400) Explanation
C) The variation in proteins expressed by each cell reflects cell-speciic expression and repression of speciic
genes. Each cell contains the same DNA in the nucleus
and the same number of genes, and thus diferentiation
results not from diferences in the genes but from selective
repression and/or activation of diferent gene promoter
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C) The variation in proteins expressed by each cell reflects cell-speciic expression and repression of speciic
genes. Each cell contains the same DNA in the nucleus
and the same number of genes, and thus diferentiation
results not from diferences in the genes but from selective
repression and/or activation of diferent gene promoter
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For all recent updates, join
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401) A 32-year-old man comes to the office due to a subcutaneous nodule on the dorsum of his right hand. He says the nodule is painless and has been slowly enlarging over the last several weeks. The patient’s past medical history is insignificant, but his father died of a heart attack at age 38 despite being a nonsmoker. His mother has diabetes mellitus. On examination, he has 2 or 3 small, flat subcutaneous nodules on the dorsum of his right hand, and a larger nodule at the Achilles tendon area. He also has a few small yellowish papules on his right lower eyelid. Which of the following is most likely decreased in this patient?
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401) A 32-year-old man comes to the office due to a subcutaneous nodule on the dorsum of his right hand. He says the nodule is painless and has been slowly enlarging over the last several weeks. The patient’s past medical history is insignificant, but his…
SUPER-SPECIALITY
#401
401) Explanation
Premature coronary artery disease (men age <55, women age<65) is frequently an indication of an underlying inherited lipid disorder, especially when it occurs in nonsmokers. Familial hypercholesterolemia (FH) is the most common inherited dyslipidemia and is an autosomal dominant disorder most often caused by a defective LDL cholesterol receptor gene. The absence of functional LDL receptors causes marked elevations in both total and LDL cholesterol because the LDL particles are not cleared effectively from circulation. The excess LDL is deposited in the arteries as atheromas and in the tendons and skin as xanthomas. Xanthomas are deposits of
lipid-rich foam cells in the dermis or subcutaneous tissue, and present as yellow rubbery nodules and plaques.
(Choice A) HDL levels in patients with FH can vary but are typically within the normal reference range.
(Choice B) Elevated homocysteine levels have been associated with an increased risk of coronary
atherosclerosis. Low homocysteine levels may be seen in patients taking folate or vitamin B,2 supplements but have little clinical relevance.
(Choice D) Familial chylomicronemia syndrome is due to a mutation in the gene encoding lipoprotein lipase. It
can cause acute pancreatitis, lipemia retinalis, and eruptive xanthomas. However,this condition is not associated with increased risk of coronary atherosclerosis. (Choice E) Secondary elevations of triglycerides (eg, obesity, diabetes, hypothyroidism) can also cause
xanthomas, but low triglyceride levels are not associated with xanthomas.
Educational objective:
Familial hypercholesterolemia is the most common inherited lipid disorder and is most often caused by defective low-density lipoprotein receptors. Common clinical features include premature atherosclerosis and xanthomas in the skin and tendons.
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Premature coronary artery disease (men age <55, women age<65) is frequently an indication of an underlying inherited lipid disorder, especially when it occurs in nonsmokers. Familial hypercholesterolemia (FH) is the most common inherited dyslipidemia and is an autosomal dominant disorder most often caused by a defective LDL cholesterol receptor gene. The absence of functional LDL receptors causes marked elevations in both total and LDL cholesterol because the LDL particles are not cleared effectively from circulation. The excess LDL is deposited in the arteries as atheromas and in the tendons and skin as xanthomas. Xanthomas are deposits of
lipid-rich foam cells in the dermis or subcutaneous tissue, and present as yellow rubbery nodules and plaques.
(Choice A) HDL levels in patients with FH can vary but are typically within the normal reference range.
(Choice B) Elevated homocysteine levels have been associated with an increased risk of coronary
atherosclerosis. Low homocysteine levels may be seen in patients taking folate or vitamin B,2 supplements but have little clinical relevance.
(Choice D) Familial chylomicronemia syndrome is due to a mutation in the gene encoding lipoprotein lipase. It
can cause acute pancreatitis, lipemia retinalis, and eruptive xanthomas. However,this condition is not associated with increased risk of coronary atherosclerosis. (Choice E) Secondary elevations of triglycerides (eg, obesity, diabetes, hypothyroidism) can also cause
xanthomas, but low triglyceride levels are not associated with xanthomas.
Educational objective:
Familial hypercholesterolemia is the most common inherited lipid disorder and is most often caused by defective low-density lipoprotein receptors. Common clinical features include premature atherosclerosis and xanthomas in the skin and tendons.
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NEET-SS exam Recalls
Plastic Surgery
IBQ Skin graft harvest - Intermediate thickness skin graft.
IBQ End-to-side vascular anastomosis wrist.
Prophylactic BL mastectomy in an actress with positive family history, reconstruction of
choice - Implant/Expander based reconstruction.
Median nerve injury in road accident with 5cm gap, RxoC - Nerve autograft.
40% burns in 60kg man - RL requirement according to Parkland formula in 24 hrs - 9600 mL.
