Disorders of metablosm Flashcards

1
Q
  1. Osteoporosis is now thought to be occurring due to
    (a) Lack of bone matrix
    (b) Deficiency of calcitonin
    (c) Deficiency of parathyroid hormone
    (d) Long-term negative calcium balance
A

(d) Once thought to be due to lack of adequate bone matrix,
osteoporosis is now believed to be due to long-term negative
calcium balance. The skeletal mass at old age is proportional
to that of maturity. Thus calcium intake at infancy and
childhood may play a significant role in occurrence and
severity of osteoporosis in old age

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1
Q
  1. The recommended daily allowance of calcium for children and
    adults is
    (a) 600 mg
    (b) 800 mg
    (c) 900 mg
    (d) 500 mg
A

(b) The RDA for infants is 360 mg, while it is 800 mg for children
as well as adults. However, adolescents, pregnant and
lactating women need to increase their daily intake to about
1200 mg

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2
Q
  1. Acrodermatitis enteropathica is a multiorgan disorder resulting
    from deficiency of
    (a) Iron
    (b) Zinc
    (c) Magnesium
    (d) Fluoride
A

(b) It is an autosomal recessive disorder resulting from faulty
zinc absorption and is manifested as diarrhea, vesicles,
eczematoid plaques, alopecia, stomatitis and glossitis

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3
Q
  1. Excessive accumulation of intracellular mucoploysaccharide
    including fibroblasts leading to formation of “gargoyle cells” is
    seen in
    (a) Hurler syndrome
    (b) Gaucher disease
    (c) Hereditary fructose intolerance
    (d) Niemann-Pick disease
A

(a) It is an autosomal recessive disorder and is characterized
by an increased mucopolysaccharide excretion in urine.
It is clinically manifested by prominent forehead, saddle
nose, hypertelorism, puffy eyelids, bushy eyebrows, thick
lips, large tongue, open mouth and noisy breathing due to
nasal congestion.

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4
Q
  1. Calcium does not play a significant role in which of the following
    bodily functions?
    (a) Regulation of body temperature
    (b) Formation of bones and teeth
    (c) Acts as secondary/tertiary messenger in hormone action
    (d) Nerve conduction
A

(a) Calcium plays an important role in teeth and bone
formation, in the maintenance of skeletal and teeth
framework, normal membrane permeability, normal heart
rhythm, neuromuscular excitability, in blood coagulation,
muscle contraction and as secondary/tertiary messenger
in hormone action

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5
Q
  1. The lowest turnover rates of phosphorus in the human body is
    in
    (a) Intestines
    (b) Bones and teeth
    (c) Kidney
    (d) Cell membranes
A

(b) There are multiple pools of phosphorus having different
turnover rates of which bones and teeth have lowest. A
major portion of phosphorus is incorporated into organic
phosphorus compounds like nucleic acids, phospholipids
of cell membranes, etc.

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6
Q
  1. Radiological evidence of “Erlenmeyer flask” deformity of distal
    femur is an early skeletal change seen in
    (a) Lipoid proteinosis
    (b) Gaucher’s disease
    (c) Kwashiorkor
    (d) Cushing’s disease
A

(b) Gaucher’s disease is a lysosomal storage disease characterized
by deposition of glucocerebroside in the cells of macrophagemonocyte system.

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7
Q
  1. Which hormone is responsible for regulation of phosphate levels
    in blood?
    (a) Calcitonin
    (b) Insulin
    (c) Parathormone
    (d) Alkaline phosphatase
A

(c) The blood levels of phosphorus are maintained by various
factors such as parathormone, phosphatase activity and
vitamin D.

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8
Q
  1. All except __________ are causes of hypophosphatemia.
    (a) Rickets and osteomalacia
    (b) Increased excretion due to diuretics, etc.
    (c) Ischemic heart disease
    (d) Decreased intake due to malabsorption, vomiting, etc.
A

(c) Normally, phosphate deficiency is nonexistent in man.
However, long-term antacid use will render phosphate
unabsorbable. Other causes of hypophosphatemia are
rickets, osteomalacia, decreased intake, increased cellular
uptake (carbohydrate rich diets), liver disease and increased
excretion due to diuretics or increased parathormone
levels

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9
Q
  1. Over half of all the body store of magnesium is found in
    (a) Bones
    (b) Teeth
    (c) Muscles
    (d) Liver
A

(a) More than half of magnesium is stored in bones and one
quarter in muscles. Remainder of magnesium is stored in
liver, pancreas, RBCs, serum and cerebrospinal fluid.

