2014 module exam Flashcards

1
Q

Which of the following represent the change in the 5-years survival rate of SLE patients in the last 50 years?

a. From 50% to 95%
b. From 80% to 90%

A

a. From 50% to 95%

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2
Q

A patient with Sickle cell anemia suffers from osteomyelitis, what is the most likely etiological organism?

a. Cryptococcus neoformans
b. Salmonella typhi
c. Candida albicans
d. Neisseria gonorrhea

A

b. Salmonella typhi

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3
Q

A patient presented with septic arthritis and severe diarrhea, what is most likely etiological pathogen?

a. Cryptococcus neoformans
b. Salmonella typhi
c. Candida albicans
d. Neisseria gonorrhea

A

b. Salmonella typhi

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4
Q

A Young female previously diagnosed with SLE, presented with spontaneous bleeding, what is the underlying immunological mechanism behind this condition?

a. Direct antibody cytotoxicity
b. Polyclonal activation

A

No answer (probably B)

google: spontaneous bleeding in SLE is rare symptom of moderate thrombocytopenia (caused by SLE)

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5
Q

SLE patient with recurrent abortions and stroke, what is the underlying pathogenesis?

A

Anti-phospholipd antibodies

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6
Q

Which of the following results in muscle dystrophy due to mutation in dystrophin gene?

A

Duchenne muscle dystrophy

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7
Q

Which of the following results in narrowing of the bone spaces in long bones?

A

Osteopetrosis

narrowing of intramedullary space

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8
Q

What is a characteristic of fast twitch muscle?

a. Few mitochondria
b. Many mitochondria

A

a. Few mitochondria

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9
Q

A patient with sever neutropenia presented with arthritis, arthrocentesis reveals branched septate hyphae:

a. Aspergillus
b. Candida albicans
c. Neisseria gonorrhea
d. S. agalactiae

A

a. Aspergillus

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10
Q

A diabetic presented with septic arthritis, which of the following is likely the cause?

a. Cryptococcus neoformans
b. S. agalactiae
c. Candida albicans
d. Aspergillus

A

b. S. agalactiae

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11
Q

What is the best radiological modality to assess ACL tear?

A

MRI

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12
Q

Which of the following in encroaching in L5 vertebral body?

A

Pedicles

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13
Q

Which of the following is responsible for restriction of movement of the spine?

a. spinous process
b. transverse process
c. articular process

A

Articular process

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14
Q
Which of the following is a non-purine xanthine oxidase inhibitor?
A) Allopurinol
B) Prednisone 
C) Febuxistat
D) Celecoxib 
E) Paracetamol
A

Febuxistat

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15
Q
Which of the following is metabolized to non-competitive xanthine oxidase inhibitor?
A) Allopurinol
B) Prednisone 
C) Febuxistat
D) Colchicine  
E) Paracetamol
A

A) Allopurinol

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16
Q

Hyperdorsiflexion can result in fracture of which of the following?

A

Talus

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17
Q

Which deformity of the spine can result from the presence of hemivertebra?

A

Scoliosis

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18
Q
Which of the following is a COX-2 selective inhibitor?
A) Allopurinol
B) Prednisone 
C) Febuxistat
D) Colchicine  
E) Celecoxib
A

E) Celecoxib

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19
Q

Which of the following is associated with HLA-DR4 gene?

A

Rheumatiod arthritis

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20
Q

What pathogenesis is seen when a motor unit is affected?

A

Group-muscle atrophy

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21
Q

What deformity can result in newborns from affected SCM muscle?

A

Torticollis

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22
Q

Mutation in which of the following mitochondrial gene results in MELAS?

A

tRNA-Leucine

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23
Q

A female presented with facial rash and maculopapular rash?

A

Erythema infectiosum

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24
Q

What forms the stem of the bottle-brush structure of proteoglycans?

A

Hyaluronic acid

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25
Q

What is the mechanism of action of Methotrexate?

A

Inhibition of DNA synthesis through inhibiting dihydrofolate reductase

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26
Q
What forms the lateral border of cubital fossa?
A) Pronator teres
B) Brachialis
C) Brachioradialis
D) Biceps brachii
A

C) Brachioradialis

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27
Q

What prevents hyperextention of the hip joint while standing?

A

Iliofemoral ligament

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28
Q

What is true regarding back pain?

A

Most common in working age

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29
Q

What can cause Reye’s syndrome in children after viral infection?

