Q-71. Gastric ulcer is caused by with bacteria
a) E. coli
b) Helicobacter
c) Proteus
d) Entamoeba histolytica
Answer: Helicobacter pylori
Explanation:
Helicobacter pylori:
Helicobacter is a Gram-negative, micro-aerophilic spiral-shaped bacterium found in stomach, causing peptic ulcer disease, gastric cancer or mucosa-associated-lymph-tissue (MALT) lymphoma.
Q-72. Creatinine phospho-kinase is increased in
a) Alcoholic myopathy
b) Clofibrates therapy
c) After electro-cardioversion
d) All
Answer: All
Explanation:
Creatine phospho-kinase (CPK) is an enzyme found mainly in the heart, brain, and skeletal muscle.
High CPK levels may be seen in patients who have:
Brain injury or Stroke, Convulsion
Polymyositis, Muscular dystrophies, Myopathy, Electric shock
Myocarditis, MI, after electro-cardioversion
Important points:
Clofibrates therapy causes myopathy, including rhabdomyolysis with acute renal failure secondary to myoglobinuria.
The myopathy may be dose-related in conjunction with increases in creatine phospho-kinase (CPK). Therapy with fibric acid derivatives should be administered cautiously in patients with preexisting myopathy or a myo-neural disorder.
Q-73. Sensation lost first in Syringomyelia is
a) Pain & temperature
b) Position
c) Touch
d) Vibration
Answer: Pain & temperature
Explanation:
Syringomyelia interrupts the decussating spino-thalamic fibers that mediate pain and temperature sensibility, resulting in loss of these sensations, while light touch, vibration, and position senses are preserved (dissociated sensory loss).
Q-74. All of the following are endocrine manifestations of renal cell carcinoma except
a) Polycythemia
b) Fever
c) Peptic ulcer
d) Renin induced hypertension
Answer: Peptic ulcer
Explanation:
Endocrine manifestations of renal cell carcinoma:
Fever
Erythrocytosis
Hyper-calcemia
Cushing syndrome
Hypertension
Q-75. In which type of renal tubular acidosis hyper-kalemia is a prominent feature
a) Type-I
b) Type II
c) Type III
d) Type IV
Answer: Type IV
Explanation:
Renal tubular acidosis:
Type I: Classical distal
Renal defect- Distal H+ secretion
Serum potassium level- Decreased
Type II: Proximal secretion
Renal defect- Proximal H+
Serum potassium level- Decreased
Type IV: Hyporeninemic hypo-aldosteronism
Renal defect- Distal Na+ reabsorption, K+ secretion and H+ secretion
Serum potassium level-Increased
Q-76. In Fanconi syndrome, failure of tubular re-absorption leads to excessive excretion of except
a) Glucose
b) Phosphate
c) Amino acid
d) Uric acid
Answer: All
Explanation:
Various defects of proximal tubular transport function occur, including impaired resorption of glucose, phosphate, amino acids, HCO3- and uric acid.
Fanconi syndrome causes glucosuria, phosphaturia, generalized aminoaciduria, and HCO3-wasting.
Q-77. Diabetes insipidus is characterized by
a) A decreased urine osmolality, increased serum osmolality
b) A normal urine osmolality, increased serum osmolality
c) A decreased urine osmolality, normal serum osmolality
d) An increased urine osmolality, decreased serum osmolality
Answer: A decreased urine osmolality, increased serum osmolality
Explanation:
Urinary specific gravity of 1.006 or less, and urinary osmolality of less than 200 mOsm/kg are the hallmark of Diabetes insipidus.
Random plasma osmolality generally is greater than 287 mOsm/ kg.
Q-78. Acute attack of gout may be precipitated all except
a) Dietary excess
b) Alcoholic binge
c) Local trauma
d) Use of nitrates for angina
Answer: Dietary excess (?) or Use of nitrates for angina (?)
Explanation:
Acute attacks can be precipitated by several factors, such as increased alcohol consumption, trauma, use of diuretics, dehydration, cyclosporine, diet (organ meat, shellfish), and any drug that can lead to sudden changes (increase or decrease) in urate levels, such as hypo-uricemic agents.
Nitrates contribute to gout by altering blood chemistry and inducing dehydration.
Q-79. Pseudo-membranous colitis is caused by
a) Cl. Perfringens
b) Cl. Welchii
c) Pseudomonas
d) Cl. Difficile
Answer: Cl. Difficile
Explanation:
Antibiotic associated colitis is almost always caused by Cl. Difficile infection.
In patients with severe illness, true pseudo-membranous colitis is seen.
This is characteristic appearance with yellow adherent plaques 2-10 mm in diameter scattered over colonic mucosa interspersed with hyperemic mucosa.
Biopsy reveals epithelial ulceration with classic volcano exudates of fibrin and neutrophils.
Q-80. Respiratory acidosis is seen in all except
a) Fibrosing alveolitis
b) Salicylates poisoning
c) Myasthenia gravis
d) Ext. inter-costal muscle paralysis
Answer: Salicylates poisoning
Explanation:
Respiratory acidosis results from hypo-ventilation and subsequent hypercapnia.
Respiratory alkalosis occurs from hyperventilation and subsequent Hypocapnia.
Respiratory acidosis:
Central nervous system disease or drug-induced respiratory depression
Neuromuscular disease or paralysis (Myasthenia gravis, GB syndrome)
Airway obstruction (Asthma and COPD)