Owner: PG Preparation URL:http://pg-prepare.blogspot.com Join Date: Tue, 20 Feb 2007 04:53:51 -0600 Rating:0 Site Description: PG Preparation Is a Blog About Getting ready For The post graduation entrance examinations in the field of medical sciences in India. It Covers various MCQs with high yield notes to help achieve success in PG Entrance tests Site statistics:Click here
MCQ Genetics 6 1970-01-01 00:59:59 Which is the gene mutation least likely to result in haemochromatosis? Heterozygous his (H63D) Heterozygous cys (C282Y) Combined his (H63D) & cys (C282Y) Homozygous cys Homozygous hisAnswerTags: MCQ, Genetics
, Hemochromatosis
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MCQ Genetics 8 1970-01-01 00:59:59 Which of the following causes a gene mutation with decreased protein production?A.MissenseB.NonsenseC. Point mutationAnswerTags: MCQ, Genetics
, Mutation
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MCQ Genetics 9 1970-01-01 00:59:59 DVT in a 40 year old woman. Which is the most likely cause?Factor V Leiden Protein C deficiency Protein S deficiency Antithrombin III deficiency Lupus anticoagulantAnswerTags: MCQ, Genetics
, DVT
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MCQ Genetics 10 1970-01-01 00:59:59 A 45 year old man has Duke’s C adenocarcinoma of the colon. There is a strong family history of colon cancer in the absence of polyps. What is the most likely genetic basis?A.Mismatch repair genes B.Ras C.Deletion in colon cancer D.P glycoprotein gene E.APC geneAnswer Tags: MCQ, Genetics
, adenocarcinoma, polyps
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DECOMPOSITION (Putrefaction) 1970-01-01 00:59:59 by the action of bacteria (putrification) and endogenous enzymes (autolysis).Dissolution of tissues - gases, liquids & saltsCommon bacteria are normal commensals coliforms, Clostridium, micrococci etc. fungi, such as Penicillium & Apergillus & sometimes from insects, which may be mature or larval stage.Septicaemia & temperature will hasten the process. 1-14 days.Obese, oedema bodies putrefy more rapidly.1 week of putrefaction in air = 2 weeks in water = 8 weeks in soil at similar temp. Casper's dictum.Buried in well drained soil, an adult body is reduced to a skeleton in about 10 years.Greenish discoloration of anterior abdominal skin. (sulph-haemoglobin)Commonly begins in the right iliac fossa."marbling" the superficial veins of the skin become visible as a purple-brown network.Epidermal shedding revealing a shiny, moist, pink base – dry - yellow parchment appearance. resembles ante-mortem abrasions and scalds.
LIVOR MORTIS 1970-01-01 00:59:59 Lividity: Dark purple coloration (not cyanosis) over dependent areas due to pooling of blood.Starts in 20-30 min as dull red patches then deepen in intensity and coalesce to form large areas of reddish-purple discoloration.Within 60min blood becomes in-coagulable due to the release of fibrinolysins.Clots may persist when the mass of clot is too large. Carbon monoxide poisoning or refrigeration soon may cause "cherry red“ or pink (methaemoglobin).After about 10-12 hours the lividity becomes "fixed" and repositioning the body, will result in a dual pattern of lividity since the primary distribution will not fade completely.The blanching of post mortem lividity by thumb pressure indicates that the lividity is not fully fixed. Distribution of lividity reflects the position at death.Contact pallor or pressure pallor. A supine corpse will display contact pallor over the shoulderblades, buttocks, calves, heels and location of firm fitting clothing
Sources of Evidence 1970-01-01 00:59:59 Corporal evidence - present in the body. Environmental and associated evidence. at the site of crime.Anamnestic evidence, i.e. that based on the deceased's ordinary habits, movements, and day to day activities. All three sources of evidence should be explored and assessed
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Methods for estimating TOD: 1970-01-01 00:59:59 The rate method: by measuring events that occur at known rates.E.g.Rigor mortis, body temp,degree of putrefaction.The concurrence method: By Comparing the occurrence of events which took place at known times. E.g. a wrist watch stopped by a blow during an assault, the extent of digestion of the last known meal.Postmortem changes and TOD: Many physico-chemical changes occur after birth in a fairly orderly fashion until the body disintegrates. Each change has its own time factor or rate. influenced by internal & external factors.Longer the PM interval, the less precise is the estimate of the time of death.