A

Aspirin

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30
Q
Which of the following is an alkaloid that binds to tubulin & act as mitotic poison?
A) Allopurinol
B) Prednisone 
C) Febuxistat
D) Colchicine  
E) Celecoxib
A

D) Colchicine

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31
Q

What is the mechanism of action of anti- inflammatory drug Indomethacin?

a. Selective COX-1
b. Selective COX-2
c. Inhibit both COX-1 & COX-2

A

c. Inhibit both COX-1 & COX-2

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32
Q

What forms from an extension of semimembranosus muscle tendon?

a. Oblique popliteal ligament
b. Tibial collateral ligament

A

a. Oblique popliteal ligament

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33
Q

What structure passes out of the lesser sciatic foramen?

A

Obturator internus muscle

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34
Q

A young patient presented with bone pain, worse at night, relieved by NSAIDs, what is the diagnosis?

A

Osteoid osteoma

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35
Q

What mediate the tissue damage in Rheumatoid arthritis?
A) Th1 and NK cells
B) Th1 cells and immune complexes

A

TH1 and immune complexes

36
Q

What is a feature of tetanus in skeletal muscles?

A

The force is increasing and then maintained

37
Q

Abnormal excretion of uric acid when given in low doses?

A

Aspirin

38
Q

An elderly patient with BMI = 21 is diagnosed with osteoarthritis. What is the first line of management?

a. Paracetamol 1mg BD
b. Intra-articular corticosteroid injection
c. Weight reduction
d. Injection of hyaluronic acid

A

a. Paracetamol 1mg BD

39
Q
Which artery is a branch of profunda brachii artery?
A) Middle collateral artery
B) Radial recurrent artery
C) Inferior ulnar collateral artery
D) Superior ulnar collateral artery
E) Ulnar artery
F) Radial artery
G) Brachial artery
H) Axillary artery
A

A) Middle collateral artery

Middle and radial collateral arteries

40
Q

A man encounters an accident and there is disk prolapse. He lost sensation over the radial part of the forearm and the thumb. Where is the prolapse?

a. C4-C5
b. C5-C6

A

b. C5-C6

41
Q

Which of the following lymph node first drain the majority of the upper limb?

a. Central
b. Apical
c. Pectoral
d. Humeral
e. Suprascapular

A

d. Humeral

42
Q

Which nerve can be injured due to fracture to neck of the humerus?

a. Axillary nerve
b. Median nerve
c. Accessory nerve
d. Ulnar nerve

A

a. Axillary nerve

43
Q

Which muscle is tested when extending the forearm against resistance?

a. Triceps
b. Anconues

A

a. Triceps

44
Q

What can result from increase Mg in the synaptic cleft?

A

?

45
Q

What can result from decrease intracellular Ca of presynaptic neuron?

A

?

46
Q

Which of the following gives the sural nerve?

A

Tibial and common peroneal

47
Q

Which muscle initiates the abduction of the upper limb?

a. Supraspinatus
b. Subscapularis

A

a. Supraspinatus

48
Q

Which ligament is associated with the medial meniscus of the knee joint?

a. Oblique popliteal ligament
b. Tibial collateral ligament

A

b. Tibial collateral ligament

49
Q

What is the most important intervention to prevent osteoarthritis at the community level?

A

Weight reduction

50
Q

What explains the reduction in mortality among Rheumatoid arthritis patients?

A

Introduction of Disease-Modifying Anti-Rhuematic drugs (DMARDS)

51
Q

Which part of long bones develops from primary ossification center?

a. Epiphysis
b. Diaphysis

A

b. Diaphysis

52
Q

What is the structure of collagen?

A

Triple helix

53
Q

The common inerosseues artery is a branch of which artery?

A

Ulnar artery

54
Q

Epaxial muscles are supplied by which if the following?

a. Dorsal rami
b. Ventral rami
c. Dorsal root
d. Ventral root

A

a. Dorsal rami

55
Q

A young patient presented with muscle weakness and jaundice, what is the most likely cause of his condition?

a. HIV
b. HBV

A

?

56
Q

Which bones form the surface that articulates with the radius at the wrist joint?

