A28 year old female weighs 35 kg. She is hesitated to take food telling that she is already
fatty. On further evaluation, ...
Sample Previous Year Question on Menorrhagia based on previous Year
Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening)....
Adenomyosis is a condition characterized by the presence of ectopic glandular
tissue found in muscle. It usually refers to...
J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham,
L.E. Calver (Eds), Williams Gynecology, 2e.
S...
A: More common in nullipara
B: Progestins are the agents of choice for medical management
C: Presents with menorrhagia, dy...
Sample Previous Year Question on Menorrhagia based on previous Year
Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening)....
Sample Previous Year Question on Menorrhagia based on previous Year
Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening)....
Correct Ans:D
Explanation
Metropathia haemorrhagica or cystic glandular hyperplasia or Schroeder’s disease is a type
of ab...
 Meclofenamate
 COCs
 Tranexamic acid
 Norethindrone
 Danazol
 GnRH agonists
 LNG-IUS
Ref: Hoffman B.L., Schorge J....
Sample Previous Year Question on Menorrhagia based on previous Year
Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening)....
Which of the following statements is incorrect regarding levonorgestrel releasing
intrauterine system?
A: There is increas...
Combined OCP is a well accepted and safe method of contraception for teens.
Sample Previous Year Question on Menorrhagia b...
B: Progestins are the agents of choice for medical management
C: Presents with menorrhagia, dysmenorrhia, and an enlarged ...
Sample Previous Year Question on Menorrhagia based on previous Year
Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening)....
Sample Previous Year Question on Menorrhagia based on previous Year
Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening)....
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Previous year question on menorrhagia based on neet pg, usmle, plab and fmge or mci screening exams

Revision with a Master Quiz of 22 questions based on NEET PG Sample Questions on Menorrhagia from Previous Year NEET PG Online Exams.
Published on: Mar 4, 2016
Published in: Health & Medicine      
Source: www.slideshare.net


Transcripts - Previous year question on menorrhagia based on neet pg, usmle, plab and fmge or mci screening exams

  • 1. A28 year old female weighs 35 kg. She is hesitated to take food telling that she is already fatty. On further evaluation, diagnosis of anorexia nervosa is made. The following symptoms are common in anorexia nervosa, EXCEPT: A: Weight loss B: Hypothermia C: Mood changes D: Menorrhagia Correct Ans:D Explanation Amenorrhea is seen in anorexia nervosa. It may precede the onset of appreciable diminished weight, because it may be related to the loss of body fat stores rather than decrease of body mass. Menarche may be delayed in prepubertal females. Physical findings in anorexia nervosa:  Emaciation  Hypotension  Bradycardia  Hypothermia  Skin dryness and flakiness  Lanugo  Peripheral edema  Petechiae on extremities  Sallow complexion  Salivary gland hypertrophy  Dental enamel erosion  Osteoporosis  Russell's sign  Scars and calluses on the back of the hand  Amenorrhea  Mood changes Ref: Gwirtsman H.E., Mitchell J.E., Ebert M.H. (2008). Chapter 26. Eating Disorders. In M.H. Ebert, P.T. Loosen, B. Nurcombe, J.F. Leckman (Eds), CURRENT Diagnosis & Treatment: Psychiatry, 2e.
