Saturday, March 15, 2008

91 - test yourself - mcqs with answers and explanations - 201 to 300

201 - most common endocrine tumor of the pancreas ?

a- INSULINOMA

b- gastrinoma

c- VIPoma

d- glucaganoma

answer is a . INSULINOMA .

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202 - A 21 year old patient attended a party the previous night and gives the following symptoms - pain in the abdomen radiating to back , pulse 100 / min , BP 100/76 , temp 39 degress celsius and vomiting before coming to the doctor. what is the diagnosis ?

a- acute pancreatitis

b- acute appendicitis

c- acute cholecystitis

d- acute diverticulitis

answer is a . acute pancreatitis - the points that support the diagnosis are pain radiating to the back and party the previous night which shows the patient might have taken alcohol.

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203 - zollinger ellison syndrome is due to tumor of which cells ?

a- G - cells

b- alpha cells

c- beta cells

d- PP cells

answer is a .

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204 - in medullary carcinoma thyroid tumor marker is ?

a- calcitonin

b- TSH

c- T3 , T4 AND TSH

d- alpha feto protein

answer is a . calcitonin .

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205 - the carcinoma of thyroid associated with hypocalcemia ?

ans: medullary carcinoma of thyroid ( remember it secretes calcitonin )

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206 - medullary carcinoma thyroid arises from ?

a- parafollicular cells

b- cells lining the acini

c- capsule of thyroid

d- stroma of the gland

the answer is a . parafollicular cells - medullary carcinoma of thyroid .

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207 - the most common histologic type of thyroid cancer ?

answer : papillary carcinoma thyroid .

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208 - thyroid carcinoma with best prognosis ?

answer : papillary carcinoma thyroid .

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209 - screening method for medullary carcinoma thyroid ?

a- serum calcitonin

b- serum calcium

c- serum ALP

d- serum acid phosphatase

answer is a . serum calcitonin .

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210 - papillary carcinoma of thyroid usually presents as ?

answer : single nodule + local lymph node

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211 - the gall bladder is capable of distending how many ml ?

a- 50 ml

b- 40 ml

c- 30 ml

d- 20 ml

answer is a . 50 ml .

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212 - association of carcinoma gall bladder with gall stones is ?

ans: 90 %

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213 - oschner sherren regime is used in the management of ?

a- appendicular mass

b- appendicular abscess

c- acute appendicitis

d- chronic appendicitis

answer is a . appendicular mass .

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214 - commonest position of the appendix ?

answer : retrocaecal

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215 - when the rectum is inflated with air through a rectal tube , pain and tenderness occur in the right iliac fossa in case of appendicitis . this is known as ?

answer : BASTEDE'S SIGN . ( murphy , boa and mac ewan )

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216 - acute appendicitis is due to ?

a- fecoliths

b- worms of ileo caecal region

c- streptococcal infections

d- abuse of purgatives

e- none

answers are both a and b .

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217 - mayo's operation is done for ?

answer: umbilical hernia .

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218 - the person whose work on the radical cure of hernia immortalised his name was ?

answer : eduardo bassini

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219 - raspberry tumor is ?

answer - congenital .

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220 - most common infection of the hand , often caused by careless nail trimming or picking the skin around the nail fold ?

answer - acute paronychia .

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221 - hour glass vertebrae and tritiated pelvis are seen radiologically in ?

ans - hyperparathyroidism .

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222 - which of the following is / are used in the management of thyroid malignancy ?

a- I 131

b- I 125

c- Tc 99

d- P 32

answer is a .

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223 - characteristic eye sign in dysthyroid staus ?

a- exopthalmos

b- ptosis

c- optic neuropathy

d- myopathy

answer is a . exopthalmos .

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224 - true about testicuar feminization are all except ?

a- short stature

b- vagina present

c- 46 XY

d- primary amenorrhea

answer is a . short stature .

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225 - hurthle cells are seen in ?

a- hashimoto's thyroiditis

b- follicular cell carcinoma

c- hurthle cell thyroid adenoma

d- all the above

answer is d . all the above

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226 - weight loss is seen all of the following , except ?

a- uremia

b- pheochromocytoma

c- adrenal insufficiency

d- insulinoma

answer is d . insulinoma is characterised by weight gain rather than weight loss .