A

triquitrium, lunate, scaphoid

57
Q

An injury to quadrangular space can affect which structure?

a. Axillary nerve
b. Median nerve
c. Accessory nerve
d. Ulnar nerve

A

a. Axillary nerve

58
Q

What is the main extensor and adductor of the foot?

a. Tibialis anterior
b. Extensor halluces longus

A

a. Tibialis anterior

59
Q

Which bones is affected in “dancers fracture”?
A) Talus
B) Metatarsals
C) Calcaneus

A

B) Metatarsals

60
Q
if he axillary artery was ligated at the level of its 2nd part, blood will be reversed in which artery?
A) thoracoacromial
B) anterior circumflex
C) subscapular
D) superior thoracic
E) lateral thoracic
A

C) subscapular

61
Q

Injury to which of the following nerves causes loss of opposition of the thumb?

a. Median nerve
b. Radial nerve
c. Accessory nerve
d. Ulnar nerve

A

a. Median nerve

62
Q

What is the sensory supply to dorsal aspect of forearm?

a. Median nerve
b. Radial nerve
c. Accessory nerve
d. Ulnar nerve

A

b. Radial nerve

63
Q

What structure passes the knee joint to insert in tibia?

A

semitendinosus tendon

64
Q

A patient with positive Trendelenburg’s sign, the hip was tilt to the right side, weakness in which muscle causes this condition?

a. Left gluteus medius
b. Right gluteus medius
c. Left gluteus maximus
d. Right gluteus maximus

A

a. Left gluteus medius

65
Q

What supplies the inferior gemellus muscle?

a. nerve to obturator internus
b. nerve to quadratus femoris
c. superior gluteal nerve
d. inferior gluteal nerve

A

Nerve to quadratus femoris

66
Q
Which of the following is a product of denovo biosynthesis of purines?
A) IMP
B) AMP
C) Xanthine 
D) Guanine
E) Ribose 5 phosphate
F) 5 phosphoribosyl pyrophosphate
A

IMP

67
Q

which process is responsible for the unidirectional passage of AP?

A

Hyperpolarization of the membrane OR refractory period

68
Q

Injury to spinal accessory nerve lead to paralysis of which muscle?

A

Trapezius

69
Q

Which muscle are responsible for lateral rotation of the arm?

A

Infraspinatus and teres minor

70
Q

injury to long thoracic nerve affects which muscle?

A

Serratus anterior

71
Q

Associated with collagen type1 synthesis and excretion?

A

Osteogeneisis imperfecta

72
Q

What is the best radiological modality to see the spinal cord?

A

MRI

73
Q

which muscle is responsible for dorsal flexion of foot?

A

Tibialis anterior

74
Q

Two diagrams showing the decrease in Ceratinine phosphate and glycogen levels with time, what is the main physiological consequence of this?

A

Muscle fatigue

75
Q

What is the preferred pathway for energy production during short strenuous workout and why?

a. Free fatty acids=> B oxidation because it gives more energy per molecule
b. Blood glucose=> glucose=>glycolysis because insulin initiates glucose uptake
c. Glycogen=>glucose=>glycolysis because it passes the slow step of hexokinase

A

c. Glycogen=>glucose=>glycolysis because it passes the slow step of hexokinase

76
Q

Activity of which of the following enzymes will increase during short strenuous workout?

A

Lactic acid dehydrogenase

77
Q

Which ligand when binds to the receptor on the skeletal muscle can increase cAMP levels?

A

Epinephrine

78
Q

If a patient is unable to extend at wrist and hand joints (i.e. “wrist drop “), at which level was the injury?

a. Neck of humerus
b. Neck of radius
c. Shaft of radius

A

b. Neck of radius

79
Q

A dermatome diagram was given in the exam and an arrow pointing on the lateral side of the arm. Which spinal nerve innervates this area?

a. C3
b. C4
c. C5

A

c. C5

80
Q

Whats an early marker of osteoarthritis?

A

Aggregan

81
Q

A patient who was on statins developed myositis that didn’t have remarkable inflammation that relieved bt steroids, what is the diagnosis?

A

Immune mediated necrotizing

82
Q

A patient with diabetes and other autoimmune disease and had infiltration CD3+ cells. Whats the diagnosis?

A

myositis

83
Q

Whats the origin of the vertebral column?

a. Endoderm
b. Mesoderm
c. Ectoderm

A

b. Mesoderm

84
Q

If the ventral roots of C5 and C6 are injured which of the following is mostly affected?

a. medial cord
b. lateral cord

A

b. lateral cord

85
Q

if ventral roots of C8 and T1 are injured which of the following is mostly affected?

a. medial cord
b. lateral cord

A

a. medial cord