  • 2. Sample Previous Year Question on Menorrhagia based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes A woman is said to be have menorrhagia if the menstrual blood loss is MORE than: A: 20 ml B: 40 ml C: 60 ml D: 80 ml Correct Ans:D Explanation Menorrhagia is defined as loss more than 80 ml of blood per cycle and frequently producing anemia. Predictors of menorrhagia includes bleeding resulting in iron deficiency anemia or a need of transfusion, passage of clots more than 1 inch diameter and changing pad or tampon more than hourly.  Normal menstrual bleeding last for an average of 5 days with a mean blood loss of 40 ml.  Menorrhagia is defined as bleeding between periods.  Polymenorrhea is defined as bleeding that occurs more often than every 21 days.  Oligomenorrhea is defined as bleeding that occur less frequently than every 35 days. Ref: Konkle B. (2012). Chapter 58. Bleeding and Thrombosis. 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. Sample Previous Year Question on Menorrhagia based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes The true regarding adenomyosis is: A: More common in nullipara B: Progestins are the agents of choice for medical management C: Presents with menorrhagia, dysmenorrhia, and an enlarged uterus D: More common in young women Correct Ans:C Explanation
  • 3. Adenomyosis is a condition characterized by the presence of ectopic glandular tissue found in muscle. It usually refers to ectopic endometrial tissue (the inner lining of the uterus) within the myometrium (the thick, muscular layer of the uterus). The condition is typically found in women between the ages of 35 and 50. Patients with adenomyosis can have dysmenorrhea & menorrhagia. In adenomyosis, basal endometrium penetrates into hyperplastic myometrial fibers. Therefore, unlike functional layer, basal layer does not undergo typical cyclic changes with menstrual cycle. Ref: Current Obstetrics and Gynecology By Gita Ganguly Mukherjee, Sudip Chakravarty, Bhaskar Pal, et al, Jaypee Brothers, Medical Publishers, 2007, Page 274 Sample Previous Year Question on Menorrhagia based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes 32 year old Anuradha presented with menorrhagia and dysmenorrhea. What is the definitive treatment of adenomyosis? A: Mifepristone B: Oral progestins C: Hysterectomy D: Conservative resection Correct Ans:C Explanation Hysterectomy is the definitive treatment and as with other conditions, the type of surgical procedure depends on uterine size and associated uterine or abdominopelvic pathology. Endometrial ablation or resection using hysteroscopy has been used to successfully treat dysmenorrhea and menorrhagia caused by adenomyosis. Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 9. Pelvic Mass. In B.L. Hoffman,
  • 4. J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e. Sample Previous Year Question on Menorrhagia based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes Shyama, a 27 year old nulliparous woman complains of severe menorrhagia and lower abdominal pain since 4 months. On examination there is a 9 wks size uterus with fundal fibroid. The treatment of choice is: A: Myomectomy B: GnRh analogues C: Hysterectomy D: Wait and watch Correct Ans:A Explanation Resection of tumors is an option for symptomatic women who desire future childbearing or for those who decline hysterectomy. This can be performed laparoscopically, hysteroscopically, or via laparotomy incision, and each is described in detail in the surgical atlas. Myomectomy usually improves pain, infertility, or bleeding. Menorrhagia improves in approximately 70 to 80 percent of patients following tumor removal. Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 9. Pelvic Mass. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e. Sample Previous Year Question on Menorrhagia based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes The true regarding adenomyosis is:
  • 5. A: More common in nullipara B: Progestins are the agents of choice for medical management C: Presents with menorrhagia, dysmenorrhia, and an enlarged uterus D: More common in young women Correct Ans:C Explanation Adenomyosis is a condition characterized by the presence of ectopic glandular tissue found in muscle. It usually refers to ectopic endometrial tissue (the inner lining of the uterus) within the myometrium (the thick, muscular layer of the uterus). The condition is typically found in women between the ages of 35 and 50. Patients with adenomyosis can have dysmenorrhea & menorrhagia. In adenomyosis, basal endometrium penetrates into hyperplastic myometrial fibers. Therefore, unlike functional layer, basal layer does not undergo typical cyclic changes with menstrual cycle. Ref: Current Obstetrics and Gynecology By Gita Ganguly Mukherjee, Sudip Chakravarty, Bhaskar Pal, et al, Jaypee Brothers, Medical Publishers, 2007, Page 274 Sample Previous Year Question on Menorrhagia based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes Which of the following is not indicated in menorrhagia: A: NSAID's B: Clomiphene C: Norethesterone D: Tranexamic acid Correct Ans:B Explanation The chief use of clomiphene citrate is in sterility due to failure of ovulation. Ref: Essentials of Medical Pharmacology By K D Tripathi, 6th Edition, Page 303 ; Reproductive Endocrinology for The MRCOG and Beyond By Adam H. Balen, 2007, Page 60 ; Textbook of Gynaecology By Shaw, Soutter, Stanton, 2nd Edition, Page 435 ; Shaw’s Textbook of Gynaecology, 12th Edition, Page 242
