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Home > MCQs > PGI > 2003 June > Medicine

All of the following are treatments for hypercalcemia, except?
A. Levamisole
B. Plicamycin
C. Streptozocin
D. Saline diuresis and hydrocholorothiazide
E. Gallium nitrate

Ans: B, D, E
[Ref: Harrison's 15th][Contributed by "Dr. Rohit Tekriwal" via email]
[Explanation -

A. Levamisole - is indicated in combination with fluorouracil for the treatment of Dukes C adenocarcinoma of the colon (after complete resection of the primary tumor)
So, this is not a treatment

B. Plicamycin - inhibits bone resoprtion, useful agent, now little used because of effectiveness of biphosphonates.
So, this is true

C. Streptozocin - antineoplastic drug used in islet cell carcinoma, pancreatic carcinoma, metastatic nonislet cell carcinoma of pancreas
So, it is not a treatment for hypercalcemia

D. Forced diuresis - with saline plus loop diuretic is used [not thiazide, at it can cause hypercalcemia]
So, this option is not used

E. Gallium nitrate - hypocalcemic action by inhibition of bone resorption and altering structure of bone crystals.
Disadvantages - 5 day duration of infusion, risk of nephrotoxicity, shorter duration of action in comparison to biphosphonates. So, not often used.
But is a treatment , so this is true.]
Features of progressive systemic sclerosis are?
A. Aortic regurgitation
B. Antifibrillin antibodies
C. Calcinosis cutis
D. Raynaud's phenomenon
E. Sclerodactyly

Ans: B,C, D, E
[Ref: Harrison, 15th] [By "Dodgethis...!!!" at PGI FORUM, thanks...!!!]
[Contribute questions, options, answers, explanations, to mcqs@netmedicos.com ]
[Explanation -

Cardiac manifestations of PSS - Pericarditis with or without effusions, heart failure, heart blocks or arrhythmias,Cardiomyopathy(due to myocardial fibrosis)
[Aortic regurgitation is not seen]
Development of calcinosis cannot be prevented and these deposits cannot be dissolved (Warfarin reduces incidence of calcinosis in some)
Antibodies in PSS -
Antinuclear antibodies -
     antitopoisomerase 1 (Scl-70),
     antinucleolar, and
     anticentromere.

Of these the antinucleolar antibodies are -
     Anti-RNA polymerases I, II, and III
     Anti-Th RNP
    Anti-PM-Scl,
    Anti-U3 RNP (anti-fibrillarin) is also highly specific for SSc
    Anti-U1 RNP is found in ~5 to 10% of SSc patients
    Anti-SS-A (Ro) and/or anti-SS-B (La)

Raynaud's phenomenon - occurs in 95% pts of PSS
Sclerodactyly - may persist even after treatment]
Acute phase reactants include?
A. Albumin
B. Alpha 1 amyloid protein
C. Fibrinogen
D. Haptoglobulins
E. Globulins

Ans: B, C, D
[Additions by "Tom", thanks...!!!]
[Explanation -

Acute phase reactants include -
1. Fibrinogen - is an acute phase reactant - Harrison's 15th, Chapter242
2. Ferritin - Harrison's 15th, Chapter61
3. Ceruloplasmin - Harrison's 15th, Chapter75
4. alpha 1 acid glycoprotein - Harrison's 15th, Chapter 70
5. Serum Amyloid A (AA amyloid) - Harrison's 15th, Chapter273
6. Thrombocytosis - Harrison's 15th, Chapter317]
Increased LAP scores are seen in ?
A. Chronic myeloid leukemia
B. Hodgkin's disease
C. Aplastic anaemia
D. Paroxysmal noctural hemoglobinuria
E. Polycythemia

Ans: E
[Contribute questions, options, answers, explanations, to mcqs@netmedicos.com ]
[Explanation -

Increased LAP (Leucocyte Alkaline Phosphatase) Scores are seen in -
1. Polycythemia Vera
2. Idiopathic myelofibrosis - may be elevated, normal or low
3. Essential thrombocytosis - either normal or elevated
4. Therapeutic use of G-CSF
Low LAP scores are seen in -
1. Chronic myeloid leukemia
2. Idiopathic myelofibrosis - either elevated, normal or low]
The true statement (s) about acanthosis nigricans include?
A. It is associated with obesity
B. It is associated with insulin resistance
C. There is hyperpigmentation
D. It occurs in axillary region
E. It is a marker for internal malignancies

Ans: A,B,C,D,E
[Contribute questions, options, answers, explanations, to mcqs@netmedicos.com ]
[Explanation -
Read about Acanthosis nigricans here]
Regarding bronchial asthma, the true statements is/are ?
A. Increased FVC
B. Decreased PEF
C. Increased DLCO
D. Increased FRC
E. Increased Tidal volume

