In an emphysematous patient with [bleep] lesion which is the best investigation to measure lung volumes?
A. Body plethysmography
b. Helium dilution
c. Trans diaphragmatic pressure
d. DLCO
ans a
A 9 yr old girl has difficulty in combing hairs and climbing upstairs since 6 months. She has Gowers sign positive and maculopapular rash over metacarpo phalangeal joints. What should be the next appropriate investigation to be done?
A. ESR
b. RA factor
c. Creatine kinase
d. Electromyography
ans c
2.antibody found in myositis is?
A. Anti jo1
b anti scl 70
c. Anti ds dna
d.anti sm antibody
ans a
3. A girl on exposure to cold has pallor of extremities followed by pain and cyanosis. In later ages of life she is prone to develop?
A. SLE
b. Scleroderma
c. Rheumatoid arthritis
d. systemic sclerosis
ans b
4. Which radiological feature would help differentiate rheumatoid arthritis with SLE?
A. Erosion
b. Juxta articular osteoporosis
c. Subluxation of MCP joint
d. Swelling of pip joint
ans a
5.all are seen in Reiters syndrome except?
A. Subcutaneous nodules
b. Oral ulcers
c. Keratoderma belanorrhagicum
d. Circinate balanitis
ans a
6.which of the organism causes reactive arthritis?
A. Ureaplasma urealyticum
b. Group a beta hemolytic streptococci
c. Borrelia burgdorferi
d. Nocadia
ans a
7.All is true about metachromatic leucodystrophy except?
A. Follows an indolent course and slow to progress
b. Tissue biopsy is diagnostic
c. Presents as visual loss and speech abnormality
d. Involves deep cortical neurons
ans d
8. Most common cause of mononeuritis multiplex in india is?
A. Hansens disease
b. Rheumatoid arthritis
c. Tuberculosis
d. Polyarteritis Nodosa
ans a
9.wiskott aldrich syndrome is characterised by all except?
A. Thrombocytopenia
b. Autosomal recessive
c. Failure of aggregation of platelets in response to agonists
d. Eczema
ans b
10.spontaneous CSF leak occurs in all except?
A. Increased ICT
b. Partial or complete empty sella syndrome
c. Pseudotumour cerebri
d. Low risk encephalocoele
ans c
11. True about fluorescent antibody detection test in diagnosis of plasmodium falcifarum are a/e?
A. It’s an immunochromatic test
b. Detection of histidine rich protein 1
c. Detection of lactate dehydrogenase antigen
d. Detection of aldolase antigen
ans b
12.microangiopathic hemolytic anemia is seen in a/e?
A. Antiphosphplipid antibody syndrome
b. Thrombotic thrombocytopenic purpura
c. Microscopic polyangitis
d. Metallic cardiac valves
ans a
13. Which of these is not a marker of active replicative phase of chronic hepatitis B?
A. Anti-HBs Ag
b. Hbv DNA polymerase
c. Anti HBc
d. AST and ALT
ans a
14.vasodialation in spider naevi is due to?
A. Hepato-toxin
b. Estrogen
c. Testosterone
d. DHEA
ans b
16.a 29 yr old unmarried female presents with dyspnea, her chest x ray is normal, fvc-92% fevi/fvc-89% dlco-59%. On exercise her oxygen saturation drops from 92% to 86%. What is the diagnosis?
A. Alveolar hypoventillation
b. Primary pulmonary hypertension
c. Interstitial lung disease
d. Anxiety
ans c
17. A man on 10 days course of cephalosporins on 8th day of treatment develops high-grade fever and rashes all over the body. What is the diagnosis?
A. Partially treated meningitis
b. Type iii hypersensitivity reaction
c. Kawasaki’s ds
d. @@@
ans b
18. Which is false about acrodermatitis enteropathica?
A. Triad of Diarrhoea dementia dermatitis
b. Low serum zinc levels
c. Symptoms improve with zinc supplementation
d. perianal Rash
ans a
19.which of the following is not a minor criteria for multiple myeloma?
A. Multiple lytic bone lesions
b. Plasmacytosis of 20% in bone marrow
c. Plasmacytoma on tissue biopsy
d. Residual IgM level less than 50 mg/dL
ans b
20.which of the following features of uremia will not improve with hemodialysis?
