Saturday, March 15, 2008

95 - test yourself in medicine - mcqs with answers and explanations - 601 to 700

601 – most common congenital defect seen in diabetic pregnant woman ?

a- cardiac defect

b- lung defect

c- renal defect

d- liver defect

answer is a .

602 – most common group of diseases following mendelian inheritance are?

a- autosomal dominant

b- autosomal recessive

c- x- linked dominant

d- x- linked recessive

answer is a .

603 – which one of the following is an autosomal dominant disorder ?

a- cystic fibrosis

b- hereditary spherocytosis

c- sickle cell anemia

d- G6PD deficiency

Answer is b .

604 – which one of the following is an autosomal dominant disorder ?

a- achondroplasia

b- hemochromatism

c- wilson’s disease

d- cystic fibrosis

answer is a .

605 – which of the following is an autosomal dominant disorder ?

a- DMD

b- Fragile X syndrome

c- Fanconi’s syndrome

d- Huntington’s disease

Answer is d .

606 – which of the following is an autosomal dominant metabolic disorder ?

a- cystic fibrosis

b- phenyl ketonuria

c- alpha 1 anti trypsin deficiency

d- familial hypercholesterolemia

answer is d .

607 – which of the following is autosomal dominant ?

a- retinoblastoma

b- ataxia telangiectasia

c- bloom’s syndrome

d- xeroderma pigmentosa

answer is a .

608 – thymoma can be associated with all except ?

a- superior mediastinum syndrome

b- myasthenia gravis

c- hypergammaglobulinemia

d- pure red cell aplasia

answer is c . it is not hyper but hypogammaglobulinemia.

609 – the chances of having an unaffected baby when both parents have achondroplasia are?

Answer: 25 % .

610 – a couple with a family history of beta thalassemia major in a distant relative , has come for counseling . the husband has Hb A2 of 4.8% and the wife has a Hb A2 of 2.3 % . the risk of having a child with beta thalassemia major are ?

answer : 0 % . thalassemia has autosomal recessive inheritance . normal values of Hb A2 are 1.5 to 3 % . so wife is normal but the husband has thalassemia minor and so there are no chances of kids developing thalassemia major.

611 – down’s syndrome

1. increased BETA HCG and INHIBIN ( h for high )

2. decreased UNCONJUGATED OESTRIOL and ALPHA FETOPROTEIN .

Q- triple test for diagnosis of down’s syndrome includes all of the following except ?

a. beta hcg

b. alpha fetoprotein

c. serum HPL level

d. serum oestriol level

answer is c .

612 – diagnosis of down’s syndrome best test ? amniocentesis .

exception to this rule is during the 9 to 12 weeks period where CHORIONIC VILLOUS SAMPLING is preferred over amniocentesis .

Q- which of the following is the investigation of choice in a pregnant lady at 18 weeks of pregnancy with past history of delivering a baby with down’s syndrome .

Answer : amniocentesis .

613 – diagnosis of down syndrome at 11 weeks is best assessed by ?

answer : chorionic villous biopsy.

614 – a 35 year old female with a previous history of down’s syndrome child presents with 18 weeks of amenorrhea .the investigation of choice to rule out down’s syndrome in the present pregnancy is ?

answer : amniocentesis .

615 – which of the following is the feature of Y chromosome ?

answer : acrocentric. X chromosome is submetacentric .

616 – thymectomy for MG is preferred for all except ?

a- thymoma

b- thymic hyperplasia

c- young females

d- males over 66 years

answer is d .

617 – which investigation is not done in brain tumor ?

a- CT Scan

b- MRI

c- X ray skull

d- Lumbar puncture

Answer is d .

618 – according to glasgow coma scale a verbal score of 1 indicates ?

a – no response

b- incomprehensible sounds

c- inappropriate words

d- disoriented response

answer is a . no response.

619 – most common cause of ashermann’s syndrome is ?

a- trauma

b- Cu T insertion

c- Curettage

d- Forceps application

Answer is c .

620 – martel’s sign is seen in ?

answer : gout .

