Q-161. Which type diabetes is HLA associated
a) Type I diabetes
b) Type II diabetes
c) Malnutrition related type disease
d) Pregnancy related type diabetes
Answer: Type I diabetes
Explanation:
Most of patients with Type 1 DM possess either HLA-DR3 or HLA-DR4.
HLA-DQ genes are even more specific markers for type 1 susceptibility.
Q-162. All of the following are sexually transmitted except
a) Candida albicans
b) Echinococcus
c) Molluscum contagiosum
d) Group B streptococcus
Answer: Echinococcus
Explanation:
Echinococcosis occurs when humans are intermediate hosts for canine tapeworm.
Infection is acquired by ingesting food contaminated with canine feces containing parasite eggs.
After human ingest parasite eggs, the eggs hatch in the intestine to form oncospheres, which penetrate the mucosa, enter the circulation and encyst in specific organs as hydatid cysts.
E. granulosus forms the cysts most commonly in the liver (65 %) and lungs (25 %), but cyst may develop in any organs.
Q-163. All of the following infections may be transmitted via blood transfusion except
a) Parvo B-19
b) Dengue virus
c) Cytomegalovirus
d) Hepatitis G virus
Answer: Dengue virus
Explanation:
Blood transfusion associated viruses:
HVN
HGV
HBV
HIV I
HTLV I
CMV
Parvo Virus B-19
Q-164. Hypoglycemia is a recognized feature of all of the following conditions except
a) Uremia
b) Acromegaly
c) Addison’s disease
d) Hepato-cellular failure
Answer: Acromegaly
Explanation:
Causes of Hypoglycemia:
Hypothermia
Hormones deficiency:
Hypopituitarism
Adrenal insufficiency
Catecholamine deficiency
Glucagon deficiency
Enzyme defect:
Glucose 6 phosphatase
Liver diseases:
Hepatic congestion
Severe hepatitis
Cirrhosis
Important points:
Acromegaly is associated with hyperglycemia.
Fasting hypoglycemia is most commonly due to an adenoma of the islets of Langerhans. Ninety percent such tumors are single and benign. Multiple adenomas have been found in conjunction with MEN Type I.
Whipple triad: It includes hypoglycemic symptoms, fasting blood glucose of 45 mg/dl or less and immediate recovery upon administration of glucose.
Q-165. All of the following feature may be seen in thrombotic thrombocytopenic purpura except
a) Fever
b) Hemolysis
c) Hypertension
d) Low platelets count
Answer: Hypertension
Explanation:
Clinical features of thrombotic thrombocytopenic purpura:
Micro-angiopathic hemolytic anemia
Thrombocytopenia
Fever
Neurological defect
Renal insufficiency- Mild or absent
Decreased activity of ADAMTS-13
Normal routine coagulation studies
Q-166. The following laboratory determinants is abnormally prolonged in ITP
a) APTT
b) Prothrombin time
c) Bleeding time
d) Clotting time
Answer: Bleeding time
Explanation:
Parameter of Thrombocytopenia:
Bleeding time
Parameters of Coagulation disorders:
Clotting time
Prothrombin time
APTT
Q-167. PNH is associated with all of the following condition except
a) Aplastic anemia
b) Increased LAP scores
c) Venous thrombosis
d) Iron deficiency anemia
Answer: Increased LAP scores
Explanation:
Leukocyte alkaline phosphatase (LAP):
An obsolete test and measured as the LAP score
Low LAP score: CML and paroxysmal nocturnal hemoglobinuria (PNH)
Paroxysmal nocturnal hemoglobinuria (PNH):
It is hematopoietic stem cell disorder and may progress to Aplastic anemia or myelo-dysplasia or AML.
Hemolytic anemia
Venous thrombosis especially mesenteric and hepatic vein
Hyper-coagulability due to complement activation
Laboratory findings of PNH:
Iron deficiency anemia due to chronic iron loss
Elevated serum LDH
TLC and platelets may be decreased
Best screening test is flow cytometry to demonstrate deficiency of CD59 and CD55 on RBCs.
Q-168. A 20 year adult presents with severe hypo-plastic anemia. What is most effective treatment?
a) Alpha-interferon
b) IL-2
c) ATG therapy
d) Bone marrow transplant
Answer: Bone marrow transplant
Explanation:
Aplastic anemia:
Hallmark of Aplastic anemia is pancytopenia.
Bone marrow aspirates- Hypo-cellular with normal hematopoietic progenitors
Treatment of mild cases:
Antibiotics and RBC and platelets transfusion
Treatment of severe cases:
Hematopoietic stem cell transplantation or bone marrow transplantation
Criteria of severe Aplastic anemia:
Neutrophil count < 500/mcL Platelets < 20,000/mcL Reticulocyte < 1 % Bone Marrow Cellularity < 20 % Q-169. Which of the following is not commonly seen in polycythemia Vera? a) Thrombosis b) Hyper-uricemia c) Prone for acute leukemia d) Spontaneous severe manifestations Answer: Spontaneous severe manifestations Explanation: Polycythemia Vera: An acquired myelo-proliferative disorder that causes overproduction of all three hematopoietic cell line (RBC, WBC and platelets) Generalized pruritis after warm shower related to histamine release from basophils. Splenomegaly Thrombosis (Most common complication) Peptic ulcer disease Low erythropoietin level Elevated B12 because of increased level of trans-cobalamin III secreted by WBCs Hyper-uricemia Absence iron store in bone marrow Important point: The diagnosis should be confirmed with finding of the JAK2 mutation.