ONE PYQ

#21. Melanosis coli. which occurs due to long term consumption of stimulant laxatives, presents as brown discolouration of colonic mucosa due to deposition of which one of the following pigments?
(a) Melanin
(b) Haemosiderin
(c) Lipofuscin
(d) Haemoglobin

#22. Consider the following with regard to Gilbert Syndrome:
I. Autosomal recessive trait of a mutation in gar for UDP-glucuronyl transferase enzyme
ll. Elevation of unconjugated bilirubin
Ill. No stigmata of chronic liver disease other than jaundice
IV. Early Liver biopsy in patients with possible Gilbert Syndrome

Which of the above are correct?
(a) I and Il only
(b) Il and Ill only
(c) I, II and III
(d) III and IV

#23. The single most important treatment and prognostic factor in alcohol-related liver disease is
(a) N-acetyl cysteine
(b) Cessation of alcohol consumption
(c) Liver transplantation
(d) High dose vitamin E

#24. A 40 year old with a known case of chronic pancreatitis presents to the OPD with complaint of skin pigmentation over the abdomen. The patient gives a history of chronic use of a hot water bottle to relieve the abominal discomfort. Which one of the following is the most appropriate diagnosis?
(a) Erythana infectiosum
(b) Erytlrma marginatum
(c) Erytherna nodosum
(d) Erythema ab igne

#25. Which one of the following is correct regarding arginine vasopressin antagonist Tolvaptan ?
(a) It is useful in hypovolemic hyponatremia
(b) It antagonises the V1 receptor
(c) It should be used for at least 1 year
(d) It is an oral drug

#26. Which one of the following conditions is caused by mutations in the gene that encodes the sodium-potassium-2-chloride co-transporter (NKCC2), and presents with sodium wasting, hypokalaemia. hypomagnesaemia and hypercalciuria ?
(a) Alport syndrome
(b) Bartter syndrome
(c) Fanconi syndrome
(d) Gitelman syndrome

#27. A 52 year Old male has uncontrolled diabetes. Which one of the following tests will help in early detection of nephropathy?
(a) Blood Urea level
(b) Serum creatinine level
(c) Ultrasonography
(d) Urine albumin

#28. Autosomal dominant mutations in which of the following genes may cause focal segmaltal glomerulolerosclerosis with abnormal genitalia, Wilm\'s tumour and mental retardation?
(a) WT1
(b) INF2
(c) LMX1B
(d) APOL1

#29. Kidney damage and Glomerular Filtration Rate (GFR) value between 15-29 mL/min/1.73 m2 are found in which stage of Chronic Kidney Disease?
(a) Stage 2 (mild)
(b) Stage 3A (mild to moderate)
(c) Stage 4 (severe)
(d) Stage 5 (kidney failure)

#30. Which one of the heralitary tubulo-interstitial kidney diseases has an autosomal recessive mode of inheritance?
(a) Medulary cystic kidney disease Type1
(b) Medulary cystic kidney disease Type2
(c) Nephronopthisis
(d) Juvenile hyperuricaemic nephropathy

#31. Which of the following findings in a patient are suggestive of acute nephritis?
I. Hematuria
ll. Oliguria
Ill. Reduced size of both kidneys
IV. Edema

Select the correct answer using the code given below :
(a) l and II
(b) III and IV
(c) I and Il only
(d) I, Il and IV

#32. A 35 Old male presents with increased urine output. On evaluation, his urinary output was around 4L/day; urinary osmolarity was 200 mosmol/L. Which of the following are various diagnosis?
I. Psychogenic polydipsia
II. Solute diuresis
Ill. Central diabetes insipidus
IV. Nephrogenic diabetes insipidus

#33. Contralateral Homonymous upper quadrantanopia is the type of visual loss seen when the lesion is located at which one of the following anatomical locations?
(a) Frontal lobe
(b) Temporal lobe
(c) Parietal lobe
(d) Occipital lobe

#34. Which of the following are clinical features of migraine?
I. It is associated with dilatation of extracranial vessels
II. Common migaine is seen without aura
Ill. Aura is most often visual

Select the correct answer using the code gival below :
(a) I, Il and lll
(b) I and Il only
(c) Il and Ill only
(d) I and Ill only

#35. A 50 year old man presents with brief episodes of lancinating unilateral facial pain, involving the buccal distribution. Pain is triggered by washing face with cold water. What is the most likely diagnosis?

(a) Migraine
(b) Medication overuse headache
(c) Chronic paroxysmal hemicrania
(d) Trigeminal neuralgia

#36. Which of the following are trigger factors for seizures ?
I. Sleep deprivation
II. Missed doses of antiepileptic drugs
ln. Recreational drug misuse
IV. Physical exhaustion

Select the correct answer using the code given below :
(a) Il and Ill only
(b) l and lV only
(c) l, Il and Ill only
(d) I, Il, III and IV

#37. Which one of the following childhood epileptic disorders often needs long term treatment with anti epileptic drugs?
(a) Benign neonatal seizures
(b) Febrile seizures
(c) Benign rolandic epilepsy
(d) Juvenile myoclonic qilepsy

#38. Which of the following are clinical features of Parkinson disease?
I. Reduced eye blinking
II. Drooling of Saliva
Ill. Soft voice
IV. Macrographia

Select the correct answer using the code given below :
(a) I, Il and III
(b) I, II and IV
(e) I, III and IV
(d) II, III and IV

#39. A 35 year female presents with easy fatigability. Investigations show that Hb is 6 g%; Red cell morphology is normocytic normcrhromic; and reticulocyte production index is 5.5. Which one of the following conditions favours this abnormality ?
(a) Iron deficiency anemia
(b) Sideroblastic anemia
(c) Folate deficiency
(d) Intravascular hemolysis

#40. A 46 year old lady on vegan diet for a decade presents with chief complaints of tingling and numbness in lower limbs for two months and a history of swaying while walking through narrow corridors. Which one of the following blood tests is advisable for in this patient ?
(a) Serum protein electrophoresis
(b) Anti-gliadin antibodies
(c) Vitamin 25(OH) D level
(d) Vitamin B12 levels