Pancreatitis, pituitary tumor and phaeochrornocytoma may be associated with:
A. Medullary carinoma of thyroid
B. Papillary carcinoma of thyroid
C. Anaplastic carcinoma of thyroid
D. Follicular carcinoma of thyroid
Correct answer : A. Medullary carinoma of thyroid
Occurs as a part of MEN syndrome.
All of the following can cause osteoporosis, except:
B. Steroid use
Correct answer : C. Fluorosis
A 30 years old male patient presents with complaints of weakness in right upper and both lower limbs of last 4 months. He developed digital infarcts involving 2nd and 3rd fingers on right side and 5th finger on left side. On examination, BP was 160/140 mm Hg, all peripheral pulses were palpable and there was asymmetrical neuropathy. Investigations showed a Hb 12 gm, TLC — 12000 Cu mm, Platelets 430,000; ESR — 49 mm. Urine examination showed proteinuria and RBC — 10-15/hpf with no casts. Which of the following is the most likely diagnosis?
A. Polyarteritis nodosa
B. Systemic lupus erythematosus
C. Wegener’s granulomatosis
D. Mixed cryoglobulemia
Correct answer : A. Polyarteritis nodosa
In PAN, there is development of digital infarcts even in the presence of good peripheral pulses. Hypertension is due to involvement of renal arteries.
Which one of the following serum levels would help in distinguishing an acute liver disease from chronic liver disease?
A. Amino transaminase
B. Alkaline phosphatase
Correct answer : D. Albumin
Albumin is significantly decreased in chronic liver diseases.
5’-Nucleotidase activity is increased in:
A. Bone diseases
B. Prostate cancer
C. Chronic renal failure
D. Cholestatic disorders
Correct answer : D. Cholestatic disorders
5′ nucleotidase and Gamma glutamyl transferase are specific for cholestatic disorders.
Which one of the following conditions commonly predisposes to Colonic carcinoma?
A. Ulcerative colitis
B. Crohn’s disease
C. Diverticular disease
D. Ischaemic colitis
Correct answer : A. Ulcerative colitis
Risk of colonic carcinoma is more in Ulcerative colitis compared to Chron’s disease
Serum angiotensin converting enzyme may be raised in all of the following, except:
D. Bronchogenic carcinoma
Correct answer : D. Bronchogenic carcinoma
Some conditions causing increase in serum angiotensin converting enzyme
The abnormal preoperative pulmonary function test in a patient with severe kyphoscoliosis includes:
A. Decreased RV and TLC
B. Reduced FEV1/ FVC ratio
C. Reduced FEF 25-75%
D. Increased FRC
Correct answer : A. Decreased RV and TLC
Kyphoscoliosis is a restrictive lung disease. There is decrease in residual volume and total lung capacity. FEV1 and FVC are proportionately decreased. Hence the ratio of FEV1 to FVC remains normal or is increased. The forced expiratory flow rate (FEF) is normal. Functional residual capacity (FRC) is decreased.
A 50 year old man, an alcoholic and a smoker presents with a 3 hour history of increasing shortness of breath. He started having this pain while eating, which was constant and radiated to the back and interscapular region. He was a known hypertensive. On examination, he was cold and clammy with a heart rate of 130/min, and a BP of 80/40 mm Hg. JVP was normal. All peripheral pulses were present and equal. Breath sounds were decreased at the left lung base and chest x-ray showed left pleural effusion. Which one of the following is the most likely diagnosis?
A. Acute aortic dissection
B. Acute myocardial infarction
C. Rupture of the esophagus
D. Acute pulmonary embolism
Correct answer : A. Acute aortic dissection
Chest pain radiating to interscapular area and signs of shock indicates the diagnosis of acute aortic dissection especially in those with risk factors like hypertension.