621 – teitz’s syndrome usually develops at which coastal cartilage ?

answer : second coastal cartilage .

622 – in leprosy most common renal lesion seen is ?

answer : MPGN .

623 – thyroid carcinoma most likely to metastasise to bone is ?

a- hurthle cell carcinoma

b- papillary

c- medullary

d- follicular

answer is a .

624 – cushing’s syndrome is not seen in ?

a- pituitary microadenoma

b- adrenal ca

c- oat cell ca of lung

d- medulloblastoma

answer is d .

625 – drug of choice in senile osteoporosis ?

a- oestrogens

b- androgens

c- calcitonin

d- etidronate

answer is d . etidronate .

626 – Monday chest tightness – byssinosis – cotton dust .

627 – bronchial asthma is associated with raised levels of ?

a- leukotrienes

b- PGI2

c- PGI1

d- Thromboxane

Answer is a . leukotrienes .

628 – best test for small intestinal malabsorption of carbohydrates?

a- shilling test

b- D xylose test

c- Lund meal test

d- Follacin test

Answer is b . D xylose test .

629 – most common site for leiyomyoma among the following ?

a- stomach

b- small intestine

c- duodenum

d- colon

answer is a . stomach .

630 – CSF glucose is ?

a- half of plasma glucose

b- 2/3 of plasma glucose

c- 1/3 of plasma glucose

d- same as plasma glucose

answer is b .

631 – ONION SKIN SPLEEN is seen in ?

answer: SLE .

632 – heberden’s nodes – osteoarthritis .

633 – schober’s index is ?

answer : flexion of lumbar spine .

634 – direct thrombin inhibitor – argotraban .

635 – causation of pancreatitis – L. asparginase

636 – lupus erythematosus like syndrome is caused by which drug ?

answer : procainamide . captopril causes taste disturbances.

637 – the commonest site of obstruction in gall stone ileus is ?

a- proximal ileum

b- distal ileum

c- ileocaecal junction

d- transverse colon

answer is b . distal ileum .

638 – most common site of gall stone impaction ?

a- duodenojejunal junction

b- proximal to ileocaecal junction

c- distal to ileocaecal junction

d- colon

answer is b .

639 – the most common site of intestinal obstruction in gall stone ileus ?

a- duodenum b- ileum

b- jejunum d- sigmoid colon

answer is ileum .

640 – bedsore is an example of which type of ulcer?

answer: trophic ulcer .

641 – ainhum is seen in ?

a- base of great toe

b- base of finger tips

c- base of toe

d- ankle

answer is c . mostly fifth toe .

642 – hydrocele is which type of cyst ?

a- retention cyst

b- distension cyst

c- exudation cyst

d- traumatic cyst

answer is c . exudation cyst .

643 – decrum’s disease is commonest in ?

a- face b- arm c- back d-thigh

answer is c . back or trunk .

644 – type of fibroadenosis most likely to undergo malignant change ?

a- epitheliosis b- adenosis c- sclerosing adenosis d- cystic

answer is a . epitheliosis .

645 – commonest type of carcinoma breast ?

answer : infiltrative ductal carcinoma ( type of invasive )

646 – recurrent laryngeal nerve is in close association with ?

answer : inferior thyroid artery.

647 – superior thyroid artery is in close association with which nerve ?

answer : external laryngeal nerve.

648 – schatazki’s ring is ?

answer: mucosal ring at squamo-columnar junction , dysphagia is the symptom.

649 – kiss cancer of the urinary bladder is ?

ans: benign ( verify ).

650 – treatment of thimble bladder ?

ans: anti-tubercular drugs + ileocystoplasty .

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651 - vaccines without any herd immunity ?

answer : tetanus and BCG .

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652 - vaccines with good herd effect ?

answer : OPV and measles .

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653 - live vaccine requiring multiple doses to induce immunity ?

answer : OPV.