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227 - somatostatin is secreted by ?

a- alpha cells or A cells

b- beta cells or B cells

c- delta cells or D cells

d- D1 cell

answer is - c . beta cells secrete insulin and the alpha cells secrete glucagon . opposite actions - opposite alphabets .

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228 - pheochromocytoma predominantly secretes ?

a- norepinephrine

b- epinephrine

c- dopamine

d- DOPA

answer is a . NE : E = 20 : 1 .

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229 - most iron is stored in combination with ?

a- sulphate

b- ferritin

c- transferrin

d- ascorbic acid

answer is b . ferritin .

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230 - microcytic hypochromic anemia is seen in ?

a- sideroblastic anemia

b- thalassemia

c- vitamin C deficiency

d- all

answer is only a and b . vitamin C deficiency does not show microcytic hypochromic anemia .

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231 - alpha 2 , gamma 2 - fetal hemoglobin

alpha 2 , delta 2 - hemohlobin A 2

alpha 2 , beta 2 - hemoglobin A - normal hemoglobin

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232 - bronchiectasis is most common in which lobe?

answer: left lower lobe - left lower bronchiectasis .

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233 - excercise induced asthma is not precipitated by

a- swimming in hot water

b- swimming in cold water

c- high altitude climb and excercises

d- cycling in cold weather

answer is a . swimming in hot water .

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234 - the production of cervical mucus is stimulated by ?

a- progesterone

b- estradiol

c- estriol

d- pregnenolone

answer is b . estradiol .

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235 - the sensitivity of uterine musculature is ?

answer : enhanced by estrogen and inhibited by progesterone .

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236 - chromosomal number of primary spermatocyte ?

answer : 46 XY .

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237 - ovary develops from GENITAL RIDGE .

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238 - corpus luteum functions maximally without an implantation for how many days ?

answer is - 9 days .

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239 - ligamentum teres is formed from ?

answer : umbilical vein .

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240 - parts of fallopian tube from ovary to uterus ?

infundibulum - ampulla - isthmus - intramural .

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241 - uterine artery is a branch of ?

answer : internal iliac artery .

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242 - clitoris develops from genital tubercle .

ovary develops from genital ridge .

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243 - peg cells are seen in ?

answer : tubes .

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244 - inhibin is secreted by ?

answer : graafian follicle .

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245 - gonadotropins remain elevated after menopause for ?

a- 2 years

b- 5 years

c- 10 years

d- 15 years

e- rest of life

answer is e . rest of life .

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246 - the symptoms of menopause are best treated with ?

a- oestrogen

b- progesterone

c- testosterone

d- clomiphene

answer is a . oestrogen .

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247 - which substrates in the citric acid cycle are coupled to the production of NADH ?

answers are ISOCITRATE ,

ALPHA KETOGLUTARATE AND

MALATE . I AM nadph in citric acid cyle .

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248 - in eukaryotes , all the enzymes for the citric acid cycle are located in the ?

answer is MITOCHONDRION .

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249 - which substrate in the citric acid cycle is coupled to the reduction of FAD to FADH2 ?

a- citrate

b- isocitrate

c- succinate

d- fumarate

answer is c . succinate .

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250 - which citric acid cycle intermediates can be used for the synthesis of amino acids and can be regenerated by the same amino acids ?

a- succinyl co A and succinate

b- succinate and fumarate

c- malate and oxaloacetate

d- alpha ketogluatarate and oxaloacetate .

the correct answer is d . alpha ketoglutarate and oxaloacetate .

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251 - herpes genitalis causes ?

a- koilocytosis in smear

b- atypical cells

c- carcinoma cervix

d- sterility

answer is c . carcinoma cervix .

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252 - commonest complication following hemorrhoidectomy ?

a- hemorrhage

b- infection

c- fecal impaction

d- urinary retention

pain - most common .

anwer is d . pain is the answer is the choice is given

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253 - best investigation to diagnose piles ?

a- proctoscopy

b- proctosigmoidoscopy

c- barium enema

d- ultrasound

answer is a . proctoscopy .

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254 - the spinbarkeit of cervical mucus in a woman is maximum at one of the following phases of the cycle ?

answer - ovulatory phase .

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255 - palm leaf cervix pattern occurs ?

answer ; due to oestrogens .

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256 - testicular tumor most sensitive to radiation ?

a- seminoma

b- teratoma

c- lymphoma

d- mixed germ cell tumor

answer is a . seminoma .

