medicine authentic answers with refference pages from harrison 17th

7/29/2019 Medicine Authentic Answers With Refference Pages From Harrison 17th

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MEDICINE AUTHENTIC ANSWERS WITHREFFERENCE PAGE FROM HARRISON

17TH AND 18TH EDITION

APPG 2013

Medicine and paediatrics


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101.h.pylori colonisation is a risk factor for allEXCEPT?

1.adenocarcinoma of distal stomach

2.GERD 3.primary gastric lymphoma

4.auto immune gastritis

Ans 2 and 4 Harrison 17th

Page 947.1870,1871


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102.non pancreatic

gastrinomas are

mostly located in

1.duodenum2.stomach

3.liver

4.heartAns 1

Page 2348 table


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103.the first choice ofdemardfor initialtreatment of moderate tosevere rheumatiod

arthritis is 1.hydroxychloroquine

2.methotrexate

3.leflunamide

4.gold salts

Ans 2

Page no 2090


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104.the most common cause of increasedred cell protoporphyrin levels is

1.absolute or relative iron deficiency

2.vit b12 deficiency 3.sideroblastic anaemia

4.erythropoietic protoporphyria

Ans 1

Page 631


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105.chronic pericardial effusion that is massivebut rarely causes cardiac tamponade is afeature of

1.mycotic infections 2.pyogenic infections

3.rhuematiod arthritis

4.myxoedemaAns 4

Page 1493


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106.the holiday heartsyndrome which typicallyappears after a drinkingbinge manifests most

freqeuntly as 1.heart failure

2.atrial fibrillation

3.complete heart block

4.sudden death

Ans 2

Page 1482


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107.one of the following is an esssentialcomponent of multi drug regimen in thetreatment of staphylococcal prosthetic valve

endocarditis 1.gentamycin

2.vancomycin

3.fluroquinolone

4.rifampin(rifampicine)

Ans 4

Page 795 h 17th


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108.autonomic nueropathy type1 or type2DM manifests as all,EXCEPT

1.resting tachycardia

2.sudden death 3.gastroparesis

4.anhidrosis of upper extremities

Ans 4 Page 2289 h 17 th


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109.the most common cause of growth

hormone releasing hormone (GHRH)mediated

acromegaly is

1.hypothalamic tumors

2.choristomas

3.chest or abdominal carciniod tumors

4.neromas

Ans 3

Page


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110.acute kidney injury caused by

acyclovir is due to

1.tubular necrosis

2.tubular obstruction

3.acute interstitial nephritis

4 all the above Ans 3

reference

GOODMAN & GILMAN'S THE PHARMACOLOGICAL

BASIS OF THERAPEUTICS - 11th Ed. (2006

The principal dose-limiting toxicities of intravenous

acyclovir are renal insufficiency and CNS side effects.

Preexisting renal insufficiency, high doses, and high

acyclovir plasma levels (>25 mg/ml) are risk factors for

both. Reversible renal dysfunction occurs in

approximately 5% of patients, probably related to high

urine levels causing crystalline nephropathy.Manifestations include nausea, emesis, flank pain, and

increasing azotemia. Rapid infusion, dehydration, and

inadequate urine flow increase the risk. Infusions should

be given at a constant rate over at least an hour.

Nephrotoxicity usually resolves with drug cessation and

volume expansion. Neurotoxicity occurs in 1% to 4% of

patients and may be manifested by altered sensorium,

tremor, myoclonus, delirium, seizures, or extrapyramidal

signs. Phlebitis following extravasation, rash,diaphoresis, nausea, hypotension, and interstitialnephritis also have been described. Hemodialysis maybe useful in severe cases.


