Hydrocephalus
The main site of CSF absorption are arachnoid granulations of A. Superior sagittal B. Inferior...
Schaffer collaterals
Schaffer collaterals are present in A. Heart B. Brain C. Kidney D. Adrenals Which of...
Anticipatory emesis
Cortical pathway which is responsible for anticipatory emesis in chemotherapy-induced nausea and vomiting is mediated...
Chemotherapy induced vomiting
Acute onset of nausea and vomiting after administration of chemotherapy usually resolves A. < 24...
Radiation encephalopathy
Early delayed radiation encephalopathy occurs —— after irradiation A. < 1 weeks B. < 2...
Raised intracranial pressure
Parinaud’s syndrome in children results from A. Cerebral herniation B. Dorsal midbrain compression C. Choroid...
Clinical Questions -2
Presentation A 71-year-old woman presented to emergency department with a 4-day history of abdominal pain...
Image Question-32
What is the Diagnosis of Image? Case courtesy of Lee-Anne Slater, Radiopaedia.org. From the case...
Risk of having prostate cancer
Prostate Health Index PHI is a blood test that estimates the risk of having prostate...
Mitral valve prolapse
What is Mitral valve prolapse (MVP)? MVP is a condition where there is usually a…
Medicine MCQs -21
What is the “gold standard” diagnostic test for Nephrolithiasis?
Nephrolithiasis - The “gold standard” diagnostic test is helical CT without contrast.
Tiopronin is used for prevention of which type kidney stones-
Cystine
Focus for cystine stone prevention is on increasing cystine solubility.
This goal may be achieved by treatment with medication that covalently binds to cystine (tiopronin and penicillamine
All of the following are CORRECT about Randall's plaques EXCEPT -
Randall's plaques
Randall's plaques - are calcium phosphate deposits
form in the papillary interstitium
Which is the most common type of kidney stone?
Calcium oxalate: The most common type of kidney stone which is created when calcium combines with oxalate in the urine.
All of the following are CORRECT about Dent's disease EXCEPT -
affects the proximal renal tubules
LMW proteinuria
Staghorn calculi is produced by which type renal stones?
Which kidney stones grow quickly to large size ?
Struvite stones - can grow very large quickly
Which renal stones are called as infection stones?
Struvite stones, also known as infection stones or triplephosphate stones, form only when the upper urinary tract is infected
with urease-producing bacteria such as
Proteus mirabilis,
Klebsiella
pneumoniae,
Providencia species
Which stones are commonly caused by a urinary tract infection?
Struvite stones are virtually always caused by a urinary tract infection
When there is a stone is in the lower part of the ureter the pain can radiate to -
stone lodges in the upper part of the ureter - pain may radiate anteriorly
if the stone is in the lower part of the ureter - pain can radiate to the ipsilateral testicle in men or ipsilateral labium in women.
Medicine MCQs -20
Anti-Müllerian hormone is -
AMH is a dimeric glycoprotein with a molar mass of 140 kDa
Primary erythromelalgia is caused by mutation of -
Primary erythromelalgia is caused by mutation of the voltage-gated sodium channel α-subunit gene SCN9A.
Vitamin-D overdose from UV exposure -
Vitamin-D overdose is impossible from UV exposure
Vitamin-D overdose is impossible from UV exposure: the skin reaches an equilibrium where the vitamin degrades as fast as it is created
Tunnel vision can be caused by all of the following EXCEPT -
Retinitis pigmentosa
Glaucoma
Which of the following is correct for people with a darker skin pigment and production of vitamin D
People with a darker skin pigment with increased amounts of melanin may have decreased production of vitamin D
Melanin absorbs ultraviolet B radiation from the sun and reduces vitamin D production
Cystic fibrosis is associated with channel defect -
CFTR is complex protein found on the surface membrane of cells in a wide variety of tissues where it functions as a regulated chloride ion channel.
Vascular angle is the angle to which the leg has to be raised before it becomes pale, whilst lying down is called as -
vascular angle - also called Buerger's angle, is the angle to which the leg has to be raised before it becomes pale, whilst lying down.