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10
Q
  1. Calcinosis cutis is the presence of calcification in
    (a) Liver
    (b) Brain
    (c) Heart
    (d) Skin
A

(d) In calcinosis cutis, there is formation of calcium carbonate
nodules in skin, surrounded by a foreign body giant cell
reaction. Similar nodules elsewhere in the soft tissues are
called calcinosis universalis

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11
Q
  1. Metastatic calcification is most commonly seen in
    (a) Hyperkalemia
    (b) Hyperparathyroidism
    (c) Osteoporosis
    (d) Pulp stones
A

(b) Metastatic calcification refers to deposition of calcium
in previously undamaged tissues and is most commonly
observed in hyperparathyroidism and hypervitaminosis
D.

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12
Q
  1. Hyperkalemia refers to increased _______ levels in blood.
    (a) Potassium
    (b) Sodium
    (c) Fluorine
    (d) Lead
A

(a) Hyperkalemia may result from excessive tissue breakdown,
adrenal insufficiency, advanced dehydration or over dosage
of potassium.

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13
Q
  1. Which one of the following special stains is utilized to demonstrate
    amyloid?
    (a) PAS
    (b) Perls’ Prussian blue
    (c) Alcian blue
    (d) Congo red
A

(d) Abnormal proteinaceous substance deposited in between
cells within the tissues and organs is called amyloidosis.
It is deposited in a variety of clinical disorders. It is seen
as intercellular pink, translucent material by H and E
staining, while a special stain called Congo red is also used
to demonstrate it.

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14
Q
  1. A reddish/brownish pigmentation of teeth along with
    photosensitivity and excretion of reddish-colored urine is
    characteristic of
    (a) Sideropenic dysphagia
    (b) Kwashiorkor
    (c) Congenital porphyria
    d) Amyloidosis
A

(c) It is a non sex-linked recessive disorder with both sexes
equally affected. Its first manifestation is excretion of red
urine containing uroporphyrin at birth or within first year.
Photosensitivity and vesiculobullous eruptions on exposed
parts of body occur later.

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15
Q
  1. Phosphate diabetes is a form of
    (a) Hypervitaminosis A
    (b) Hypervitaminosis E
    (c) Avitaminoses
    (d) Vitamin D resistant rickets
A

(d) Familial hypophosphatemia or vitamin D resistant rickets
is now recognized as an X-linked dominant defect in renal phosphate metabolism and is characterized by
hypophosphatemia, hypophosphaturia, rickets that does
not respond to administration of vitamin D, normal vitamin
D metabolism, diminished growth, etc.

16
Q
  1. Which amongst the following is not a function associated with
    vitamin A?
    (a) Differentiation of epithelial cells
    (b) Vision
    (c) Lysosomal stability
    (d) Collagen synthesis
A

(d) A continuous supply of vitamin A is needed for rod (low
light) vision. It is also needed for lysosomal stability and is
essential for the process of differentiation of epithelial cells.

16
Q
  1. Nyctalopia, keratomalacia and xerophthalmia are classical
    deficiency symptoms of which vitamin?
    (a) Vitamin C
    (b) Vitamin B12
    (c) Vitamin A
    (d) Vitamin E
A

(c) These features are seen in initial stages of deficiency.
In advanced cases, there is keratinizing metaplasia in
tracheobronchial tree, kidney, conjunctiva, cornea, salivary
glands and genitourinary tract.

17
Q
  1. Hypophosphatasia is produced by a deficiency of
    (a) Phosphate
    (b) Alkaline phosphatase
    (c) Acid phosphatase
    (d) Vitamin D
A

(b) Hypophosphatasia is a hereditary disease transmitted as
autosomal recessive characteristic manifested in three
forms—Infantile, childhood and adult types.

18
Q
  1. Tocopherol is the generic name for
    (a) Vitamin B12
    (b) Vitamin B6
    (c) Vitamin E
    (d) Vitamin K
A

(c) Tocopherol means “The alcohol which brings forth
offspring”. The main function of vitamin E is to prevent
peroxidation of polyunsaturated fatty acids.

19
Q
  1. Which vitamin is responsible for iron uptake in the intestinal
    tract?
    (a) Vitamin C
    (b) Vitamin A
    (c) Vitamin B1
    (d) Folic acid
A

(a) The functions of vitamin C include normal development
of intercellular ground substance in connective tissues,
promotion of non heme iron absorption, maintenance of
intracellular oxidation reduction potential, etc. It also acts
as an antioxidant, aids iron uptake in GIT. Over and above all
this, it aids the hydroxylation of proline in collagen synthesis.

