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A 53-year-old woman presents complaining of fatigue over the past 6 months. During this time, she has also developed pruritus and lost 4 pounds. She is not sexually active, and her past medical history is significant only for Sjögren syndrome. On physical examination, she is afebrile and has mildly icteric sclera. There are excoriations noted on all four extremities and trunk and back. The liver edge is smooth and non-tender and measures 9 cm at the midclavicular line. There is no ascites, splenomegaly, or peripheral edema. Laboratory results reveal a normal complete blood count, normal electrolytes, and liver function tests with an alkaline phosphatase of 260 U/L (normal, <110 U/L), total bilirubin of 3.1 mg/dL, and normal transaminase levels. Which of the following is the most likely diagnosis? a) Acute cholecystitis b)Acute hepatitis A infection c)Bacterial cholangitis d)Primary biliary cirrhosis e)Primary sclerosing cholangitis  Explanation: The cor...

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. O...

Endocrinology MCQs 1) A meal rich in proteins but low in carbohydrates does not cause hypoglycaemia because a. glucagon secretion is stimulated by meals        b. the meal causes compensatory increase in T4 secretion c. cortisol in circulation prevents glucose from entering the muscles        d. the amino acids in the meal are converted to glucose Ans. a 2) Which of the following is incorrectly paired a. beta cells-insulin          b. F cells- gastrin c. delta cells- somatostatin          d. alpha cells- glucagon Ans. b 3) After intravenous administration of a large dose of insulin, the return of a low blood sugar level to normal is delayed by a. thyrotoxicosis               b. glucagon deficiency c.   diabetes    ...

GIT MCQs 1) Which of the following are incorrectly paired a. pancreatic alpha amylase-starch           b. elastase-tissue rich in elastin c. renin-coagulated milk                d. erythropeptidase-polypeptides Ans. d 2) All are GIT hormones except a. cholecystokinin            b. gastrin c. secretin           d. erythropoietin Ans. d 3) Iron is absorbed in a. stomach          b. duodenum c. jejunum          d. ileum Ans. b 4) In infants, defecation often follows a meal. The cause of colonic contractions in this situation is a. gastro-ileal reflex        b. increased circulating levels of CCK c. gastrocolic ref...

Nerve Muscle MCQs: 1) Which of the following has slowest conduction a. A alpha            b. A gamma c. B fibres            d. C fibres Ans. d 2) A man falls into deep sleep with one arm under his head. After awakening the arm is paralyzed but tingling sensation and pain sensation persists. This loss of motor function without the loss of sensory function is due to a. A fibres are more susceptible to hypoxia that B             b. A fibres are more sensitive to pressure than C c. C fibres are more sensitive to pressure than A               d. Sensory nerves are nearer bone and hence affected by pressure Ans. b 3) Saltatory conduction a. is seen only in myelinated nerve fibres         ...