Saturday, November 19, 2011

445 - AIIMS NOVEMBER 2011 Mcqs with answers - part 17

81.A child of down's syndrome presents with mental retardation.All of the following are seen except :
a. trisomy 21
b. mosiac 21
c. balanced translocation 21/21
d. deletion 21

82.Which investigation should be avoided in a proven case of renal papillary necrosis?
A. Urine acidification test
B. Sickling test
C. TB-PCR – urine
D. Bacterial culture of urine

83.A known alcoholic presents with flexed metacarpophalangeal joint of little finger at 15 degrees.What should be done?
b.percutaneous fasciotomy
c.subtotal fasciotomy fasciotomy

84.Gallow's traction is done in
a.Fracture femur
b.Fracture tibia
c.Fracture humerus

85.Alzheimer's disease is associated with all of these except :

EXPLANATION: (Read the below lines from Harrison 18th edition) :
The cognitive changes of Alzheimer's disease(AD) tend to follow a characteristic pattern, beginning with memory impairment and spreading to language and visuospatial deficits. Yet, approximately 20% of patients with AD present with nonmemory complaints such as word-finding, organizational, or navigational difficulty. In the early stages of the disease, the memory loss may go unrecognized or be ascribed to benign forgetfulness. Once the memory loss becomes noticeable to the patient and spouse and falls 1.5 standard deviations below normal on standardized memory tests, the term MCI is applied. This construct provides useful prognostic information, because approximately 50% of patients with MCI (roughly 12% per year) will progress to AD over 4 years. Slowly the cognitive problems begin to interfere with daily activities, such as keeping track of finances, following instructions on the job, driving, shopping, and housekeeping. Some patients are unaware of these difficulties (anosognosia), while others remain acutely attuned to their deficits. Changes in environment (such as vacations or hospital stays) may be disorienting, and the patient may become lost on walks or while driving. In the middle stages of AD, the patient is unable to work, is easily lost and confused, and requires daily supervision. Social graces, routine behavior, and superficial conversation may be surprisingly intact. Language becomes impaired—first naming, then comprehension, and finally fluency. In some patients, aphasia is an early and prominent feature. Word-finding difficulties and circumlocution may be a problem even when formal testing demonstrates intact naming and fluency. Apraxia emerges, and patients have trouble performing learned sequential motor tasks. Visuospatial deficits begin to interfere with dressing, eating, or even walking, and patients fail to solve simple puzzles or copy geometric figures. Simple calculations and clock reading become difficult in parallel.

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