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257 - fournier's gangrene - scrotum .

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258 - seminoma corresponds to ?

answer - dysgerminoma . in the ovaries of female .

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259 - which of the following is not seen in undescended testis ?

a- hydrocele

b- seminoma

c- teratoma

d- hernia

answer is a . hydrocele does not occur in undescended testis .

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260 - 2-year-old boy with gross obesity associated with compulsive eating and has some developmental delay. diagnosis ?

Answer- prader willi syndrome .

Prader Willi syndrome is associated with compulsive eating and gross childhood obesity and is associated with some developmental delay.

It is related to abnormalities on Chromosome 15.

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261 - Arson is likely to be repeated if associated with epilepsy. - FALSE

Arson, in general, is the crime of setting a fire for an unlawful or improper purpose.Arson is not considered as part of automatisms seen in people with epilepsy. There is no reliable evidence to suggest that such behaviour increases people with epilepsy.

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262 - the threshold temperatures below which malignant cardiac arrythmias spontaneously occur in hypothermic patients is

answer - 30 degree celsius .

Patients are at risk for malignant dysrhythmias at a body temperatures below 30 degree Celsius, with the risk increasing the lower the temperature. Although various rhythms can occur at any time the typical progression is from sinus bradycardia to slow atrial fibrillation to ventricular fibrillation and finally asystole. The hypothermic myocardium is extremely irritable and ventricular fibrillation may be induced by a variety of manipulations and interventions that stimulate the heart, including rough handling of the patient.

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263 - Regarding physiological change in pregnancy

a. Cardiac output increases by 40% (True)

Explanation: Pregnancy is, however, associated with an increased coagulant activity. Any prolongation of the thrombin time suggesting a coagulation defect requires urgent attention.

b. Peripheral vascular resistance falls (True)

c. Blood pressure should be measured with the woman lying flat (False)

d. Oxygen consumption increases ( true )

e. The ureters can appear dilated (True)

Explanation: Oxygen consumption increases by 15% to meet the increased needs of the mother and fetus.

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264 - Rigler's sign is seen in

a. ulcerative colitis

b. Chron's disease

c. Megacolon

d. pneumoperitoneum

The correct answer is D

Rigler's sign, also known as the double wall sign, is seen on an x-ray of the abdomen when air is present on both sides of the intestine; a Rigler's sign is present when air is present on the inside (lumenal side) and the outside (peritoneal side).

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265 - The first modality of sensation to be lost in leprosy is

a. Touch

b. Pain

c. Temparature

d. Joint sense

The correct answer is C

Temperature is the first sensation that is lost. Patients cannot sense extremes of hot or cold. The next sensation lost is light touch, then pain, and finally deep pressure. These losses are especially apparent in the hands and feet; therefore, the chief complaint may be a burn or ulcer in an anesthetic extremity.

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266 - Carbon dioxide transported in blood mostly as

a. Carboxyhemoglobin

b. In combination with plasma proteins

c. Bicarbonate

d. Carbonic acid dissolved in plasma

The correct answer is C

Carbon Dioxide Transport

* Carbon dioxide is transported in the blood in three forms

* Dissolved in plasma – 7 to 10%

* Chemically bound to hemoglobin – 20% is carried in RBCs as carbaminohemoglobin

* Bicarbonate ion in plasma – 70% is transported as bicarbonate (HCO3–)

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267 - Failure to initiate and maintain spontaneous respiration following birth is clinically known as

a. Birth asphyxia

b. RDS- Respiratory Distress Syndrome

c. Respiratory failure

d. Pulmonary oedema

The correct answer is A

WHO has defined perinatal asphyxia as a “failure to initiate and sustain breathing at birth”.

Moderate Birth asphyxia was defined as “Slow gasping breathing or an Apgar score of 4-6 at 1 minute of age.

Severe Birth asphyxia was defined as no breathing or an Apgar Score of 0-3 at 1 minute of age.

