Q-41. Incorrect statement (s) about small cell carcinoma of lung
a) Not associated smoking
b) Surgery is treatment of choice
c) Associated with para-neoplastic syndrome
d) Most patients have distant metastases on diagnosis
e) Contain neuro-secretory granules
Answer: a and b
Explanation:
Small cell lung cancer is a neuro-endocrine carcinoma that exhibits aggressive behavior, rapid growth, early spread to distant sites, exquisite sensitivity to chemotherapy and radiation, and frequent association with distinct para-neoplastic syndromes, including hyper-calcemia, Eaton-lambert syndrome, syndrome of inappropriate diuretic hormone, and many others.
The predominant cause of small cell lung cancer (SCLC) (and non-SCLC) is tobacco smoking.
Q-42. Features seen in Menkes disease is/are
a) Increased copper level
b) Decreased circulating cerulo-plasmin
c) Hypo-pigmented & brittle hair
d) Mental retardation
e) Failure to thrive
Answer: b, c, d and e
Explanation:
Menkes disease, also known as kinky hair disease, is an X-linked neurodegenerative disease of impaired copper transport.
Children with the classic form of Menkes disease usually present at 2-3 months of age with the following:
Loss of developmental milestones
Profound truncal hypotonia
Epilepsy
Failure to thrive
Kinky, colorless or steel colored hair
Q-43. Clubbing is/are seen in
a) Mesothelioma
b) Bronchial asthma
c) Idiopathic pulmonary fibrosis
d) TB
e) Sarcoidosis
Answer: a, c, d and e
Explanation:
Finger clubbing may be a clue to an underlying systemic disorder. Digital clubbing is classified into primary (i.e., idiopathic, hereditary) and secondary forms.
Finger clubbing associated with Underlying Systemic Diseases:
Cyanotic congenital heart disease
Infective endo-carditis
Variety of lung diseases
Metastatic lung carcinoma
Bronchiectasis
Asbestosis
Sarcoidosis
Lung abscess
Cystic fibrosis
Tuberculosis
Mesothelioma
Hepatic cirrhosis
In Jackhammer operators
Primary Hypertrophic Osteo-arthropathy
Q-44. Correct combinations are
a) Apnea: Airway blockage or on air entry through nasal aperture for ⪖ 10 sec
b) Hypopnea: ⪖ 10 sec events in which there is continued breathing but the ventilation is reduced by at least 50% from the previous baseline during sleep
c) Snoring: Occur from obstruction of lower airway
d) Apnea index: No of apnoeic episode/hr
e) Apnea-Hypocapnia index: 5-15 indicates mild obstruction
Answer: a, b, d and e
Explanation:
Apnea: Airway blockage or on air entry through nasal aperture for ⪖ 10 sec
Hypopnea: ⪖ 10 sec events in which there is continued breathing but the ventilation is reduced by at least 50% from the previous baseline during sleep
Apnea index: No of apnoeic episode/hr
Apnea-Hypocapnia index < 5/ hour: Normal Apnea-Hypocapnia index 10-15/ hour: Mild Apnea-Hypocapnia index 15-30/ hour: Moderate Apnea-Hypocapnia index > 30/ hour: Sever
Q-45. Hypernatremia is/are seen in
a) Severe brain trauma
b) Supra-sellar mass surgery
c) Judicious use of diuretics
d) Extensive burn
e) Intra-cerebral hemorrhage
Answer: a, b, d and e
Explanation:
Hypernatremia: Causes
Non-renal causes:
Fever, exercise, heat exposure, severe burn, mechanically ventilated patients and diarrhoea
Renal causes:
Osmotic diuresis (Over use)
Diabetes insipidus
Most common causes of central diabetes insipidus is destruction of neuro-hypophysis. This may occur as result of trauma, neurosurgery, granulomatous diseases, neoplasms, vascular accidents or infection.
Q-46. Causes of secretary diarrhea is/are
a) V. cholera
b) Laxatives use
c) Excess phenolphthalein intake
d) Ulcerative colitis
e) Pancreatic exocrine insufficiency
Answer: a, b and c
Explanation:
Ulcerative colitis- Inflammatory diarrhoea
Pancreatic exocrine insufficiency- Steatorrheal diarrhoea
Causes of secretary diarrhea:
Viral damage to mucosal epithelium
Bacterial Entero-toxin mediated
Excessive laxative use (Non-osmotic laxative use
Phenolphthalein)
Neoplastic conditions: Villous adenoma in distal colon and tumors elaborating peptides, serotonin and prostaglandins
Q-47. CRF can differentiated from ARF by presence of following feature in CRF
a) Normocytic normochromic Anemia in CRF
b) Small size kidney
c) Hyper-phosphatemia
d) Hyperkalemia
e) Peripheral neuropathy
Answer: a, b and e
Explanation:
CRF:
Pericardial Effusion/ pericarditis
Progressive Azotemia
Bilateral small kidney
Normocytic normochromic anemia
Peripheral neuropathy
Q-48. Feature of acute rheumatic fever includes
a) Carey Coombs murmur
b) Pan-carditis
c) Always cause residual joint disease
d) Chorea
e) Previous h/o of streptococcal infection
Answer: a, b, d and e
Explanation:
Jones criteria
The presence of two major manifestations or one major and two minor manifestations indicates a high probability of ARF.
Major criteria:
Carditis
Polyarteritis
Chorea
Erythema marginatum
Subcutaneous nodules
Minor criteria:
Arthralgia
Fever
Elevated ESR or CRP level
Prolonged PR interval
Evidence of preceding group A streptococcal infection Elevated or rising streptococcal antibody titer
-> Carey Coombs murmur is a delayed diastolic mitral murmur heard during the course of acute rheumatic fever.
Q-49. A patient is suffering from HIV & TB which of the following statement is correct regarding management of the patient:
a) ATT drugs should be given before ART drug
b) ART drugs should be given before ATT drugs
c) Efavirenz dose should be reduced
d) Adverse drug effects of ATT may be more pronounced
Answer: a and d
Explanation:
Q-50. Acute flaccid paralysis is/are seen in all except
a) Porphyria
b) Hypokalemia
c) Hypo-magnesemia
d) Hyper-calcemia
e) Hypophosphatemia
Answer: c and d
Explanation:
Acute flaccid paralysis seen in:
Metabolic causes:
Hypokalemia and Hyperkalemia
Hypophosphatemia
Hyper-magnesemia