137 - AIIMS november 2008 medicine mcqs

111. A 9 YR OLD GIRL HAS DIFFICULTY IN COMBING HAIRS AND CLIMBING UPSTAIRS SINCE 6 MONTHS.SHE HAS GOWERS SIGN POSITIVE AND MACULOPAPULAR RASH OVR METACARPO PHALANGEAL JOINTS.WHAT SHUOLD BE THE NEXT APPROPRIATE INVESTIGATIO TO BE DONE?
A. ESR
B. RA FACTOR
C. CREATINE KINASE
D. ELECTROMYOGRAPHY

112.ANTIBODY FOUND IN MYOSITIS IS?
A. ANTI JO1
B ANTI SCL 70
C. ANTI DS DNA

113.A GIRL ON EXPOSURE TO COLD HAS PALLOR OF EXTERMITIES FOLLOWED BY PAIN AND CYANOSIS. IN LATER AGES OF LIFE SHE IS PRONE TO DEVELOP?
A. SLE
B. SCLERODERMA
C. RA
D. SYSTEMIC SCLEROSIS

114. WHICH RADIOLOGICAL FEATURE WOULD HELP DIFFERENTIATE RHEUMATOID ARTHRITIS WITH SLE?
A. EROSION
B. JUXTA ARTICULAR OSTEOPOROSIS
C. SUBLUXATION OF MCP JOINT
D. SWELLING OF PIP JOINT

115.ALL ARE SEEN IN REITERS SYNDROME EXCEPT?
A. SUBCUTANEOUS NODULES
B. ORAL ULCERS
C. KERATODERMA BELANORRHAGICUM
D. CIRCINATE BALANITIS

116.WHICH OF THE ORGANISM CAUSES REACTIVE ARTHRITIS?
A. UREAPLASMA UREALYTICUM
B. GROUP A BETA HEMOLYTIC STREPTOCOCCI
C. BORRELIA BURGDORFERI

117.ALL ARE TRUE ABOUT METACHROMATIC LEUCODYSTROPHY EXCEPT?
A. FOLLOWS AN INDOLENT COURSE AND SLOW TO PROGRESS
B. TISSUE BIOPSY IS DIAGNOSTIC
C. PRESENTS AS VISUAL LOSS AND SPEECH ABNORMALITY
D. INVOLVES DEEP CORTICAL NEURONS


118. MOST COMMON CAUSE OF MONONEURITIS MULTIPLEX IN INDIA IS?
A. HANSENS DISEASE
B. RA
C. TB
D. PAN

119.WISKOTT ALDRICH SYNDROME IS CHARACTERISED BY ALL EXCEPT?
A. THROMBOCYTOPENIA
B. AUTOSOMAL RECESSIVE
C. FAILURE OF AGGREGATION OF PLATELETS IN RESPONSE TO AGONISTS
D. ECZEMA

120.SPONTANEOUS CSF LEAK OCCOURS IN ALL EXCEPT?
A. INCREASED ICT
B. PARTIAL OR COMPLETE EMPTY SELLA SYNDROME
C. PSEUDOTUMOUR CEREBRI
D. LOW RISK ENCEPHALOCOELE

121. TRUE ABOUT FLUORESCENT ANTIBODY DETECTION TEST IN DIAGNOSIS OF PLASMODIUM FALCIFARUM ARE A/E?
A. IT’S A IMMUNOCHROMATIC TEST
B. DETECTION OF HISTIDINE RICH PROTEIN 1
C. DETECTION OF LACTATE DEHYDROGENASE ANTIGEN
D. DETECTION OF ALDOLASE ANTIGEN

122.MICROANGIOPATHIC HEMOLYTIC ANAEMIA IS SEEN IN A/E?
A. ANTIPHOSPHPLIPID ANTIBODY SYN
B.TTP
C. MICROSCOPIC POLYANGITIS
D. METALLIC CARDIAC VALVES

123. WHICH OF THESE IS NOT A MARKER OF ACTIVE REPLICATIVE PHASE OF CHRONIC HEPATITIS B?
A. HBV DNA
B. HBV DNA POLYMERASE
C. ANTI Hbc
D. AST &ALT

124.VASODIALATION IN SPIDER NAEVI IS DUE TO?
A. HEPATOTOXIN
B. ESTROGEN
C. TESTOSTERONE
D. DHEA

125. IN A EMPHYSEMATOUS PATIENT WITH [bleep] LEISON WHICH IS THE BEST INVESTIGATION TO MEASURE LUNG VOLUMES?
A. BODY PLETHYSMOGRAPHY
B. HELIUM DILUTION
C. TRANS DIAPHRAGMATIC PRESSURE
D. DLCO





126.A 29 YR OLD UNMARRIED FEMALE PRESENTS WITH DYSPNEA, HER CHEST X RAY IS NORMAL, FVC-92% FEVI/FVC-89% DLCO-59%. ON EXERCISE HER OXYGEN SATURATION DROPS FROM 92% TO 86%.WHAT IS THE DIAGNOSIS?
A. ALVEOLAR HYPOVENTILLATION
B. PRIMARY PULMONARY HYPERTENSION
C. INTERSTITIAL LUNG DISEASE
D. ANXIETY

127.A MAN ON 10 DAYS COURSE OF CEPHALOSPORINS ON 8TH DAY OF TREATMENT DEVELOPS HIGN GRADE FEVER AND RASHES ALL OVER THE BODY.WHAT IS THE DIAGNOSIS?
A. PARTIALLY TREATED MENINGITIS
B. TYPE III HYPERSENSITIVITY REACTION
C. KAWASAKI’S DS