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654 - a girl named stiff usha came running and sat on a small chair in her house , then her dad came and held her hand and she climbed upstairs . there she went to a drawer and opened it , but found nothing . then she went to a nearby waste basket and started searching . she first found 4 cubes with which she built a tower , later she found a book with pictures and started indentifying the pictures . she looked at a naked man's picture and cud name only one or two body parts . then she started scribbling on the pictures , which were vertical strokes mostly . then she found a bottle filled with mud and emptied it onto herself . realising she was wet and muddy she ran and complained to her mother . her mother started feeding her but she took the plate from her mother and started eating with her own hands. her mother started saying " this girl can only say 10 words but she makes lot of noise" . the girl then kissed her parent with a pucker and ran away .

all these happen at 18 months or 1 1/2 year of age .

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655 - 1 , 3 , 7 , 12 , 16 - chromosmes involved in ulcerative colitis and crohn's disease.

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656 - Hb A 2 - Alpha 2 Delta 2

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657 - new drugs

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2005

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Exenatide: For the adjunctive treatment of Type 2 diabetes mellitus

Mecasermin: For the treatment of growth failure due to Primary IGFD

Pramlintide: For the treatment of type I and type II diabetes

Tipranavir: For the adjunctive treatment of HIV-1 infections

Entecavir: For the treatment of chronic hepatitis B infections with evidence of active viral replication

Ibandronate: For the treatment and prevention of osteoporosis

Galsulfase: For the treatment of mucopolysaccharidosis VI (Maroteaux-Lamy syndrome)

Ramelteon: For the treatment of sleep-onset insomnia

Natalizumab: For the treatment of relapsing forms of multiple sclerosis

Nelarabine: For the treatment of T-cell acute lymphoblastic leukemia and T-cell lymphoblastic lymphoma

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2004

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Bevacizumab: For the treatment of metastatic carcinoma of the colon or rectum

Cetuximab: For the treatment of EGFR-expressing, metastatic colorectal cancer

Azacitidine: For the treatment of several myelodysplastic syndrome subtypes including refractory and chronic myelomonocytic leukemias

Telithromycin: For the treatment of infections caused by bronchitis, bacterial sinusitis and Community-acquired pneumonia

Rifaximin: For the treatment of Travelers' diarrhea caused by noninvasive strains of Escherichia coli

Fosrenol, lanthanum carbonate; For the treatment of hyperphosphatemia related to kidney dysfunction

Trospium chloride: For the treatment of overactive bladder with symptoms of urge urinary incontinence

Cinacalcet: For the treatment of secondary hyperparathyroidism and hypercalcemia in parathyroid carcinoma patients

Solifenacin succinate: For the treatment of overactive bladder with symptoms of urge urinary incontinence

Eszopiclone: For the treatment of insomnia and sleep maintenance

Natalizumab: For the treatment of relapsing forms of multiple sclerosis (currently suspended in US)

clofarabine: For the treatment of acute lymphoblastic leukemia in pediatric patients

Erlotinib, OSI 774: For the treatment of advanced refractory metastatic non-small cell lung cancer

Pegaptanib: For the treatment of wet age-related macular degeneration

Duloxetine: For the treatment of major depressive disorder

Tiotropium bromide: For the treatment of bronchospasm associated with chronic obstructive pulmonary disease

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2003

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Rosuvastatin calcium: For the treatment of primary hypercholesterolemia (heterozygous familial and nonfamilial) and mixed dyslipidemia

Vardenafil: For the treatment of erectile dysfunction related to sexual activity in men

Alefacept: For moderate to severe chronic plaque psoriasis

Laronidase: For the treatment of Mucopolysaccharidosis I (MPS I) in subjects aged 5 to 65

Agalsidase beta: For the treatment of Fabry disease in adult patients

Pegvisomant: Injectable formulation for the treatment of acromegaly

Palonosetron: For the prevention of nausea and vomiting associated with emetogenic cancer chemotherapy

Aprepitant: For the treatment of nausea and vomiting associated with chemotherapy

Bexxar; For the treatment of patients with CD20 positive, follicular, non-Hodgkin's lymphoma following chemotherapy relapse

Atazanavir sulfate: For the treatment of HIV-1 infection in combination with other antiretroviral agents