  • 6. Sample Previous Year Question on Menorrhagia based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes Which of the following treatments for menorrhagia is not supported by evidence? A: Combined oral contraceptive pills B: Progesterone C: Tranexamic acid D: Ethamsylate Correct Ans:D Explanation Ethamsylate is thought to act by reducing capillary fragility though the precise mechanism is uncertain. Studies with objective MBL (Menstrual Blood Loss) measurements using the currently recommended doses show that it is ineffective. Ref: Dewhurst's Textbook of Obstetrics and Gynecology, 7th Edition, Page 402; William's Gynaecology, 1st Edition, Page 187; Obstetrics and Gynecology for Postgraduates By Arulkumaran, Sarala, Pratap, Volume 2, 3rd Edition, Page 108 Sample Previous Year Question on Menorrhagia based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes Which of the following treatments for menorrhagia is not supported by evidence? A: Combined oral contraceptive pills B: Progesterone C: Tranexamic acid D: Ethamsylate Correct Ans:D Explanation Ethamsylate is thought to act by reducing capillary fragility though the precise mechanism is uncertain. Studies with objective MBL (Menstrual Blood Loss) measurements using the currently recommended doses show that it is ineffective. Ref: Dewhurst's Textbook of Obstetrics and Gynecology, 7th Edition, Page 402; William's Gynaecology, 1st Edition, Page 187; Obstetrics and Gynecology for Postgraduates By Arulkumaran, Sarala, Pratap, Volume 2, 3rd Edition, Page 108
  • 7. Sample Previous Year Question on Menorrhagia based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes A patient comes to you with history of frequent cycles with heavy bleeding. This condition is called: A: Menorrhagia B: Polymenorrhea C: Polymenorrhagia D: Metrorrhagia Correct Ans:C Explanation Menorrhagia - regular cycles with prolonged or heavy bleeding  Polymenorrhea - frequent cycle with normal bleeding  Polymenorrhagia - frequent cycles with heavy bleeding  Menorrhagia - Inter menstrual bleeding Also know  Normal cycle - 21 - 35 days ( frequency)  Normal duration - 2 - 8 days  Normal volume - 15 - 80 ml Ref: Essentials of Gynaecology by Lakshmi Seshadri, Edition 1, page - 105. Sample Previous Year Question on Menorrhagia based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes Which of the following condition shows cystic glandular hyperplasia of all the endometrial components microscopically? A: Menorrhagia B: Polymenorrhea C: Oligomenorrhea D: Metropathia haemorrhagica
  • 8. Correct Ans:D Explanation Metropathia haemorrhagica or cystic glandular hyperplasia or Schroeder’s disease is a type of abnormal bleeding, usually met in premenopausal women. The basic pathology may lie in the ovaries or may be due to disturbance of the rhythmic secretion of the gonadotrophins. There is slow increase in secretion of estrogen but no negative feedback inhibition of FSH. After a variable period, the estrogen level falls resulting heavy bleeding. Microscopic findings of uterus:  Marked hyperplasia of all the endometrial components  Absence of secretory changes  Areas of necrosis in the superficial layers Ref: Textbook of Gynecology by D C Dutta, 4th edition, Page 178-179 Sample Previous Year Question on Menorrhagia based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes Which of the following treatments for menorrhagia is NOT supported by evidence? A: Tranexamic acid B: Ethamsylat e C: Combined OCP D: Norethindrone Correct Ans:B Explanation Etamsylate does not have a clinical role in the treatment of menorrhagia. Its effectiveness varies in randomized trials, and ranges from no reduction in flow to a 50-percent decrease. Medical Treatment of Menorrhagia: Acute Treatment  Premarin  Combination oral contraceptive pills (COCs) Chronic Treatment  Mefenamic acid  Naproxen  Ibuprofen  Flurbiprofen
  • 9.  Meclofenamate  COCs  Tranexamic acid  Norethindrone  Danazol  GnRH agonists  LNG-IUS Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 8. Abnormal Uterine Bleeding. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e. Sample Previous Year Question on Menorrhagia based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes A 48 years old female suffering from severe menorrhagia (DUB) underwent hysterectomy. She wishes to take hormone replacement therapy. Physical examination and breast are normal but X-ray shows osteoporosis. The treatment of choice is: A: Progesterone B: Estrogen progesterone C: Estrogen D: None Correct Ans:C Explanation Osteoporosis in this patient is due to estrogen deficiency. Estrogens are efficacious when administered orally or transdermally. Various types of estrogens (conjugated equine estrogens, estradiol, estrone, esterified estrogens, ethinyl estradiol, and mestranol) reduce bone turnover, prevent bone loss, and induce small increases in bone mass of the spine, hip, and total body. The effects of estrogen are seen in women with natural or surgical menopause and in late postmenopausal women with or without established osteoporosis. Ref: Lindsay R., Cosman F. (2012). Chapter 354. Osteoporosis. 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.
