceral artery arising anteriorly at the level of T12. It is also known as the celiac trunk and supplies the liver, stomach, abdominal oesophagus, spleen, the superior duodenum and the superior pancreas.
  • Superior mesenteric artery: A large, unpaired visceral artery arising anteriorly, just below the celiac artery. It supplies the distal duodenum, jejuno-ileum, ascending colon and part of the transverse colon. It arises at the lower level of L1.
  • Middle suprarenal arteries: Small paired visceral arteries that arise either side posteriorly at the level of L1 to supply the adrenal glands.
  • Renal arteries: Paired visceral arteries that arise laterally at the level between L1 and L2. They supply the kidneys.
  • Gonadal arteries: Paired visceral arteries that arise laterally at the level of L2. Note that the male gonadal artery is referred to as the testicular artery and in females, the ovarian artery.
  • Inferior mesenteric artery: A large, unpaired visceral artery that arises anteriorly at the level of L3. It supplies the large intestine from the splenic flexure to the upper part of the rectum.
  • Median sacral artery: An unpaired parietal artery that arises posteriorly at the level of L4 to supply the coccyx, lumbar vertebrae and the sacrum.
  • Lumbar arteries: There are four pairs of parietal lumbar arteries that arise posterolaterally between the levels of L1 and L4 to supply the abdominal wall and spinal cord.

Inside bone and cortex

Inside your bone - cortex and medulla!! 🦴
Bone forms an important component of our skeleton. Because of its rigidity and hardness, it provides the strength and form necessary to keep human body in its shape, and protects the delicate organs vital for life, for example the skull protects the brain and the ribcage protects heart and lungs.

There are two types of bone tissue: compact (cortical) and spongy (medullary).
The names imply that the two types differ in density, or how tightly the tissue is packed together.

Cortical bone contains haversian systems (osteons), which are packed tightly together to form what appears to be a solid mass.
They contain a central Haversian canal surrounded by osseous tissue in a concentric lamellar pattern.
Osteonic canals contain blood vessels that are parallel to the long axis of the bone. These blood vessels interconnect, by way of perforating canals, with vessels on the surface of the bone.
The outermost layer (between the outer surface of the bone and soft tissue) is periosteum and the innermost layer (between compact bone and the medullary space containing spongiosa) is endosteum.
The thickness of the cortex is from subperiosteal deposition of bone. In children, the periosteal layer loosely adheres to the cortex. The periosteum becomes thicker, vascular, and active with age and increased activity.

Spongy (cancellous) bone is lighter and less dense than compact bone. Spongy bone consists of plates (trabeculae) and bars of bone adjacent to small, irregular cavities that contain red bone marrow. The canaliculi connect to the adjacent cavities, instead of a central haversian canal, to receive their blood supply. It may appear that the trabeculae are arranged in a haphazard manner, but they are organized to provide maximum strength similar to braces that are used to support a building. The trabeculae of spongy bone follow the lines of stress and can realign if the direction of stress changes.

Mcq part 5

Mcq part 5

Q.Probiotics, which are cultures of potentially beneficial gut microflora bacteria, have been studied in the primary prevention of which of the following diseases?
A. Celiac disease
B. Atopic dermatitis
C. Psoriasis
D. Cutaneous T-cell lymphoma
E. Asthma

ANS: B

Q.A potentially dangerous side effect of spironolactone is:
A. Hypokalemia
B. Hyperkalemia
C. Hypercalcemia
D. Hyponatremia
E. Hypernatremia

ANS: B

Q.Narrowband UVB is effective for psoriasis and can be used in pregnancy and in childhood. It is also less carcinogenic than PUVA. The wavelength of narrowband UVB is:
A. 311-312nm
B. 315-317nm
C. 300-302nm
D. 318-320nm
E. 317-319nm

ANS: A

Q.Fluorescent UVA bulbs used for phototesting or PUVA therapy have a peak emission at:
A. 254 nm
B. 311 nm
C. 312 nm
D. 352 nm
E. 468 nm

ANS: D

Q.What bacteria may play a role in the pathogenesis of Morphea?
A. B. burgdorferi
B. H. pylori
C. E. coli
D. S. aureus
E. S. enteritidis