Gissane angle, also known as the "critical angle of Gissane", is a measurement on lateral foot radiographs used to evaluate the severity of calcaneal fractures.
Böhler's angle is defined by two intersecting lines: one drawn from anterior process of the calcaneus to the highest part of posterior articular surface and a second drawn from the same point of posterior articular surface to the most superior point of tuberosity.
Meary's angle or the (lateral) talus-first metatarsal angle has been used to identify the apex of deformity in patients with pes cavus and pes planus on lateral weight-bearing foot radiographs.
Vascular angle of less than -------------- indicates severe ischaemia
vascular angle of less than 20 degrees indicates severe ischaemia
POEMS syndrome includes all of the following EXCEPT -
The name POEMS is an acronym for some of the disease's major signs and symptoms -
polyneuropathy
organomegaly
endocrinopathy
myeloma protein
skin changes
Intrinsic factor -
Intrinsic factor - glycoprotein produced by the parietal cells
Amaurosis Fugax
Transient visual loss Amaurosis fugax is a harbinger of an imminent stroke. Amaurosis fugax is…
Chest radiograph signs of Pulmonary Embolism
Classic chest radiograph signs of pulmonary emboli include – Signs of Pulmonary EmbolismFindings on X-Ray1…
Medicine MCQs – 19
All of the following are findings in Bronchiectasis EXCEPT -
CT findings include airway dilation (detected as parallel “tram tracks” or as the “signet-ring sign”
Fleishner sign - central pulmonary artery enlargement - sign seen in Pulmonary emboli
Which of the following is the imaging modality of choice for confirming the diagnosis?
Chest computed tomography (CT) is more specific for bronchiectasis and is the imaging modality of choice for confirming the diagnosis.
Which is the cardinal sign of bronchiectasis?
Bronchial dilation
Bronchial dilation, the cardinal sign of bronchiectasis
All of the following are common ccauses of 'Traction bronchiectasis' EXCEPT -
Traction bronchiectasis seen in - pulmonary fibrosis or distorted lung parenchymal architecture.
Which of the following is the most common clinical presentation in bronchiectasis ?
Most common clinical presentation is a persistent productive cough with ongoing production of thick, tenacious sputum.
Bronchial dilation in bronchiectasis is characterized ALL of the following EXCEPT -
- Broncho arterial ratio (BAR) of more than 1
- Lack of bronchial tapering (normal airways diminish in caliber as they extend toward the lung periphery)
- Visibility of airways within 1 cm of the pleural surface (normal airways should not be visualized this far out in the lung periphery
- Abutting the mediastinal pleural surface
Which of the following cells dominate in airway inflammation of bronchiectasis?
Neutrophils
Neutrophils dominate airway inflammation in bronchiectasis, driven by high concentrations of neutrophil chemoattractants such as interleukin-8 (CXCL-8), and leukotriene B4.
Which of the following has a particular propensity for colonizing damaged airways in bronchiectasis?
Pseudomonas
FACED scale uses ---------------- to predict clinical outcomes in bronchiectasis as one of the parameters.
FACED scale uses the FEV-1 (forced expiratory volume in 1 second), age of the affected person, presence of chronic infection, extent of disease (number of lung lobes involved) and dyspnea scale rating (MRC dyspnea scale) to predict clinical outcomes in bronchiectasis.
FACED scale is used in bronchiectasis for -
Bronchiectasis Severity Index and the FACED scale
Two clinical scales have been used to predict disease severity and outcomes in bronchiectasis
Hanging Jaw Sign
“Hanging Jaw Sign” Myasthenia gravis Weakness of the muscles of facial expression and muscles of…
Medicine MCQs-18
“signet-ring sign” in CT chest seen in -
Bronchiectasis
CT findings include airway dilation - detected as parallel
“tram tracks”
“signet-ring sign”
Focal bronchiectasis seen in which of the following cases?
Focal Obstruction
- aspirated foreign body
- tumor mass
Mononeuritis multiplex most commonly involves -
Mononeuritis multiplex most commonly involves the peroneal nerve, but also involves the ulnar, radial, internal popliteal, and occasionally, cranial nerves.
Which is the most common cancer associated with asbestos exposure?
