Skin MCQs for MCCEE, MCCQE



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1. Treatment of the rash seen in a newborn includes:

       A)Antibiotic ointment

       B)Antifungal ointment

       C)Reassurance the mother

               D)Topical steroids

Ans: C  

This is heat rash in a newborn. It occurs due to blockage of sweat ducts when the ambient temperature is high or the baby is kept covered. The rash is benign and self limiting, and no treatment is indicated. Concerned mother should be reassured.

       

2.

The rash in the picture is pathognomonic of:

               A)Typhoid fever

               B)Rubella

               C)Deep vein thrombosis

               D)Dengue recovery rash *

Ans: D

Dengue recovery rash is seen in secondary dengue in its recovery phase. There is generalized erythema on all four extremities. The rash shows round areas of clearing before it subsides. This pattern is pathognomonic of dengue recovery rash. It heralds recovery.

3. Which of the following skin condition is contagious?                                                                  

A)     Psoriasis

B)      Rosacea

C)      Pityriasis rosea

D)     Tinea pedis

Ans: D

Psoriasis is an immune mediated disease and is non infectious. Rosacea is a skin condition precipitated by exposure to sun light, ambient temperature changes, emotional stress etc. The exact cause is not known. Pityriasis rosea is a self limiting skin condition of yet unknown etiology. It gives lifelong immunity, thus indicating a viral etiology but it is not known to be contagious. Tinea pedis is highly contagious infection, especially in athletes.

4. Following skin cancer is not predisposed by excessive sun exposure:                                                 

A)     Kaposi Sarcoma

B)      Basal cell carcinoma

C)      Squamous cell carcinoma

D)     Melanoma

Ans: A

Kaposi sarcoma is associated with Acquired immunodeficiency disease. Skin may be involved but the occurrence is not related to sun light exposure.

 

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Endocrinology MCQs for MCCEE, AIPGMEE, PGIEE, JIPMER, FMGE, State PG entrance,

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. Drug effectively used in treatment of Cushing’s syndrome is:                                                                

A)     Insulin

B)      Prednisolone

C)      Ketoconazole

D)     High dose multivitamin

Ans: C

Ketoconazole inhibits steroidogenesis and is used for medical treatment of cushing’s syndrome.

2. Corticosteroid hormones are responsible for all of the following functions, EXCEPT:                   

A)     Mobilization of glucose from liver

B)      Control of total body water

C)      Inhibition of lymphocyte proliferation

D)     Increase in muscle mass

Ans: D

Corticosteroids have catabolic effect on protein metabolism hence they do not increase muscle mass unlike anabolic steroids.

3. Addison’s disease is associated with serum levels of:                                                                                

A)     Elevated potassium and low sodium

B)      Elevated Sodium and low potassium

C)      Elevated sodium and potassium

D)     Decreased sodium and potassium

Ans: A

Addison’s disease is name given to primary adrenal insufficiency. There is deficiency of glucocorticoid and mineralocorticoid (aldestrerone) hormones. Potassium excretion from kidney is impaired, due to low aldosterone. Low serum sodium is due to low aldosterone and high corticotropin releasing hormone causing increase in ADH (anti diuretic hormone).

4. Adrenal cortex does not produce:                                                                                                                      

A)     Glucocorticoid hormone

B)      Adreno corticotropic hormone

C)      Androgen

D)     Aldosterone

Ans: B

5. Nelson syndrome is:                                                                                                                                               

A)     ACTH producing tumour in pituitary

B)      Ectopic ACTH producing tumour

C)      Unilateral adrenal hyperplasia

D)     Bilateral adrenal hyperplasia

Ans: A

Nelson syndrome is rapid enlargement of pituitary gland tumour after removal of both adrenal glands that is performed in order to treat hyperadrenalism.

6. Hormone responsible for stimulating appetite is:                                                                                        

A)     Ghrelin

B)      Obestatin

C)      Motilin

D)     Leptin

Ans: A

Ghrelin is appetite stimulating peptide the levels of which increases before a meal and decreases after a meal. Leptin and obstetin suppress appetite. Motilin does not affect appetite.

7. Choose a statement that is not true about Gigantism.

A)     In most cases it is because of pituitary tumour

B)      It is diagnosed by measurement of fasting growth hormone level

C)      It occurs only if high growth hormone is present before fusion of bone epiphysis

D)     Growth hormone is inhibited by increase in blood glucose.

Ans: B

Growth hormone is secreted by pituitary in pulses hence single point measurement is not reliable.