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Algor Mortis: (body cooling) 1970-01-01 00:59:59 Most useful single indicator in first 24 hours. (in cool places only – not in tropic)No Oral or axillary temperature.per rectum or the intra-hepatic/sub-hepatic temperature an abdominal stab.clinical thermometer’s range is too small.A chemical thermometer 10-12" long with a range from 0-50o Celsius or digital probe thermometer is ideal.Normal Temp 35.9oC (96.7oF) to 37.2oC (99oF). The rectal temp is + 0.3oC (0.5F)Factors affecting.The "size" of the body. Fat slow..!Clothing and coveringsMovement and humidity of the air.Immersion in water.Clothed body will cool in air at the rate of about 1.5oC an hour for the first 6 hours & 1oC for the first 12h.
MUSCULAR CHANGES 1970-01-01 00:59:59 After death, the muscles of the body pass through three stages:1) Primary relaxation or flaccidity2) Rigor mortis or cadaveric rigidity3) Secondary flaccidityRIGOR MORTIS Body becomes hard & fixed. (no shortening)The shape or position depends upon the position at the time of death. If the body is supine then the large joints of the limbs become slightly flexed.Rigor does not cause any significant change in the attitude adopted at death.Rigor involves both voluntary and involuntary muscles.Latin for "stiffness of death". Starts within the first 4 hours(90%)The face first then hands and feet. Maximal rigor develops in 12 to 48 hours Rigor disappears in 36-48h in cool temp or early 9-12h in hot climates.Intensity of rigor depends on muscle mass.Later leads to flaccidity due to lysis.MechanismFall in ATP – links actin and myosin – rigor.Exhaustion before death – Rapid rigor.Rapid cooling of the body after death can inhibit rigor mortis,
MCQ Genetics 11 1970-01-01 00:59:59 Which of the following most specifically describes the use of linkage analysis in the search for a disease specific gene in a family?A.The correlation of a DNA polymorphism with a family specific mutationB.The finding of an association of a DNA polymorphism with the clinical phenotypeC.The drawing of a pedigree & to find who is normal & who is affectedD.To access a large pedigree & be able to obtain DNA from most of the family membersE.The drawing of a pedigree & to exclude the potential of non-paternityAnswerTags: MCQ, Genetics
, Linkage Analysis
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MCQ Genetics 12 1970-01-01 00:59:59 Although type 2 diabetes is strongly inherited, the nature of the genetic defect remains unknown in most cases. In those cases where the responsible mutation has been identified, it most frequently involves the gene encoding which one of the following? InsulinInsulin ReceptorGlucose transporterGlucokinaseGlycogen SynthetaseAnswerTags: MCQ, Genetics
, Diabetes
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Anti-Cholinergics (aka Anti-Muscarinics) 1970-01-01 00:59:59 Remember, these block acetylcholine receptors and should therefore yield sympathetic effects Effects include blind as a bat (mydriasis), red as a beet (flush), dry as a bone (xerostomia), mad as a hatter (psychosis), and hot as a hare (increased body temperature). All competitively block muscarinic receptors (quarternaries block nicotinics as well) Tertiary Amines Cross BBB Do not block nicotinic receptors Atropine – (natural) behavioral effects, biphasic cardiac response (low dose = bradycardia, high = tachycardia), relax smooth muscle, decrease secretions, etc. Scopolamine – (natural) motion sickness, vestibulation, biphasic cardiac response, relax smooth muscle, decrease secretions, etc. Homatropine, Cyclopentolate, Tropicamide – [eye
Cholinergics 1970-01-01 00:59:59 Remember, these mimic acetylcholine and should therefore yield parasympathetic effects Effects include DUMBELS (defecation, urination, miosis, bronchoconstriction, electrical changes (heart), lacrimation, secretion) Direct-Acting (Agonists) All activate muscarinic receptors, some also activate nicotinics (carbachol, e.g.) Low oral bioavailability Contraindicated in Parkinson’s, pregnancy, etc. Choline Esters Due to quarternary state, do not cross BBB Acetylcholine – short ½ life makes it useless Methacholine – strong effect on heart (use for paroxysmal atrial tachycardia) Carbachol – use for open-angle glaucoma, least antagonized by atropine Bethanecol – give PO