A. Peripheral neuropathy
b. Pericarditis
c. Seizures
d. Metabolic acidosis
ans a
21.not a major Framingham criteria for diagnosis of congestive Heart failure?
A. Hepatomegaly
b. Cardiomegaly
c. S3 gallop
d. Paroxysmal nocturnal dyspnea
ans a
22.a 54 yr old smoker man comes with fever hemoptysis weight loss and oligo-arthritis. Serial skiagram shows fleeting opacities. What is the diagnosis?
A. Allergic bronchopulmonary aspergillosis
b. Ca lung
c. Tuberculosis
d. Wegeners granulomatosis
ans a
23.Misfolded proteins are seen in a/e?
A. Prion disease
b. Multiple sclerosis
c. Amyloidosis
d. Creutzfeldt jacob disease
ans c
157. A 7 yr old girl with non-productive cough, mild stridor for 3 months duration. Patient is improving but suddenly developed wheeze productive cough mild fever and hyperlucency on cxr and pft shows obstructive curve.diagnosis is?
A. Bronchiolitis obliterans
b. Hemosiderosis
c. Pulmonary alveolar microlithiasis
d. Follicular bronchitis
ans c
158. 3.5 kg term male baby born of uncomplicated pregnancy developed respiratory distress at birth not responded to surfactant, echo is normal, CXR shows ground glass appearance. Culture negative. Apgar score 4 and 5 at 1 and 5 min. and a history of 1-month female sibling died before diagnosis?
A. TAPVC
b. Meconium aspiration
c. Neonatal plmonary alveolar proteinosis
d. Diffuse herpes simplex infection
ans c
159. All are true about congenital rubella except?
A. Igg persists for more than 6 months
b. Igm antibody is present at birth
c. Most common anomalies are hearing and heart defects
d. Increased congenital malformation if infection after 16 weeks
ans d
160. A 10 yr old child is always restless inattentive to study and always wants to play outside. Parents are extremely distressed. What would you advise?
A. It’s a normal behaviour
b. Behaviour therapy
c. It’s a serious illness requires medical treatment
d. Needs change in environment
ans b
161.a 2yr old child brought to emergency at 3 am. Child has barky cough and stridor only while crying. Normal hydration RR -36/min temp -39.6 Degrees Celsius. What will be your next step?
A. Racemic epinephrine nebulisation
b. High dose dexamethasone inj
c. Nasal was for influenza/rsv
d. Antibiotics and blood culture
ans b
162.Bad prognostic factor for acute lymbhoblastic leukemia is?
A. Age 2-8 years
b. TLC <50000
c. Hyperdiploidy
d. T (9:22), t( 8:14),t(4:11)
ans d
Saturday, November 22, 2008
Sunday, November 2, 2008
MCI 08 sept
1. Marcus Gunn pupil seen in?
a. Neurosyphilis
b. Diabetes mellitus
c. Multiple sclerosis
d. Gullian barre syndrome.
Explanation: answer is C
Choice C: MARCUS GUNN pupil is weird pupil, which does not have a direct light reflex but has a consensual light reflex. HOW? Read on …………………………
Light reflex has an afferent pathway of optic and efferent pathway through Occulomotor nerve. The afferent info is sent via the lateral geniculate body to the edinger Westphal nucleus located in the midbrain. The basic point to be understood is that the Edinger westphal nucleus has a bilateral discharge i.e. if you shine a torch in lets say left eye of the patient, the left eye of the patient shows pupillary constriction known as DIRECT LIGHT reflex and the opposite eye also shows papillary constriction known as CONSENSUAL light reflex.
Multiple sclerosis as per English language means gliosis at multiple sites in the brain. These sites of gliosis are known as plaques and can be seen in an MRI. The plaques have a propensity to involve the optic pathway, mainly the optic pathway.
Assuming In case only the left optic nerve is affected the DIRECT light reflex on the left side will be afflicted. So the pupil on left side is not constricting. In these circumstances you shall now swing your torchlight to the right side and voila!!!! You manage to stimulate the edinger westphal nucleus, which has a bilateral discharge. You get a direct light reflex in the right eye and a consensual light reflex in the left eye.
