Image Question-32
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Medicine MCQs – 23
All of the following are correct about Eculizumab EXCEPT -
Meningococcal vaccination is recommended at least 2 weeks before receiving eculizumab
Most common finding in Paroxysmal nocturnal hemoglobinuria is -
Paroxysmal nocturnal hemoglobinuria (PNH) - most common- hemolytic anemia, hemoglobinuria, and shortness of breath.
Other findings - thrombosis, renal insufficiency, and bone marrow failure.
Under normal circumstances, free hemoglobin released by hemolysis is removed by -
Clinical settings - Haptoglobin assay is used to screen for and monitor intravascular hemolytic anemia.
In intravascular hemolysis, free hemoglobin will be released into circulation and hence haptoglobin will bind the hemoglobin. This causes a decline in haptoglobin levels.
All of the following are correct for Paroxysmal nocturnal hemoglobinuria EXCEPT:
In PNH - Mutation of the X-linked gene phosphatidylinositol glycan class A (PIGA), produces a deficiency in the glycosylphosphatidylinositol (GPI) protein, which is responsible for anchoring other protein moieties to the surface of erythrocytes.
Eculizumab is a recombinant humanized monoclonal antibody against the complement protein -
Eculizumab is a recombinant humanized monoclonal antibody against the complement protein C5
Which of the following support a diagnosis of hemolysis?
Decrease in haptoglobin and Low Hb and Hematocrit support a diagnosis of hemolysis
Which medicine dramatically alters the natural course of PNH, reducing symptoms and disease complications as well as improve survival?
Eculizumab- is a medication used to treat
- paroxysmal nocturnal hemoglobinuria (PNH)
- atypical hemolytic uremic syndrome (aHUS)
- generalized myasthenia gravis
- neuromyelitis optica
All of the following are CORRECT about thrombosis in PNH patients EXCEPT -
Cerebral venous thrombosis is common
Cerebral venous system is the second most frequent location of thrombosis after hepatic veins.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4602837/
All of the following are useful in treatment of Paroxysmal nocturnal hemoglobinuria as required EXCEPT:
Long-term glucocorticoids not useful and contraindicated
Which is the most common site for thrombosis in PNH patients?
Hepatic vein thrombosis (Budd-Chiari syndrome) is recognized as one of the most common sites of thrombosis
Hepatic failure is a common cause of mortality in PNH
Ankle:Brachial Index
What is Ankle Brachial Index? ABI is a non-invasive tool for the assessment of vascular…
Gait disturbances
Gait disturbancesGaitCause Of GaitCause 1Antalgic Gaitpain2Vaulting gaitcommon in children with limb length discrepancypelvic droop, decreased…
“Cock-walk” gait and “horseshoe moustache” sign
MCQ “Cock-walk” gait and “horseshoe moustache” sign on MRI seen in- A. Hypermagnesemia B. Hypermanganesemia…
Adrenal Cortex
Where is adrenal cortex situated? adrenal cortex forms the outer three-quarters of the gland What…
Medicine MCQs-22
What is the primary defect of type 2 renal tubular acidosis?
type 2 RTA - Proximal HCO3 - reabsorption
type 1 RTA - Diminished distal H+ secretion
What is the primary defect of type 1 renal tubular acidosis?
Primary defect of type 1 renal tubular acidosis -impairment in hydrogen ion secretion in the distal tubule
Metabolic acidosis is defined as a reduced serum pH, and an abnormal serum bicarbonate concentration of -
Metabolic acidosis is defined as a reduced serum pH, and an abnormal serum bicarbonate concentration of <22 mEq/L
Most common cause of a low anion gap is -
Low anion gap is often due to hypoalbuminemia.
Albumin is an anionic protein and its loss results in the retention of other negatively charged ions such as chloride and bicarbonate.
As bicarbonate and chloride anions are used to calculate the anion gap, there is a subsequent decrease.
It is called as elevated anion gap when anion gap is -
elevated anion gap - when anion gap is >12 mEq/L
Delta ratio is a formula that can be used to assess -
Delta ratio, or "delta-delta", is a formula that can be used to assess elevated anion gap metabolic acidosis
Salicylate poisoning causes typically -
Two of the most common and notable causes of increased anion gap metabolic acidosis -
High anion gap metabolic acidosis conditions include -
diabetic ketoacidosis (DKA)
salicylate poisoning
Which is the most common cause of metabolic acidosis in hospitalized patients?
Lactic acidosis is the most common cause of metabolic acidosis in hospitalized patients.