ANS: A

Q.Which HLA type is more commonly associated with balnitis circinata ?
A. HLA-B7
B. HLA-B15
C. HLA-B27
D. HLA-B51
E. HLA-DR4

ANS: C

Q.Human orf, also known as ecthyma contagiosum, was diagnosed in a 43 year old farmer by an astute resident dermatologist. Patient presented with a dome shaped, firm bulla with an umbilicated crust. Which of the following virus is responsible?
A. Pox virus
B. HHV-8
C. Parapox virus
D. HPV 5,8
E. Mycobacterium bovis

ANS: C

Q.A child presents with a 1 cm yellow-red nodule on the face. Pathology shows Touton giant cells.
What is the most frequent site of extracutaneous involvement in this disease?
A. Eye
B. Lung
C. Bone
D. CNS
E. Visceral

ANS: A

Q.Mast cells are derived from bone marrow ____+ cells?
A. CD3
B. CD6
C. CD20
D. CD34
E. CD68

ANS: D

Q.Sebaceous glands:
A. Respond to chemical stimuli such as hormones
B. Respond to cholinergic neural activity, exclusively
C. Respond to adrenergic neural activity, exclusively
D. Respond to both adrenergic and cholinergic stimuli
E. Respond to the local release of cytokines from inflammatory cells

ANS: A

Q.Retinoids upregulate transcription of which types of collagen?
A. 1 and 3
B. 1 and 4
C. 1 and 7
D. 3 and 7
E. 4 and 7

ANS: C

Q.Defects in what kind of structural protein lead to pyloric atresia associated with junctional
epidermolysis bullosa:
A. Collagen
B. Elastin
C. Loricrin
D. Integrin
E. Plectin

ANS: D

Q.Meibomian glands are:
A. Eccrine glands localized to the vermillion
border of the lips
B. Sebaceous glands found on the areola of the
breast
C. Sebaceous glands found on the eyelids
D. Apocrine glands found in the anogenital
regions

ANS: C

Q.Regarding the stratum germinativum (basale):
A. Intermediate filaments in basal cells insert
into only hemidesmosomes
B. Keratins 1 and 10 are expressed
C. Not all basal cells have the potential to
divide
D. Microfilaments assist in downward
movement of cells
E. Plectins regulate adhesion and initiation of
differentiation.

ANS: C

Q.Which of the following cells are required for wound healing?
A. Neutrophil
B. Macrophage
C. Eosinophil
D. Langerhans cell
E. Lymphocyte

ANS: B

Q.Which of the following is true regarding BPAg1?
A. It is pathogenic in cicatricial pemphigoid
B. It is a member of the plakin family
C. It is pathogenic in pemphigoid gestationis
D. It is not pathogenic in paraneoplastic
pemphigus
E. It coprecipitates with plakoglobin

ANS: B

Q.The antibody target in ocular cicatricial pemphigoid is also mutated in:
A. Junctional epidermolysis bullosa, Herlitz
type
B. Recessive dystrophic epidermolysis bullosa
C. Junctional epidermolysis bullosa with
myotonic dystrophy
D. Dominant dystrophic epidermolysis bullosa
E. Junctional epidermolysis bullosa with
pyloric atresia

ANS: E

Mnemonics part 2

Mnemonics Part 2


🔷 Some Facts About #Hodgkin's #Lymphoma
►Commonest HL → Nodular Sclerosis HL
►Least common HL → Lymphocyte depleted HL
►HL with Best Prognosis → Lymphocyte Predominant HL
►HL with worst Prognosis → Lymphocyte depleted HL
►Commonest with Mediastinal Involvement → Nodular Sclerosis HL
►Commonest nodes affected → Cervical LNs
►Most Aggressive HL → Lymphocyte depleted HL
►HIV commonest association with → Mixed Cellularity HL
►EBV Commonest association with → Mixed Cellularity HL
►Commonest mode of Spread → LN to LN through lymphatics
►Most specific marker for RS cells → PAX-5 > CD 30 > CD 15
►Most common chemo regimen → ABVD
►Commonest secondary tumor in HL → Acute Leukemias
►Commonest Type of leukemia seen after HL Rx→ AML