Choice A: neurosyphilis has ARGYL ROBERTSON pupil. [Read it as ARP: ACCOMODATION reflex present, PRA – Pupillary reflex absent.]
Choice B: Diabetes mellitus neuropathy can have 3rd nerve palsy with pupillary sparing as per Harrison so light reflex would be preserved.
Choice D: Gullian Barre syndrome is a de-myelinating disorder of the spinal cord presenting with ASCENDING SYMETRICAL FLACCID paralysis. The cranial nerve involved in GBS is the 7th nerve and therefore can be easily excluded.
2. A pregnant woman on phenytoin presents to your clinic, which shall be the best recommendation for her?
a. Continue phenytoin add folic acid
b. Start phenobarbitone
c. Start phenobarbitone and folic acid
d. Start vigarbatrin and folic acid
EXPLANATION: answer is C
Phenytoin causes folic acid deficiency, which is obviously going to cause a dimorophic anemia in the mother. But at the same time the folic acid deficiency has been categorically linked to neural tube defects NTD, the most common being spina bifida occulta.
Hence it is prudent that phenytoin be withdrawn and cover up with phenobarbitone be recommended but with a COVER Of folic acid 0.4mg once a day.
3. Thyrotoxicosis patient presents with palpitations to the OPD. Best immediate management shall be?
a. Propranolol
b. Start propylthiouracil with propranolol
c. Start levothyroxine
d. Start carbimazole with iodine drops
EXPLANATION: ANSWER IS A
Thyroid hormones have a sympathomimetic effect via beta 1 receptors causing palpitations. At the same time they act via beta 2 receptors to cause tremors. Adding fuel to the fire is increased BMR causing heat intolerance.
Since this query does not talk about atrial fibrillation but simple presentation of the patient to the OPD the best answer shall be non selective beta blocker – propranolol.
Choice B would be prudent in case the question talked about a thyroid storm where propyl-thioracil would also prevent formation of T3 form T4
Choice C is used for hypothyroidism
Choice D is used for preoperative management of toxic nodular goiter to prevent the onset of thyroid storm
THYROTOXICOSIS
Primary
Secondary
Cause
L.A.T.S. long acting thyroid stimulator antibody, which mimics TSH.
Remember its different from T.P.O. thyroid peroxidase antibody which is seen in Hashimoto’s Thyroiditis
Pituitary adenoma
Manifestations
Young patient mainly women
Bilateral PROPTOSIS +
MYXEDEMA+
ACROPACHY+
No gender predilection
PROPTOSIS absent
MYXEDEMA absent
ACROPACHY absent
ATRIAL FIBRILLATION present
4. A patient of Tuberculosis present with malaise, fatigue and hyperpigmentation on flexural creases. On lab investigation sodium is 120meq /dl and potassium is 6.5meq/dl. Most probable diagnosis is
a. Addison disease
b. Conn syndrome
c. Secondary Hyperaldosteronism
d. Simmond syndrome
Explanation: Answer is A
Every time you read in any MCQ sodium and potassium values given together the MCQ is obviously gonna talk about aldosterone. The basic action of aldosterone is sodium and water reabsorbtion through the distal tubule and in return gives away potassium. Potassium is precious so after a while the body gives up losing potassium and in turn loses hydrogen ions.
Normal values
Sodium = 135-145meq/dl
Potassium = 3.5-5.5meq/dl
MCQ data states
Hyponatremia
Hyperkalemia
So obviously this MCQ is about hypo aldosteronism. Moreover the cementing point in its favor is hyper pigmentation due to ACTH increase by feedback mechanism.
Tuberculosis dissemination involves various organs incidence wise: peritoneum, genitourinary, Potts spine and adrenal in that order. So in this case TB has spread to the adrenal gland and damaged it causing Addison disease.
Most common cause of ADDISON disease is autoimmunity globally bout in India is TB
The manifestations are weakness due salt wasting, hyper pigmentation, Hyponatremia, Hyperkalemia and metabolic acidosis.
The IOC is ACTH stimulation test that will fail [miserably ………the gland is damaged.]
Drug support would be salt intake to be increased to 8gms /day with FLUDORCORTSIONE which has a high mineralo-corticoid activity.
