Best e Book on Medical MCQs

Want to make best use of you time?
Want to prepare anywhere? anytime?
Want to achieve the best result in shortest time?
Ace medical MCQs is an e book you can access on your smart phone and your tablet. It is a collection of MCQs in all medical subjects prepared by a group of experts in the field.

Haematology MCQs for AIPGEE, FMGE, MCCEE

Want to make best use of you time?
Want to prepare anywhere? anytime?
Want to achieve the best result in shortest time?
Ace medical MCQs is an e book you can access on your smart phone and your tablet. It is a collection of MCQs in all medical subjects prepared by a group of experts in the field.

1. Most common blood transfusion reaction is:

A)     Hemolysis

B)     Febrile nonhaemolytic reactions

C)     Fluid overload

D)     Transmission of viruses

2. Heparin induced thrombocytopenia is treated with:

A)     Corticosteroid

B)      Lepirudin

C)      Vitamin K

D)     Platelet transfusion

3. Following is not a manifestation of antiphospholipid syndrome:

A)     Hrperlipedemia

B)      Pulmonary hypertension

C)      Recurrent abortions

D)     Deep vein thrombosis

4. Mainstay of treatment of antiphospholipid syndrome is:

A)     Statins

B)      Warfarin

C)      Ecospirin

D)     Corticosteroids

5. Activity of which of the coagulation factors is reduced in Von Willebrand (VW) disease?

A)     Factor VIII

B)      Factor XI

C)      Factor IX

D)     Factor V

6. Autosplenectomy is most commonly seen in long standing:

A)     Lymphoblastic leukemia

B)      Hereditary spherocytosis

C)      Sickle cell anemia

D)     Thalassemia

7. Aplastic crisis in sickle cell anaemia is due to infection due to:

A)     Salmonella Typhi

B)      Pneumococci

C)      Herpes virus

D)     Parvovirus B19

8. Replacement of Glutamate by Valine in beta chain causes increase in concentration of:

A)     Haemoglobin A

B)      Haemoglobin S

C)      Haemoglobin C

D)     Haemoglobin E

9. Most common manifestation of sickle cell anaemia is:

A)     Severe anaemia

B)      Haemolytic crisis

C)      Sequestration crisis

D)     Repeated episodes of skeletal pain

10. What is not true about sickle cell anaemia?

A)     Hypersplenism may warrent splenectomy

B)      Cardiomegaly and heart failure develop with time

C)      Patients have susceptibility to pneumococcal infection

D)     Pulmonary hypertension develops with time

Answers:

Ans: 1- B

There are two types of blood transfusion reactions; immunologic and infectious. 7% of transfusions result in febrile nonhaemolytic reactions due to reaction between donor WBCs and Recipient antibodies. The febrile reaction can be prevented by using leucoreduction filters. The treatment is with antipyretics after acute haemolysis is ruled out.

Ans: 2-B

Lepirudin is a direct thrombin inhibitor. Heparin should be discontinued if it induces thrombocytopenia. In such cases Lepirudin is indicated.

Ans: 3-A

Antiphospholipid syndrome is an autoimmune disorder. It is associated with thrombosis in both arteries and veins. Deep vein thrombosis of lower limbs is the commonest complication. It is also associated with pulmonary hypertension due to pulmonary embolism and pregnancy related complications such as recurrent abortions and preeclampsia. It does not affect lipid profile.

Ans: 4-B

Antiphospholipid syndrome is associated with increased thrombogenicity.  Prolonged anticoagulation can be achieved by warfarin. Pregnant women with the disease are treated with heparin, as warfarin can cross the placenta and is teratogenic.

Ans: 5-A

VW disease is an autosomal dominant disorder due to deficiency in coagulation factor that is required for normal platelet adhesion (bleeding pathway). VW factor serves as a plasma carrier for factor VIII c (Intrinsic clotting pathway) resulting in reduced activity of factor VIII. VW disease is associated with prolonged bleeding and clotting time and normal prothrombin time and partial thromboplastin time.