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268 - The Meckel's diverticulum is situated within about __________ cms from the ileocecal valve

a. 25 cms

b. 60

c. 75

d. 100

The correct answer is B

Meckel's diverticulum is a true diverticulum containing all layers of the intestinal wall, usually arising from the antimesenteric border of the ileum 45–90 cm. proximal to the ileocecal valve. It is a vestige of the omphalomesenteric or vitelline duct, which usually undergoes complete obliteration during the seventh week of gestation. Autopsy studies have estimated the incidence of Meckel's diverticulum to be 1% to 2% with men being more commonly affected than women by a ratio of 2:1. Gastric mucosa is present in 50% of all Meckel's diverticula, but in over 75% of symptomatic individuals.

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269 - Commonest site of otosclerosis is

a. Round window

b. Oval window

c. Utricle

d. Ossicles

The correct answer is B

New spongy bone is laid down around the footplate of the stapes which impedes its ability to move freely in the oval window. This causes a conductive deafness which gets worse as the disease process develops.

Examination is normally normal although in very active disease it may be possible to see a pink hue to the drum, from very vascular spongy bone deposits on the medial wall of the middle ear. (Schwarze's sign).

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270 - ASO (Antistreptolysin O) test is used for the diagnosis of

a. Rheumatoid Arthritis

b. Typhoid fever

c. Rheumatic Fever

d. Rickettsial fever

The correct answer is C

Antistreptolysin O antibodies will be raised after infection with streptococci. Levels greater than 200 units per millilitre are considered significant (although cut off levels will vary between laboratory undertaking the test).

Measurement can be useful diagnostically if recent infection with streptococci is known to be important in aetiology. Diseases include:

* rheumatic fever

* post streptococcal glomerulonephritis

* scarlet fever

* erysipelas

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271 - All are features of Plummer-vinson syndrome EXCEPT

a. Oesophageal web

b. Iron deficiency

c. Achalasia Cardia

d. Dysphagia

The correct answer is C .

Plummer-Vinson syndrome: hypopharyngeal web + iron-deficiency anemia in middle-aged women. This syndrome occurs most commonly in individuals of Scandinavian descent and is characterized by esophageal webs, iron deficiency anemia, dysphagia, koilonychia, achlorhydria, atrophic gastritis, hiatal hernia, and increased risk of cancer. Dysphagia improves in the Plummer-Vinson syndrome with iron therapy, though the webs remain.

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272 - BCG vaccine-------Danish 1331 strain.

A DANISH STUDENT BY NAME B.C . GUERIN WHO WAS SUFFERING FROM POLIO FINISHED HIS L.L.B and overcome by jealousy TOOK OKA CHICKEN POX VIRUS AND 17 YELLOW FEVER VIRUSES AND SAW PARK WILLIAMS DOING DIPS AND JUMPS BUT GAVE MEASLES VACCINE TO EDMONOSTON ZAGREB .

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273 - hamman's crunch is seen in?

ans : mediastinal emphysema or pneumomediastinum ( rupture of esophagus ).

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277 - GIFT - gamete intrafallopian transfer

ZIFT - zygote intrafallopian transfer .

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278 - knee jerk - L3 AND L4 sometimes L2.

ankle jerk - S1 and S2 .

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279 - BMI - 25 to 29 . 9 - over weight .

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280 - DRUG CAUSING SIADH

Ans : VINCRISTINE .

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281 - a pregnant woman with fibroid uterus develops acute pain in abdomen with low grade fever and mild leucocytosis at 28 weeks , the most likely diagnosis is ?

a- preterm labour

b- torsion of fibroid

c- red degeneration of fibroid

d- infection

answer is c . red degeneration is common in 2nd trimester .

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282 - which of the following decreases the size of myoma ?

a- GnRH agonists

b- Danazol

c- progesterone

d- mifepristone( RU 486 )

e- oestrogens

answer is a , b and d . oestrogens and progesterones do not help in reducing the size of myoma .

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283 - Commonest cause of post menopausal bleed ?

answer : Ca endometrium .

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284 - most common fibroid leading to malignancy ?

answer : intramural .

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285 - torsion common in which fibroid ?

answer : subserous .

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286 - urinary retention causing fibroid ?

ans: anterior cervical and central cervical fibroid .

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287 - fibroid causing pseudo meig syndrome ?

answer : subserous .

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288 - inversion of uterus - which fibroid ?

answer : fundal fibroid .

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289 - wandering or parasitic fibroid ?

answer - subserous fibroid .

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299 - fibroid with maximum symptoms ?

answer - submucous .

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300 - most common fibroid to undergo calcerous degeneration ?

answer : subserous .

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