🔷 Pneumonia Plus > diagnostic pointers

Pneumonia + hemolysis= mycoplasma
Pneumonia + erythema multiforme = mycoplasma
Pneumonia + hyponatremia = legionella
Pneumonia + rusty sputum = strept pneumonie
Pneumonia + elderly / diabetic / alcoholic = klesiella
Pneumonia + mutilple abscesses = staph aureus.
Pneumonia + parrots = chalymdia
Pneumonia + smoker = hemoph. influenze.
Pneumonia + neutropenia / chemotherapy= pseudomonas auregenosa.
Pneumonia + unconsiouness / anasthesia = anaerobes.

🔷 Important Diagnostic Points :
1:-Fever + constipation +relative bradycardia =Typhoid
2:-Fever (3 weeks) then 10 days free +arthralgia +lymphadenopathy + History of contact with milk products =Brucella
3:-Fever+tender hepatomegaly +GIT upset =ambeobic liver abscess
4:-Fever +chills +sweats+jaundice+travelling to endemic area =malaria
5:-Fever +lymphadenopathy+history of dealing with cats =Toxoplasmosis
6:-Night Fever = T.B , lymphoma , brucella or Malaria
7:-Fever + arthritis +UTI =gonococcal or chlamydia infection
8:-Fever +strawberry tongue =scarlet fever or kowasaki disease
9:-Fever +diarrhea +Heamolytic anemia =Hemolytic uremic syndrome or TTP
10:-Fever +fatigue +lymphadenopathy +bil hilar lymphadenopathy =sarciodosis or histocytosis X
12:-Fever +relative bradycardia=Typhoid
13:-Fever +low platletes+sub conjuctival hge = Dengue fever
14:-Fever +rigidity +history of atypical anti psychotic within 1 week =Neuroleptic Malignant syndrome
15-Fever +neck rigidty+photophopia+headache -+ agitation= meningitis
16-Fever +headache +nick stiffness+manifestation of cerebral dysfunction(aphasia , convulsion , monoplegia or flexion U.L and extension L.L ) +- urinary incontinence=encephalitis
17:-Fever + cardiac murmer +vegetations on Echo= infected endocarditis
18:-Fever +High E.S.R >100+renal impairment+hypercalcemia in old age =multiple myloma

🔷 Glasgow_Criteria_for_prognosis_of_Acute Pancreatitis---:-
...(.#PANCREAS)
*P-----PaO2 <60mmHg
*A-----Age >5

Mnemonics part1

🔴KEYS /MNEMONICS🔴 : PART : 1
 
🔷 Serological marker in inflammatory bowel disease :

1. P ANCA ( 60_70% ulcerative colitis , 5 _10 % in crohns disease). .
2.ASCA ( Anti sacharomyses ceroviciae antibody) ( 10_15% of ulcerative cilitis , 60_70% of crohns )
3. Anti OMP C antibody . ( 55 % of cases of crohns disease)
4. Anti I 2 antibody (50_55% of crohns )
5.anti flagellin antibody .

🔹 Significans :
** anti OMP C : Predict intestinal perforation
**anti I2 : indicate fibrostenotic disease
** anti flagellin : indicate : _ small bowel disease
_fibrostenotic disease
_ penetrating disease

🔷DAY OF APPEARANCE OF RASH IN A FEBRILE PATIENT – MNEMONIC



🔹 Mnemonic for Day of appearance of rash in a febrile patient is : Very Sick Person Must Take Double Tablets

Very – Varicella (day 1)
Sick – Scarlet fever (day 2)
Person – Pox – small pox (day 3)
Must – Measles (day 4)
Take – Typhus (day 5)
Double – Dengue (day 6)
Tablets – Typhoid (day 7)

🔷 Heart Sounds
:

S1➔ Closure Tricuspid/Mitral

S2➔ Closure Pulmonic/Aortic

S3➔ Passive filling ➔ compliant LV

S4➔ Active filling ➔ stiff LV

Mcq part 4

Mcq part 4

Q.The crista galli is......
A - The sphenoid bone
B - The ethmoid bone
C- The patatine bone
D- The temporal bone

ANS: B

Q. Which type of joint is Pubic Symphysis
A. Sydesmosis
B. Fibrocartilagenous
C. Primary cartilagenous
D. Secondary cartilagenous.