Ans: 6-C

Repeated episodes of microinfarctions due to sickled RBCs cause hyposplenism which is also known as autosplenectomy. The condition causes increased susceptibility to infection with Pneumococcus, Meningococcus and H. Influenza. Thalassemia causes splenomegaly and hypersplenism.

Ans: 7-D

Parvovirus B19 triggers aplastic crisis in sickle cell anaemia. The virus causes complete suppression of haematopoesis for 2-3 days. It has little effect in normal individuals; but in sickle cell anaemia due to shortened RBC life span, crisis results. Patients may require blood transfusion.

Ans: 8-B

Sickle cell anaemia results when glutamate of beta chain of haemoglobin A is replaced by Valine. Concentration of Haemoglobin S increases causing sickling of RBCs.

Ans: 9-D

Anaemia in sickle cell disease is moderate. Haemolytic crisis is uncommon; it causes jaundice and reduction in haemoglobin. Sequestration crisis is rare; it causes massive pooling of RBCs in spleen in children between 6 months and 3 years. Most common manifestation of sickle cell disease is recurrent episodes of skeletal pain caused due to microinfarction.

Ans: 10-A

Sickle cell anaemia is associated with hyposplenism due to repeated splenic infarctions. This results in autosplenectomy. Reduced splenic function causes impaired opsonisation and infection due to capsulated organisms such as pneumococci. Cardiomegaly, heart failure and pulmonary hypertension are common with chronic sickle cell anaemia.
http://www.lulu.com/shop/search.ep?type=&keyWords=Ace+medical+Mcqs&x=8&y=6&sitesearch=lulu.com&q=

Endocrinology for AIPGMEE, JIPMER, MCCEE

Want to make best use of you time?
Want to prepare anywhere? anytime?
Want to achieve the best result in shortest time?
Ace medical MCQs is an e book you can access on your smart phone and your tablet. It is a collection of MCQs in all medical subjects prepared by a group of experts in the field.

1. Levothyroxin (T4) supplementation in the dose of 25 micrograms per day is a preferred initial dose for:

A)   All adults newly diagnosed as hypothyroid

B)   If  the diagnosis is made during pregnancy

C)   Persons with stable angina

D)   Persons with myxedema

2. Over correction of hypothyroidism with levothyroxin increases the risk of:

A)   Exophthalmos

B)   Osteoporosis

C)   Hypercholestolemia

D)   Goiter

  

3. Parathyroid hormone is normally secreted in response to:

A)   Low calcium ion concentration

B)   Low levels of serum vitamin D

C)   High calcium ion concentration

D)   High Vitamin D concentration

  

4. Following endocrinopathy is associated with Peptic ulcer disease:

A)   Hyperthyroidism

B)   Hypothyroidism

C)   Hyperparathyroidism

D)   Hypoparathyroidism

  

5. Estimation of calcium ion concentration is important to diagnose hypertension secondary to:

A)   Hyperaldostrerinism

B)   Hyperparathyroidism

C)   Renal artery stenosis

D)   Syndrome of inappropriate Anti-diuretic Hormone secretion (SIADH)

  

6. Hypovitaminosis D causes:

A)   Primary Hyperparathyroidism

B)   Secondary hyperparathyroidism

C)   Tertiary hyperparathyroidism

D)   Malignant hyperparathyroidism 

7. Which is the commonest malignancy in MEN 2a (multiple endocrine neoplasia 2a)?

A)   Gastrinoma

B)   Insulinoma

C)   Medullary thyroid carcinoma

D)   Pheochromocytoma

  

8. Commonest cause of secondary adrenal insufficiency is:

A)   Iatrogenic

B)   Tuberculosis

C)   Autoimmunity

D)   Waterhouse friederichsen syndrome

9. True about gynecomastia:

A)   Estrogen: Androgen ratio is increased

B)   It can normally occur at puberty

C)   Prolactin levels are increased

D)   Spironolactone can cause iatrogenic gynecomastia

10. Which is the cause of primary hyperaldosteronism?

A)   Renal artery stenosis

B)   Cirrhosis of liver

C)   Congestive cardiac failure

D)   Glucocorticoid remediable aldosteronism

Answers:

Ans: 1-C

The usual starting dose for any adult with hypothyroidism is 50-100 microgram per day. Elderly people and people with heart disease should be given lower initial doses as increase in heart rate can precipitate myocardial ischemia. Pregnant women can be treated with usual dosage of thyroxin. Myxedema is a manifestation of hypothyroidism and the treatment remains the same.

