https://meditropics.com/1202-2/
*Prasanta Deka
*Post-graduate resident, Lady Hardinge Medical College
- A 18-year-old male presented with complaints of recurrent episodes of jaundice in the past few weeks. He also complaints of passage of dark yellow coloured urine and brown coloured stools. Laboratory findings revealed conjugated hyperbilirubinemia. A liver biopsy was done that shows the following features. The most likely diagnosis is?
A.Rotor syndrome.
B.Gilbert syndrome.
C.Crigler Najjar syndrome.
D.Dubin Johnson syndrome.
2.A patient with severe MS and atrial fibrillation presented with NYHA class 2 dyspnoea. He is on anticoagulants with past history of TIA. A transthoracic echocardiography was done that shows mitral valve stenosis with calcification and the presence of LA appendage clot. What is the most appropriate treatment for this patient?
A.Balloon valvotomy.
B.Open valvotomy.
C.Close valvotomy.
D.Medical management and continue anticoagulants.
3.A patient developed tingling numbness in the feet on a chronic multivitamin supplement. Which among the following would have led to the presentation?
A.Vitamin B6 toxicity.
B.Vitamin C toxicity.
C.Vitamin D toxicity.
D.Vitamin E toxicity.
4.A patient presents to the OPD with shortness of breath. He reports walking slower than his peers due to breathlessness. He has had two hospitalizations for similar complaints this year. His post-bronchodilator PFTs are FEV1/FVC <0.55 and FEV1 55%. Under what category would he be classified based on GOLD criteria?
A.Moderate COPD, Group C.
B.Moderate COPD, Group E.
C.Severe COPD, Group A.
D.Severe COPD, Group D.
5.A 4-year-old boy is brought to the OPD by his worried mother as he urinates more than ten times a day and is always drinking water. She also reports that despite eating more than his brother did at that age, he is not gaining any weight. Random blood glucose is 252 mg/dl. Which of the following statement is true about this condition?
A.Antibodies against zinc transporters may be present.
B.It is non-insulin dependent.
C.It is associated with a strong family history.
D.Insulin-resistance is the hallmark for pathogenesis.
6.Oculomasticatory myoclonus seen with chronic meningitis is caused by which of the following organisms?
A.Brucella
B. Tropheryma whipplei.
C. Nocardia
D. Actinomyces israelli
7. Decrease in anion gap in Multiple myeloma is due to
A.M component is cationic.
B. Retention of bicarbonate ion.
C. Both A and B.
D. None of the following.
8.A patient with recent MI, 2 months back has undergone PTCA and is currently on dual anti-platelet therapy planned for screening colonoscopy for abdominal pain. Which among the following is true regarding anti-platelet therapy for this procedure?
A. Stop Clopidogrel and continue Aspirin.
B. Stop Aspirin and continue Clopidogrel.
C. Stop both.
D. Continue both.
9.Which of the following AKI markers is not associated with tubular injury?
A.Kim1
B. Ngal
C. Cystatin c.
D. Osteopontin
10. Avacopanis an investigational drug being tried in which disease?
A. Henoch-Schonlein Purpura.
B. Kawasaki disease.
C. Granulomatosis with polyangiitis.
D. Polyarteritis Nodosa.
Answers:
- D; Dubin Johnson syndrome; REF: Sherlock’s disease of liver and biliary system, 13TH edition page 667
- B; Open Valvotomy; REF: Harrison’s principles of Internal Medicine, 21ST edition page 1994
- A; Vitamin B6 Toxicity; REF: Harrison’s principles of Internal Medicine, 21ST edition page 2527, 2528
- B; Moderate COPD, Group E; REF: Harrison’s principles of Internal Medicine, 21ST edition page 2185, 2186
- A; Antibodies against Zinc transporter may be present; REF: Harrison’s principles of Internal Medicine, 20ST edition page 2855
- B; Trophyrema whipplei; REF: Harrison’s principles of Internal Medicine, 21ST edition page 1113
- A;M component is cationic; REF: Harrison’s principles of Internal Medicine, 21ST edition page 870
- D; Continue both; REF: Harrison’s principles of Internal Medicine, 21ST edition page 2404 table no 322-2
- D; Osteopontin; REF: Brenner and Rector’s The Kidney – 11th edition; page 877 fig 27.2
- C; Granulomatosis with polyangiitis; REF: Harrison’s principles of Internal Medicine, 21ST edition page 2809