  • 10. Sample Previous Year Question on Menorrhagia based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes All of the following conditions are contraindications for the use of Mirena a progestin releasing intrauterine device, EXCEPT: A: Carcinoma of the breast B: Women with menorrhagia C: Acute liver disease or tumor D: Hypersensitivity to any component of this product Correct Ans:B Explanation Menorrhagia is not a contraindication for the use of levonorgestrel intrauterine system(Mirena). It is used in the treatment of menorrhagia because it significantly reduces the monthly blood loss. It is also superior to combined oral contraceptives in the treatment of dysmenorrhea. Contraindications specific to the use of Mirena are:  Acute liver disease or tumor  Known or suspected carcinoma of the breast  Hypersensitivity to any component of this product Contraindications to Use of an Intrauterine Device:  Pregnancy or suspicion of pregnancy  Genital actinomycosis  Acute pelvic inflammatory disease  Genital bleeding of unknown etiology  Woman or her partner having multiple sexual partners  A previously inserted IUD that has not been removed  Abnormalities of the uterus resulting in distortion of the uterine cavity  Postpartum endometritis or infected abortion in the past 3 months  Known or suspected uterine or cervical neoplasia, or unresolved abnormal cytological smear  Untreated acute cervicitis or vaginitis, including bacterial vaginosis, until infection is controlled  History of ectopic pregnancy or condition that would predispose to ectopic pregnancy Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 32. Contraception. Sample Previous Year Question on Menorrhagia based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes
  • 11. Which of the following statements is incorrect regarding levonorgestrel releasing intrauterine system? A: There is increased incidence of menorrhagia B: This system can be used as hormone replacement therapy C: This method is useful for the treatment of endometrial hyperplasia D: Irregular uterine bleeding can be problem initially Correct Ans:A Explanation Levonorgestrel releasing intrauterine system used for reversible long-term treatment of specific menstrual disorders such as dysfunctional uterine bleeding, or menorrhagia. It is associated with a decreased incidence and not an increased incidence of menorrhagia. Ref: Contraception By Donna Shoupe, 2011, Page 166. Sample Previous Year Question on Menorrhagia based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes A 30 yr old multipara, hypertensive woman complaints of menorrhagia. Which is best treatment for her? A: Combined pills B: MIREN A C: Hysterectomy D: Transcervical resection of endometrium Correct Ans:B Explanation MIRENA is a levonorgestrel containing IUD particularly in elderly parous women assuming that they have no history of PID, ectopic pregnancy, leukemia, sickle cell disease or valvular heart disease. In this patient MIRENA is the best treatment for her. It is an effective alternative to hysterectomy to reduce heavy vaginal bleeding. IUD is not indicated for young nulliparous women due to the potential for dysmenorrhea and high risk of STD.
