Sunday, January 10, 2010

330 - AIPGMEE 2010 Mcqs with answers - part 2

6q: Which of the following is to be monitored in a patient who is on linezolid treatment ?
a. Renal function tests
b. Liver function tests
c. Rash
d. Platelet count

Linezolid seems to be well tolerated, with generally minor side effects (e.g., gastrointestinal complaints, headache, rash). Myelosuppression, including anemia, leukopenia, pancytopenia, and thrombocytopenia, has been reported in patients receiving linezolid. Thrombocytopenia or a significant reduction in platelet count has been associated with linezolid in 2.4% of treated patients, and its occurrence is related to duration of therapy. Platelet counts should be monitored in patients with risk of bleeding, preexisting thrombocytopenia, or intrinsic or acquired disorders of platelet function (including those potentially caused by concomitant medication) and in patients receiving courses of therapy lasting beyond 2 weeks. Linezolid is a weak, nonspecific inhibitor of monoamine oxidase. Patients receiving concomitant therapy with an adrenergic or serotonergic agent or consuming more than 100 mg of tyramine a day may experience palpitations, headache, or hypertensive crisis. Peripheral and optic neuropathy, which seem to be reversible upon drug discontinuation, have been reported with prolonged use. Linezolid is neither a substrate nor an inhibitor of CYPs.

7q: Low CSF protein is seen in all of the following except ?
a. Infant
b. Recurrent Lumbar puncture
c. Hypothyroidism
d. Pseudotumor cerebri

*Low CSF protein levels can occur in conditions such as repeated lumbar puncture or a chronic leak, in which CSF is lost at a higher than normal rate. Low CSF protein levels also are seen in some children between the ages of six months and two years, in acute water intoxication, and in a minority of patients with idiopathic intracranial hypertension. CSF protein levels do not fall in hypoproteinemia. 
-The above lines were taken from here 

*The CSF protein level can be increased in patients with hypothyroidism. One study suggested that CSF albumin and CSF IgG were both increased during over hypothyroidism but not with subclinical disease. 
-The above 2 lines about hypothyroidism were taken from this google book reference. 

8q: Gluteus medius is supplied by ?
a. Superior gluteal nerve
b. Inferior gluteal nerve
c. ???????????
d. ???????????

9q: Time of surgery for undescended testis ?
a. 6 months
b. 12 months
c. 24 months
d. just after birth

-Read these lines from Schwartz's surgery 9th edition.

*Males with bilateral undescended testicles are often infertile. When the testicle is not within the scrotum, it is subjected to a higher temperature, which results in decreased spermatogenesis. Mengel and coworkers studied 515 undescended testicles by histologic analysis and demonstrated a decreasing presence of spermatogonia after 2 years of age. Consequently it is now recommended that an undescended testicle be surgically repositioned by 2 years of age.

-But before u jump into any conclusions, read these lines from sabiston textbook of surgery, 18th edition.

*When a unilateral gonad is palpated in the inguinal canal, but cannot be manipulated into a scrotal position, an orchidopexy is performed. In most pediatric centers, this is done when patients have reached about 6 months of age. This early intervention may permit postnatal germ cell development to proceed normally. The orchidopexy is done through an inguinal incision.

CONCLUSION : After reading both the versions, i think it is 6 months, because, firstly schwartz mentions that it should be done before 2 years, but does not specify a time. Whereas sabiston mentions the exact time with proper explanation of  - "This early intervention may permit postnatal germ cell development to proceed normally.". So i am gonna go with 6 months. 

10q: Which one of the following has the maximum ionization potential ?
a. Alpha rays
b. Beta rays
c. X-rays
d. Gamma rays

*The same question was asked in AIPGMEE 2006 paper,
- The rays with the most ionization potential or damaging power are - Alpha rays, followed by Beta rays, followed by X-rays and lastly Gamma rays - arranged in the decreasing order of ionization .
- The reverse is true for the penetrating power of these rays, that means, the rays with the most penetrating power are the Gamma rays and the rays with the least penetrating power are the alpha rays.


drkoushik said...

nice post

boss u r flawless....

molak said...

good job..keep it up

Rahul said...

great work dude.....big help...
continue the gr8 work!!!!!!!!

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