Ans: 2-B

Exophthalmos is one of the manifestations of autoimmune process associated with Grave’s disease. Hypothyroidism can elevate levels of LDL cholesterol. Treatment of hypothyroidism may correct hypercholesterolemia to some extent. Osteoporosis and atrial fibrillation are associated with overcorrection or iatrogenic hyperthyroidism.

Ans: 3-A

Low calcium ion concentration is the only stimulation for secretion of parathyroid hormone from the glands. Vitamin D does not directly affect secretion of parathyroid hormone.

Ans: 4-A

Hyperparathyroidism is associated with Acid peptic disease causing duodenal ulcer more frequently than gastric ulcers. It is important to do calcium levels in all cases of peptic ulcer disease.

Ans: 5-B

Hyperparathyroidism can cause hypertension. The condition can be suspected if serum calcium is raised.

Ans: 6-B

Parathyroid adenoma (80%) and hyperplasia (20%) cause primary hyperparathyroidism. Low vitamin D levels cause low serum calcium level stimulating parathyroid stimulation and secondary hyperparathyroidism. When parathyroid gland is stimulated for long duration, it may become autonomous causing high calcium levels and high parathyroid levels resulting in tertiary hyperparathyroidism. Secretion of parathyroid related protein from some lung, breast or kidney cancers causes malignant hyperparathyroidism

Ans: 7-C

Medullary thyroid carcinoma occurs in 100% cases of MEN 2a. Gene involving MEN 2 a and b is ret proto onchogene. Those testing positive for ret mutation can be treated with prophylactic thyroidectomy, usually before three years of age.

Ans: 8-A

Tuberculosis and autoimmunity are common causes of primary adrenal insufficiency or Addison’s disease, when the insult is directly to the adrenal gland due to which they stop functioning. Waterhouse freidrichsen syndrome causes acute adrenal insufficiency due to adrenal hemorrhage. Long term use of steroids (iatrogenic) suppress pituitary adrenal axis, which remains suppressed even after stoppage of steroid, causing secondary adrenal insufficiency. During periods of stress steroid supplementation is needed in such cases.

Ans: 9-C

Increase in prolactin levels causes galactorrhea.

Ans: 10-D

Glucocorticoid remediable aldosteronism is a genetic condition where aldosterone production is under control of ACTH, when steroid suppresses ACTH, aldosterone secretion reduces. Option A, B and C are causes of secondary hyperaldostreronism.

www.lulu.com/shop/search.ep?type=Ace+medical+Mcqs&x=11&y=9&sitesearch=lulu.com&q=

Basic medical genetics for AIPGEE, FMGE, PGIEE, MCCEE

Want to make best use of you time?
Want to prepare anywhere? anytime?
Want to achieve the best result in shortest time?
Ace medical MCQs is an e book you can access on your smart phone and your tablet. It is a collection of MCQs in all medical subjects prepared by a group of experts in the field.

1. A series of three nucleotides on a gene that encodes a protein is called:                                          

A)     Intron

B)      Exon

C)      Codon

D)     Messenger RNA

2. Antibiotic resistance in bacteria is genetically transmitted through:                                                     

A)     Chromatid

B)      Chromosome

C)      Plasmid

D)     Centrioles

3. Chromosomal makeup in Turner syndrome is:                                                                                              

A)     45XO

B)      45XX

C)      46XX

D)     46XXX

4. A newborn female child presenting with hypoplastic left heart syndrome was found to have 45XO chromosomes. The diagnosis is:                                                                                                                                       