Clinical history. Nasal lesion with recent ulceration – BCC > Keratoacanthoma.
Solve NEET-SS questions at @neetssdmmchmcqs
Plastic Surgery
IBQ Skin graft harvest - Intermediate thickness skin graft.
IBQ End-to-side vascular anastomosis wrist.
Prophylactic BL mastectomy in an actress with positive family history, reconstruction of
choice - Implant/Expander based reconstruction.
Median nerve injury in road accident with 5cm gap, RxoC - Nerve autograft.
40% burns in 60kg man - RL requirement according to Parkland formula in 24 hrs - 9600 mL.
Clinical history. Nasal lesion with recent ulceration – BCC > Keratoacanthoma.
Solve NEET-SS questions at @neetssdmmchmcqs
Medicine Q
Q) pt has level of leison at umbilicus, what is the vertebral leison
- T7- T9
Q) one from onco, CKD 20 + CDK 7-, not seen on PET scan
- ovarian
- breast
- lung
- colon
Q) mean>median >
mode( values were given)
- positively skewed
- negatively skewed
- no change
-
Q) pt with steatorrhoea schillings positive, d xylose normal, duodenal biopsy normal
- ileal disease
- intestinal lymphangectasia
- UC
- celiac disease
Q) elderly patient with MI 6 months back require add on therapy to metformin,
- SGLT2
- voglibose
-
-
Q) In CLD pt Not useful in MRSA
Meropenam
Linezolid
Daptomycin
Teicoplanin
Q) One hyponatremia correction,
S Na 110
Body weight 75
How much ml of 3percent saline will increase sodium by 8 meq:
800ml
400ml
200ml
100ml
Q) clinically homocyteinuria, which one will u add in diet
- pyridoxine
- carbo
- protein
- lipid
Q) something on body packing/cocaine/heroin
Q) which is used in Hairy cell leukemia recently treated with Fludaribine, requires blood transfusion
- leukoreduced RBCS
- irradiated RBCS
- whole blood
-
Q) patient with 2 spon abortions in past, travelled for 8 hrs,
Now has DVT,
Aptt 3 time ULN
Treatment
- warf then aspirain
- LMWH f/b warf with inr target 2.5-3.5 for life long
- LMWH f/b warf with INr target 2-3 for 12 months
-
Q) which is not a/ with hep C
- FSGS
-PAN
- MN
-MPGN
Q) which is not seen in amyloid
- stroke
- sensory neuropathy
- lumbisacral radiculopathy
- autonomic neuropathy
Q) which one is not used in fluid resuscitation
- IVC collapsiblity
- SV with passive SLR
- USG of lung
-
Q) which is not used as initial inv for secondary ammenorrhea
-FSH/LH
- USG abdo
- testosterone
- prolactin
Q) which is not included in clinical pulmonary infection score
- BP
- fever
- CXR
-
Q) which is not a feature of seronegative spA
- strongly associated with HLA B27
- Rf negative
- uveitis
- symmetrical polyarthritis
Q) Elderly male with hyponatremia ,which of the test is not useful as first line investigation:
-ONDST
-ACTH stimulation
-TSH
-Urine sodium
Q) diff SIADH vs CSW
- extravasc volume status
- serun uric acid levels
- high urine Na
- high urine osm
Q) On routine examination patient found to have LVH, systolic ejection murmur, ( sounded like HOCM)
Performs valsalva, what will happen to his murmur
- increase
- decrease
- no change
-
Q) one patient sudden collapses while playing basketball, found to have VT, which electrolytes will u ask
- ca, k, Mg
-na, k, ca
- na, ca, mg
-
Q) In relation to SACD which is false
- always corealtes with anemia
- inv of lateral and dorsal colums
- cu def has similar manifestation
-
Q) patient of DM on triple drugs- Metformin, dapagliflozim and ?
