Q-261. All of the following are the known cause of osteoporosis except
Fluorosis is not associated with osteoporosis but associated with osteo-sclerosis.
Osteoporosis and endocrine disorders:
DM type II
Acromegaly, Cushing’s syndrome
Q-262. Which of the following is not a feature of hyper-calcemia?
Features of hyper-calcemia:
Polyuria and nocturia
ECG findings: Short QT interval
Q-263. The most common location of hypertensive intracranial hemorrhage is:
a) Subarachnoid space
b) Basal ganglia
Answer: Basal ganglia
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)
The putamen/ basal ganglia are the most common site for hypertensive hemorrhage.
Q-264. The common cause of subarachnoid hemorrhage is
a) Arterio- venous malformation
b) Cavernous angioma
The most common cause of subarachnoid hemorrhage is rupture os saccular aneurysm, Berry aneurysm and most commonly occur in the anterior circulation on the circle of the Willis (Excluding head trauma).
Q-265. Which one of the following agents has been associated with hemorrhagic stroke?
Similar to ephedrine
Used in oral decongestant combination remedies
Used for weight loss as appetitic suppressant.
Its use is associated with hemorrhagic stroke.
Q-266. Which of the following is the most common type of glial tumors?
Astrocytoma is the most common primary intra-cranial neoplasm.
Q-267. Brain abscess in cyanotic heart disease is commonly located in
a) Cerebellar hemisphere
c) Temporal lobe
d) Parietal lobe
Answer: Parietal lobe
Brain abscess associated with congenital heart disease:
The abscesses are located in the parietal, frontal, and temporal lobes.
Parietal and frontal lobe are most common sites because of middle cerebral artery embolization in congenital heart disease.
Q-268. Which one of the following clinical findings excludes the diagnosis of Polymyositis?
a) Neck muscle involvement
b) Extra-ocular muscle involvement
d) Abdominal muscle involvement
Answer: Extra-ocular muscle involvement
Extra-ocular muscle and facial muscle involvement exclude the diagnosis of Polymyositis.
Q-269. A young girl has consumed barium carbonate with suicidal intent. She complains of generalized muscle weakness. The most likely electrolyte is
Barium carbonate ingestion results into hypo-kalemia due to large shift of extra-cellular potassium into muscle.
Q-270. All of the following statements regarding primary effusion lymphoma are true except
a) It generally presents in elderly patients
b) There is often an association with HHV-8
c) The proliferating cells are NK cells
d) Patients are commonly HIV positive
Answer: The proliferating cells are NK cells
Primary effusion lymphoma is rare subtype of diffuse large B-cell lymphoma.
Primary effusion lymphoma may also be called body cavity lymphoma.
Primary effusion lymphoma is linked to human herpes virus 8 (HHV8) infections. It is also associated with Epstein-Barr virus (EBV) infection in many cases.
Primary effusion lymphoma most often occurs in people with weakened immune systems, such as those with HIV/AIDS.
Q-271. A patient with leukemia on chemotherapy develops acute right lower abdominal pain associated with anemia, thrombocytopenia and leucopenia. Which of following is the clinical diagnosis?
b) Leukemic colitis
c) Perforation peritonitis
d) Neutropenic colitis
Answer: Neutropenic colitis
Neutropenic entero-colitis, also known as typhlitis is an acute life-threatening condition classically characterized by trans-mural inflammation of the caecum, often with involvement of the ascending colon and ileum, in patients who are severely myelo-suppressed.
Most patients who are affected with neutropenic entero-colitis are receiving anti-neoplastic drugs and are profoundly neutropenic.
Symptoms include the following:
Right lower quadrant abdominal pain, which may be cramping and intermittent or a continuous dull ache
Watery or bloody diarrhea
Q-272. All of the following are major complications of massive transfusion except
Major complications of massive transfusion:
Decreased 2, 3 DPG
Q-273. All of the following are risk factors for atherosclerosis except
a) Increased waist-hip ratio
c) Decreased fibrinogen levels
d) Decreased HDL levels
Answer: Decreased fibrinogen levels
Increased level of fibrinogen is associated with increased risk of atherosclerosis.
Q-274. All of the following may occur due to hyper-kalemia, except:
a) Prolonged PR interval
b) Prolonged QRS interval
c) Prolonged QT interval
d) Ventricular asystole
Answer: Prolonged QT interval
ECG findings in hyper-kalemia:
Prolonged PR interval
Prolonged QRS interval
Q-275. All of the following may be seen in patients of cardiac tamponade except
a) Kussmaul’s sign
b) Pulsus paradoxus
c) Electrical Alternans
d) Right ventricular diastolic collapse on echocardiogram
Answer: Kussmaul’s sign
Q-276. All of the following are true for mitral valve prolapse except
a) Transmission may be as an autosomal dominant trait
b) Majority of cases present with features of mitral regurgitation
c) The value leaflets characteristically show Myxomatous degeneration
d) The disease is one of the common cardiovascular manifestations of Marfan’s syndrome
Answer: Majority of cases present with features of mitral regurgitation
Mitral valves prolapse:
Floppy or Myxomatous mitral valve
Associated with skeletal deformities (Pectus excavatum, scoliosis) and systemic collagen abnormality (Marfan or Ehlers Danlos syndrome)
Most patients are female.
Single or multiple mid-systolic clicks and pansystolic or late systolic murmur
Echocardiography is confirmatory.
Q-277. Sudden cardiac death may occur in all of the following except
a) Dilated cardiomyopathy
b) Hypertrophic cardiomyopathy
c) Eisenmenger’s syndrome
d) Ventricular septal defect
Answer: Ventricular septal defect
Causes of sudden cardiac death:
Coronary artery disease
Long QT syndrome
Ventricular arrhythmia- Eisenmenger’s syndrome
Electrolyte imbalance (Hypo-kalemia)
Q-278. Which of the following is least likely to cause infective endocarditis?
a) Staphylococcus albus
b) Streptococcus fecalis
c) Salmonella typhi
d) Pseudomonas aeruginosa
Answer: Salmonella typhi
Causes of infective endocarditis:
Staphylococcus albus- Prosthetic valve endocarditis
Streptococcus fecalis- Most common cause of entero-coccal infective endocarditis
Pseudomonas aeruginosa- Infective endocarditis in drug users
Q-279. Mycotic aneurysm is an aneurysm infected because of
a) Fungal infection
b) Blood- borne infection (intra-vascular)
c) Infection introduced from outside (extra-vascular)
d) Both intravascular and extra-vascular infection
Answer: Both intravascular and extra-vascular infection
Mycotic aneurysms are an aneurysm arising from infection of the arterial wall, usually bacterial.
Origin of infections:
Primary or cryptogenic origin
Osler first used the term “mycotic aneurysm” in 1885 to describe a mushroom-shaped aneurysm in a patient with sub-acute bacterial endocarditis.
This may create considerable confusion, since “mycotic” is typically used to define fungal infections.
Q-280. Mycotic abscesses are due to
a) Bacterial infection
b) Fungal infection
c) Viral infection
d) Mixed infection
Answer: Fungal infection
Mycotic abscess is characterized by a soft, cystic mass without or with mild inflammation caused by fungal infections.