ANS: D

Q.Methemoglobinemia is possible adverse effect of:
A. Aspirin
B. Paracetamol
C. Analgin
D. Ketorolac

ANS: B

Q.Correct statements concerning aspirin include all of the following EXCEPT:
A It inhibits mainly peripheral COX
B It does not have an anti-inflammatory effect
C It inhibits platelet aggregation
D It stimulates respiration by a direct action on the respiratory center

ANS: B

Q.Indicate the local anesthetic agent, which has a shorter duration of action:
A. Lidocaine
B. Procaine
C, Bupivacaine
D. Ropivacaine

ANS: A

Q.A good local anesthetic agent shouldn’t cause:
A. Local irritation and tissue damage
B. Systemic toxicity
C. Fast onset and long duration of action
D. Vasodilatation

ANS: B

Q.What is true in relation to drug receptors:
A. All drugs act through specific receptors
B. All drug receptors are located on the surface of
the target cells
C. Agonists induce a conformational change in
the receptor
D. Partial agonists have low affinity for the
receptor

ANS : A, C & D

Q.Which of the following drugs acts by inhibiting an
enzyme in the body:
A. Atropine
B. Allopurinol
C. Levodopa
D. Metoclopramide

ANS: B

Q.Diffusion of drugs across cell membrane:
A. Is dependent upon metabolic activity of the cell
B. Is competitively inhibited by chemically
related drugs
C. Is affected by extent of ionization of drug molecules
D. Exhibits saturation kinetics

ANS: C

Q.Which of the following hypnotic agents is absorbed slowly?
A Phenobarbital
B Flurazepam
C Triazolam
D Temazepam

ANS: D

Q.The area under curve gives useful information about?
A. Amount of drug systematically absorbed
B. The time to reach peak concentration
C. The time to reach minimum toxic concentration
D. The concentration at which pharmacological actions of drug would be initiated

ANS:" A

Q.What kind of substances can’t permeate membranes by passive diffusion?
A. Lipid-soluble
B. Non-ionized substances
C. Hydrophobic substances
D. Hydrophilic substances

ANS: D

Q.Pick out the parenteral route of medicinal agent administration:
A. Rectal
B. Oral
C Sublingual
D Inhalation

ANS: D

Q.Which of the following local anesthetics is more likely to cause allergic reactions?
A. Lidocaine
B. Bupivacaine
C. Procaine
D. Ropivacaine

ANS: A

Q.Anxiolytic agents should:
A. Relieve pain
B. Reduce anxiety and exert a calming effect
C. Improve mood and behavior in patient with psychotic symptoms
D. Produce drowsiness, encourage the onset and maintenance of a state of sleep

ANS: B

Q.True statement about the structure (mycelia) shown below is
A. Unicellular growth form of fungi
B. Thread like branching cylindrical tubules
C. Clumps of intertwined branching hyphae
D. Reproducing bodies of molds

ANS: C

Q.which of the following are NoT treated with Nifedipine?
A Arrythmias
B HtN
C Fluid retention
D Angina
E B & D

ANS: c

Q.Blue vision is caused by
A. digoxin
B. rifampicin
C. ethambutol
D. chloroquine.

ANS: C

Q.Sample registration system is done in once in
A. 6 months
B. 1 year
C 2 years
D. 5 years

ANS : B

Q.Transovarial transmission occurs in
A. malaria
B. plague
C. filariasis
D. dengue fever

ANS : D

Q.Commonest most type of colour blindness is
A. protanopes
B. deutanopes
C. tritanopes
D. none of these

ANS : B

Q.Photophthalmia is due to
A. X-rays
B. UV rays
C IR rays
D. gamma rays

ANS : B

Q.Trachoma can cause
A. trichiasis
B. entropion
C. blindless
D. all of the above

ANS: D

Q.Satellite nodules in the cornea are caused by
A. bacteria
B. virus
C. fungus
D. none of these

ANS: C

Mcq part 3

Mnemonicsmed Mcq part 3

Q.Cereal-based fermented sweets and snacks foods select only those microbes which can survive in
A. High water activity
B. No water activity
C. Low water activity
D. None of the above