5. Zollinger Ellison syndrome the best diagnostic protocol:
a. 24 hr basal acid output and maximal acid output.
b. 24 hr secretin study
c. 24 hr gastrin study
d. Histamine stimulation test
6. Bitemporal hemianopia is seen with
a. Pituitary tumor
b. Empty sella syndrome
c. Optic tract damage
d. Occipital cortex damage
7. Definitive diagnosis of phaeochromocytoma?
a. 24 hr urinary catecholamines
b. MIBG Scan
c. CTU
d. Metapyrone test
8. Vessel rupture in hypertension in all parts of the brain except:
a. Temporal lobe
b. Thalamus
c. Cerebrum
d. Putamen
9. Most common cause of mortality after 70 yrs of age?
a. Cardiovascular mortality
b. Diabetes mellitus and complications
c. Peripheral vascular disease
d. Mesenteric insufficiency
10. Which is a pre-cancerous lesion of esophagus
a. barret esophagus
b. x
c. crohn disease
d. Ulcerative colitis
11. Recurrent episodes of Blood stained sputum can be the presenting symptom of?
a. Bronchial adenoma
b. Cavity
c. Bronchiectasis
d. Tuberculosis
12. Lesion of the caudate lobe of basal ganglia causes
a. Chorea
b. atheotosis
c. hemiballismus
d. Intentional tremors
EXPLANATION: The answer is A
Chorea
Atheotosis
Hemiballismus
Lesion of caudate nucleus
Remember the C word
Lesion of putamen
Lesion of subthalaamic nucleus
Involuntary proximal movements eg shrugging of shoulders
Involuntary distal movements eg snake head like movement of hand
Combo of proximal and distal involuntary movements eg involuntary flinging of the arms
Choice D is intentional tremors, which are seen in patients of cerebellar disease.
13. Deficiency of which vitamin does not cause anemia?
a. Biotin
b. Pyridoxine
c. Folic acid
d. B12
14. Punched out lesion in the skull is seen in:
a. Mutiple myeloma
b. Hyperparathyroidism
c. Pagets disease
d. Osteopetrosis
15. Closed Pneumothorax, the best position of the CXR shall be?
a. Expiration in erect position
b. Lateral decubitus position
c. Inspiration in erect position
d. Inspiration in lateral decubitus position.
16. Wide fixed split S2 is seen in:
a. ASD
b. VSD
c. PDA
d. TOF
17. Thrombocytopenia is diagnosed by
a. Bleeding time
b. Clotting time
c. Prothrombin time
d. Activated partial thromboplastin time
18. Extrinsic pathway is measured by
a. BT
b. CT
c. APTT
d. PT
19. Hemophilia pattern of inheritance is:
a. XLR
b. XLD
c. AR
d. AD
20. Digitalis toxicity is managed by:
a. Potassium
b. digiband
c. amiodarone
d. lignocaine
21. Preserved blood does not contain
a. Citrate
b. Heparin
c. Dextrose
d. Phosphate
22. Tumor marker for pancreatic cancer
a. Ca19.9
b. Ca –125
c. BRCA
d. CEA
23. Lumbar puncture needle doesn’t puncture
a. supraspinatus
b. infrspinatus
c. ligamentum flavum
d. x
24. CSF glucose levels are reduced in all of the following except:
a. Bacterial meningitis
b. Viral meningitis
c. Tubercular meningitis
d. Subdural Empyema
25. Diagnostic procedure for kala azar can be which of the following?
a. Indirect fluoroscent antibody test
b. L.D. bodies in splenic aspirate
c. Aldehyde test
d. ELISA
26. Most dangerous toxin is:
a. botulinism
b. x
c. x
d. x
27. NNN media is used for diagnosis of
a. Brucella
b. Leshmania
c. ankylostoma
d. strongyloides stercoralis
28. Young female with complaints of dysnea on exertion and related symptoms of heart etiology. Best modality for investigation shall be:
a. CXR
b. ECG
c. Echocardiography
d. Angiography
29. The following can cause Hypocalcemia
a. calcitonin
b. Hyperparathyroidism
c. Sarcoidosis
d. Lithium therapy
30. The following vitamin is given with vitamin D for osteoporosis
a. Vitamin A
b. Vitamin E
c. Vitamin K
d. Vitamin E
31. Least common fungal infection in immunocompromised hosts shall be:
a. Malazzia furfur
b. Cryptosporidium
c. Candida
d. Penicillium marafucci
Malassezia furfur a lipophilic yeast causes pityriasis versicolor , follicular titriasis, sebborheic dermatitis .
