Internal Medicine MCQs (part 1)

1.Disseminated intravascular coagulation (DIC) differs from thrombotic thrombocytopenic purpura. In this reference the DIC is most likely characterized by:
A. Significant numbers of schistocytes
B. A brisk reticulocytosis
C. Decreased coagulation factor levels
D. Significant thrombocytopenia

Correct answer : C. Decreased coagulation factor levels
In DIC, the levels of coagulation factors are decreased. Whereas in TTP, coagulation factor levels are normal.

2.Isolated 3rd nerve palsy is seen in?
A. Frontal lobe tumor
B. Weber’s syndrome
C. Diabetes
D. All of the above

3.All of the following are true about manifestations of vitamin E deficiency, except:
A. Hemolytic anemia
B. Posterior column abnormalities
C. Cerebellar ataxia
D. Autonomic dysfunction
Correct answer : D. Autonomic dysfunction
Autonomic dysfunction is not seen with vitamin E deficiency.

4.Vitamin B12 deficiency can give rise to all of the following, except:
A. Myelopathy
B. Optic atrophy
C. Peripheral neuropathy
D. Myopathy
Correct answer : D. Myopathy
Myopathy is not seen with vitamin B12 deficiency.

5.All of the following are neurologic channelopathies except:
A. Hypokalemic periodic paralysis
B. Episodic ataxia type 1
C. Familial hemiplegic migraine
D. Spinocerebellar ataxia 1
Correct answer : D. Spinocerebellar ataxia 1
Spinocerebellar ataxia (SCA) type 1 is not a neurological channelopathy. But SCA type 6 is a neurological channelopathy.

6. EEG is usually abnormal in all of the following, except:
A. Subacute sclerosing panencephalitis
B. Locked — in state
C. Creutzfeldt — Jakob disease
D. Hepatic encephalopathy
Correct answer : B. Locked — in state
In locked in state, normal alpha activity is found in EEG.

7.A 45 year old male with a history of alcohol dependence presents with confusion, nystagmus and ataxia. Examination reveals 6th cranial nerve weakness. He is most likely to be suffering from:
A. Korsakoff’s psychosis
B. Wernicke encephalopathy
C. De Clerambault syndrome
D. Delirium tremens
Correct answer : B. Wernicke encephalopathy
Wernicke encephalopathy is characterised by a triad of confusion, ophthalmoplegia and ataxia in an alcoholic patient.

8.A 40 year old male with history of daily alcohol consumption for the last 7 years, is brought to the hospital emergency room with acute onsent of seeing snakes all around him in the room, not recognizing family members, violent behavior and tremulousness for a few hours. There is history of his having missed the alcohol drink for 2 days. Examination reveals increased blood pressure, tremors, increased psychomotor activity, fearful affect, hallucinatory behaviour, disorientation, impaired judgement and insight. He is most likely to be suffering from:
A. Alcoholic hallucinosis
B. Delirium tremens
C. …

9.Which of the following is a cause of reversible dementia?
A. Subacute combined degeneration
B. Picks disease
C. Creutzfeldt — Jakob disease
D. Alzheimers disease
Correct answer : A. Subacute combined degeneration
Subacute combined degeneration is caused by vitamin B12 deficiency and is potentially reversible.

10. All of the following CSF findings are present in tuberculous meningitis, except:
A. Raised protein levels
B. Low chloride levels
C. Cob web formation
D. Raised sugar levels
Correct answer : D. Raised sugar levels
Glucose levels are decreased in tuberculous meningitis.