8. Commonest hormonal disturbance of pituitary gland is, increased secretion of:

A)     Prolactin

B)      Growth hormone

C)      Antidiuretic hormone

D)     Thyroid secreting hormone

Ans: A

9. Choose an option that is not a cause of gynecomastia:

A)     Cirrhosis of liver

B)      Spirinolactone treatment

C)      Tamoxifane treatment

D)     Use of anabolic steroid

Ans: C

Gynecomastia is due to increase in ratio of estrogen and teastoaterone in male subjects. Estrogen breakdown is impaired in cirrhosis if liver. Spironolactone treatment is often used in patients of cirrhosis of liver. Spironolactone inhibits production of androgens and is a potent androgen antagonist. Excess testosterone in anabolic streroids gets converted to estrogen causing gynecomastia. Tamoxifane blocks effect of estrogen on breast tissue, hence it is used in treatment of gynecomastia.

10. Causes of virilisation of a female foetus are all EXCEPT:                                                                          

A)     21 hydroxylase deficiency

B)      17 hydroxylase deficiency

C)      11  bera hydroxylase deficiency

D)     3 beta hydroxysteroid dehydrogenase deficiency

Ans: B

17 hydroxylase deficiency causes defect in steroid hormone synthesis in foetus leading to deficiency of glucocorticoid and sex steroids and increased production of mineralocorticoids. It manifests as inadequate virilisation of male foetus, causing ambiguous genitalia. It causes partial or no secondary sexual development in affected female. Hypertension and hypokalemia result due to high mineralocorticoid activity later in life. (To remember, only nos. 1,2,3  cause virilisation as in11, 21 and 3)

Liver MCQs for MCCEE, AIPGMEE, PGIEE, JIPMER, FMGE, State PG entrance,

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1. Which of the following is least likely to cause cirrhosis of liver?                                                              

A)     Biliary atresia

B)      Nonalcoholic steatohepatitis

C)      Hepatitis E

D)     Hepatitis C

Ans: C

Hepatitis E infection is self limiting in most cases. It may become chronic in presence of immunodeficiency and rarely leads to cirrhosis of liver.

2. In a case of portal hypertension; porto-systemic shunts develop at all of the following sites EXCEPT:                                                                                                                                                                  

A)     Anal canal

B)      Retroperitoneal space

C)      Anterior abdominal wall

D)     Spleen

Ans: D

Spleen vein drains into the portal vein. Spleen does not have systemic venous drainage, hence there is no porto systemic shunt in the spleen.

3. Which drug is useful in lowering blood pressure in portal system?                                                       

A)     Sodium nitroprusside

B)      Propranolol

C)      Amlodepin

D)     Diltiazam

Ans: B

4. Portal hypertension presenting with intractable ascitis and hepatomegaly is likely to be due to:                                                                                                                                                                                            

A)     Portal vein thrombosis

B)      Budd-chiari syndrome

C)      Alcoholic cirrhosis

D)     Biliary cirrhosis

Ans: B

Occlusion of hepatic vein (Budd- Chiari syndrome) produces abdominal pain, hepatomegaly and ascitis. Portal vein thrombosis causes splenomegaly and porto-systemic shunt. In cirrhosis, the liver is usually shrunken and there is no hepatomegaly.

5. Commonest cause of portal hypertension is:                                                                                                

A)     Cirrhosis of liver

B)      Portal vein thrombosis

C)      Budd chiari syndrome

D)     Spenomegaly

Ans: A

6. In portal hypertension, dilated periumbilical collateral veins are known as:                                      

A)     Asterixix

B)      Caput medusa

C)      Migrating thrombophebitis

D)     Spider angiomata

Ans: B

Asterixix is the flapping tremors of hepatic encephalopathy. Migrating thromboplebitis is non metaststic manifestation of malignancy such as carcimoma of pancreas. Spider angiomata are seen as small lesions with central arterioles, these are due to high estrogen level in cirrhosis of liver.

7. All of the following are features of cirrhosis of liver EXCEPT:                                                                   

A)     Erythema nodosum

B)      Asterixix

C)      Depuytren’s contracture

D)     Gynecomastia

Ans: A

Erythema nodosum is inflammation of fat cells due to immunologic response to infections such as streptococcus, tuberculosis, mycoplasma pneumonia etc. It is not a manifestation of liver cell failure.

8.Late manifestations of cirrhosis of liver include all, EXCEPT:

A)     Portal hypertension

B)      Coagulation disorders

C)      Fatty liver

D)     Hepatorenal syndrome

Ans: C

Fatty liver is early manifestation of liver involvement in alcoholism. It is reversible if alcohol is discontinued. Other options are late manifestations.

9. Commonest type liver cancer is:

A)     Hepatoblastoma

B)      Hepato cellular carcinoma

C)      Hepatic adenoma

D)     Cholangiocarcinoma

Ans: B

Hepatoblastoma is a rare hepatic tumour occurring in children. Cholangiocarcinoma has frequency of 1-2 for 10 cases of hepatocellular carcinoma. Hepatic adenoma is benign tumour.

