Q-141. All of the following are true regarding a patient with acid peptic disease except
a) Misoprostol is the drug of choice in patients on NSAIDS
b) DU is preventable by the use of single night time H2 blockers
c) Omeprazole may help ulcer refractory to H2 blockers
d) Misoprostol is DOC in pregnant patients
Answer: Misoprostol is DOC in pregnant patients Explanation:
Misoprostol, a synthetic prostaglandin E1 has potent anti-secretory and cyto-protective effects on the gastric and duodenal mucosa which should make it an effective drug in the treatment of gastric and duodenal ulcer.
Because of the known uterotropic effect of prostaglandins the drug should not be used in pregnant women or women of child bearing age unless they are using adequate contraceptive measures.
Q-142. A man presents with mass at duodenojejunal flexor invading renal papillae. Histopathology reports it as lymphoma; true statement is
a) II E stage
b) III E stage
c) IV E stage
d) Staging cannot be done until bone marrow examination is performed
Answer: IV E stage
Explanation:
Cotswold’s modification of the original Ann arbor staging system for Lymphoma:
Stage I: One nodal group or organ
Stage II: Two or more nodal groups, same side of diaphragm
Stage III: Nodal groups on both sides of the diaphragm
Stage IV: Disseminated involvement of one or more extra-lymphatic organ (e.g. lung, bone) +/- any nodal involvement
E: Involvement of a single, extra-nodal site contiguous or proximal to a known nodal site (stages I to III only; additional extra-nodal involvement is stage IV)
Q-143. A 45 years male presents with hypertension. He has sudden abnormal flinging movements in right upper and lower limbs. Most likely site of hemorrhage is
a) Substantia nigra
b) Caudate nuclei
c) Pons
d) Sub-thalamic nuclei
Answer: Sub-thalamic nuclei
Explanation:
Site of hemorrhage or lesion: Abnormal movement
Caudate and putamen: Chorea
Globus pallidus (Lentiform nucleus): Athetosis
Substantia nigra: Parkinsonism
Sub-thalamic nuclei: Hemi-ballismus (Flinging movement of a proximal limb)
Q-144. True about hemophilia A are all except
a) PTT increased
b) PT increased
c) Clotting time is increased
d) Serum levels of factor VIII are decreased
Answer: PT increased
Explanation:
Prolonged PTT:
Deficiency of Factor I, II, VIII, IX, XI, XII and thrombin
Prolonged PT:
Deficiency of Factor I, II, V, VII and thrombin
Important point:
Hemophilia A occurs due to deficiency or reduced activity of factor VIII.
Q-145. IPPV can cause
a) Baro-trauma
b) Pleural effusion
c)
d) None of the above
Answer: Baro-trauma
Explanation:
Complications of Intermittent Positive Pressure Ventilation:
Baro-trauma
Nosocomial pneumonia
Oxygen toxicity
Tracheal stenosis
Deconditioning of respiratory muscles
Stress ulcer in GIT
Cholestasis
Q-146. Characteristic finding in CT in a TB case is
a) Exudates seen in basal cistern
b) Hydrocephalus is non-communicating
c) Calcification commonly seen in umbellium
d) Ventriculitis is a common carditis
Answer: Exudates seen in basal cistern
Explanation:
In tuberculosis meningitis (TBM), contrast-enhanced CT scanning of the brain depicts prominent lepto-meningeal and basal cistern enhancement.
Q-147. Vegetations on undersurface of A-V valves are found in
a) Acute rheumatic carditis
b) Limban sack’s endocarditis
c) Non thrombotic bacterial endocarditis
d) Chronic rheumatic carditis
Answer: Limban sack’s endocarditis
Explanation:
Libman-Sacks endocarditis is the most characteristic cardiac manifestation of the autoimmune disease systemic lupus erythematosus.
The condition most commonly involves the mitral and aortic valves and occurs on surface of cups. Both surface of may be involved, most common being the undersurface.
Q-148. Triage means
a) Sorting out of cases on availability of medical resources and severity of patients condition
b) Patients are divided into 3 groups
c) Severely injured patients are attended first in military camps
d) None of the above
Answer: Sorting out of cases on availability of medical resources and severity of patients condition
Explanation:
Triage systems are most often used following trauma incidents but may be required in other situations, such as an influenza epidemic.
Trauma triage is the use of trauma assessment for prioritizing of patients for treatment or transport according to their severity of injury.
Primary triage is carried out at the scene of an accident and secondary triage at the casualty clearing station at the site of a major incident.
Q-149. A 60 yr old man is suspected of having bronchogenic ca; TB has been ruled out in this pt. What should be the next investigation?
a) CT guided FNAC
b) Bronchoscopy and biopsy
c) Sputum cytology
d) X-ray chest
Answer: Bronchoscopy and biopsy
Explanation:
Screening of lung cancer:
Sputum cytology
Chest Radiography
Tissue diagnosis:
CT guided FNAC
Fibre optic bronchoscopy and bronchial or trans-branchial biopsy
HRTC if bronchoscopy is negative
Important points:
Fibre optic bronchoscopy allows visualization of the major airways, cytology brushing of visible lesions or lavage of lung segments with cytologic evaluation, direct biopsy of endo-branchial abnormalities, trans-bronchial biopsy of pulmonary parenchyma or peripheral nodules and FNA biopsy of mediastinal lymph nodes.
Q-150. A man presents with fever, wt loss and cough; Mantoux reads an induration of 17X19 mm, sputum cytology is negative for AFB. Most likely diagnosis is
a) Pulmonary tuberculosis
b) Fungal infection
c) Viral infection
d) Pneumonia
Answer: Pulmonary tuberculosis
Explanation:
Essentials of diagnosis of pulmonary tuberculosis:
Fever, fatigue, weight loss, night sweats, and cough
Positive tuberculin skin test reaction (In most cases)
Chest radiograph: Pulmonary infiltration, most often apical
Negative sputum cytology doesn’t rule out pulmonary tuberculosis.