ANS: D

Q.Antimicrobial substances mainly produced by probiotic bacteria is
A. Tetracycline
B. Bacteriocins
C. Chloramphenicol
D. Azithromycin

ANS: B

Q.Stirrer glands and bearings in the fermentors are very important for
A. Maintaining aseptic condition
B. Down-stream processing
C. Maintenance of a uniform environment
D. Control of foam

ANS: C

Q.The first major step in the development of baker’s yeast technology can be said to be
A. Vienna process
B. Fermentation process
C. Respiration process
D. Anaerobic process

ANS: B

Q.Corneal edema in hypoxic condition due to accumulation of
A.Lactate
B. Pyruvate
C. Glycogen
D Carbon dioxide

ANS : A

Q-. Which one of following is used in retinal sealing?
A. Co
B SF6
C Nitrous oxide
D So2

ANS : B

Q. Which of the following antibiotics can be used in the treatment of fungal kerato-mycosis?
A. Linezolid
B. Vancomycin
C. Silver sulphadiazine
D. Doxycycline

ANS : C

Q-. Which of the following topical agents causes hetero-chromia iridis?
A Latanoprost
B Prednisolone
C Timolol
D Olopatadine

ANS : A

Q-. Evisceration of eye is not done in
A Malignancy
B Pan-ophthalmitis
cC Trauma
D Hemorrhage

ANS : A

Q-. Vitreous humor has high concentration of what compared to blood
A Glucose
B Sodium
C Potassium
D Ascorbate

ANS : D

Q-. Corneal sensation is lost in which nerve palsy
A Naso-Cilliary nerve
B Supra-trochlear nerve
C Infra-trochlear nerve
D Infra-orbital nerve

ANS : A


Q. High molecular weight proteins in cataractous lens seen only in humans
A HM 1 and 2
B. HM 2 and 4
C. HM 3 and 4
D HM 2 and 3

ANS : C

Q-. Universal marker of limbal stem cells
A. Elastin
B. Keratin
C Collagen
D.ABCG2

ANS : D


Q.The most accurate investigation for assessing ventricular function is:
A. Multislice CT
B. Echocardiography
C. Nuclear scan
D. MRI

ANS : D

Q. Blood supply to head and neck of femur is mainly from?

A. Superficial epigastric artery
B. Medial circumflex femoral artery
C. Lateral circumflex femoral artery
D. Artery of ligamentum teres

ANS :B


Q. Oblique head of adductor pollicis arises from?
A. Trapezium
B. Trapezoid
C. Capitate
D. Hamate

ANS :C

Q. Anterior choroidal artery is a branch of?
A. Anterior cerebral artery
B. Posterior cerebral artery
C. Internal carotid artery
D. Anterior communicating artery

ANS : C

Q.Common peroneal nerve is related to which of the following structures
A Shaft of tibia
B Neck of fibula
C Lower tibio fibular joint
D Shaft of fibula

ANS :B

Q.The structures passing posterior to diaphragm are all except
A Aorta
B Azygos vein
C Thoracic duct
D Greater splanchnic nerve

ANS : D

Q.. Which is a hinge joint?
A Knee
B Elbow
C Metacarpophalangeal
D Atlanto-axial

ANS : B

Q-. The medial collateral ligament of the elbow joint is closely related to the following structure
A Brachial artery
B Radial nerve
C Ulnar artery
D Basilic vein
E Ulnar nerve

ANS :E

Q-. Muscles that can flex the forearm include all except
A Brachialis
B Brachio-radialis
C Pronator teres
D Anconeus
E Biceps brachialis

ANS :C, D

Mcq part 2

Mnemonicsmed Mcq part 2

Q. Which of the following is not usually used to treat pruritus in obstructive jaundice?

A. Cholestyramine
B. Antihistamines
C. Rifampicin
D. Naltrexone
E. Plasmapheresis

ANS: B

Q. Which of the following disorder can casue both bulbar and pseudobulbar palsy?

A. Multiple sclerosis
B. Motor neuron disease
C. Lacunar infarction bilateral
D. Cerebral vasculitis
E. Lyme Disease

ANS: B

Q. Which of the following is NOT a muscle channelopathy due to abnormal SODIUM channel?

A. Paramyotonia congenita
B. Hyperkalemic periodic paralysis
C. Anderson-Tawil syndrome
D. Hypokalemic periodic paralysis
E. Potassium aggregated myotonia