A)     Klinefelter syndrome

B)      Down’s syndrome

C)      Turner syndrome

D)     Robertsonian translocations

5. All of the following are single gene disorders except:                                                                                

A)     Klinefelter syndrome

B)      Marfan syndrome

C)      Cystic fibrosis

D)     Hemophilia

6. Choose an option that does not represent chromosomal disorder:                                                     

A)     Klinefelter syndrome

B)      Down Syndrome

C)      Turner syndrome

D)     Duchenne muscular dystrophy

7. All of the following conditions represent autosomal recessive inheritance EXCEPT:                     

A)     Sickle cell anemia

B)      Cystic fibrosis

C)      Haemophilia

D)     Phenylketonuria

8. What is the most common viable aneuploidy (abnormal number of chromosomes) in humans?

A)     Klinefelter syndrome

B)      Down syndrome

C)      Edwards syndrome

D)     Turner syndrome

9. The commonest mechanism of genetic abnormality in a case of Trisomy 21 is:

A)     Nondysjunction in maternal gamete

B)      Nondysjunction in paternal gamete

C)      Translocation to chromosome 14

D)     Translocation to any autosome

10. Chorionoc villus sampling is done at what gestation?

A)     6-9 weeks

B)      10-12 weeks

C)      14-20 weeks

D)     14-28 weeks

Answers:

Ans: 1- C

Genetic code is represented by codons, which are a series of three nucleotides. The code specifies the amino acid to be added next, in the process of protein synthesis. Messenger RNA is the RNA that conveys genetic information from DNA to ribosomes. When a messenger RNA is synthesised, exons (nucleotide sequence encoded by gene) become part of mature messenger RNA, whereas introns are spliced away.

Ans: 2-C

A plasmid is DNA material separate from chromosomal DNA. The plasmid DNA can be transmitted by horizontal gene transfer to bacteria of same or other species. This is the mechanism of antibiotic resistance in bacteria.

ANS: 3-A

Turner syndrome is also known as monosomy X, as one of the X chromosome is missing from all cells or from some cells (mosaicism). Characteristic features of turner syndrome are; Short stature, low hair line, low set ears and webbed neck.

Ans: 4- C

45XO represents monosomy X or Turner syndrome. Most commonly observed congenital heart disease are obstructive lesions of the left side of the heart including coarctation of aorta, bicuspid aortic valve and hypoplastic left heart syndrome.

Ans: 5-A

Klinefelter syndrome is a chromosomal disorder in which there is at least one extra X chromosome in the genetic makeup. Thus it is known as the chromosomal disorder and is not a single gene mutation.

Ans: 6- D

Duchenne muscular dystrophy is X- linked recessive condition.

Ans: 7- C

Haemophilia is recessive disorder of X- chromosome. Males are affected more frequently than females. Mothers are carriers. Others are autosomal recessive disorders.

Ans: 8- B

Down syndrome ( Trisomy 21) is the most common autosomal aneuploidy that the infant can servive with. Klinefelter syndrome (at least one extra X chromosome) is the most common sex chromosome aneuploidy. Most cases of Turner syndrome (Monosomy X) result in abortions. Edwards syndrome (trisomy 18) is rare.

Ans: 9- A

Trisomy 21 is caused by a meiotic nondysjunction event most commonly in the ovum. The affected ovum has 24 chromosomes with an extra copy of chromosome 21. When it combines with a normal sperm, the embryo has 47 chromosomes with trisomy 21. Mechanisms mentioned in other options are less common causes of Down syndrome.

Ans: 10- B

Chorionic villus sampling is done after 9 weeks of gestation till 12.5 weeks of gestation. Amniocentesis can be done from about 14 weeks till 20weeks.

Orthopedic MCQs for AIPGMEE, PFI, JIPMER, FMGE, MCCEE

Want to make best use of you time?
Want to prepare anywhere? anytime?
Want to achieve the best result in shortest time?
Ace medical MCQs is an e book you can access on your smart phone and your tablet. It is a collection of MCQs in all medical subjects prepared by a group of experts in the field.

