Internal Medicine MCQs (part 4)

Part 4:

1. In which of the following conditions Splenectomy is not useful?
A. Herediatary spherocytosis
B. Porphyria
C. Thalassemia
D. Sickle cell disease with large spleen
Correct answer : B. Porphyria
Splenectomy has little role in the management of porphyria

2. Renal artery stenosis may occur in all of the following except:
A. Atherosclerosis
B. Fibromuscular dysplasia
C. Takayasu’s arteritis
D. Polyarteritis nodosa
Correct answer : D. Polyarteritis nodosa
Causes of renal artery stenosis:

Atherosclerosis
Giant cell arteritis
Fibromuscular dysplasia
Takayasu arteritis
Tranplant renal artery stenosis
Antiphospholipid antibody syndrome

3. The presence of anti Saccharomyces cerevisae antibody is a surrogate marker of one of the following:
A. Celiac disease
B. Crohn’s disease
C. Ulcerative colitis
D. Tropical sprue
Correct answer : B. Crohn’s disease
Saccharomyces cerevisae antibody positivity:

Chron’s disease – 60-70%
Ulcerative colitis – 10-15%

4. Anticentromere antibodies are most commonly associated with:
A. Diffuse cutaneous systemic sclerosis
B. Mixed connective tissue disease
C. CREST syndrome
D. Polymyositis
Correct answer : C. CREST syndrome
Anticentromere antibodies are seen mostly in those with CREST syndrome. (40-80% patients with CREST syndrome are anticentromere antibody positive)

5. Drug induced lupus can be identified by:
A. Anti histone antibodies
B. Double stranded DNA antibodies
C. Antinuclear antibodies
D. Anti SM antibodies
Correct answer : A. Anti histone antibodies
Anti histone antibodies are present in more than 95% individuals with drug induced lupus.

6. Which of the following is the most common presenting symptom of non cirrhotic portal hypertension?
A. Chronic liver failure
B. Ascites
C. Upper gastrointestinal bleeding
D. Encephalopathy
Correct answer : C. Upper gastrointestinal bleeding
Acute gastrointestinal bleed is the most common presenting symptom of extrahepatic portal hypertension.

7. Which of the following is not a common feature of Anorexia Nervosa?
A. Binge eating
B. Amenorrhoea
C. Self perception of being ‘fat`
D. Under weight
Correct answer : A. Binge eating
Binge eating is a common feature of bulimia. It is rarely seen in anorexia nervosa.

8. Smoking is not a risk factor for development of?
A. Small cell carcinoma
B. Respiratory bronchiolitis
C. Emphysema
D. Bronchiolitis obliterans organizing pneumonia
Correct answer : D. Bronchiolitis obliterans organizing pneumonia
Smoking is a known risk factor for small cell carcinoma, respiratory bronchiolitis and emphysema.

9. Mycotic abscesses are due to:
A. Bacterial infection
B. Fungal infection
C. Viral infection
D. Mixed infection
Correct answer : B. Fungal infection

10. Mycotic aneurysm is an aneurysm infected because of:
A. Fungal infection
B. Blood-borne infection (intravascular)
C. Infection introduced from outside (extravascular)
D. Both intravascular and extravascular infection
Correct answer : D. Both intravascular and extravascular infection
The source of infection in a mycotic aneurysm can be intravascular or extravascular.