ANS: C

Q. Pain is the prominent feature of -

A. Spinal cord lesion
B. Peripheral neuropathy
C. Nerve root lesion
D. Brainstem lesion
E. Motor neuron lesion

ANS: C

Q.Following are NOT feature of Upper motor neuron lesion -

A. No clonus
B. Preferentially affects flexors in leg
C. Deep tendon reflexes increased
D. Babiniski sign positive
E. Wasting in chronic lesion

ANS: B

Q. Which statement is false for MRI -

A. Useful in posterior fossa lesion
B. Modality of choice for Inflammatory lesion
C. Modality of choice for Epilepsy
D. Resolution is affected by bone
E. Pacemakers are contraindication

ANS: D

Q.Which neuroimaging technique can be used to assess brain metabolism & chemical compositions ?

A. Doppler
B. SPECT
C. CT
D. DTI
E. MRI

ANS: D

Q.Not an indication for Renal biopsy -

A. Isolated hematuria
B. Isolated proteinuria
C. Nephrotic syndrome in adults
D. CKD with small size kidneys
E. Nephrotic syndrome in children not responding treatment

ANS: D


Q.Risk for contrast media induced nephropathy increases in -

A. Diabetes mellitus
B. Hypertension
C. Dehydration
D. Hypernatremia
E. Hyperkalemia

ANS: C

Q.eGFR is not reliable in -

A. Muscle wasting
B. Pregnancy
C. Oedematous patient
D. Stage 4 chronic kidney disease
E. Diabetic nephropathy

ANS: A B , C

Q. Which is not a recognized feature of Vitamin B12 deficiency?

A. Degeneration of anterior spinal cord
B. Paraesthesia
C. Optic atrophy
D. Papilloedema
E. Dorsal column lesion

ANS: A

Q. Secondary hypercholesterolaemia occurs in --
A. Hypothyroidism
B. Abdominal obesity
C. Pregnancy
D. Diurectics therapy
E. Excess Alcohol intake

ANS: A

Q.Which vitamin is associated with collagen synthesis?

A. Phytomenadione
B. Biotin
C. Vitamin C
D. Beta Carotin
E. Vitamin D

ANS: C

Q.Jugular venous waveform is associated with tricuspid valve closure in following part -

A. a wave
B. x descent
C. y descent
D. c wave
E. v wave

ANS : C

Q.Which part of the cell is responsible for the sorting and modification of proteins?
A. Endoplasmic reticulum
B. Golgi apparatus
C. Lysosome
D. Nucleus
E. Ribosome

ANS : B

Q.Which electrolyte abnormality is most commonly associated with massive blood transfusion?

A. Hypokalaemia
B. Hypocalcaemia
C. Hypomagnesaemia
D. Hyponatremia
E. Hypophosphotaemia

ANS : B

Q.Neoplasms found in patients with HIV infections are -

A. Breast carcinoma
B. Kaposi sarcoma
C. Lung cancer
D. Non-Hodgkin's Lymphoma
E. Invasive cancer of uterine cervix

ANS: B

Q.Which drug may cause Hypertrichosis -

A. Spiranolactone
B. Clofazimine
C. Ciclosporin
D. Psoralans
E. Minocycline

ANS : C

Q.Earliest ECG change for acute MI -

A. ST - Elevation
B. T- inversion
C. Pathological Q
D. Flat T
E. ST - depression

ANS: A

Q.Which antibody is likely to be found in the dermis of Dermatitis Herpetiformis -

A. IgA
B. IgM
C. IgG
D. IgD
E. IgE

ANS: A

Q.which of the following therapies is not used in the management of Obstructive sleep apnoea?