Adrenergics 1970-01-01 00:59:59 Remember, these drugs have sympathetic effects Direct activation of adrenergic receptors, stimulate release/inhibition of reuptake, and reflex homeostatic mechanism (e.g. heart) a-b Agonists Refer to chart below for cardiovascular effects Causes general vasoconstriction, relaxation of smooth muscle, i GI motility and bronchorelaxation. Epinephrine – used for glaucoma, anaphylactic shock, asthma. Hits a1 a2 b1 b2 receptors, diabetogenic effects (decreased insulin, increased lipolysis). Norepinephrine – used for hypotension and neurogenic shock. No b2, vagal reflex overrides direct effect, vasodilates cardio/pulmonary vessels. Dopamine – [renal] used as "renal drug" causing vasodilation in kidneys; also for cardiogenic and septic shock. Inotropic in
Anti–Adrenergics (aka Adrenergic Antagonists) 1970-01-01 00:59:59 Remember, these drugs have parasympathetic effects (dumbels) Nonselective alpha Receptor Antagonists Blocks alpha receptors effecting: smooth muscle (vasodilation causing orthostatic hypertension) and increase in HR (reflex sympathetic stimulation); presynaptic terminals (abolish/reverse catecholamine effects); pancreatic beta cells (decreased insulin release); trigone and sphincter of bladder (urination) Larger doses hits more receptors Phenoxybenzamine – pheochromocytoma; used for irreversible alpha blockade Phentolamine – used for frost bite alpha 1 Receptor Antagonists Similar to above: slight increase in HR (reflex sympathetic stimulation); increased contractility due to inhibition of phosphodiesterase (degrades cAMP); "first dose phenomenon" causing syncope (fainting) and subduing reflex response. Prazosin, doxosin – chronic
MCQ Neurology 20 1970-01-01 00:59:59 An 85 year old patient is brought in by his son with increasing forgetfulness & general deterioration over 2-3 weeks with loss of weight. He was previously well & independent with no other medical problems. Physical examination & CT head are normal. What is the best next step?MRI Thyroid function & B12 levels EEG Cognitive & psychometric testing MMSE AnswerTags: MCQ, Neurology
, Dementia
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MCQ Orthopedics 6 1970-01-01 00:59:59 A 73 year old woman has become progressively kyphotic over the last 3 years. Her past history includes Ca Colon & hysterectomy at age 26 for fibroids. She now presents with acute back pain & localised mid-thoracic tenderness. CXR & lateral spine X-rays are shown (interpreted as osteopaenia with wedge compression # in mid-thoracic vertebrae with no lytic or sclerotic lesions seen). The most likely diagnosis is:Multiple myeloma Bone metastases Osteoarthritis Osteoporosis HyperparathyroidismAnswerTags: MCQ, Orthopedics
, Kyphosis
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MCQ Surgery 8 1970-01-01 00:59:59 An 84 year old woman, previously well, presents with stress incontinence. An Ultrasound shows an 80ml residual volume. Examination shows a 2cm cystocoele. What is the best management?ReassureVaginal pessaryReferral to gynaecology to fix cystocoele Pelvic floor exercises & bladder retraining Oxybutynin AnswerTags: MCQ, Surgery
, Gynecology, Stress incontinence, Cystocele
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MCQ Genetics 13 1970-01-01 00:59:59 Which of the following is most suggestive of a mitochondrial DNA defect as the cause of a genetic disease?A.Autosomal pattern of transmissionB.Maternal pattern of transmissionC.The finding of a cardiomyopathyD.A change in the mitochondrial DNA sequenceE.The presence of somatic mosiacismAnswerTags: MCQ, Genetics
, Mitochondria