Penicillium marafucci causes hyalohyphomycosis.
32. All are features of hypothyroidism except
a. pretibial myxedema
b. Puffiness of face
c. Low voltage ECG
d. Alopecia and constipation
33. Type 2 diabetes mellitus is caused by:
a. Deficiency of insulin
b. Excess of insulin
c. Resistance to insulin
d. Defective structure of insulin
34. Most common Valvular lesion after MI is seen in:
a. Mitral regurgitation
b. Mitral stenosis
c. Aortic stenosis
d. Aortic regurgitation
35. Auer rods are seen in:
a. ALL
b. AML
c. CML
d. CLL
36. Falciparum malaria causes all except:
a. blackwater fever
b. Algid malaria
c. Hypoglycemia
d. Alkalosis
37. Splenomegaly is not seen in:
a. Sickle cell anemia
b. Gaucher
c. TORCH
d. Kala Azar
38. Bilaterally shrunken kidneys are seen in:
a. Diabetes mellitus
b. Amyloidosis
c. Hydronephrosis
d. Renal vein thrombosis
39. Daily sodium requirement per day would be?
a. 3-5gm
b. 300mg-500mg
c. 3ug- 5ug
d. 3-5mg
40. FTA –ABS is used for diagnosis of
a. Syphilis
b. Borrelia
c. Brucella
d. Lyme disease
a. Neurosyphilis
b. Diabetes mellitus
c. Multiple sclerosis
d. Gullian barre syndrome.
Explanation: answer is C
Choice C: MARCUS GUNN pupil is weird pupil, which does not have a direct light reflex but has a consensual light reflex. HOW? Read on …………………………
Light reflex has an afferent pathway of optic and efferent pathway through Occulomotor nerve. The afferent info is sent via the lateral geniculate body to the edinger Westphal nucleus located in the midbrain. The basic point to be understood is that the Edinger westphal nucleus has a bilateral discharge i.e. if you shine a torch in lets say left eye of the patient, the left eye of the patient shows pupillary constriction known as DIRECT LIGHT reflex and the opposite eye also shows papillary constriction known as CONSENSUAL light reflex.
Multiple sclerosis as per English language means gliosis at multiple sites in the brain. These sites of gliosis are known as plaques and can be seen in an MRI. The plaques have a propensity to involve the optic pathway, mainly the optic pathway.
Assuming In case only the left optic nerve is affected the DIRECT light reflex on the left side will be afflicted. So the pupil on left side is not constricting. In these circumstances you shall now swing your torchlight to the right side and voila!!!! You manage to stimulate the edinger westphal nucleus, which has a bilateral discharge. You get a direct light reflex in the right eye and a consensual light reflex in the left eye.
Choice A: neurosyphilis has ARGYL ROBERTSON pupil. [Read it as ARP: ACCOMODATION reflex present, PRA – Pupillary reflex absent.]
Choice B: Diabetes mellitus neuropathy can have 3rd nerve palsy with pupillary sparing as per Harrison so light reflex would be preserved.
Choice D: Gullian Barre syndrome is a de-myelinating disorder of the spinal cord presenting with ASCENDING SYMETRICAL FLACCID paralysis. The cranial nerve involved in GBS is the 7th nerve and therefore can be easily excluded.
2. A pregnant woman on phenytoin presents to your clinic, which shall be the best recommendation for her?
a. Continue phenytoin add folic acid
b. Start phenobarbitone
c. Start phenobarbitone and folic acid
d. Start vigarbatrin and folic acid
EXPLANATION: answer is C
Phenytoin causes folic acid deficiency, which is obviously going to cause a dimorophic anemia in the mother. But at the same time the folic acid deficiency has been categorically linked to neural tube defects NTD, the most common being spina bifida occulta.
Hence it is prudent that phenytoin be withdrawn and cover up with phenobarbitone be recommended but with a COVER Of folic acid 0.4mg once a day.