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111.lesh-nyhans syndrome is characterisedby all except

1.hyperuricemia

2.self mutilation behaviuor 3.choreo athetosis

4partial deficiency of HPRT

ANS 4 PAGE 2447 h 17th


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112.hyperprolactenemia is caused by allEXCEPT

1.drugs

2.pitutary stalk compression 3.hyperthyriodism

4.renal failure

Ans 3 Page 2205


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113.the drug of chioce in patients with

generalized epilepsy syndromes having mixed

seizure type is

1.phenytion

2.oxcarbazepine

3.lamotrigine

4.valproic acid

Ans 4

Page 2509 h 17th


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114.most cases of hemifacial spasms arerelated to

1.sequeale of bells palsy

2.secondary to compression of nerve bytumor

3.multiple sclerosis

4vascular compression of facial nerve inpons

Ans 1

Page 2585


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115.the most common cause ofcardioembolic stroke is

1.rhuematic heart disease

2.non rhuematic atrial fibrillations 3.myocardial infraction

4.mitral valve prolapse

Ans 2 Page 2517


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116.extra renal manifestations of autosomaldominant polycystic kidney disease(ADPKD)includes all EXCEPT

1.saccular anuerysms 2.aortic root and annulus dilatations

3.colonic diverticulae

4.splenic cysts

Ans 4

Page 1798 h 17th


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117.focal seizures in bacterial meningitis areusually due to

1.cortical venous thrombosis with

haemorrage 2.hyponatremia

3.cerebral anoxia

4.toxic effects of high dose pencillinAns 1

Page


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118.patchy specific lesions seen on smallbowel biopsy includes all EXCEPT

1lymphoma

2.whipples disease 3.amyloidosis

4 eosinphilic gastroenteritis

Ans 2 Page 1880


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119

Which one of the following significantly reducesplasma levels of lp(a) upto 40%

1.HMG COA reductase inhibitors 2.fibric acid derivatives

3.nicotinic acid

4.bile acid sesuestrantsAns 3

Page


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Wikipedia given only 20 to 30% for nicitinic

acid

I didnt information in 17 th and 18th harrison


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120.in patients with severe structural lungdisease ,such as bronchectasis or severecopd,the infective agent most likely to causepneumonia is

1.h.influenza

2pnuemococcous

3.legionella

4.p.aeruginosa

Ans 4

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121.the most common life threatening metaboliccomplication of squamous cell carcinoma oflung is

1.hyponatremia 2.hypercalcemia

3.hypokalemia

4.hypomagnesemia

Ans 2

Page 2306


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122.the predominant causeof diarrhoea among elederlypatients in chronic careinstitutiins is

1.enteropathogenic e. coli

2.shigella 3.c .difficle

4.klebsiella

Ans 3

Harrison 18th editin lines

Enteropathogenic E. colihasbeen associated withoutbreaks of diarrhea innurseries for newborns. One-third of elderly patients inchronic-care institutionsdevelop a significantdiarrheal illness each year;more than one-half of thesecases are caused bycytotoxin-producing C.difficile.Antimicrobial therapycan predispose topseudomembranous colitis byaltering the normal colonicflora and allowing themultiplication ofC. difficile(Chap. 129).


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123.in bronchiectasis pedominantinvolvement of central airways is seen in

1.allergic bronchopulmonary aspergillosis

2.infection with m avium complex 3.cystic fibrosis

4tuberculosis

Ans 1 Page 1259


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124.all the sideeffects of interferon theray arereversible upon dose lowering or cessation oftherapy EXCEPT.

1alopecia 2.diarrhoea

3.autoimmune thyrioditis

4.tingling of extremities

Ans 3

Page see below


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Complications of IFN therapy includesystemic "flu-like" symptoms; marrowsuppression; emotional lability (irritability,

depression, anxiety); autoimmune reactions(especially autoimmune thyroiditis); andmiscellaneous side effects such as alopecia,rashes, diarrhea, and numbness and tingling

of the extremities. With the possibleexception of autoimmune thyroiditis, allthese side effects are reversible upondose lowering or cessation of therapy.