Has acidosis . What is the cause
- metformin induced lactic acidosis
- euglycemia ketoacidosis
-
-
Q) which is not useful in ICH scoring
- age
- volume kf bleed
- location of bleed
- delay in presentation
Q)regarding covid vaccine which is incorrect
- VITT is an indiosyncratic reaction
- chadox is adenovirus vector
- mrna vaccines rarely causes myocarditis in males
-
Q) which is false about tocilizumab
In a patient who has presented with ARDS and is planed to get intubated
- subcut is inferior to iv
- used when CRP>60
- given as single dose
-
Q) patient on treatment of depression, one ECG was given ( looked like TCA toxicity)
Which is false statement
- this ia a case of BZD poisoning
- QRS> 100 increases risk of seizures
- ? Gastric decontamination
Q) patient with oligouria, u output of 10ml/hr is started on furosemide infusion of 0.3mg/hr
Which is false
- furosemide increases risk of ATn in sepsis
- Furosemide delays Need of dialysis
-at this dose it wont cause ototoxicity
-
@superspeciality
Q) pt has level of leison at umbilicus, what is the vertebral leison
- T7- T9
Q) one from onco, CKD 20 + CDK 7-, not seen on PET scan
- ovarian
- breast
- lung
- colon
Q) mean>median >
mode( values were given)
- positively skewed
- negatively skewed
- no change
-
Q) pt with steatorrhoea schillings positive, d xylose normal, duodenal biopsy normal
- ileal disease
- intestinal lymphangectasia
- UC
- celiac disease
Q) elderly patient with MI 6 months back require add on therapy to metformin,
- SGLT2
- voglibose
-
-
Q) In CLD pt Not useful in MRSA
Meropenam
Linezolid
Daptomycin
Teicoplanin
Q) One hyponatremia correction,
S Na 110
Body weight 75
How much ml of 3percent saline will increase sodium by 8 meq:
800ml
400ml
200ml
100ml
Q) clinically homocyteinuria, which one will u add in diet
- pyridoxine
- carbo
- protein
- lipid
Q) something on body packing/cocaine/heroin
Q) which is used in Hairy cell leukemia recently treated with Fludaribine, requires blood transfusion
- leukoreduced RBCS
- irradiated RBCS
- whole blood
-
Q) patient with 2 spon abortions in past, travelled for 8 hrs,
Now has DVT,
Aptt 3 time ULN
Treatment
- warf then aspirain
- LMWH f/b warf with inr target 2.5-3.5 for life long
- LMWH f/b warf with INr target 2-3 for 12 months
-
Q) which is not a/ with hep C
- FSGS
-PAN
- MN
-MPGN
Q) which is not seen in amyloid
- stroke
- sensory neuropathy
- lumbisacral radiculopathy
- autonomic neuropathy
Q) which one is not used in fluid resuscitation
- IVC collapsiblity
- SV with passive SLR
- USG of lung
-
Q) which is not used as initial inv for secondary ammenorrhea
-FSH/LH
- USG abdo
- testosterone
- prolactin
Q) which is not included in clinical pulmonary infection score
- BP
- fever
- CXR
-
Q) which is not a feature of seronegative spA
- strongly associated with HLA B27
- Rf negative
- uveitis
- symmetrical polyarthritis
Q) Elderly male with hyponatremia ,which of the test is not useful as first line investigation:
-ONDST
-ACTH stimulation
-TSH
-Urine sodium
Q) diff SIADH vs CSW
- extravasc volume status
- serun uric acid levels
- high urine Na
- high urine osm
Q) On routine examination patient found to have LVH, systolic ejection murmur, ( sounded like HOCM)
Performs valsalva, what will happen to his murmur
- increase
- decrease
- no change
-
Q) one patient sudden collapses while playing basketball, found to have VT, which electrolytes will u ask
- ca, k, Mg
-na, k, ca
- na, ca, mg
-
Q) In relation to SACD which is false
- always corealtes with anemia
- inv of lateral and dorsal colums
- cu def has similar manifestation
-
Q) patient of DM on triple drugs- Metformin, dapagliflozim and ?
Has acidosis . What is the cause
- metformin induced lactic acidosis
- euglycemia ketoacidosis
-
-
Q) which is not useful in ICH scoring
- age
- volume kf bleed
- location of bleed
- delay in presentation
Q)regarding covid vaccine which is incorrect
- VITT is an indiosyncratic reaction
- chadox is adenovirus vector
- mrna vaccines rarely causes myocarditis in males
-
Q) which is false about tocilizumab
In a patient who has presented with ARDS and is planed to get intubated
- subcut is inferior to iv
- used when CRP>60
- given as single dose
-
Q) patient on treatment of depression, one ECG was given ( looked like TCA toxicity)
Which is false statement
- this ia a case of BZD poisoning
- QRS> 100 increases risk of seizures
- ? Gastric decontamination
Q) patient with oligouria, u output of 10ml/hr is started on furosemide infusion of 0.3mg/hr
Which is false
- furosemide increases risk of ATn in sepsis
- Furosemide delays Need of dialysis
-at this dose it wont cause ototoxicity
-
@superspeciality
SUPER-SPECIALITY pinned «Medicine Q Q) pt has level of leison at umbilicus, what is the vertebral leison - T7- T9 Q) one from onco, CKD 20 + CDK 7-, not seen on PET scan - ovarian - breast - lung - colon Q) mean>median > mode( values were given) - positively skewed - negatively…»
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Main Channel :-
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- Join us for daily MCQs, Quizzes, Active Discussions and Recent Advances to target your favourite branch.
- These groups are run to maintain your regularity and consistency on a daily basis and keep you motivated.
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Main Channel :-
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- Join us for daily MCQs, Quizzes, Active Discussions and Recent Advances to target your favourite branch.
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SUPER-SPECIALITY pinned «SUPER-SPECIALITY 🔺🔹🔺🔹🔺🔹🔺🔹🔺 | NEET SS | INI-SS | MCH | DM 🔺🔹🔺🔹🔺🔹🔺🔹🔺 This is a platform for future SuperSpecialists 👨⚕⚕🧑⚕⚕ preparing for SS exam.⚕🏥 Main Channel :- https://t.me/SUPERSPECIALITY - Join us for daily MCQs, Quizzes, Active Discussions and…»
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Based on Nelson's 22nd Ed
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Subscribe before April 30th & get
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📌Free access to Marathon INI-CET – live revision program
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