1. Commonest risk factor for fracture neck femur is:

A)     Osteoporosis

B)      Osteomalacia

C)      Bone tumour

D)     Osteomyelitis

2. What is NOT true about indication of X-ray in a case of ankle sprain? X-ray is indicated:

A)     If there is persistence inability to bear weight for four steps

B)      When tenderness is present at the tip of medial meleolus

C)      When tenderness is present at the tip of lateral meleolus

D)     In all ankle injuries as most cases are associated with fracture

3. Pain of carpal tunnel syndrome characteristically                                                                                         

A)     Increases on exposure to cold

B)      Increases on exposure to heat

C)      Has no diurnal variation

D)     Is most severe at night

4. Ankylosis is : 

A)     Restriction of motion in a joint

B)      Degenerative changes of vertebra

C)      Dislocation of vertebra

D)     Loss of normal vertebral curvature

                                                       

5. Most commonly diseased cervical vertebral disc is:                                                                                     

A)     Between C1-C2

B)      Between C3- C4

C)      Between C5-C6

D)     Between C6-C7

6. Unilateral involvement of deltoid muscle is seen in:                                                                                   

A)     Erb’s palsy

B)      Klumpke’s palsy

C)      Proximal myopathy

D)     Duchenne muscular dystrophy

7. Which nerve roots are damaged in Erb’s palsy:                                                                                             

A)     C1-C2

B)      C3-C4

C)      C5-C6

D)     C7-T1

8. Dislocation of shoulder is most commonly:                                                                                     

A)     Anterior in location

B)      Posterior in location

C)      Inferior in location

D)     Superior in location

9. All the statements about Giant cell tumor of bone are true, EXCEPT:

A)     On an X-ray, it appear as an area of bone sclerosis

B)      rarely converts to malignancy

C)      are epiphyseal in location

D)     Local pain is the most common presentation

10. Baker’s cyst is a synovial cyst seen at:

A)     Anterior aspect of knee

B)      Posterior aspect of knee

C)      Medial aspect of ankle

D)     Lateral aspect of ankle

Answers:

Ans: 1-A

Fracture neck femur is a pathological fracture due to osteoporosis in old age. Osteomalacia is less common and is less frequently a cause of the fracture. Rarely pathological fracture due to bone tumour or osteomyelitis involves neck of femur.

Ans: 2-D

Ottawa ankle guidelines are sensitive guidelines to decide about the need for X-ray, in a case of ankle sprain. Options A,B,C are the indications for X-ray as per the guidelines. All cases of ankle sprain do not require X-rays, as most are ligament injuries only.

Ans: 3- D

Worsening of pain on exposure to cold occurs in Raynaud’s disease. The increase in severity of neuropathic pain in carpal tunnel syndrome during night is attributed to night time posture of hand.

Ans: 4- A

Ans: 5- C

The vertebral mobility is more at C5-C6 level; hence the disc is most affected cervical spine disc.

Ans: 6-A

Erb’s palsy is caused by injury to C5-C6 nerve roots during difficult labour. The nerves most affected are suprascapular, musculocutaneous and axillary nerves. Deltoid, biceps and brachialis muscles are involved. The injury is due to traction and is always unilateral. The muscles of arm including deltoid are paralysed. Klumple’s palsy involves lower roots of brachial plaxus. Muscles of hand and forearm are affected. Both proximal myopathy and Duchenne muscular dystrophy have bilateral distribution.

Ans: 7- C

Ans: 8-A

The shoulder joint has great range of motion due to which it is particularly susceptible to dislocation. 95% of shoulder dislocations are anterior in location and may cause injury to axillary artery and axillary nerve.

Ans: 9-A

The giant cell tumor (GCT) appears on an X-ray as lytic lesions, described as soap bubble appearance. It is not surrounded by area of sclerosis. Most GCTs are benign, only 5% metastasize to lungs. They are epiphyseal in location and most commonly manifests as local pain.

Ans: 10-B

Baker’s cyst also known as popliteal cyst is found at the posterior aspect of knee, easily visualised when the patient is standing with knee extended. It is associated with knee arthritis or cartilage tear.