Prenatal Genetic Counseling
Contents1 Frequency of Turner syndrome in pregnancy is2 Not true of serum screening options for...
Preconception Counseling
Contents1 Uncontrolled diabetes in mother is associated with following defects in neonate except2 To avoid...
Stove-in Chest
stove-in chest is a subtype of flail chest in which there is a depression or...
Nephrology MCQs-3
Contents1 Most common primary inherited aminoaciduria-2 Most common cause of autosomal recessive proximal renal tubular...
ECG Question-2
Contents1 What is the diagnosis of ECG?2 What is the diagnosis of ECG?3 Paroxysmal AF...
Fetal Skull and Maternal Pelvis
Contents1 Asynclitism during labor can be assessed by palpating2 Which of the following represents a...
LeCompte maneuver
Contents1 LeCompte maneuver is done in2 LeCompte maneuver is done in3 If LeCompte maneuver is...
Arterial switch operation
Contents1 Which of the following is the Arterial switch operation?2 Jatene procedure is ideally performed...
Image Question-25
Contents1 What is the most probable diagnosis?2 Egg-on-a-string sign3 What is the management line for...
Marcus Gunn pupil
Contents1 In Marcus Gunn pupil there is relative weakness of which of the following pathway...
Reinke crystals
Which conditions Reinke crystals are found? Reinke crystals are rod-like cytoplasmic inclusions which can be…
Coffee Bean Nuclei
Seen in – Granulosa cell tumors.Brenner tumor Granulosa cell tumors Tumors consists of – monotonous…
Medicine MCQs -9
Pseudo Meigs syndrome constitutes all of the following EXCEPT -
Pseudo Meigs syndrome: Ascites and pleural effusion in a patient with pelvic or abdominal tumor (other than the benign tumors included in the definition of Meigs syndrome). The tumors in pseudo-Meigs syndrome could be benign or malignant.
What is the most common tissue elements in dermoid cyst?
Most common tissue elements are ectodermal
Walthard cell nests most commonly found in
Walthard cell nests, are a benign cluster of epithelial cells most commonly found in - Most commonly found in Fallopian tubes, but also seen in the mesovarium, mesosalpinx and ovarian hilus
Pseudo-pseudo Meigs' syndrome is associated with -
Tjalma syndrome or pseudo-pseudo Meigs' syndrome
characterized by
- pleural effusion,
- ascites
- elevated CA-125
- with no associated benign or malignant ovarian tumor
-Seen in a patient with systemic lupus erythematosus (SLE).
Which is the largest benign ovarian tumor?
MUCINOUS CYST ADENOMA
What is the most common complication of dermoid cyst?
Torsion is the most common (15–20%)
Rupture is an uncommon (1%) complication
Malignancy is rare - about 1–2 percent
Walthard cell rest found in -
Histologically islands of transitional epithelium - Walthard nests.
Rokitansky’s protuberance seen in which of the following cases?
Rokitansky nodule or dermoid plug refers to a solid protuberance projecting from an ovarian cyst
Rokitansky’s protuberance
- Dermoid cyst of ovary
- Area of solid projection called Rokitansky’s protuberance which is covered by skin with sweat and sebaceous glands.
- It is here that teeth and bones are found.
- Section should be made from this area
Which is the commonest functional cysts in ovary?
Follicular cyst is the commonest functional cysts.
Meigs’ syndrome has all of the following EXCEPT
Meigs’ syndrome:
Ascites
Right side hydrothorax
Benign ovarian tumor -fibroma of the ovary, Brenner, thecoma and granulosa cell tumor
Diagnostic criteria -Type -2 Diabetes
Diagnostic criteria by the American Diabetes Association (ADA) include the following: A fasting plasma glucose…
INFO-CARDS : Medicine Review -2
Type 2 Diabetes ADA Diagnosis Criteria
Impetigo
Endometriosis
Duke criteria
Type 2 Diabetes Diagnosis
Hanifin and Rajka criteria
Skin Punch Biopsy
Theca lutein cysts
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Hyponatremia
What is the sodium level below which symptomatic hyponatremia occurs? MCQSymptomatic hyponatremia usually does not…
Spasticity and Rigidity
What is Spasticity? Increased tone of muscles called as spasticitySpasticity – Resistance determined by the…
Hürthle Cells
What is a Hürthle Cell? Hürthle cell is used to describe follicular-derived epithelial cells with oncocytic cytology. Oncocytes…
Medicine MCQs-8 : Frostbite
Mildest form of peripheral cold injury is -
The mildest form of peripheral cold injury is frostnip, which tends to occur in apical structures (nose, ears, hands, feet), where blood flow is most variable because of the richly innervated arteriovenous anastomoses.