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MCQ Genetics 14 1970-01-01 00:59:59 Mutations in which of the following genes when inherited in the germline are least likely to be associated with the development of breast cancer?A. ATM geneB. bcl-2 geneC. BRCA 1 geneD. BRCA 2 geneE. p53 geneAnswerTags: MCQ, Genetics
, Breast Cancer
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MCQ Medicine 15 1970-01-01 00:59:59 An elderly patient has dysphagia. The patient is at high risk of aspiration with which of the following?A. Refusal to eatB. Absent gag reflex bilaterallyC. DysarthriaD. Facial weakness & droolingE. Weak cough & decreased voice strengthAnswerTags: MCQ, Medicine
, Geriatrics, Aspiration
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MCQ Surgery 7 1970-01-01 00:59:59 A 78 year old woman describes passing small amounts of urine on coughing. There is no dysuria, nor any systemic symptoms. The best therapeutic intervention is: Pelvic floor exercisesIntermittent self catheterisationAnticholinergic agentsVoluntary micturition every 4 hours Fluid restriction AnswerTags: MCQ, Surgery
, Incontinence
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MCQ Medicine 16 1970-01-01 00:59:59 What is the most common organism causing pneumonia in an elderly lady living in a rest home?St pneumonia H influenzae Mycoplasma Klebsiella Chlamydia pneumonia Answer Tags: MCQ, Medicine
, Pneumonia
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MCQ PSM 4 2007-03-01 13:01:00 Which of the following is the best method for detecting protein calorie malnutrion in the elderly hospital inpatient?Serum albumin Body mass index Triceps skin fold thickness Total lymphocyte count Calculated arm muscle areaAnswerTags: MCQ, PSM, PEM, Malnutrition
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MCQ ENT 2 2007-03-01 12:47:00 An 85 year old woman who complains of difficulty in hearing conversational speech also complains about the noise her grandchildren are making. What best explains these complaints?Hypersensitivity of hair cells in the inner ear Impaired sound localisation Wax obstructing the external auditory canal Otosclerosis High frequency hearing lossAnswerTags: MCQ, ENT, Hearing Loss
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MCQ Neurology 22 2007-03-01 12:43:00 A 68 year old woman has a 10 year history of Parkinson’s disease which ahs been treated with a combination of levodopa & benserazide 3 times a day & benztropine 3 times a day. During the last year she has experienced periods of mid rigidity ½ hour prior to the next dose of levodopa, but her overall mobility is reasonable. She now presents with a 1/12 history of increasing confusion & agitation, particularly at night. The most appropriate next option is : Addition of bromocriptine & reduction in levodopa Cease benztropine Reduction in levodopa Addition of haloperidol at night Addition of selegiline & reduction of levodopaAnswerTags: MCQ, Neurology
, Parkinsonism
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MCQ Medicine 17 2007-03-01 11:31:00 A 75 year old man presents with a 1 year history of progressive memory loss. He has a past history of MI, hypertension & type II diabetes. Examination reveals absent peripheral pulses & bilateral carotid bruits. Which of the following tests is most likely to determine the cause of his memory loss?Psychometric testing CSF examination CT Brain EEG Carotid dopplerAnswerTags: MCQ, Medicine
, Dementia
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MCQ Neurology 21 2007-03-01 11:09:00 What is the greatest independent risk factor for stroke?Hypotension Age Smoking Hypercholesterolaemia HypertensionAnswerTags: MCQ, Neurology
, Stroke
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MCQ Genetics 15 2007-03-02 07:17:00 About autosomal dominant inheritance all are true excepta.it is always expressed in homozygotesb.always one parent is affectedc.50% of children affectedd.Offspring of a nondiseased child of a diseased parent will not have the mutant gene.AnswerTags: MCQ, Genetics
, Autosomal Dominant
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