Thursday, April 2, 2009

191 - UPSC 2007 medical entrance mcqs with answers part 1

1. A five year old girl presents with fever and conjunctivitis. Physical examination is significant for oral erythema and fissuring along with a generalised maculopapular rash and cervical lymphadenopathy. What is the most likely diagnosis?

(a) Henoch-Schonlein purpura
(b) Polyarteritis nodosa
(c) Kawasaki disease
(d) Takayasu arteritis

Kawasaki disease, also referred to as mucocutaneous lymph node syndrome, is an acute, febrile, multisystem disease of children. Some 80% of cases occur prior to the age of 5,with the peak incidence occurring at less than or equal to 2 years. It is characterized by nonsuppurative cervical adenitis and changes in the skin and mucous membranes such as edema; congested conjunctivae; erythema of the oral cavity, lips, and palms; and desquamation of the skin of the fingertips.

2. The following can be associated with fatty liver except

(a) Amiodarone
(b) Zidovudine
(c) Sodium valproate
(d) Chlorpropamide

3. which one of the following is not associated with a high reticulocyte count?

(a) Acute bleed
(b) Haemolytic anaemia
(c) Megaloblastic anaemia
(d) Response to treatment in nutrition /
deficiency anaemia

4. A young boy presents with failure to thrive. Biochemical analysis of a duodenal aspirate after a meal reveals a deficiency of enteropeptidase (enterokinase). The levels of which one of the following digestive enzymes would be affected?

(a) Amylase
(b) Pepsin
(c) Lactose
(d) Trypsin

Enteropeptidase (also called enterokinase) is an enzyme involved in human digestion. It is produced by cells in the duodenum wall, and is secreted from duodenum's glands, the crypts of Lieberk├╝hn, whenever ingested food enters the duodenum from the stomach. Enteropeptidase has the critical job of turning trypsinogen (a zymogen) to trypsin, indirectly activating a number of pancreatic digestive enzymes.

5. Regarding falciparam malaria, consider the following statements: 

1. The mortality rises steeply when the proportion of infected erythrocytes increases above 3 per cent.
2. The patient may develop hypoglycemia even when not treated with quinine.

Which of the statements given above is/are correct?

(a) 1 only
(b) 2 only
(c) Both 1 and 2
(d) Neither 1 nor 2

Appropriately and promptly treated, uncomplicated falciparum malaria (i.e., the patient can swallow medicines and food) carries a mortality rate of ~0.1%. However, once vital-organ dysfunction occurs or the total proportion of erythrocytes infected increases to greater than 2% (a level corresponding to greater than 1012 parasites in an adult), mortality risk rises steeply.

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