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125.in juvenile pernicious anemia all arepresent EXCEPT

1.gatric atrophy

2.achlorhydria 3.serum IF antibodies

4parietal cell anti bodeis

Ans 4 Page 648


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126.a unique form of hemolytic anemia (withspur cells and acanthocytes) can occur inpatiens with sever alcoholic hepatitis is called as

1.kostmanns syndrome 2.zieves syndrome

3.seckel syndrome

4dubowitz syndrome

Ans 2

Page 1972


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127.in vertebral osteomylitis,anterior erosions ofthe superior end plate of vertebrae are typicallythe first feature to become evident in

1.typhiod 2 tuberculosis

3.brucellosis

4.staphylococcal osteomylitis

Ans 3

Page 804


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128 aplstic anemia with pancreaticinsufficiency and malabsorption is seen in

1.fanconis syndrome

2.dyskeartosis congenita 3.shwachmann diamond syndrome

4 diamond blackfan syndrome

Ans 3 Page 665


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129.the areas most often involved in lesionsof toxoplasmosis in CNS includes allEXCEPT

1brain stem 2.meninges

3.basal ganglia

4.pitutary glandAns 2

Page 1308


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130.autosommal reccessive hyperig Esyndrome is charecterised by all EXCEPT

1.recurrent bacterial infections of skin and

respiratory tract 2severe allergic manifestations

3.T & B lymphocyte count are low

4.deficiency in tyk2,a JAK family kinase

Ans 4

page


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131. All are primary causes of nephroticsyndrome in infants younger than one year,EXCEPT

A. Congenital nephrotic syndromeB. Minimal change diseaseC. Membranous nephropathy.D. Systemic lupus erythematosusAns d

Page robbins 7th edition

979


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132. Regarding Reye syndrome, all of the followingstatements are TRUE, EXCEPT

A. The white liver disease and encephalopathy withfatty degeneration of the viscera are its other

nomenclaturesB.Sporadic Reye syndrome can occur in the contextof varicella or influenza B virus infectionC. The condition is usually observed in children below3 years of ageD. Mitochondrial dysfunction of fatty acid oxidation issignificant

Ans c

Page 524 op ghai


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133. Hemorrhagic cystitis is a dreadedcomplication associated with use of

A. ClobazamB. CyclosporinC. CycloserineD. Cyclophosphamide

Ans d Page katzung 885


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134. An 18 month old boy presents with prominenteyeballs and periorbital ecchymosis and an enlargingswelling on the left upper abdomen. He is markedly pale.A large left sided mass distinct from the spleen waspalpable. The most likely diagnosis is

A. Wilm's tumorB. OsteopetrosisC. NeuroblastomaD. Gauchers Disease

Ans C Page op ghai

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135. One of the following intrauterine infectionshas characteristically the following triad ofchorioretinitis, microcephaly and intraceiebralcalcifications.

A. CytomegalovirusB. Toxoplasmosis ,C. RubellaD. Herpes simplexAns A pg 1110 harrison 17th


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136. A 5 year old girl has 3 months history of joint painsand morning stiffness. Knees and ankles are involvedwith mild swelling and tenderness. Slit lamp examinationreveals IRIDOCYCLITIS. The diagnosis is

A. Juvenile Rheumatoid Arthritis (JRA)B. Systemic Lupus Erythematosus (SLE)C. Henoch Schonlein Purpura (HSP)D. Rheumatic Arthritis

Ans A

581

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137. A 7 year old/ boy has short stature,large skull, prominent forehead, saddleshaped nose, exaggerated lordosis andnormal intelligence and development, thediagnosis is

A. Noonan syndrome

B. HypopituitarismC. Isolated Growth Hormone V DeficiencyD. Achondroplasia

Ans D


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138. Immediately after birth, the preventablecauses of mental retardation include all of thefollowing, EXCEPT

A. HypothyroidismB. Phenylketonuria.C. KernicterusD. Hurlers disease

Ans d

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139. Which of the following is associated withlarge anterior fontanel ?

A. AchondroplasiaB. Apert syndrome

C. Cleidocranial Dysostosis

D. All of the aboveAns D


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140. An aggressive looking, thin and talladolescent boy aged 15 years is noted tohave prominent long limbs and small testes.What is the most relevant investigation ?

A. Hormonal assaysB. Chromosomal analysis

C. Skeletal surveyD. Ultrasound evaluation

Ans b

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