Question Bank

Nephrology MCQs-3

Contents1 Most common primary inherited aminoaciduria-2 Most common cause of autosomal recessive proximal renal tubular...


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 -

Correct! Wrong!

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?

Correct! Wrong!

Most common tissue elements are ectodermal

Walthard cell nests most commonly found in

Correct! Wrong!

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 -

Correct! Wrong!

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?

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MUCINOUS CYST ADENOMA

What is the most common complication of dermoid cyst?

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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 -

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Histologically islands of transitional epithelium - Walthard nests.

Rokitansky’s protuberance seen in which of the following cases?

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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?

Correct! Wrong!

Follicular cyst is the commonest functional cysts.

Meigs’ syndrome has all of the following EXCEPT

Correct! Wrong!

Meigs’ syndrome:
Ascites
Right side hydrothorax
Benign ovarian tumor -fibroma of the ovary, Brenner, thecoma and granulosa cell tumor

INFO-CARDS : Medicine Review -2

Type 2 Diabetes ADA Diagnosis Criteria

What is the HbA1C levels for diagnosis of Diabetes -Type2 in by the American Diabetes Association (ADA) diagnostic criteria?
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6.5% (48 mmol/mol) or higher

Impetigo

What is the diagnostic clinical features of impetigo
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Honeycolored crusts or bullae

Endometriosis

Which is the most common site for endometriosis?
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Ovary is the most common site for endometriosis.

Duke criteria

Duke criteria for the diagnosis of
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Infective Endocarditis

Type 2 Diabetes Diagnosis

In Type 2 Diabetes ADA Diagnosis Criteria what is the Fasting Plasma Glucose level
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Fasting plasma glucose (FPG) level of 126 mg/dL (7.0 mmol/L) or higher

Hanifin and Rajka criteria

Hanifin and Rajka criteria is used for which disease diagnosis
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Atopic Dermatitis

Skin Punch Biopsy

What is the most commonly used sizes for diagnostic biopsies in skin punch biopsy
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3 to 4 mm.

Theca lutein cysts

What is the cause of Theca lutein cysts?
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Theca lutein cysts are due to excessive gonadotropin (endogenous or exogenous) stimulation of the ovaries

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Hyponatremia

What is the sodium level below which symptomatic hyponatremia occurs? MCQSymptomatic hyponatremia usually does not…

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 -

Correct! Wrong!

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 -

Correct! Wrong!

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 ?

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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 -

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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 -

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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…

Renal Stones MCQs

Medicine MCQs – 7

Randall's plaque is microscopically a plaque of -

Correct! Wrong!

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?

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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

Correct! Wrong!

5 mm

Which of the following is used to differentiate between phleboliths and ureteric stone ?

Correct! Wrong!

"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?

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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.

Correct! Wrong!

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?

Correct! Wrong!

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 ?

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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?

Correct! Wrong!

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?

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Jackstone calculi - almost always composed of calcium oxalate dihydrate and consist of a dense central core and radiating spicules.

Medicine MCQs

Medicine MCQs -6 : Folates

Large amounts of supplemental folic acid can hide ------------- deficiency

Correct! Wrong!

Large amounts of supplemental folic acid can hide vitamin B12 deficiency

Risk of neural tube defects is associated with deficiency of -

Correct! Wrong!

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

Correct! Wrong!

vitamin B12

Which vitamin deficiency causes 'methylfolate trap' ?

Correct! Wrong!

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?

Correct! Wrong!

Reduced folate transporter -mediates uptake of methotrexate by cells.

Folate is also known as -

Correct! Wrong!

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 ?

Correct! Wrong!

Deficiency of enzymes that cause homocystinuria -


- Methionine synthase
- MTHFR
- Cystathionine synthase

Deficiency of iron may be masked by which vitamin deficiency?

Correct! Wrong!

Deficiency of folic acid or vitamin B12 may mask the deficiency of iron

Folates are best absorbed from -

Correct! Wrong!

Folates are best absorbed from the upper small intestine

Which is the most frequently affected tissues in folate and vitamin - B12 deficiency?

Correct! Wrong!

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.

Medicine MCQs – 6 : Folates

Medicine Question Bank

Gastric cells

Gastric cells Cells found in the gastric glands include CellsAlso calledSecret1Foveolar cellsMucous neck cells Mucus2Chief…

Megaloblastic Anemia

Megaloblastic Anemia MCQs

Cobalamin requires Intrinsic Factor for absorption in ------------ cases

Correct! Wrong!

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?

Correct! Wrong!

Forms of cobalamin -


• Adenosylcobalamin • Cyanocobalamin • Hydroxocobalamin • Methylcobalamin

Intrinsic Factor for Vitamin -B12 is produced by which cells?

Correct! Wrong!

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.

Correct! Wrong!

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?

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Bioactive forms of vitamin B12 -


• Methylcobalamin in cytosol
• Adenosylcobalamin in mitochondria

Transcobalamin-1 [Haptocorrin] is derived primarily from -

Correct! Wrong!

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?

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Essential function of haptocorrin is protection of the acid-sensitive vitamin B12 while it moves through the stomach

Cubilin receptors are present in -

Correct! Wrong!

Cubilin receptors are present in -


- Ileum - helps to absorb Vitamin B12 - IF Complex
- Yolk sac
- Renal proximal tubular epithelium

Cobalamin is synthesized by -

Correct! Wrong!

Cobalamin is synthesized solely by microorganisms.

Which of the following has a cobalt atom at the center of a corrin ring?

Correct! Wrong!

Vitamin B12 - has a cobalt atom at the center of a corrin ring.

Medicine Question Bank

Haptocorrin

Follow the link to Get Answers Contents What are the other names of Haptocorrin?What is…

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