Zemaira (alpha1-proteinase inhibitor: For the treatment of alpha1-proteinase inhibitor deficiency (Alpha-1) and emphysema

Enfuvirtide: For the treatment of HIV-1 infection in combination with other antiretroviral agents

Fosamprenavir calcium: For the treatment of HIV infection in adults in combination with other antiretroviral agents

Atazanavir sulfate: For the treatment of HIV-1 infection in combination with other antiretroviral agents

Laronidase: For the treatment of Mucopolysaccharidosis I (MPS I) in subjects aged 5 to 65

Ibandronate: For the treatment and prevention of osteoporosis

Pegvisomant: Injectable formulation for the treatment of acromegaly

Bortezomib: Injectable agent for the treatment of multiple myeloma patients who have received at least two prior therapies

Agalsidase beta: For the treatment of Fabry disease in adult patients

Tadalafil: Oral agent for the treatment for erectile dysfunction

Memantine: For the treatment of moderate to severe dementia of the Alzheimer’s type

Palonosetron: For the prevention of nausea and vomiting associated with emetogenic cancer chemotherapy

Aprepitant: For the treatment of nausea and vomiting associated with chemotherapy

Gefitinib: For the second-line treatment of non-small-cell lung cancer

Bortezomib: Injectable agent for the treatment of multiple myeloma patients who have received at least two prior therapies.

Gefitinib: For the second-line treatment of non-small-cell lung cancer

Note: References: FDA Website (main source of background information).

We recieved some feedback from students that this list does not cover Herceptin (new breast cancer drug). We should mention here that Herceptin was approved in 1998 (not in last three years as covered by the list above) and we have a dedicated article covering it at http://www.rxpgonline.com/article1478.html.

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658 - many common medications cause hyperprolactinemia, usually with prolactin levels of less than 100 ng/mL.

Drugs that may cause the condition include the following:

* Dopamine-receptor antagonists (eg, phenothiazines, butyrophenones, thioxanthenes, risperidone, metoclopramide, sulpiride, pimozide)

* Dopamine-depleting agents (eg, methyldopa, reserpine)

* Others (eg, isoniazid, danazol, tricyclic antidepressants, monoamine antihypertensives, verapamil, estrogens, antiandrogens, cyproheptadine, opiates, H2-blockers [cimetidine], cocaine).

Use of prescription drugs is the most common cause of hyperprolactinaemia. Prolactin secretion in the pituitary is normally suppressed by the brain chemical dopamine. Drugs that block the effects of dopamine at the pituitary or deplete dopamine stores in the brain may cause the pituitary to secrete prolactin. These drugs include the major tranquilizers (phenothiazines), trifluoperazine (Stelazine), and haloperidol (Haldol); some antipsychotic medications; metoclopramide (Reglan), used to treat gastroesophageal reflux and the nausea caused by certain cancer drugs; and, less often, alpha-methyldopa and reserpine, used to control hypertension; and oestrogens and TRH.

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659 - arsenic - marsh's test

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660 - filigree burns - lightening burns

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661 - odourless poisoning - calotropis .

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662 - lucid interval - extradural hemorrhage .

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663 - gettler's test - death due to drowning .

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664 - kleptomania is a type of ?

a- obsession

b- delusion

c- illusion

d- impulse neurosis

answer is d . impulse neurosis .

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665 - which poisoning resembles tetanus ?

answer : strychnine poisoning .

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666 - bhang - cannabis sativa .

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667 - cafe coronary - death due to choking .

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668 - spontaneous absorption of lenticular material is seen in ?

answer : HALLERMANN STREIFF SYNDROME .

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669 - at what blood concentration of alcohol is the vehicle driver considered dead drunk ?

answer : 0.3 % .

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670 - a person is declared dead if he is not found for ?

answer : 7 years .

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671 - pugilistic attitude - burns .

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672 - poroscopy is useful in ?

a- race determination

b- age determination

c- sex determination

d- identification of a person

answer is d . identification of a person - further study of finger prints .