3. Thyrotoxicosis patient presents with palpitations to the OPD. Best immediate management shall be?
a. Propranolol
b. Start propylthiouracil with propranolol
c. Start levothyroxine
d. Start carbimazole with iodine drops
EXPLANATION: ANSWER IS A
Thyroid hormones have a sympathomimetic effect via beta 1 receptors causing palpitations. At the same time they act via beta 2 receptors to cause tremors. Adding fuel to the fire is increased BMR causing heat intolerance.
Since this query does not talk about atrial fibrillation but simple presentation of the patient to the OPD the best answer shall be non selective beta blocker – propranolol.
Choice B would be prudent in case the question talked about a thyroid storm where propyl-thioracil would also prevent formation of T3 form T4
Choice C is used for hypothyroidism
Choice D is used for preoperative management of toxic nodular goiter to prevent the onset of thyroid storm
THYROTOXICOSIS
Primary
Secondary
Cause
L.A.T.S. long acting thyroid stimulator antibody, which mimics TSH.
Remember its different from T.P.O. thyroid peroxidase antibody which is seen in Hashimoto’s Thyroiditis
Pituitary adenoma
Manifestations
Young patient mainly women
Bilateral PROPTOSIS +
MYXEDEMA+
ACROPACHY+
No gender predilection
PROPTOSIS absent
MYXEDEMA absent
ACROPACHY absent
ATRIAL FIBRILLATION present
4. A patient of Tuberculosis present with malaise, fatigue and hyperpigmentation on flexural creases. On lab investigation sodium is 120meq /dl and potassium is 6.5meq/dl. Most probable diagnosis is
a. Addison disease
b. Conn syndrome
c. Secondary Hyperaldosteronism
d. Simmond syndrome
Explanation: Answer is A
Every time you read in any MCQ sodium and potassium values given together the MCQ is obviously gonna talk about aldosterone. The basic action of aldosterone is sodium and water reabsorbtion through the distal tubule and in return gives away potassium. Potassium is precious so after a while the body gives up losing potassium and in turn loses hydrogen ions.
Normal values
Sodium = 135-145meq/dl
Potassium = 3.5-5.5meq/dl
MCQ data states
Hyponatremia
Hyperkalemia
So obviously this MCQ is about hypo aldosteronism. Moreover the cementing point in its favor is hyper pigmentation due to ACTH increase by feedback mechanism.
Tuberculosis dissemination involves various organs incidence wise: peritoneum, genitourinary, Potts spine and adrenal in that order. So in this case TB has spread to the adrenal gland and damaged it causing Addison disease.
Most common cause of ADDISON disease is autoimmunity globally bout in India is TB
The manifestations are weakness due salt wasting, hyper pigmentation, Hyponatremia, Hyperkalemia and metabolic acidosis.
The IOC is ACTH stimulation test that will fail [miserably ………the gland is damaged.]
Drug support would be salt intake to be increased to 8gms /day with FLUDORCORTSIONE which has a high mineralo-corticoid activity.
5. Zollinger Ellison syndrome the best diagnostic protocol:
a. 24 hr basal acid output and maximal acid output.