Lung cancer is the most common cancer associated with asbestos exposure.
Which of the following shows characteristic “eggshell” pattern?
characteristic “eggshell” pattern -silicosis
All of the following are false about 'Lead neuropathy' EXCEPT -
Lead toxicity is a very rare cause of neuropathy in adults. It has an unusual pattern that is classically an isolated motor neuropathy with a predilection for extensor muscles of the arms and legs.
Which of the following is the commonest form of Bronchiectasis?
Tubular - most common form of Bronchiectasis
Varicose, Cystic, Cylindrical
Which of the following medicine has side effect of 'dry mouth'?
Anticholinergics
Anticholinergic, sympathomimetic, or diuretic drugs are usually responsible
Bronchodilator effect is due to inhibition of -
Bronchodilator effect of Theophylline is due to inhibition of phosphodiesterases
presence of “tram tracks” in CT scan chest seen in -
Bronchiectasis -presence of “tram tracks” indicating dilated airways is consistent with bronchiectasis.
Whic of the following the the most common CT finding in EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS?
most common CT findings include -
bilateral ground-glass opacity and airspace consolidation that is predominantly subpleural.
Other CT findings include bronchial wall thickening, hyperinflation, interlobular septal thickening, lymph node enlargement, and pericardial and pleural effusion
Medicine MCQs- 17
Most common dementia diagnosis among older adults
Alzheimer’s disease,
Tropical spastic paraparesis is caused by -
HTLV-1
Tropical spastic paraparesis - is a medical condition that causes weakness, muscle spasms, and sensory disturbance by human T-lymphotropic virus
Cerebellar gait ataxia is characterized by ALL of the following EXCEPT -
Cerebellar gait ataxia is characterized by a
wide base of support
Lateral instability of trunk
Erratic foot placement
Decompensation of balance
What is the commonest type of gait disorders can also be classified by etiology?
Gait disorders can also be classified by etiology
Sensory deficit - 18%
Myelopathy - 16%
Multiple infarcts - 15%
Parkinsonism -11%
ALL of the following are correct about 'cautious gait' EXCEPT -
walks with an abbreviated stride and lowered center of mass， as if walking on a slippery surface
This disorder can be observed in more than one-third of older patients with gait impairment.
Frontal gait disorder is also known as -
Frontal gait disorder sometimes known as gait apraxia，
Commonest cause of cerebellar ataxia in older patients -
Causes of cerebellar ataxia in older patients include stroke , trauma，tumor，and neurodegenerative disease
FREEZING GAIT is seen in all of the following EXCEPT -
Parkinsonism
Progressive supranuclear palsy
Multiple-system atrophy
Corticobasal degeneration
Shuffling gait seen characteristically in -
Parkinsonian gait known as shuffling gait presents as short steps, narrow-based with flexed knees and stooped posture.
Most common cause of frontal gait disorder is -
Most common cause of frontal gait disorder is vascular disease
Most common cause of frontal gait disorder is vascular disease， particularly subcortical small-vessel disease. Lesions are frequently found in the deep frontal white matter and centrum ovale.
Medicine MCQs-16
All of the following causes Hypercalcemia EXCEPT -
Hypercalcemia - sarcoidosis, tuberculosis, Paget disease
Hypocalcemia is common in advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD)
Most common cause of hypercalcemia is -
Hyperparathyroidism
Hypercalcemia of malignancy occurs in approximately ........ of all cancer patients during their clinical course.
Hypercalcemia of malignancy occurs in approximately 20% of all cancer patients during their clinical course.
Hungry bone syndrome seen after -
Parathyroid surgery
While mild hypocalcemia is common after partial parathyroidectomy, some people experience persistently prolonged low calcium levels. This is called hungry bone syndrome.
Which of the following is the commonest pathophysiology of hypercalcemia of malignancy?
Excessive secretion of parathyroid hormone-related protein (PTHrP)
Excessive secretion of PTHrP is the most common cause of hypercalcemia of malignancy. It is also known as humoral hypercalcemia of malignancy (HHM) and accounts for about 80% of the cases.