20
Q
  1. Which amongst the following does not belong to the vitamin B
    complex group?
    (a) Inositol
    (b) Para-aminobenzoic acid
    (c) Tocopherol
    (d) Pantothenic acid
A

(c) Currently there are 11 well-known vitamins in the vitamin
B complex group namely, thiamine, riboflavin, niacin,
pyridoxine, pantothenic acid, biotin, folic acid, vitamin B12,
inositol, para-aminobenzoic acid and choline.

21
Q
  1. Wernicke’s encephalopathy occurs in chronic ______ deficiency.
    (a) Thiamin
    (b) Riboflavin
    (c) Folic acid
    (d) Vitamin B12
A

(a) Alcoholic patients with chronic thiamine deficiency
suffer from CNS manifestations known as Wernicke’s
encephalopathy, which consists of horizontal nystagmus,
ophthalmoplegia, cerebral ataxia and mental derangement.

22
Q
  1. Acromegaly occurs due to hypersecretion of
    (a) Hormones from posterior pituitary after ossification is
    complete
    (b) Hormones from anterior pituitary before ossification is
    complete
    (c) Hormones from posterior pituitary before ossification is
    complete
    (d) Hormones from anterior gland after ossification is complete
A

(d) Acromegaly occurs due to over secretion of anterior pituitary
hormones after ossification is complete and is manifested
by temporal headaches, photophobia and reduction in
vision. Terminal phalanges of hand and feet enlarge and
lips become negroid

23
Q
  1. Cretinism and myxedema result from hyposecretion of
    (a) Thyroid hormones
    (b) Growth hormones
    (c) Adrenal medullary hormones
    (d) Parathormone
A

(a) If thyroid insufficiency occurs in infants, it is called cretinism,
if it occurs in childhood, juvenile myxedema and if it occurs
in adults, then it is referred to as adult myxedema.

24
Q
  1. Repeated pathological fractures, generalized osteoporosis, giant
    cell tumors in jaws and urinary tract stones are characteristic
    signs of
    (a) Hypoparathyroidism
    (b) Hyperparathyroidism
    (c) Hyperthyroidism
    (d) Hypothyroidism
A

(b) Hyperparathyroidism may be primary (excessive secretion
of parathormone) or secondary (due to other disease
especially end stage renal diseases). Both types usually
manifest with urinary calculi, pathologic fractures, multiple
pseudocyst formation in bones and drifting and spacing of
teeth.

25
Q
  1. Chronic insufficiency of adrenal cortical hormones lead to
    (a) Cushing’s disease
    (b) Goiter
    (c) Addison’s disease
    (d) Kimura’s disease
A

(c) It usually develops secondary to autoimmune destruction
of adrenal glands and frequently occur in conjunction
with other autoimmune disorders. It manifests as lethargy,
muscle fatigue, feeble heart action, vomiting, diarrhea and
severe anemia.

26
Q
  1. Glycosuria, polydipsia, polyuria, weakness and weight loss are
    encountered in
    (a) Diabetes insipidus
    (b) Diabetes mellitus
    (c) Addison’s disease
    (d) Marasmus
A

(b) Diabetes mellitus (DM) is classified into type 1 or juvenile
and type 2 or maturity onset diabetes. It characterized by
glycosuria, polyuria, polydipsia, weakness and weight loss.
Accelerated and abnormal amino acids and fats result
in ketoacidosis. Its complications are atherosclerosis,
retinopathy, neuropathy, autonomic insufficiency and
susceptibility to infections.

27
Q
  1. Which amongst the following is commonly associated with
    diabetes mellitus?
    (a) Candidiasis
    (b) Porphyria
    (c) Actinomycosis
    (d) Cardiac arrhythmia
A

(a) The oral manifestations in DM are mainly due to inflammation
and infection because of abnormal neutrophil function,
microangiopathy and altered oral flora. Most patients of DM
manifest with dry mouth, persistent gingivitis, periodontal
disease and candidiasis.

28
Q
  1. Bronze diabetes occurs due to overload of which trace element
    in the body?
    (a) Copper
    (b) Lead
    (c) Iron
    (d) Zinc
A

(c) Bronze diabetes occurs due to iron overload and is
manifested by micronodular cirrhosis, marked brown
pigmentation, diabetes mellitus and skin pigmentation.