  • 12. Combined OCP is a well accepted and safe method of contraception for teens. Sample Previous Year Question on Menorrhagia based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes Which among the following is associated with cystic glandular hyperplasia in premenopausal women? A: Menorrhagia B: Polymenorrhea C: Oligomenorrhea D: Metropathia haemorrhagica Correct Ans:D Explanation Metropathia haemorrhagica is otherwise known as cystic glandular hyperplasia or Schroeder’s disease. It is a type of abnormal bleeding, usually met in premenopausal women. The basic pathology may lie in the ovaries or may be due to disturbance of the rhythmic secretion of the gonadotrophins. There is slow increase in secretion of estrogen but no negative feedback inhibition of FSH. After a variable period, the estrogen level falls resulting heavy bleeding. Microscopic findings of uterus:  Marked hyperplasia of all the endometrial components  Absence of secretory changes  Areas of necrosis in the superficial layers Ref: Textbook of Gynecology by D C Dutta, 4th edition, Page 178-179. Sample Previous Year Question on Menorrhagia based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes The true regarding adenomyosis is: A: More common in nullipara
  • 13. B: Progestins are the agents of choice for medical management C: Presents with menorrhagia, dysmenorrhia, and an enlarged uterus D: More common in young women Correct Ans:C Explanation Adenomyosis is a condition characterized by the presence of ectopic glandular tissue found in muscle. It usually refers to ectopic endometrial tissue (the inner lining of the uterus) within the myometrium (the thick, muscular layer of the uterus). The condition is typically found in women between the ages of 35 and 50. Patients with adenomyosis can have dysmenorrhea & menorrhagia. In adenomyosis, basal endometrium penetrates into hyperplastic myometrial fibers. Therefore, unlike functional layer, basal layer does not undergo typical cyclic changes with menstrual cycle. Ref: Current Obstetrics and Gynecology By Gita Ganguly Mukherjee, Sudip Chakravarty, Bhaskar Pal, et al, Jaypee Brothers, Medical Publishers, 2007, Page 274 Sample Previous Year Question on Menorrhagia based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes You suspect Ca cervix in one of your patients. Which of the following would be the earliest symptom of Ca cervix? A: Pain B: Post coital bleed C: Metrorrhagia D: Menorrhagi a Correct Ans:B Explanation Post coital bleeding is the earliest symptom of Ca cervix. Vaginal bleeds in the form of menorrhagia or metrorrhagia may be the most common symptom. Pelvic pain is usually suggestive of advanced disease. Ref: Shaw's textbook of gynaecology, edition 13, Page - 387.
  • 14. Sample Previous Year Question on Menorrhagia based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes A 13-year old girl with Menorrhagia having Von Willebrands disease will show : A: Isolated prolonged PT with a normal PTT B: Prolongation of both PT and PTT C: Prolongation of thrombin time D: Isolated prolonged PTT with a normal PT Correct Ans:D Explanation Von Willebrand's factor acts as a plasma carrier of factor VIII and circulates in the blood as factor VIII- VWF complex. Its deficiency therefore impairs the intrinsic pathway of coagulation and prolongs the GPTT as the intrinsic pathway of coagulation. Ref:Kligman, Behrman, Jenson, Stanton (2008), Chapter 477, “VON WILLEBRAND DISEASE”, In the book, “Nelson’s Textbook of Pediatrics”, Volume 2, 18th Edition, New Delhi, Page 2073 Sample Previous Year Question on Menorrhagia based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes Misoprostol has been found to be effective in all of the following except: A: Missed abortion B: Induction of labour C: Menorrhagia D: Prevention of post-partum hemorrhage (PPH) Correct Ans:C Explanation Treatment of Menorrhagia involves administration of prostaglandin inhibitors. Misoprostol (PGE1) is a prostaglandin and is therefore certainly not indicated for treatment of metrorrhagia. Ref: Textbook of Gynecology By D C Dutta, 6th Edition, Page 505
  • 15. Sample Previous Year Question on Menorrhagia based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes Misoprostol has been found to be effective in all of the following except: A: Missed abortion B: Induction of labour C: Menorrhagia D: Prevention of post-partum hemorrhage (PPH) Correct Ans:C Explanation Treatment of Menorrhagia involves administration of prostaglandin inhibitors. Misoprostol (PGE1) is a prostaglandin and is therefore certainly not indicated for treatment of metrorrhagia. Ref: Textbook of Gynecology By D C Dutta, 6th Edition, Page 505 Sample Previous Year Question on Menorrhagia based on previous Year Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such Quizzes

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