Ans: B, D
[Corrected by "Tom" via email, thanks...!!!]
[Explanation -

In Bronchial asthma we see -
1. Forced vital capacity - reduced
2. FEV1 - reduced
3. PEFR - reduced
4. Residual volume - increased (may be upto 400% of normal)
5. FRC - increased (may be double)
6. Tidal volume - reduced (due to increased airway resistance)
7. DCLO - ?]
Reduction of blood cholesterol levels is achieved by ?
A. Regular exercise
B. Increased vegetable and fibre in diet
C. Increased saturated fatty acid in diet
D. Decreased total fat intake
E. Increased polyunsaturated fatty acid in diet

Ans: A, B, D, E
[Additions by "Tom" via email, thanks...!!!][Ref: Harrison's 15th, Ch.344]
[Explanation -

Dietary Measures to reduced cholesterol levels -
1. Diet low in cholesterol
2. Diet reduction of total fat intake
3. Diet low in saturated fat
4. Increase polyunsaturated fatty acid in diet (as hydrogenated vegetable oils, raise LDL and lower HDL cholesterol levels
5. Replacement of fat in diet with complex carbohydrates, fresh fruits and vegetables]
All of the following statements are true about a man suffering from low back pain with progressive stiffness of the back, except?
A. Association with HLA B 27
B. Association with Anterior uveitis
C. More commonly seen in females
D. Xrays of Sacroiliac joints may be helpful
E. Xrays of Abdomen is useful

Ans: ? C/E
[Contribute questions, options, answers, explanations, to mcqs@netmedicos.com ]
Diseases caused by Prions include ?
A. Alzheimer's disease
B. Creutz feldt Jacob's disease
C. Familial fatal insomnia
D. Gerstmann Strausler Disease
E. Hungtington's disease

Ans: B,C,D
[Ref: Harrison's 15th][Contributed by "Tom" thanks...!!!]
[Explanation -

Prion diseases in humans are -
1. Kuru
2. Creutz Feldt Jacob disease
3. Gerstmann Straussler Scheinker disease
4. Familial fatal insomnia
5. Sporadic fatal insomnia]

Palpable Purpura is seen in?
A. TTP
B. HUS
C. DIC
D. Scurvy
E. Henoch Schonlein Purpura

Ans: E
[Ref: Harrison's 15th][Supported by "Tom" thanks...!!!]
[Explanation -

Palpable purpura	Non palpable purpura

Henoch Scholein purpura Infections - Acute meningococcemia Disseminated gonococcal infection Rocky mountain spotted fever Ecthyma gangrenosum Infective endocarditis Vasculitis - Polyarteritis nodosa Wegener's granulomatosis Hypersentive vasculitis / Cutaneous leukocytoclastic vasculitis Drug induced vasculitis Necrotizing vasculitis	Cutaneous - Trauma Steroid purpura Solar purpura Capillaritis Livedoid vasculitis Systemic - Vascular fragility - Scurvy Ehlers-Danlos syndrome Amyloidosis Clotting abnormalities - Thrombocytopenia (eg TTP) / Platelet function defect Clotting factor defect Thrombi - DIC Monoclonal cryoglobulinemia TTP Warfarin drug reaction Embolic - Cholesterol & Fat Immune complex - Gardner Diamond syndrome Waldenstrom's macroglobulinemia

So, we see that E is the answer]

Peripheral neuropathy is seen in all of the following conditions, except?
A. Diabetes Mellitus
B. Polyarteritis Nodosa
C. SLE
D. Tuberculosis
E. Vitamin B 12 deficiency

Ans: D
[Solution by "Tom" via email, thanks...!!!]
Among the following, the ones that predispose a patient to (?pre) hepatic encephalopathy) is/are ?
A. Bacterial peritonitis
B. Constipation
C. Dehydration
D. Haemorrhage
E. Hyperkalemia

Ans: A, B, C, D
[Solution by "Tom" via email, thanks...!!!]
[Explanation -

C - dehydration produces hypovolemia and electrolyte disturbances leading to hepatic encephalopathy
So, this is correct

E - Hypokalemia / Alkalosis predisposes to hepatic encephalopathy
So, this is incorrect]
True statment(s) regarding alpha - 1 - antitrypsin deficiency include?
A. It is inherited as autosomal recessive
B. It is associated with enzyme defect
C. It has an association with emphysema
D. There is presence of Orcein positive granules in the liver
E. There is presence of PAS positive diastase resistant granules in the liver

Ans: B, C, E
[Supported by "Tom" via email, thanks...!!!]
[Explanation -

A. Inheritance of alpha-1-antitrypsin deficiency is - autosomal codominant - so it is false
B. It is associated with antiprotease deficiency - so this is true
C. Deficiency of alpha-1-antitrypsin is the only genetic abnormality specifically linked to COPD (i.e. emphysema & chronic bronchitis) - so this is true
D. ?
E. The hepatocytes contains granules which is PAS positive - so true]
Transient weakness is seen in?
A. Hypokalemia
B. Lambert Eaton syndrome
C. Guillain Barre syndrome
D. Myasthenia gravis
E. Multiple sclerosis
[Contribute questions, options, answers, explanations, to mcqs@netmedicos.com ]
The infusion of glucose in a suspected case of hypoglycemia coma is based upon?
A. Clincial assessment only
B. After blood glucose estimation
C. After urinary glucose determination
D. After excluding electrolyte imbalance
E. After endocrinologist consultation