b. 24 hr secretin study
c. 24 hr gastrin study
d. Histamine stimulation test
6. Bitemporal hemianopia is seen with
a. Pituitary tumor
b. Empty sella syndrome
c. Optic tract damage
d. Occipital cortex damage
7. Definitive diagnosis of phaeochromocytoma?
a. 24 hr urinary catecholamines
b. MIBG Scan
c. CTU
d. Metapyrone test
8. Vessel rupture in hypertension in all parts of the brain except:
a. Temporal lobe
b. Thalamus
c. Cerebrum
d. Putamen
9. Most common cause of mortality after 70 yrs of age?
a. Cardiovascular mortality
b. Diabetes mellitus and complications
c. Peripheral vascular disease
d. Mesenteric insufficiency
10. Which is a pre-cancerous lesion of esophagus
a. barret esophagus
b. x
c. crohn disease
d. Ulcerative colitis
11. Recurrent episodes of Blood stained sputum can be the presenting symptom of?
a. Bronchial adenoma
b. Cavity
c. Bronchiectasis
d. Tuberculosis
12. Lesion of the caudate lobe of basal ganglia causes
a. Chorea
b. atheotosis
c. hemiballismus
d. Intentional tremors
EXPLANATION: The answer is A
Chorea
Atheotosis
Hemiballismus
Lesion of caudate nucleus
Remember the C word
Lesion of putamen
Lesion of subthalaamic nucleus
Involuntary proximal movements eg shrugging of shoulders
Involuntary distal movements eg snake head like movement of hand
Combo of proximal and distal involuntary movements eg involuntary flinging of the arms
Choice D is intentional tremors, which are seen in patients of cerebellar disease.
13. Deficiency of which vitamin does not cause anemia?
a. Biotin
b. Pyridoxine
c. Folic acid
d. B12
14. Punched out lesion in the skull is seen in:
a. Mutiple myeloma
b. Hyperparathyroidism
c. Pagets disease
d. Osteopetrosis
15. Closed Pneumothorax, the best position of the CXR shall be?
a. Expiration in erect position
b. Lateral decubitus position
c. Inspiration in erect position
d. Inspiration in lateral decubitus position.
16. Wide fixed split S2 is seen in:
a. ASD
b. VSD
c. PDA
d. TOF
17. Thrombocytopenia is diagnosed by
a. Bleeding time
b. Clotting time
c. Prothrombin time
d. Activated partial thromboplastin time
18. Extrinsic pathway is measured by
a. BT
b. CT
c. APTT
d. PT
19. Hemophilia pattern of inheritance is:
a. XLR
b. XLD
c. AR
d. AD
20. Digitalis toxicity is managed by:
a. Potassium
b. digiband
c. amiodarone
d. lignocaine
21. Preserved blood does not contain
a. Citrate
b. Heparin
c. Dextrose
d. Phosphate
22. Tumor marker for pancreatic cancer
a. Ca19.9
b. Ca –125
c. BRCA
d. CEA
23. Lumbar puncture needle doesn’t puncture
a. supraspinatus
b. infrspinatus
c. ligamentum flavum
d. x
24. CSF glucose levels are reduced in all of the following except:
a. Bacterial meningitis
b. Viral meningitis
c. Tubercular meningitis
d. Subdural Empyema
25. Diagnostic procedure for kala azar can be which of the following?
a. Indirect fluoroscent antibody test
b. L.D. bodies in splenic aspirate
c. Aldehyde test
d. ELISA
26. Most dangerous toxin is:
a. botulinism
b. x
c. x
d. x
27. NNN media is used for diagnosis of
a. Brucella
b. Leshmania
c. ankylostoma
d. strongyloides stercoralis
28. Young female with complaints of dysnea on exertion and related symptoms of heart etiology. Best modality for investigation shall be:
a. CXR
b. ECG
c. Echocardiography
d. Angiography
29. The following can cause Hypocalcemia
a. calcitonin
b. Hyperparathyroidism
c. Sarcoidosis
d. Lithium therapy
30. The following vitamin is given with vitamin D for osteoporosis
a. Vitamin A
b. Vitamin E
c. Vitamin K
d. Vitamin E
31. Least common fungal infection in immunocompromised hosts shall be:
a. Malazzia furfur
b. Cryptosporidium
c. Candida
d. Penicillium marafucci
Malassezia furfur a lipophilic yeast causes pityriasis versicolor , follicular titriasis, sebborheic dermatitis .
Penicillium marafucci causes hyalohyphomycosis.