128. WHICH IS FALSE ABOUT ACRODERMATITIS ENTEROPATHICA?
A. TRIAD OF DIARRHOEA DMENTIA DERMATITIS
B. LOW SERUM ZINC LEVELS
C. SYMPTOMS IMPROVE WITH ZINC SUPPLEMENTATION

129.WHICH OF THE FOLLOWING IS NOT A MINOR CRITERIA FOR MULTIPLE MYELOMA?
A. MULTIPLE LYTIC BONE LEISONS
B. PLASMACYTOSIS OF 20% IN BONE MARROW
C. PLASMACYTOMA ON TISSUE BIOPSY
D. IgG- 3g/Dl IgA-1.5g/Dl

130.WHICH OF THE FOLLOWING FEATURES OF UREMIA WILL NOT IMPROVE WITH HEMODIALYSIS?
A. PERIPHERAL NEUROPATHY
B. PERCARDITIS
C. SEIZURES
D. METABOLIC ACIDOSIS

131.NOT A MAJOR FRAMINGHAM CRITERIA FOR DIAGNOSIS OF CHF?
A. HEPATOMEGALY
B. CARDIOMEGALY
C. S3 GALLOP
D. PAROXYSMAL NOCTURNAL DYSPNEA

132.A 54 YR OLD SMOKER MAN COMES WITH FEVER HEMOPTYSIS WEIGHT LOSS AND OLIGOARTHRITIS. SERIAAL SKIAGRAM SHOWS FLEETING OPACITIES.WHAT IS THE DIAGNOSIS?
A. ALLERGIC BRONCHOPULMONARY ASPERGILLOSIS
B. CA LUNG
C. TB
D. WEGENERS GRANULOMATOSIS

133.MISFOLDED PROTEINS ARE SEEN IN A/E?
A. PRION DS
B. MULTIPLE SCLEROSIS
C. AMYLOIDOSIS
D. CREUTZFELDT JACOB DS

134.ZINC DEFICIENCY CAUSES A/E?
A. PULMONARY FIBROSIS

to view all the 200 mcqs of AIIMS november 2008 click here

136 - infectious diseases mcqs - 1

Match the clinical description with the most likely etiologic agent.

a. Candida albicans
b. Aspergillus flavus
c. Coccidioides immitis
d. Herpes simplex type 1
e. Herpes simplex type 2
f. Hantavirus
g. Tropheryma whippelii
h. Coxsackievirus B
i. Histoplasma capsulatum
j. Human parvovirus
k. Cryptococcus neoformans

55. An HIV-positive patient develops fever and dysphagia; endoscopic
biopsy shows yeast and hyphae.

56. A 50-year-old develops sudden onset of bizarre behavior. CSF shows
80 lymphocytes; magnetic resonance imaging shows temporal lobe abnormalities.

57. A patient with a previous history of tuberculosis now complains of
hemoptysis. There is an upper lobe mass with a cavity and a crescentshaped
air-fluid level.

58. A Filipino patient develops a pulmonary nodule after travel through
the American Southwest.

59. A 35-year-old male who had a fever, cough, and sore throat develops
chest pain after several days, with diffuse ST segment elevations on ECG.

60. Overwhelming pneumonia with adult respiratory distress syndrome
occurs on an Indian reservation in the Southwest following exposure to
deer mice.

The answers are 55-a, 56-d, 57-b, 58-c, 59-h, 60-f.

(Kasper,
pp 1038, 1055–1056, 1144–1146, 1172, 1180–1181, 1186–1187, 1188, 1413,
2480–2483.)

There are several causes for dysphagia in the HIV-positive
patient, including C. albicans, herpes simplex, and cytomegalovirus. The
biopsy result in this patient confirms Candida infection with the typical picture
of both yeast and hyphae seen on smear.

Herpes simplex encephalitis can occur in patients of any age—usually
in immunocompetent patients. Most adults with HSV encephalitis have
previous infection with mucocutaneous HSV-1. The bizarre behavior
includes personality aberrations, hypersexuality, or sensory hallucinations.
CSF shows lymphocytes with a close-to-normal sugar and protein. Focal
abnormalities are seen in the temporal lobe by CT scan, MRI, or EEG.

The patient who has had a previous history of tuberculosis and now
complains of hemoptysis would be reevaluated for active tuberculosis.
However, the chest x-ray described is characteristic of a fungus ball—
almost always the result of an aspergilloma.

The Filipino patient who has developed a pulmonary nodule after
travel through the Southwest would be suspected of having developed coccidioidomycosis.Individuals from the Philippines have a higher incidence
of the disease and are more likely to have complications of dissemination.

The 35-year-old with cough, sore throat, and fever went on to develop
symptoms of myopericarditis with typical ECG findings. Coxsackievirus B
infection is the most likely cause of URI symptoms that evolve into a picture
of myocarditis. Myocarditis may be asymptomatic or can present with
chest pain, both pleuritic and ischemic-like. Enteroviruses rarely if ever
attack the pericardium alone without involving the subepicardial
myocardium.

Hantavirus pulmonary syndrome begins with a prodromal illness of
cough, fever, and myalgias that is difficult to distinguish from other viral
illnesses such as influenza. However, the illness progresses to increased
dyspnea, hypoxia, and hypotension. The picture resembles adult respiratory
distress syndrome (ARDS), and most patients require mechanical ventilation.
The infection should be suspected when a previously healthy adult
develops unexplained pulmonary edema or ARDS without known causes.
Thrombocytopenia is also a useful clue. Transmission of hantavirus usually
occurs through aerosolization of urine from infected rodents or through the
bite of an infected rodent