10.Commonest cause of hepatitis C infection is:

A)     Intravenous recreational drug use

B)      Blood transfusion

C)      Vertical transmission from mother to foetus

D)     Accidental needle stick injury

Ans: A

Infected needle use by intravenous drug users is the commonest cause of transmission of hepatitis C. Blood is tested for Hepatitis C before transfusion, hence incidence of transfusion induced hepatitis C has come down.

Medicine MCQs MCCEE, AIPGMEE, PGIEE, JIPMER, FMGE, State PG entrance,

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1. Beta blockers are used in patients with coronary artery disease for all of the following properties, EXCEPT:                                                                                                                                                                     

A)     Negative ionotropic effect

B)      Coronary vasodilatation

C)      Negative chronotropic effect

D)     Antihypertrnsive effect

Ans: B

Beta blockers prevent action of adrenalin on myocardium, thus they reduce myocardial contractility (negative ionotropic effect) and prevent increase in heart rate during stress (negative chronotropic effect). Antihypertensive effect of beta blockers prevents progression of atherosclerosis. Beta blockers do not have vasodilatory effect on coronary vasculature.

2. A 10 year old child presents with progressively worsening dyspnoea and cough for past 2 months,   he should be evaluated for all of the following conditions, EXCEPT:                                                                                           

A)     Rheumatic heart disease

B)      Bronchial asthma

C)      Cardiomyopaty

D)     Pulmonary tuberculosis

Ans: B

Bronchial asthma is characterised by episodic bronchospasm and hence episodic symptoms. All other listed conditions can present with progressively worsening symptoms.

3. Pneumocystis carinii (Jiroveci) pneumonia is:                                                                                               

A)     Fungal pneumonia

B)      Viral pneumonia

C)      Bacterial pneumonia

D)     Allergic pneumonia

Ans: A

4. Pneumocystis carinii pneumonia is treated with:                                                                                         

A)     Amphotericin B

B)      Amoxicillin salbactum

C)      Amoxicillin- clavulinic acid

D)     Trimethoprim-sulphamethoxazole

Ans: D

5. Smoking cessation is the mainstay of treatment for:                                                                                  

A)     Migrating thrombophebitis

B)      Deep vein thrombosis

C)      Thromboangitis obliterens

D)     Thrombocytopenia

Ans: C

Thromboangitis obliterens is also known as Buerger’s disease. Peripheral arteries and veins in limbs are thrombosed and inflamed. It is strongly associated with smoking and smokeless tobacco. Smoking cessation slows down the disease process but may not halt progress.

6. Which substance exerts maximum effect on plasma osmolarity:                                                          

A)     Sodium

B)      Glucose

C)      Urea

D)     Creatinine

Ans: A 

 Sodium exerts maximum effect on plasma osmolarity, this can be seen from the example. In a person with serum sodium of 140mg/ dl, Blood glucose of 135mg/dl and blood urea of 14mg/dl, using the formula:

2x Na+ Glu/18+ Urea/2.8 = 280+7.5+5= 292.5

Thus it is clear that sodium exerts maximum effect on osmolarity. 

7. Treatment of prinzmetal angina is:

A)     Calcium channel blockers

B)      Ecospirin

C)      Beta blockers

D)     Angioplasty

Ans: A

Prinznetal angina, also known as variant angina is due to unexplained vasospasm of coronaries. It responds to nitrates and calcium channel blockers. Beta blockers are contraindicated. Ecospirin has no role. Angiography may be normal unless provocative test is performed. Angioplasty has no role.

8. Most sensitive and specific marker of myocardial necrosis is:

A)     Cardiac troponin

B)      Creatinine kinase MB

C)      Myoglobin

D)     Alanine transaminase

Ans: A

Cardiac troponins are most sensitive and specific indicators of cardiac necrosis. They are measured in cases of acute chest pain to differentiate between unstable angina and myocardial infarction.

9. Multidrug resistant tuberculosis(TB)  is defined as:                                                                     

A)     Bacteria resistant to any two antiTB drugs

B)      Bacteria resistant to INH and refampicin

C)      Bacteria resistant to INH or refampicin

D)     Bacteria resistant to INH, refampicin and amikacin

Ans: B

10. What is not true about Patit-mal epilepsy?                                                                                                   

A)     Several episodes occur everyday

B)      May manifest with unexplained deterioration in school performance

C)      Staring spells may be the sole manifestations

D)     Seizure is followed by cloudy consciousness

Ans: D

Patit mal seizure, also known as absence seizure; is brief disturbance in electrical activity of brain resulting in staring spells several times in a day. It may remain undiagnosed and untreated resulting in deterioration in school performance. Consciousness remains clear following a seizure.