32. All are features of hypothyroidism except
a. pretibial myxedema
b. Puffiness of face
c. Low voltage ECG
d. Alopecia and constipation
33. Type 2 diabetes mellitus is caused by:
a. Deficiency of insulin
b. Excess of insulin
c. Resistance to insulin
d. Defective structure of insulin
34. Most common Valvular lesion after MI is seen in:
a. Mitral regurgitation
b. Mitral stenosis
c. Aortic stenosis
d. Aortic regurgitation
35. Auer rods are seen in:
a. ALL
b. AML
c. CML
d. CLL
36. Falciparum malaria causes all except:
a. blackwater fever
b. Algid malaria
c. Hypoglycemia
d. Alkalosis
37. Splenomegaly is not seen in:
a. Sickle cell anemia
b. Gaucher
c. TORCH
d. Kala Azar
38. Bilaterally shrunken kidneys are seen in:
a. Diabetes mellitus
b. Amyloidosis
c. Hydronephrosis
d. Renal vein thrombosis
39. Daily sodium requirement per day would be?
a. 3-5gm
b. 300mg-500mg
c. 3ug- 5ug
d. 3-5mg
40. FTA –ABS is used for diagnosis of
a. Syphilis
b. Borrelia
c. Brucella
d. Lyme disease
MOST COMMON IN HIV
MOST COMMON IN HIV
¨ Kaposi sarcoma is the most common AIDS-related tumor in homosexual men and in populations in parts of Africa
¨ Non-Hodgkin lymphoma is the second most common AIDS-associated neoplasm · The most common ocular manifestation of AIDS is a form of retinopathy consisting of cotton-wool spots, hemorrhages, and capillary abnormalities· Cytomegalovirus (CMV), a double-stranded DNA virus in the herpesvirus family, is the most common cause of life-threatening opportunistic viral infection in AIDS patients · · Esophagus is the most common site of HIV related ulcer· Candidiasis in AIDS=the esophagus is the most common site of infection· The colon is the most common site of involvement of Histoplasma organisms in the gastrointestinal tract in AIDS patients · Terminal ileum is the most common gastrointestinal site of disseminated histoplasmosis in the non-AIDS immunocompromised patient· Cryptosporidiosis in AIDS=the jejunum is the most common site· Pneumonia is the most common manifestation of P carinii infection in AIDS· The liver, spleen, and lymph nodes are the most common sites of extrapulmonary pneumocystosis· The ileocecal region is the most common site of tuberculosis in the gastrointestinal tract· The most common non-tuberculous mycobacterial infection in AIDS patients is caused by M avium.It is the most common opportunistic infection of bacterial origin in AIDS patients in developed countries . Acquired most commonly through the mouth or gastrointestinal tract· Bacillary angiomatosis =cutaneous lesions, which mimic those of Kaposi sarcoma, are the most common manifestation· The most common causes of vision loss affecting patients with AIDS --Cytomegalovirus (CMV) retinitis· Pulmonary TB is the most common type of TB in persons with HIV infection· One controversy:PCP is the most common cause of death in AIDS patient or Liver failure is the most common cause of death in people with AIDS
¨ Kaposi sarcoma is the most common AIDS-related tumor in homosexual men and in populations in parts of Africa
¨ Non-Hodgkin lymphoma is the second most common AIDS-associated neoplasm · The most common ocular manifestation of AIDS is a form of retinopathy consisting of cotton-wool spots, hemorrhages, and capillary abnormalities· Cytomegalovirus (CMV), a double-stranded DNA virus in the herpesvirus family, is the most common cause of life-threatening opportunistic viral infection in AIDS patients · · Esophagus is the most common site of HIV related ulcer· Candidiasis in AIDS=the esophagus is the most common site of infection· The colon is the most common site of involvement of Histoplasma organisms in the gastrointestinal tract in AIDS patients · Terminal ileum is the most common gastrointestinal site of disseminated histoplasmosis in the non-AIDS immunocompromised patient· Cryptosporidiosis in AIDS=the jejunum is the most common site· Pneumonia is the most common manifestation of P carinii infection in AIDS· The liver, spleen, and lymph nodes are the most common sites of extrapulmonary pneumocystosis· The ileocecal region is the most common site of tuberculosis in the gastrointestinal tract· The most common non-tuberculous mycobacterial infection in AIDS patients is caused by M avium.It is the most common opportunistic infection of bacterial origin in AIDS patients in developed countries . Acquired most commonly through the mouth or gastrointestinal tract· Bacillary angiomatosis =cutaneous lesions, which mimic those of Kaposi sarcoma, are the most common manifestation· The most common causes of vision loss affecting patients with AIDS --Cytomegalovirus (CMV) retinitis· Pulmonary TB is the most common type of TB in persons with HIV infection· One controversy:PCP is the most common cause of death in AIDS patient or Liver failure is the most common cause of death in people with AIDS
Thursday, October 30, 2008
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