MDS PREP
What is the primary mechanism by which H. pylori is able to survive in the acidic environment of the stomach?
1) It produces hydrochloric acid
2) It has a protective outer coating
3) It produces urease, which generates ammonia
4) It lives in the mucus layer without contacting the acid
H. pylori produces the enzyme urease, which breaks down urea into ammonia and carbon dioxide, raising the local pH around the bacteria and protecting them from the acidic gastric environment.
A patient with a history of liver cirrhosis develops a hemorrhagic tendency. Which coagulation factor is likely to be deficient?
1) Factor I (Fibrinogen)
2) Factor II (Prothrombin)
3) Factor V
4) Factor VIII
In liver disease, especially cirrhosis, there is a decrease in hepatic synthesis of clotting factors, particularly factor II (prothrombin). Vitamin K deficiency is also common in liver disease, which further contributes to hypoprothrombinemia. The deficiency of fibrinogen (factor I) would also result in a bleeding diathesis but is less common in liver disease. Factors V and VIII are also synthesized in the liver but are less frequently affected than factor II in such cases.
Which of the following is NOT a complication of chronic kidney disease?
1) Hypertension
2) Anemia
3) Hyperkalemia
4) Hypernatremia
Chronic kidney disease can lead to hypertension, anemia, and hyperkalemia due to impaired renal function. However, hypernatremia is typically associated with decreased water intake or increased water loss, not increased sodium levels.
Which of the following is the most common cause of primary hyperparathyroidism?
1) Parathyroid adenoma
2) Parathyroid carcinoma
3) Multiple endocrine neoplasia type 1 (MEN 1)
4) Secondary hyperparathyroidism due to chronic renal failure
Primary hyperparathyroidism is most commonly caused by a single parathyroid adenoma, leading to excessive secretion of parathyroid hormone and increased serum calcium levels.
What is the primary target of alcohol toxicity in the liver?
1) Hepatocyte membranes
2) Hepatic stellate cells
3) Kupffer cells
4) Mitochondria
The primary target of alcohol toxicity in the liver is the mitochondri1) Alcohol is metabolized in the liver, generating acetaldehyde and reactive oxygen species, which can disrupt mitochondrial function and lead to cell damage and necrosis.
What is the typical age of onset for children with growth hormone deficiency due to hypopituitarism?
1) At birth
2) During infancy
3) At the onset of puberty
4) Variable, but often in childhood
Growth hormone deficiency due to hypopituitarism can manifest at different ages depending on the underlying cause. It is often recognized in childhood when growth patterns are monitored regularly.
In a patient with a pulmonary embolism, which of the following is the most sensitive diagnostic test?
1) Chest X-ray
2) D-dimer assay
3) Computed tomography pulmonary angiogram (CTPA)
4) Ventilation-perfusion (V/Q) scan
CTPA is the most sensitive diagnostic test for pulmonary embolism, as it directly visualizes the emboli in the pulmonary arteries.
Bronchiectasis is most common in which lobe
1) Right upper lobe
2) Right middle lobe
3) Left upper lobe
4) Left lower lobe
General Medicine
Answer: 4
Bronchiectasis is most common in the left lower lobe