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Medicine Review MCQs-IX

Mycobacterium tuberculosis commonly infects -

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Macrophages
Infected macrophages in the lung, through their production of chemokines, attract inactivated monocytes, lymphocytes, and neutrophils , none of which kill the bacteria very efficiently .
Granulomatous focal lesions composed of - macrophage-derived giant cells and lymphocytes begin to form.

Acid-fast microscopy may be reported based on the World Health Organization and International Union Against Tuberculosis and Lung Diseases (WHO-IUTLD) :
For the Ziehl-Neelsen Method (via light/brightfield microscopy) More than 10 AFB per field in at least 20 visual fields -

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The results of acid-fast microscopy may be reported based on the World Health Organization and International Union Against Tuberculosis and Lung Diseases (WHO-IUTLD):For the Ziehl-Neelsen Method (via light/brightfield microscopy)-
No Acid-fast bacilli (AFB) seen - Report as "0". It means no AFB was observed in 2 lengths (i.e., 300 visual fields), thus, conferring a "negative" result. 1-9 AFB in 1 length - Record the actual number of AFB seen (e.g. +1, +2, +9). Note that the plus sign should precede the number. This is also referred to as a scanty positive result.


10-99 AFB in 1 length - Report as "1+". Note that the plus sign should come after the number. This is a positive result.
1-10 AFB per field in at least 50 visual fields - Report as "2+". Note that the plus sign should come after the number. This is a positive result.
More than 10 AFB per field in at least 20 visual fields - Report as "3+". Note that the plus sign should come after the number. This is a positive result and is highly infectious.

For Auramine Method (via fluorescence microscopy at 400x magnification) more than 60 AFB in 1 length - Report as

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Microscopy of M. tuberculosis caseating granulomas revealed a type of cell that has a "horseshoe" pattern of nuclei. What is the name of that cell?

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M. tuberculosis is characterized in tissue by caseating granulomas containing Langhans giant cells, which have a "horseshoe" pattern of nuclei.

Touton giant cells are seen in all of the following EXCEPT?

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Touton giant cells are a type of multinucleated giant cell seen in lesions with high lipid content such as -
- fat necrosis,
- xanthoma,
- xanthelasma
- xanthogranulomas.


They are also found in dermatofibroma

What is the name of pointed Microscopic structure?

Medicine Questions
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Diagnosis - Granulomatous lesion


Langhans giant cell

Autoantibodies against LRP4 have been seen in some cases of -

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Myasthenia gravis is an autoimmune - T-cell-dependent disease.
Acetylcholine receptor (AChR) antibodies are found in approximately 80% of patients,
Other antibodies
Muscle-specific tyrosine kinase (Musk) antibodies [Anti-MUSK]
Low-Density Lipoprotein Receptor-Related Protein 4 (LRP4),
Agrin antibodies ,
Rapsyn antibodies ,
Striational antibodies

All of the following are LESS COMMON autoantibodies in Myasthenia Gravis EXCEPT -

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The most common antibodies detected in MG are antibodies against acetylcholine receptors (AChRs), muscle-specific kinase (MuSK) and low-density lipoprotein receptor-related protein 4 (LRP4)


Additional antibodies of interest in MG are directed against agrin, titin, KV1.4, ryanodine receptors, collagen Q, and cortactin
Antibodies to cytolethal distending toxin B (CdtB) and vinculin are novel biomarkers that rule-in and differentiate irritable bowel syndrome with diarrhea (IBS-D) from other causes of diarrhea and healthy controls.

What % of patients with MG may present with prominent bulbar symptoms?

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20% of patients in MG Shows Bulbar symptoms

All of the following auto-antibody seen in Graves' disease EXCEPT ?

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Antibodies to glutamic acid decarboxylase (anti-GAD) are reliable serological markers of Type-1 Diabetes Mellitus.


Anti-GAD antibodies [high titre] are associated with the stiff-person syndrome (60% sensitivity),

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