All of the following are the exogenous causes of hyperchloremic acidosis EXCEPT -
Exogenous causes of hyperchloremic acidosis -
Ammonium chloride supplement
Hydrochloric acid supplement
Large volume resuscitation with normal saline
Which of the following is the major cause of Hyperchloremic metabolic acidosis?
Hyperchloremic metabolic acidosis is a pathological state that results from bicarbonate loss, rather than acid production or retention.
Auer rods
Which conditions are associated with Auer rods ? Also called – Auer bodies These are…
Mitral valve prolapse
What is Mitral valve prolapse (MVP)? MVP is a condition where there is usually a…
Medicine MCQs -21
What is the “gold standard” diagnostic test for Nephrolithiasis?
Nephrolithiasis - The “gold standard” diagnostic test is helical CT without contrast.
Tiopronin is used for prevention of which type kidney stones-
Cystine
Focus for cystine stone prevention is on increasing cystine solubility.
This goal may be achieved by treatment with medication that covalently binds to cystine (tiopronin and penicillamine
Staghorn calculi is produced by which type renal stones?
Which stones are commonly caused by a urinary tract infection?
Struvite stones are virtually always caused by a urinary tract infection
Which is the most common type of kidney stone?
Calcium oxalate: The most common type of kidney stone which is created when calcium combines with oxalate in the urine.
All of the following are CORRECT about Randall's plaques EXCEPT -
Randall's plaques
Randall's plaques - are calcium phosphate deposits
form in the papillary interstitium
When there is a stone is in the lower part of the ureter the pain can radiate to -
stone lodges in the upper part of the ureter - pain may radiate anteriorly
if the stone is in the lower part of the ureter - pain can radiate to the ipsilateral testicle in men or ipsilateral labium in women.
All of the following are CORRECT about Dent's disease EXCEPT -
affects the proximal renal tubules
LMW proteinuria
Which kidney stones grow quickly to large size ?
Struvite stones - can grow very large quickly
Which renal stones are called as infection stones?
Struvite stones, also known as infection stones or triplephosphate stones, form only when the upper urinary tract is infected
with urease-producing bacteria such as
Proteus mirabilis,
Klebsiella
pneumoniae,
Providencia species
Medicine MCQs -20
This is the paid quiz, please complete the payment to play.
Vascular angle is the angle to which the leg has to be raised before it becomes pale, whilst lying down is called as -
vascular angle - also called Buerger's angle, is the angle to which the leg has to be raised before it becomes pale, whilst lying down.
Gissane angle, also known as the "critical angle of Gissane", is a measurement on lateral foot radiographs used to evaluate the severity of calcaneal fractures.
Böhler's angle is defined by two intersecting lines: one drawn from anterior process of the calcaneus to the highest part of posterior articular surface and a second drawn from the same point of posterior articular surface to the most superior point of tuberosity.
Meary's angle or the (lateral) talus-first metatarsal angle has been used to identify the apex of deformity in patients with pes cavus and pes planus on lateral weight-bearing foot radiographs.
Which of the following is correct for people with a darker skin pigment and production of vitamin D
People with a darker skin pigment with increased amounts of melanin may have decreased production of vitamin D
Melanin absorbs ultraviolet B radiation from the sun and reduces vitamin D production
Intrinsic factor -
Intrinsic factor - glycoprotein produced by the parietal cells
Anti-Müllerian hormone is -
AMH is a dimeric glycoprotein with a molar mass of 140 kDa
Vascular angle of less than -------------- indicates severe ischaemia
vascular angle of less than 20 degrees indicates severe ischaemia
Primary erythromelalgia is caused by mutation of -
Primary erythromelalgia is caused by mutation of the voltage-gated sodium channel α-subunit gene SCN9A.
Tunnel vision can be caused by all of the following EXCEPT -
Retinitis pigmentosa
Glaucoma
Cystic fibrosis is associated with channel defect -
CFTR is complex protein found on the surface membrane of cells in a wide variety of tissues where it functions as a regulated chloride ion channel.
Vitamin-D overdose from UV exposure -
Vitamin-D overdose is impossible from UV exposure
Vitamin-D overdose is impossible from UV exposure: the skin reaches an equilibrium where the vitamin degrades as fast as it is created
POEMS syndrome includes all of the following EXCEPT -
The name POEMS is an acronym for some of the disease's major signs and symptoms -
polyneuropathy
organomegaly
endocrinopathy
myeloma protein
skin changes
Amaurosis Fugax
Transient visual loss Amaurosis fugax is a harbinger of an imminent stroke. Amaurosis fugax is…
Chest radiograph signs of Pulmonary Embolism
Classic chest radiograph signs of pulmonary emboli include – Signs of Pulmonary EmbolismFindings on X-Ray1…
Medicine MCQs – 19
Which of the following cells dominate in airway inflammation of bronchiectasis?
