ERRATA Grand Test 98

Q-1 A 46-year-old woman presents with complaints of feeling as if she has "sand in her eyes" and reports difficulty swallowing such foods as crackers or toast. Which of the following pairs of tests would likely yield positive results in this patient?

a. Anti-Scl-70 antibody and anti-Smith antibody

b. Anti-Smith antibody and anti-double stranded DNA antibody

c. Rheumatoid factor and anti-double stranded DNA

d. Rheumatoid factor and anti-SS-A antibody

Ans-1: (d) Rheumatoid factor and anti-SS-A antibody

Ref:Read the text below

Sol:

· This patient has Sjogren's syndrome, which is an autoimmune disease characterized by lymphocytic infiltration of exocrine glands resulting in dry mouth (xerostomia) and dry eyes (keratoconjunctivitis sicca).

· Patients have an increased risk of malignant lymphoma. Autoantibodies produced include anti-Ro (SS-A), anti-La (SS-B), antinuclear antibodies, and rheumatoid factor.

· Anti-centromere antibodies are a very specific marker for CREST syndrome.

· Rheumatoid factor is usually positive in rheumatoid arthritis but may be seen in low titers in patients with other autoimmune diseases and chronic inflammatory conditions.

Q-52 The electrolyte abnormality typical seen in primary aldosteronism is

1. Hypokalemia
2. Hyperkalemia
3. Hyponatremia
4. Hypernatremia

Ans-52: (a) Hypokalemia (d) Hypernatremia

Q-72 A 46-year-old woman presents with complaints of feeling as if she has "sand in her eyes" and reports difficulty swallowing such foods as crackers or toast. Which of the following pairs of tests would likely yield positive results in this patient?

a. Anti-Scl-70 antibody and anti-Smith antibody

b. Anti-Smith antibody and anti-double stranded DNA antibody

c. Rheumatoid factor and anti-double stranded DNA

d. Rheumatoid factor and anti-SS-A antibody

Ans-72: (d) Rheumatoid factor and anti-SS-A antibody

Ref:Read the text below

Sol:

· This patient has Sjogren's syndrome, which is an autoimmune disease characterized by lymphocytic infiltration of exocrine glands resulting in dry mouth (xerostomia) and dry eyes (keratoconjunctivitis sicca).

· Patients have an increased risk of malignant lymphoma. Autoantibodies produced include anti-Ro (SS-A), anti-La (SS-B), antinuclear antibodies, and rheumatoid factor.

· Anti-centromere antibodies are a very specific marker for CREST syndrome.

· Rheumatoid factor is usually positive in rheumatoid arthritis but may be seen in low titers in patients with other autoimmune diseases and chronic inflammatory conditions.

Q-84 25 yr old female with fever, malaise and erythematous nodules over the shin diagnosis is

a. Erythema nodosum

b. Hensen's disease

c. Weber-christian disease

d. Urticarial vasculitis

Ans-84: (c) Weber-christian disease ; (a) Erythema nodosum

Ref:Read the text below

Sol:

Q-152 Chemotherapeutic agent producing SIADH is:

a. Vincristine

b. 5-FU

c. Cyclophosphamide

d. Bleomycin

Ans-152: (a) Vincristine (c) Cyclophosphamide

Ref: Read the text below

Sol:

· Vasopressin,oxytocin,Chlorpropamide,Vincristine,cyclophosphamide,Carbamezapine,Phenothiazine,MAO inhibitors,SSRI’s,TCA’s,Nicotine.

Q-229 Not true about type 1 lepra reaction

a. Type IV hypersensitivity reaction

b. Paucibacillary

c. Association with systemic features

d. Immunity is good.

Ans-229: (c) Association with systemic features

Ref:Read the text below

Sol:

· Type 1 Lepra Reaction is associated with Type IV Cell mediated Hypersensitivity and happens in Paucibacillary (where Immunity is good)

· Type 2 Lepra Reaction is associated with Type III Hypersensitivity and happens in Multibacillary leprosy (where there are lot of antibodies with poor immunity.

· The type I Lepra reaction is usually not associated with systemic features. Type 2 Lepra reaction (ENL) Erythema Nodosom Leprosom is usually associated with constitutional symptoms like fever, jointpainsand systemic complications involving various structures like eye (Iridocyclitis) ENT (Epistaxis), Pleurisy, pericarditis - ECG changes, hepatitis, acute glomerulo nephritis,arthritis, tenosynovitis and dactylitis.

Q-240. Successful block is confirmed by absence of knee jerk known as :

1. Gutrirrez’s Sign
2. Westphal’s sign
3. Durran’s sign
4. Light sign.

Ans 240: - (a) Gutrirrez’s Sign

Ref- Read the text below

Sol

Hanging drop technique (Gutrirrez’s Sign): If a drop of saline is placed on the hub it will be sucked in (due to negative pressure) once the needle is in epidural space.

Successful block is assised by:

· Absence of knee jerk (Westphal’s sign).

· Absence of pain by pin prick.

Durran’s sign: In unconscious patient rapid injection of drug in epidural space causes increases in rate and depth of respiraton.