Most imminent threat to life in cold injuries is -
Systemic hypothermia - When hypothermia is identified, treatment should be instituted immediately with both passive and active rewarming measures
All of the following is non-freezing cold injury EXCEPT ?
Local cold injuries may be divided into freezing (frostbite) and nonfreezing (chilblains and immersion [trench] foot) injuries.
Mildest form of peripheral cold injury is frostnip
Snow blindness is produced by -
Snow blindness is produced by ultraviolet (UV) solar radiation reflected from snow, ice, or water. It tends to be more common at high altitudes, where the air filtration of UV radiation is diminished.
“chunk of wood” sensation in the extremity is seen in -
Frost bite - “chunk of wood” sensation in the extremity
Hospital-acquired AKI
Most common clinical settings for hospital-acquired AKI- sepsis- major surgical procedures- critical illness involving heart…
Medicine MCQs – 7
Randall's plaque is microscopically a plaque of -
Randall's plaque is microscopically a plaque of calcium deposited in the interstitial tissue of the renal papilla. These plaques are thought to serve as a nidus for urinary stone formation. Large amounts of Randall's plaque are unique to idiopathic calcium oxalate stone formers.
Which of the following stone formation is promoted by the alkaline urine (pH >7.2) and the presence of ammonia in the urine?
Two conditions must coexist for the formation of struvite calculi. These are (1) alkaline urine (pH >7.2) and (2) the presence of ammonia in the urine.
Struvite stones are also known as triple-phosphate (3 cations associated with 1 anion), infection (or infection-induced), phosphatic, and urease stones.
If a stone grows to more than ----- millimeters, it can cause blockage of the ureter
5 mm
Which of the following is used to differentiate between phleboliths and ureteric stone ?
"rim sign " - rim, ring, or halo of soft tissue visible on CT scans that completely surrounds ureteral stones.
The effect is enhanced by the local inflammation a stone produces in the ureteral wall, with subsequent edema at the site of the calculus.
The rim sign is generally missing or incomplete with phleboliths.
Urease-positive bacteria increase chances of which of the following stone formation?
Urease-positive bacteria, such as Proteus mirabilis can produce the enzyme urease, which converts urea to ammonia and carbon dioxide.
This increases the urinary pH and promotes struvite stone formation.
Which of the following microorganism is not associated with struvite stone formation in urinary tract.
Struvite stones are formed by urinary tract infection with urease producing bacteria that splits urea to ammonium, and increases urine pH to neutral or alkaline values.
Organisms splitting urea are Proteus, Pseudomonas, Klebsiella, Staphylococcus, and Mycoplasma.
E coli is not associated with struvite stones
Which of the following is the diagnostic method to detect kidney stones?
helical CT scan with 5 millimeters (0.2 in) sections is the diagnostic method to use to detect kidney stones and confirm the diagnosis of kidney stone disease
Adding contrast to the CT scan study may sometimes help clarify a difficult or confusing case but in general, contrast obscures calcific densities and as such, contrast scans are usually only indicated during subsequent evaluation of patients with stones.
The noncontrast CT is the cornerstone of initial radiographic assessment.
All of the following true for Struvite stone EXCEPT ?
Struvite readily forms in alkaline conditions.
Potentiated by alkaline urine and high magnesium excretion
Which of the following is most common type of kidney stone?
Calcium oxalate: The most common type of kidney stone
High dietary intake of potassium appears to reduce the risk of stone formation because potassium promotes the urinary excretion of citrate, an inhibitor of calcium crystal formation.
What is the composition of Jackstone calculus?
Jackstone calculi - almost always composed of calcium oxalate dihydrate and consist of a dense central core and radiating spicules.
Medicine MCQs -6 : Folates
Large amounts of supplemental folic acid can hide ------------- deficiency
Large amounts of supplemental folic acid can hide vitamin B12 deficiency
Risk of neural tube defects is associated with deficiency of -
Folic acid is- supplement by women during pregnancy to reduce the risk of neural tube defects
Elevated Methyl malonic acid levels indicate ---------- deficiency
Please select 2 correct answers
vitamin B12
Which vitamin deficiency causes 'methylfolate trap' ?
Vitamin -B12 -
THF starvation or the methylfolate trap:
MTHF accumulates in plasma
Intracellular folate concentrations fall due to failure of formation of THF
Which of the following mediates uptake of methotrexate by cells?
Reduced folate transporter -mediates uptake of methotrexate by cells.
Folate is also known as -
Folate- vitamin B9 https://medicalwikipedia.org/
Vitamin B1
Thiamine
Required as coenzyme in the catabolism of sugars and amino acids.
Vitamin B2
Riboflavin
A precursor of coenzymes called FAD and FMN, which are required for flavoprotein enzyme reactions. Vitamin B3
Niacin (nicotinic acid)
A precursor of coenzymes called NAD and NADP required for metabolic processes.