A. Acupuncture
B. Avoidance of alcohol and tobacco
C. CPAP
D. Imipramine
E. Tonsillectomy

ANS : D

Cough D/D

Cough (chronic) : differential

Cough (chronic): differential "CRADLE":
Cystic fibrosis
Rings, slings, and airway things (tracheal rings)/ Respiratory infections
Aspiration (swallowing dysfunction, TE fistula, gastroesphageal reflux)
Dyskinetic cilia
Lung, airway, and vascular malformations (tracheomalacia, vocal cord dysfunction)
Edema (heart failure)

Coughing General info

 might sometimes be uncomfortable, but it actually serves a useful purpose. When you cough, you bring up mucus and foreign material from your airways that can irritate your lungs. Coughing can also be in response to inflammation or illness.

Most coughs are short-lived. You may catch a cold or the flu, cough for a few days or weeks, and then you’ll start to feel better.

Less often, a cough lingers for several weeks, months, or even years. When you keep coughing without an obvious cause, you may have something serious.

A cough that lasts eight weeks or more is called a chronic cough. Even chronic coughs often have a treatable cause. They can result from conditions like postnasal drip or allergies. Only rarely are they a symptom of cancer or other potentially life-threatening lung conditions.

A chronic cough can have a big impact on your life, though. It can keep you awake at night and distract you from work and your social life. 

Causes of chronic cough

The most common causes of a chronic cough are:

• postnasal drip
• asthma, especially cough-variant asthma, which causes a cough as the main symptom
• acid reflux or gastroesophageal reflux disease (GERD)
• chronic bronchitis or other forms of chronic obstructive pulmonary disease (COPD)
• infections, such as pneumonia or acute bronchitis
• ACE inhibitors, which are medications used to treat high blood pressure
• smoking

Less common causes for a chronic cough include:

• bronchiectasis, which is damage to the airways that causes the bronchial walls in the lungs to become inflamed and thickened
• bronchiolitis, which is an infection and inflammation of the bronchioles, the tiny air passages in the lungs
• cystic fibrosis, an inherited condition that damages the lungs and other organs by causing thick secretions
• interstitial lung disease, a condition that involves scarring of lung tissue
• heart failure
• lung cancer
• pertussis, a bacterial infection which is also known as whooping cough
• sarcoidosis, which consists of clusters of inflamed cells, known as granulomas, that form in the lungs and other parts of the body

Other possible symptoms

Along with the cough, you might have other symptoms, depending on the cause. Common symptoms that often go along with a chronic cough include:

• a feeling of liquid dripping down the back of your throat
• heartburn
• hoarse voice
• runny nose
• sore throat
• stuffed nose
• wheezing
• shortness of breath

A chronic cough can also cause these issues:

• dizziness or fainting
• chest soreness and discomfort
• headaches
• frustration and anxiety, especially if you don’t know the cause
• sleep loss
• urine leakage

Mcq part 1

Free Mcqs By Mnemonicsmed Group


Q1 . 27 year old sexually active male develops a vesiculobullous lesion on the glans soon after taking a paracetamol tablet for fever. The lesion healed with hyperpigmentation. The most likely diagnosis is:
A. Behcet’s syndrome
B. Herpes genitalis
C. Fixed drug eruption
D. Pemphigus vulgaris

ANS: C

Q2 . Most common type of vitiligo is?
A. Segmental vitiligo
B. Focal vitiligo
C. Generalized vitiligo
D. Mucosal vitiligo

ANS: C

Q 3. Neoplastic dyskeratosis is seen in?
A. Darier’s disease
B. Warty dyskeratoma
C. Familial benign pemphigus
D. Actinic keratosis

ANS: D

Q .4  A patient posted for surgery has raised intracranial tension. Which of the following anesthetics would be preferred in him?
A . Halothane
B . Isoflurane
C . Sevoflurane
D . Desflurane

ANS: B

Q .5 Hypothermia in anesthesia true is
A .  Occurs in all patients irrespective of the type of anesthesia
B . Can be prevented by administration of warm fluids
C . Is beneficial to the patient
D . The most common mechanism of heat loss is conduction

ANS: B




 Q6.A 10-year-old  boy presents with lethargy and reduced exercise tolerance. His mother says that he often complains of stomach pains.
Investigations show:
Hb 1 9.8 g/dL
WBC 7.8 × 109/L
MCV 65 fL
Platelets 430 × 109/L
Give two likely diagnoses.
A. Thalassemia trait
B. α-Thalassaemia trait
C. β-Thalassaemia trait
D Hookworm infection