Most common cancer associated with hypercalcemia of malignancy is -
The most common cancer associated with hypercalcemia of malignancy is multiple myeloma which has the highest prevalence of hypercalcemia of malignancy.
What s the mechanism of action of Denosumab?
Denosumab inhibits this maturation of osteoclasts by binding to and inhibiting RANKL.
Parathyroid hormone-related protein cause hypercalcemia by all of the following mechanism EXCEPT -
Parathyroid hormone-related protein
similarity in structure, it acts at the same receptor as PTH and causes bone resorption, increased phosphate excretion from the proximal tubules, and calcium reabsorption from the distal tubules. It does not have any effect on 1,25-dihydroxy vitamin D production.
Human monoclonal antibody useful for treatment of hypercalcemia?
Denosumab - Human monoclonal antibody against RANKL
Inhibits the maturation, function and survival of osteoclasts.
Denosumab mimics the natural action of -
Denosumab mimics the natural action of osteoprotegerin
Osteoprotegerin (OPG), also known as osteoclastogenesis inhibitory factor (OCIF) or tumour necrosis factor receptor superfamily
Medicine MCQs-15
Which of the following nerve fibers first involved in Peripheral Neuropathy?
Type C
Dysesthesias restricted to the fifth digit and the adjacent one-half of the fourth finger on one hand point to disorder of the -
Dysesthesias restricted to the fifth digit and the adjacent one-half of the fourth finger on one hand reliably point to disorder of the ulnar nerve， most commonly at the elbow
Megavitamin-B6 syndrome has been reported in doses as low as -
Megavitamin-B6 syndrome has been reported in doses as low as 24 mg/day
ALL of the following causes stocking neuropathy EXCEPT -
Excess vitamin B6 can cause nerve damage
Most common inherited cause of peripheral neuropathy -
Most common type inherited cause of peripheral neuropathy is Charcot-Marie-Tooth disease
This is one of the hereditary motor and sensory neuropathies.
Most common polyneuropathy is -
Most common polyneuropathy is diabetic sensorimotor polyneuropathy
In the CNS, including the spinal cord, myelin sheaths are produced by -
In the CNS, including the spinal cord, myelin sheaths are produced by oligodendrocytes and not by Schwann cells.
ALL of the following are CORRECT about Wallerian degeneration EXCEPT -
Part of the axon distal to the injury (i.e. farther from the neuron's cell body) degenerates
Wallerian degeneration is an active process of degeneration that results when a nerve fiber is cut or crushed and the part of the axon distal to the injury (i.e. farther from the neuron's cell body) degenerates
Inverted champagne bottle appearance seen in -
Lipodermatosclerosis
Charcot-Marie Tooth Disease
Which nerve fiber has slowest conduction velocity?
Type C
C fibers are unmyelinated unlike most other fibers in the nervous system.
This lack of myelination is the cause of their slow conduction velocity
All of the following are CORRECT for peripheral neuropathy EXCEPT -
Toes are involved first then Fingers
Medicine MCQs-14
Stemmer-Kaposi sign is a helpful clinical sign in diagnosing -
Kaposi-Stemmer sign - inability to pinch and lift the skin at the dorsum of the base of the second toe
Kaposi-Stemmer sign has been shown to be the most useful.
Which of the following is called potato nose?
Rhinophyma
Recent study has proven the link between geographic tongue and ....
Recent study has proven the link between geographic tongue and psoriasis - the presence of geographic tongue can be a predictor of psoriasis.
Most widely accepted cause of Yellow nail syndrome is dysfunction of - lymphatic system
Most widely accepted explanation for the signs and symptoms associated with Yellow nail syndrome is a dysfunction of the lymphatic system.
Blueberry muffin baby is due to -
Blueberry muffin baby - also known as extramedullary hematopoiesis
Milroy's disease is -
Milroy's disease - autosomal dominant
Hereditary Lymphedema type II known as -
Hereditary lymphedema type II - known as - Meige disease
Most common presentation of Milroy Disease is -
Most common presentation of Milroy Disease is unilateral lower extremity lymphedema
Milroy's disease is also known as -
Primary or hereditary lymphedema type 1A
Early onset lymphedema.
