Friday, April 3, 2009

202 - UPSC 2007 medical entrance mcqs with answers part 12

56. In a patient with ischaemic stroke, intravenous recombinant tissue plasminogen activator has mainly been found to be useful during the initial

(a) 3 hours
(b) 6 hours
(c) 12 hours
(d) 24 hours

Read these exact lines from Harrison's internal medicine 17th edition .  

The National Institute of Neurological Disorders and Stroke (NINDS) recombinant tPA (rtPA) Stroke Study showed a clear benefit for IV rtPA in selected patients with acute stroke . The NINDS study used IV rtPA (0.9 mg/kg to a 90-mg max; 10% as a bolus, then the remainder over 60 min) vs. placebo in patients with ischemic stroke within 3 h of onset. Half of the patients were treated within 90 min. Symptomatic intracerebral hemorrhage occurred in 6.4% of patients on rtPA and 0.6% on placebo. There was a nonsignificant 4% reduction in mortality in patients on rtPA (21% on placebo and 17% on rtPA); there was a significant 12% absolute increase in the number of patients with only minimal disability (32% on placebo and 44% on rtPA.) Thus, despite an increased incidence of symptomatic intracerebral hemorrhage, treatment with IV rtPA within 3 h of the onset of ischemic stroke improved clinical outcome. 

57. Consider the following:

1. Malnutrition
2. Lithostatin (pancreatic stone protein) deficiency
3. Cassava tuber
4: Oxidant stress (heightened cytochrome P-450 activity)

Which of the above produce tropical calcific pancreatitis (fibrocalculous pancreatic diabetes) ?

(a) 1, 2 and 3 only
(b) 2, 3 and 4 only
(c) I and 4 only
(d) 1, 2, 3 and 4

58. The prognosis in reduced or unreduced fractures involving epiphyseal plate is very poor if the fracture line

(a) runs along the epiphyseal plate
(b) extends into epiphysis
(c) crushes the epiphyseal plate
d) crosses the epiphyseal plate

59. A green stick fracture

(a) occurs mainly in the elderly
(b) is a fatigue fracture
(c) is a spiral fracture of long bone
(d) is a fracture where part of cortex is intact and part is crumpled

60. With reference to varicocele, which one of the following is not true of it ?

(a) Varicosity of cremasteric veins
(b) Left side is affected usually
(c) Feels like a bag of worms
(d) May lead to infertility

No comments:

FeedBurner FeedCount