Internal Medicine MCQs (part 6)

Part: 6

1. All of the following statements regarding primary effusion lymphoma are true except:
A. It generally presents in elderly patients
B. There is often an association with HHV 8
C. The proliferating cells are NK cells
D. Patients are commonly HIV positive

Correct answer :C. The proliferating cells are NK cells
Primary effusion lymphomas are aggressive malignancies that present as serous effusion without any tumour mass.

2. An 18-year-old male presented with acute onset descending paralysis of 3 days duration. There is also a history of blurring of vision for the same duration. On examination, the patient has
quadriparesis with areflexia. Both the pupils are non reactive. The most probable diagnosis is:
a) Poliomyelitis
b) Botulism
c) Diphtheria
d) Porphyria
Correct answer : b) Botulism
The important features of the patient are descending paralysis, blurring of vision and non reactive pupils. Descending paralysis is caused by 3 of the conditions mentioned – polio, botulism, and diphtheria. Diphtheria and botulism can cause ocular symptoms. …

3. Episodic generalized weakness can occur due to all of the following acute electrolyte disturbances, except:
a) Hypokalemia
b) Hypocalcemia
c) Hyponatremia
Correct answer : b) Hypocalcemia
Electrolyte imbalances which result in Episodic generalized weakness:

Hyperkalemia
Hypokalemia
Hypernatremia
Hyponatremia
Hypercalcemia
Hyperphosphatemia
Hypermagnesemia

4. A patient aged 65 years, is diagnosed to have severe aplastic anemia. HLA compatible sibling is available. The best option of treatment is;
a) Anti thymocyte globulin followed by cyclosporine
b) A conventional bone marrow transplantation from the HLA identical sibling
c) A non-myeloablative bone marrow transplantation from the HLA identical sibling
d) Cyclosporine
Correct answer : a) Anti thymocyte globulin followed by cyclosporine
Treatment of choice in an elderly individual with severe aplastic anemia is immunosuppression – Anti thymocyte globulin followed by cyclosporine. Bone marrow transplantation is tried only in young adults.

5. ln acute pulmonary embolism, the most frequent ECG finding is:
a) S1Q3T3 pattern
b) P. pulmonale
c) Sinus tachycardia
d) Right axis deviation
Correct answer : c) Sinus tachycardia
All of the above features may be seen in acute pulmonary embolism, but sinus tachycardia is seen in all cases.

6. A hoursewife ingests a rodenticide white powder accidentally. She is brought to hospital where the examination shows generalized, flaccid paralysis and an irregular pulse. ECG shows multiple ventricular ectopics, generalized changes with ST-T. Serum potassium is 2.5 m Eq/L. The most likely ingested poison is:
a) Barium carbonate
b) Super warfarins
c) Zinc phosphide
d) Aluminium phosphide
Correct answer : a) Barium carbonate
Read more : Features of barium carbonate poisoning

7. The endotoxin of the following gram negative bacteria does not play any part in the pathogenesis of the natural disease:
a) Escherichia coli
b) Klebsiella sp.
c) Vibrio cholerae
d) Pseudomonas aeruginosa
Correct answer : c) Vibrio cholerae
Vibrio cholerae exotoxins are responsible for tis pathogenecity.

8. Salmonella typhi is the causative agent of typhoid fever. The infective dose of S. typhi is:
a) One bacillus
b) 10(8) – 10(10) bacilli
c) 10(2) – 10(5) bacilli
d) 1-10 bacilli
Correct answer : c) 10(2) – 10(5) bacilli (factual question)

9. The single most common cause of pyrexia of unknown origin is:
a) Mycobacterium tuberculosis
b) Samonella typhi
c) Brucella sp.
d) Salmonella paratyphi A
Correct answer : a) Mycobacterium tuberculosis (factual question)

10. “lntestinal angina” is a symptom complex of the following:
a) Postprandial abdominal pain, weight loss, actue mesenteric vessel occlusion
b) Postprandial abdominal pain, weight loss, chronic mesenteric vessel occlusion
c) Preprandial abdominal pain, weight loss, chronic mesenteric vessel occlusion
d) Preprandial abdominal pain, weight gain, acute mesenteric vessel occlusion
Correct answer : b) Postprandial abdominal pain, weight loss, chronic mesenteric vessel occlusion
Intestinal angina is due to chronic mesenteric vein occlusion. It causes abdominal pain, cramping following food intake, weight loss and chronic diarrhoea