Nicotinamide
Nicotinamide riboside
Vitamin B5
Pantothenic acid
A precursor of coenzyme A
metabolize many molecules.
Vitamin B6
Pyridoxine
Required as coenzyme in metabolism.
Pyridoxal
Pyridoxamine
Vitamin B7
Biotin
Coenzyme for carboxylase enzymes
Required for of fatty acids and in gluconeogenesis.
Vitamin B9
Folate
Required for repair, and methylate DNA;
Cofactor in various reactions involving rapid cell division and growth, such as in infancy and pregnancy.
Vitamin B12
Cobalamins
Coenzyme involved DNA synthesis and regulation,fatty acid metabolism and amino acid metabolism.
All of the following enzyme deficiency cause homocystinuria EXCEPT ?
Deficiency of enzymes that cause homocystinuria -
- Methionine synthase
- MTHFR
- Cystathionine synthase
Deficiency of iron may be masked by which vitamin deficiency?
Deficiency of folic acid or vitamin B12 may mask the deficiency of iron
Folates are best absorbed from -
Folates are best absorbed from the upper small intestine
Which is the most frequently affected tissues in folate and vitamin - B12 deficiency?
Marrow - most commonly affected tissue in folate and vitamin - B12 deficiency
Next most frequently affected tissues are -
Mouth,
Stomach,
Small intestine
Respiratory,
Urinary,
Female genital tracts.
Gastric cells
Gastric cells Cells found in the gastric glands include CellsAlso calledSecret1Foveolar cellsMucous neck cells Mucus2Chief…
Megaloblastic Anemia MCQs
Cobalamin requires Intrinsic Factor for absorption in ------------ cases
Cobalamin requires IF for absorption - 99%. Free cobalamin is absorbed passively in the terminal ileum -1%. This why oral replacement with large vitamin is required in pernicious anemia
Which of the following is major natural cobalamin?
Forms of cobalamin -
• Adenosylcobalamin • Cyanocobalamin • Hydroxocobalamin • Methylcobalamin
Intrinsic Factor for Vitamin -B12 is produced by which cells?
IF is produced in the gastric parietal cells of the fundus and body of the stomach, and its secretion parallels that of hydrochloric acid.
Gastric cells -
Cells found in the gastric glands include -
-Foveolar cells - also called mucous neck cells - produce mucus
-Chief cells - Zymogen cells/ peptic cells - zymogens – pepsinogen (precursor to pepsin) and prorennin [in childhood only ]
-Parietal cells - oxyntic cells -secrets : HCl , castle's intrinsic factor
-G cells - secret : gastrin hormone
-D-cells - secret : somatostatin
-Enterochromaffin- like cells (ECLs) - release serotonin and histamine
Methylmalonyl coenzyme A mutase uses -------------- to convert L-methylmalonyl-CoA to succinyl-CoA, an important step in the catabolic breakdown of some amino acids into succinyl-CoA.
Methylmalonyl coenzyme A mutase (MUT) is an isomerase enzyme which uses the Adenosylcobalamin form to convert L-methylmalonyl-CoA to succinyl-CoA, an important step in the catabolic breakdown of some amino acids into succinyl-CoA, which then enters energy production via the citric acid cycle.
Methylmalonyl-CoA mutase (MCM) [mitochondrial] also known as methylmalonyl-CoA isomerase
Methylmalonyl-CoA mutase is a vitamin B12-dependent enzyme that catalyzes the isomerization of methylmalonyl-CoA to succinyl-CoA in humans. This functionality is lost in vitamin B12 deficiency, and can be measured clinically as an increased serum methylmalonic acid (MMA) concentration.
Bioactive forms of vitamin B12 in mitochondria?
Bioactive forms of vitamin B12 -
• Methylcobalamin in cytosol
• Adenosylcobalamin in mitochondria
Transcobalamin-1 [Haptocorrin] is derived primarily from -
Transcobalamin-1 [Haptocorrin] is derived primarily from the specific granules in neutrophils.
Which of the following helps in protection of the acid-sensitive vitamin B12 while it moves through the stomach?
Essential function of haptocorrin is protection of the acid-sensitive vitamin B12 while it moves through the stomach
Cubilin receptors are present in -
Cubilin receptors are present in -
- Ileum - helps to absorb Vitamin B12 - IF Complex
- Yolk sac
- Renal proximal tubular epithelium
Cobalamin is synthesized by -
Cobalamin is synthesized solely by microorganisms.
Which of the following has a cobalt atom at the center of a corrin ring?
Vitamin B12 - has a cobalt atom at the center of a corrin ring.
Haptocorrin
Follow the link to Get Answers Contents What are the other names of Haptocorrin?What is…