Ans: A
[Contribute questions, options, answers, explanations, to mcqs@netmedicos.com ]
Extrahepatic biliary obstruction is associated with?
A. Conjugated hyperbilirubinemia
B. Ascites
C. Malabsorption
D. ↑ serum alkaline phosphatase
E. Pale stools

Ans: A, C, D, E
[Contribute questions, options, answers, explanations, to mcqs@netmedicos.com ]
Secretory diarrhoea is caused by?
A. Carcinoid tumor
B. Gastrinoma
C. Lactase deficiency
D. Mastocytosis
E. Short bowel syndrome

Ans: A, B, D, E
[Contribute questions, options, answers, explanations, to mcqs@netmedicos.com ]
[Explanation -

Secretory diarrhoea is caused by -
1. Laxatives / drugs / toxins
2. Chronic alcohol ingestion
3. Bowel resection, disease or fistula (due to decreased absorption), obstruction or fecal impaction
4. Hormone producing tumors (Carcinoid, Mastocytosis, Gastrinoma, Colorectal villous adenoma, VIPoma, Meduallary cancer of thyroid
5. Addison's disease
6. Congenital defects of electrolyte absorption
7. Idiopathic
Lactase and other diasaccharidase deficiency causes - osmotic diarrhoea]
Herpes Zoster infection in a patient suggests that he is suffering from?
A. Nephrotic syndrome
B. HIV
C. Leukemia
D. Lymphoma
E. Diabetes mellitus
[Contribute questions, options, answers, explanations, to mcqs@netmedicos.com ]
A non-alcoholic, diabetic patient with increased serum ferritin levels and hyperpigmentation, may be suffering from ?
A. Aceruloplasminemia
B. Atransferrinemia
C. Sideroblastic anaemia
D. Thalassemia
E. Wilson's disease

Ans: B
[Solution by "Tom" via email, thanks...!!!]
[Explanation - This is a case of haemochromatosis]
Diabetes mellitus is associated with all of the following except?
A. Encephalopathy
B. Myopathy
C. Myelopathy
D. Myelitis
E. Neuropathy

Ans: C, D (?)
[Solution by "Tom" via email, thanks...!!!]
[Explanation -
Encephalopathy occurs - due to hypo / hyper glycemia
Myelopathy is not mentioned
Neuropathy is seen in DM]
A patient presented with headache, and his blood pressure was found to be 190/120. The management may be with?
A. Beta blockers
B. Oral enalapril
C. Sublingual nifedipine
D. Intravenous enalapril
E. I.V. nitroglycerine

Ans: B/C??
[Solution by "Tom" via email, thanks...!!!]
The hormone that is predominantly secreted by an extra-adrenal phaeochromocytoma is?
A. Dopamine
B. Norepinephrine
C. Epinephrine
D. Phenylalanine
E. VMA

Ans: B
[Supported by "Tom" via email, thanks...!!!]
[Explanation -
1. Most pheochromocytoma secrete both epi and norepinehprine, but percentage of NORepinephrine is greater.
2. Most extraadrenal pheochromocytomas - secrete NORepinephrine
3. Rarely - only epinephrine is produced, esp,. in association with MEN syndrome]
There is an association of pulmonary hypertension with?
A. Myocardial infarction
B. Bronchial asthma
C. Congestive cardiac failure
D. Interstitial lung fibrosis
E. Mitral stenosis

Ans: A, B, C, D, E
[Solution by "Tom" via email, thanks...!!!]
Paraneoplastic effects in a patient of bronchogenic carcinoma, include?
A. Addison's disease
B. Cushing's syndrome
C. Hypercalcemia
D. Jaundice
E. Lytic bone lesions

Ans: A, B, C,
[Supported by "Tom" via email, thanks...!!!]
"Susruha Samhita" was translated by?
A. Bernard
B. Bagha bhatta
C. Milliard
D. Celsius
E. Maurice
[Contribute questions, options, answers, explanations, to mcqs@netmedicos.com ]
A patient was brought to the emergency with dehydration, Blood pressure was 90/70 mm of Hg, and blood examination revealed a pH of 7.28. Further management includes?
A. Adrenaline injection
B. Potassiym supplementation
C. Dopamine infusion
D. Bicarbonate injection
E. I.V. fluids to correct dehydration
[Contribute questions, options, answers, explanations, to mcqs@netmedicos.com ]
Acute injury to lungs is associated with?
A. pericardial effusion
B. pulmonary parenchymal oedema
C. normal pulmonary capillary wedge pressure
D. selective dilatation of pulmonary blood vessels
E. Shunting of blood

Ans: B,C,D, E
[Solution by "Tom" via email, thanks...!!!]
[Explanation - This is a case of ARDS]
Vanishing bile duct syndrome is assciated with?
A. Polyarteritis nodosa
B. Graft verus host disease
C. Hepatitis C
D. Sarcoidosis
E. Non - cirrhotic portal fibrosis
[Contribute questions, options, answers, explanations, to mcqs@netmedicos.com ]

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