0 Skull and achondroplasia

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MCQ 152

Q. Skull is not involved in all except :

a. Achondroplasia
b. Hypochondroplasia
c. Pseudoachondroplasia
d. All of the above

ANSWER:

Answer : A
Skull changes are mandatory to diagnose achondroplasia. - Calvarium large, base shortened , foramen magnum small and funnel shaped.
Skull is never involved in Hypochondroplasia and pseudochondroplasia.

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MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

0 Black liver

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MCQ 121

Q. Black liver is seen in ?

a. Dubin–Johnson syndrome
b. Rotor syndrome
c. Both a and b
d. None

ANSWER:

Dubin–Johnson syndrome

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MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

0 Rheumatic fever - Causitive organism

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MCQ 119

Q. Rheumatic fever most commonly follows pharyngeal infections with ?

a. Group A Streptococci

b. Group B Streptococci

c. Group C Streptococci

d. Group D Streptococci

ANSWER:

Ans : A
Please see, many times people confuse it with Group B streptococci.
It is Beta haemolytic but Group A , Not Group B.
Do not confuse Beta with Group B.

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MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

0 Contraindications of Indomethacin

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Q. Contraindications of Indomethacin include all except ?

a. Large IVH
b. Renal Failure
c. Hepatic Failure
d. NEC

ANSWER:

Ans : A (Large IVH)

C/I of Indomethacin are:

1. Renal Failure
2. Hepatic Failure
3. DIC
4. NEC

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2 Shock - Early Late

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Q. An alert 6 month old child is brought with vomiting & diarrhea. RR-45/min, HR-180/min, SBP-85 mm of Hg. Extremities are cold & mottled. Capillary refilling time is 4 secs. Diagnosis is

a) Early (compensated) shock due to hypovolemia
b) Early (compensated) shock due to SVT
c) Late (decompensated) shock due to hypovolemia
d) Late (decompensated) shock due to SVT

ANSWER:

Ans : A
Please see - Some books give an option " Late Compensated "
There is nothing like Late Compensated , if its Late then it is Decompensated.

Also

Must Read : Early and Late Shock :

Early (Compensated) Hypovolemic shock : Compensatory Mechanisms -Tachycardia & Peripheral Vasoconstriction

• Decreased pulse strength
• Pallor or mottling
• Delayed Capillary refill time
• Dry and cool skin temperature
• SBP - Normal

Late (Decompensated) Hypovolemic shock ( Compensatory Mechanisms fail to maintain sufficient blood flow to core organs )

• Organ failure
• Hypotension
• Tachypnoea 
• Tachycardia (if shock not reversed , then later Bradycardia)

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0 TAR , Fanconi Anemia

Absent thumb, radial deviation of wrist, bowing of forearm wid thrombocytopenia, which invg. need NOT to be done?
A. Echochardiography
b. Bone marrow examination
c. Platelet count
d. Karyotyping

ANSWER:

Ans is D....
D/D to this ques are :
1. TAR syndrome
2. Fanconi Anemia
Associations of absent radius-
1.TAR - thrombocytopenia and absent radius ass. with holt oram - ASD
2.Fanconi anemia has congenital aplastic anemia - therefore do bone marrow examination
3.Karyotyping will not be helpful(but very rarely Edwards can have absent radius )

0 Switch over from fetal to adult Hb

At what gestational age switch over from fetal to adult hb synthesis begins? 
a.30 weeks 
b.36 weeks 
c.7 days post natal 
d.3 weeks post natal

ANSWER:

Ans here is 30 wks and NOT 36wks... If 20 wks was in options then the ans would be 20 wks.... many MCQ books give the wrong answer to it....
CORRECT POINTS ARE ---
1.After the first 8 weeks of development, the fetus' primary form of hemoglobin switches from embryonic hemoglobin to fetal hemoglobin....
2.Fetal Hb to Adult Hb SWITCHOVER BEGINS at 20 wks Intrauterine...
3.Significant switch over to adult Hb at 30 wks Intrauterine...
4.Adult Hb levels attained at 7 months of LIFE...
CLICK IMAGE TO ENLARGE --> Wintrobe's Clinical Hematology, Volume 1 By John P. Greer, Maxwell Myer Wintrobe

0 Wiskott-Aldrich

Elevated IgA levels n presence of thrombocytopenia
A.Job's syndrome
B.Wiskott-Aldrich
C.Carcinoid synd
D.Sjogren's

ANSWER:

Ans=B


Wiskott–Aldrich syndrome (WAS) is a rare X-linked recessive disease characterized by eczema, thrombocytopenia (low platelet count), immune deficiency, and bloody diarrhea (secondary to the thrombocytopenia.
IgM levels are reduced, IgA and IgE are elevated, and IgG levels can be reduced or elevated