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673 - superimposition technique is applied to establish the identity of an individual from ?

a- skull

b- mandible

c- pelvis

d- long bones

answer is a .

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674 - atropine sulphate - antidote for - organophosphorous poisoning .

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675 - gutter fracture - skull - bullet injury - glance bullet

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676 - pectus carinatum - pigeon chest - childhood asthma .

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677 - spinal cord ends at - L 1 lower border .

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678 - normal GFR - 120 ml/min .

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679 - posterior column transmits - touch and proprioception .

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680 - anterior cruciate ligament - prevents - anterior translation of tibia .

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681 - esthiomene ( eating away ) - caused by LGV .

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682 - smoke stack appearance on fluoroscein angiogram is seen in ?

answer : central serous retinopathy .

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683 - An allograft or allogeneic transplant or homograft is a transplant in which transplanted cells, tissues, or organs are sourced from a genetically non-identical member of the same species. Most human tissue and organ transplants are allografts.

In contrast, a transplant from another species is called a xenograft. When a transplanted organ or tissue from a genetically identical donor, i.e., an identical twin, is termed an isograft. Finally, when a tissue is transplanted from one site to another on the same patient, it is termed an autograft.

Allografts and xenografts will be recognised by the recipient's immune system as foreign and will therefore be attacked in a process termed rejection. This does not occur in autografts or true isografts, although in practice, transplants between identical twins are usually covered with immunosuppressants in case they are not 100% genetically identical.

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684 - a 18yr old female has cinema sign positive.she probably has

a)osteochondritis dissecans

b)osteomalacia

c)chondromalacia patellae

d)carpal tunnel syn

answer is c .chondromalcia patellae .

athlete complains of peripatellar pain with high impact activities and with prolonged knee flexion (Cinema Sign) .

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685 - Patella Alta

In patella alta the kneecap rides too high up on the femur (thigh bone). This happens in quite a few people and may never do any harm. However, at the higher end of the thigh bone the groove in which the patellar slides is much shallower than it is in the normal position, so people with patella alta are more likely to dislocate their kneecaps.

Patella alta is also seen in patellar tendon rupture.

Patella Baja

Patella baja is the opposite of patella alta - the kneecap rides too low down the femur. This may occur on its own or, more commonly, it may be a result of the patellar tendon shortening after surgery or injury and pulling the patella downwards. This condition causes pain rather than dislocation.

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686 - thomas test is for identifying which deformity

1.fixed flexion deformity

2.fxd extn def

3.spinal def

4.rotational def

answer is a . of hip .

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687 - m.c site for osteoid osteoma is femur and tibia while incase of osteoblastoma affects mainly spine and flat bones.

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688 - ewings tumour arises from

1.mesothelial cell

2.endothelial c

3.squamous c

4.none of the above

They arise from the Endothelial cells of medullary cavity.

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689 - exercise improves the pain of

1.OA

2.Ankylosing spondylitis

3.neurogenic jnt

4.RA

answer is 2 .

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690 - treatment of wilson's disease ?

answer : pencillamine .

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691 - endemic hemoptysis is caused by ?

answer : paragonimus westermani.

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692 - differential clubbing is seen in ?

a- coarctation of aorta

b- PDA with reversal of shunts

c- eisenmenger's complex

d- all the above

answer is d . all the above.

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693 - O group blood will have ?

answer : no agglutinogens , but A and B agglutinins .

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694 - A group blood will have ?

answer : A agglutinogen and B agglutinin .

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695 - nucleoside = base + sugar . nucleoside + phosphate = nucleotide .

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696 - heparin - SULPHATED D-GLUCOSAMINE and D-GLUCURONIC ACID .

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697 - serotonin is a derivative of ?

answer : tryptophan .

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698 - donovanosis is caused by ?

answer : calymmatobacterium granulomatis .

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699 - viviparous parasite among the following ?

a- wuchereria bancrofti

b- ascaris

c- ankylostoma

d- trichuris

answer : wuchereria .

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700 - ring worm is caused by ?

answer : trichophyton .

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