Neutrophils
Neutrophils dominate airway inflammation in bronchiectasis, driven by high concentrations of neutrophil chemoattractants such as interleukin-8 (CXCL-8), and leukotriene B4.
FACED scale uses ---------------- to predict clinical outcomes in bronchiectasis as one of the parameters.
FACED scale uses the FEV-1 (forced expiratory volume in 1 second), age of the affected person, presence of chronic infection, extent of disease (number of lung lobes involved) and dyspnea scale rating (MRC dyspnea scale) to predict clinical outcomes in bronchiectasis.
All of the following are findings in Bronchiectasis EXCEPT -
CT findings include airway dilation (detected as parallel “tram tracks” or as the “signet-ring sign”
Fleishner sign - central pulmonary artery enlargement - sign seen in Pulmonary emboli
Which of the following has a particular propensity for colonizing damaged airways in bronchiectasis?
Pseudomonas
Bronchial dilation in bronchiectasis is characterized ALL of the following EXCEPT -
- Broncho arterial ratio (BAR) of more than 1
- Lack of bronchial tapering (normal airways diminish in caliber as they extend toward the lung periphery)
- Visibility of airways within 1 cm of the pleural surface (normal airways should not be visualized this far out in the lung periphery
- Abutting the mediastinal pleural surface
Which of the following is the most common clinical presentation in bronchiectasis ?
Most common clinical presentation is a persistent productive cough with ongoing production of thick, tenacious sputum.
Which of the following is the imaging modality of choice for confirming the diagnosis?
Chest computed tomography (CT) is more specific for bronchiectasis and is the imaging modality of choice for confirming the diagnosis.
All of the following are common ccauses of 'Traction bronchiectasis' EXCEPT -
Traction bronchiectasis seen in - pulmonary fibrosis or distorted lung parenchymal architecture.
Which is the cardinal sign of bronchiectasis?
Bronchial dilation
Bronchial dilation, the cardinal sign of bronchiectasis
FACED scale is used in bronchiectasis for -
Bronchiectasis Severity Index and the FACED scale
Two clinical scales have been used to predict disease severity and outcomes in bronchiectasis
Hanging Jaw Sign
“Hanging Jaw Sign” Myasthenia gravis Weakness of the muscles of facial expression and muscles of…
Medicine MCQs-18
Whic of the following the the most common CT finding in EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS?
most common CT findings include -
bilateral ground-glass opacity and airspace consolidation that is predominantly subpleural.
Other CT findings include bronchial wall thickening, hyperinflation, interlobular septal thickening, lymph node enlargement, and pericardial and pleural effusion
presence of “tram tracks” in CT scan chest seen in -
Bronchiectasis -presence of “tram tracks” indicating dilated airways is consistent with bronchiectasis.
Focal bronchiectasis seen in which of the following cases?
Focal Obstruction
- aspirated foreign body
- tumor mass
“signet-ring sign” in CT chest seen in -
Bronchiectasis
CT findings include airway dilation - detected as parallel
“tram tracks”
“signet-ring sign”
All of the following are false about 'Lead neuropathy' EXCEPT -
Lead toxicity is a very rare cause of neuropathy in adults. It has an unusual pattern that is classically an isolated motor neuropathy with a predilection for extensor muscles of the arms and legs.
Bronchodilator effect is due to inhibition of -
Bronchodilator effect of Theophylline is due to inhibition of phosphodiesterases
Which of the following medicine has side effect of 'dry mouth'?
Anticholinergics
Anticholinergic, sympathomimetic, or diuretic drugs are usually responsible
Which of the following is the commonest form of Bronchiectasis?
Tubular - most common form of Bronchiectasis
Varicose, Cystic, Cylindrical
Which of the following shows characteristic “eggshell” pattern?
characteristic “eggshell” pattern -silicosis
Which is the most common cancer associated with asbestos exposure?
Lung cancer is the most common cancer associated with asbestos exposure.
Mononeuritis multiplex most commonly involves -
Mononeuritis multiplex most commonly involves the peroneal nerve, but also involves the ulnar, radial, internal popliteal, and occasionally, cranial nerves.