ANS: A , D

Q.7Microorganism causing food posining except
A.staph aureus
B. entaboeba coli
C.shigela flexneri
D.giarda lamblia
E.entaemoba histolytica

ANS: D

Q. 8vitamin k helps in activation of all EXCEPT
A.factor VII
B.factor VIII
C.VonWilibrand factor
D.Protein C

ANS: B

Q9.The Ventricular repolarization in ECG iz best seen in ?
A- "P" wave
B- "Q" wave
C- "R" wave
D- "T" wave

ANS : D

Q.10Long acting barbiturates are mainly excreted by?
A. Kidneys
B. Salivary glands
C. Small intestine
D. all

ANS: D

Q11.Steriod hormones are believed to enter target cells via......??
A- Facilitated diffusion
B- Carrier-mediated endocytosis
C- cholestrol lined pores in plasma membrne
D- Simple diffusion...

ANS: D

Q12.Severe magnesium deficiency
A. Hypocalcemia
B. Hypercalcemia
C. Hypokalemia
D.Hypophosphatemia

ANS : A

Q13.Most active gluconeogenesis results from
metabolism of ?
A.fatty acid
B.protein
C.cholesterol
D.glycogen
E. TG

ANS: D


Q14. Which of the following is the most common cause of acute pancreatitis in children in US?
A. Seat belt trauma
B. Mumps
C. Cytomegalovirus infection
D. Annular pancreas

ANS: A


Q15. Which of the following is the most common cause of liver cirrhosis in children?
A. Reye syndrome
B. Wilson disease
C. Alpha1-antitrypsin deficiency
D. Hemochromatosis

ANS: C


Q16.Which of the following marker is useful for diagnosing hepatitis B during window period?
A. HBV DNA
B. HBsAg
C. HBeAg
D. Anti-HBV surface antibody
E. Anti HBcIgM antibody

ANS: E


Q17. Which of the following is a feature of extravascular hemolysis?
A. Increased ALT
B. Increased AST
C. Increased ALP
D. Increased gamma-GT
E. None of the above

ANS: B


Q18. Which of the following is the most common site for colon cancer?
A. Rectosigmoid junction
B. Descending colon
C. Transverse colon
D. Ascending colon

ANS: B


Q19. Which of the following is the most common cause of hematochezia?
A. Angiodysplasia
B. Meckel diverticulum
C. Sigmoid diverticulosis
D. Ulcerative colitis

ANS: C


Q20. Which of the following is the most common site for diverticula in the entire gastrointestinal tract?
A. Esophagus
B. Duodenum
C. Ileum
D. Sigmoid colon
E. Rectum

ANS: D


Q21. Which of the following statement is correct regarding the secretory diarrhea?
A. Fecal smear for leukocyte is positive
B. Stool osmotic gap is < 50 mOsm/kg
C. Commonly occurs in disaccharidase deficiency
D. Campylobacter jejuni is a common cause

ANS: B


Q22. Which of the following nerve is most likely to be injured while giving intramuscular injection in gluteal region if proper site is not selected?
A. Superior gluteal nerve
B. Inferior gluteal nerve
C. Femoral nerve
D. Obturator nerve

ANS: A


Q23. Which of the following is the most common chest x-ray finding in pulmonary thromboembolism?
A. Elevation of ipsilateral hemidiaphragm
B. Pleural effusion
C. Cut-off sign
D. Hampton hump

ANS: A


Q24. Which of the following condition is associated with decreased erythropoietin levels?
A. Relative polycythemia
B. Appropriate absolute polycythemia
C. Inappropriate absolute polycythemia
D. Polycythemia vera

ANS: D

Q25. Which of the following is the most common inherited bleeding disorder?
A. Hemophilia A
B. Hemophilia B
C. Hemophilia C
D. von Willebrand disease

ANS: D


Q26. Hemiballism is a movement disorder that usually results from a vascular lesion of the:
A. Subthalamic nucleus
B. Putamen
C. Globus pallidus
D. Insular cortex

ANS: A