Potato Nose [Rhinophyma] develops in certain individuals with -
Rhinophyma develops in some individuals after long-standing rosacea that has progressed to acne rosacea
Virchow's law is applied for which of the following?
Virchow's law - during craniosynostosis, skull growth is restricted to a plane perpendicular to the affected, prematurely fused suture and is enhanced in a plane parallel to it.
Medicine MCQs -13
'Maltese crosses' under polarized light are commonly seen in the urinary sediment of patients with -
Maltese crosses under polarized light are commonly seen in the urinary sediment of patients with a nephrotic syndrome
When non painful stimulus is experienced as painful is is called as -
Hypesthesia or hypoethesia refers to a reduction of cutaneous sensation to a specifc type of testing such as pressure， light touch， and warm or cold stimuli
Allodynia describes the situation in which a nonpainful stimulus is experienced as painful
Hyperalgesia denotes severe pain in response to a mildly noxious stimulus
Which is the VECTOR for Babesiosis?
Babesiosis - Tick-borne
Tsetse flies - Sleeping sickness (African trypanosomiasis) - Parasite
Sandflies - Leishmaniasis.
Lice - Typhus - Louse-borne relapsing fever
Upper motor neuron lesions ALL of the following are CORRECT EXCEPT -
Fasciculations may be a sign of degeneration of lower motor neurons in which case they may be associated with muscle cramps and neuromyotonia.
'Coat-Hanger' headache seen in -
Headache of Orthostatic hypotension - is called coat-hanger ache because it affects the neck and shoulders in a coat-hanger pattern.
Neck pain， typically in the suboccipital， posterior cervical， and shoulder region (the "coat-hanger headache")，
Coat-hanger headache -most likely due to neck muscle ischemia
Abiliity to identify common objects by palpation, recognizing their shape, texture and size is called as -
Stereognosis
'Maltese cross appearance' in RBCs seen in -
Babesia microti, a hemoprotozoan parasite of rodents, is also important as a zoonotic agent of human babesiosis. The Maltese cross form, which consists of four masses in an erythrocyte, is characteristic of the developmental stage of B. microti.
Most common purpose of Lumbar puncture is in suspected -
Most common purpose is in suspected meningitis, since there is no other reliable tool with which meningitis, a life-threatening but highly treatable condition, can be excluded.
Orthostatic hypotension is defined as a reduction in systolic blood pressure of at least ...... mmHg or diastolic blood pressure of at least ..... mmHg within ..... min of standing
Orthostatic hypotension is defined as a reduction in systolic blood pressure of at least 20 mmHg or diastolic blood pressure of at least 10 mmHg within 3 min of standing
'Brugada syndrome' is most frequently linked to mutations in the
Brugada syndrome - most frequently linked to mutations in the Na+ channel α-subunit， SCN5A
Downey cells
Seen in EBV infection Downey type I cells Downey type I cells are slightly larger…
Medicine MCQs – EBV
Which is the most prominent sign in EBV infection?
Pharyngitis, often the most prominent sign, can be accompanied by enlargement of the tonsils with an exudate resembling that of streptococcal pharyngitis.
"kissing disease" is other name for
Infectious mononucleosis is often called the kissing disease.
Epstein-Barr virus is spread through saliva.
Severity of the disease in EBV infection correlates with the levels of
Severity of the disease correlates with the levels of CD8+ T cells and EBV DNA in the blood.
Epstein-Barr virus spreads primarily through -
Epstein-Barr virus, or EBV- It spreads primarily through saliva
In the endemic type Burkitt's lymphoma ALL of the following factors primarily contribute to its development EXCEPT -
In the endemic type Burkitt's lymphoma there are three factors that contribute to its development:
- Malaria,
- EBV,
- Expression of the c-myc gene.
All of the following are CORRECT for EBV infection EXCEPT -
Fever is usually low-grade and is most common in the first 2 weeks of the illness
In EBV infection Lymphadenopathy most often affects -
Lymphadenopathy most often affects the posterior cervical nodes but may be generalized.
Enlarged lymph nodes are frequently
tender and symmetric but are not fixed in place.
