MDS PREP
The most common cause of hypercalcemia in malignancy is:
1) Osteoblastic metastasis
2) Osteolytic metastasis
3) Hyperparathyroidism-jaw tumor syndrome
4) Ectopic parathyroid hormone-related protein (PTHrP) secretion
Hypercalcemia is a common metabolic complication in cancer patients, particularly those with solid tumors such as breast cancer, lung cancer, and multiple myeloma. The most common cause is the secretion of a parathyroid hormone-like protein called PTHrP by the tumor cells.
What is the most common site for hydatid cyst formation in humans?
1) Brain
2) Lung
3) Liver
4) Spleen
Hydatid disease, caused by Echinococcus granulosus, primarily affects the liver in approximately 70% of cases. This is because the ova ingested by humans are carried to the liver via the portal venous system, where they are trapped and develop into cysts.
Class II of HIV associated diseases describes
1) Acute infections
2) Asymptomatic infections
3) Persistent generalized lymphadenopathy
4) All of the above
General Medicine
Answer: 2
Class II of HIV associated diseases describes asymptomatic infections where patients are HIV positive but do not exhibit symptoms. Class I includes acute infections, and Class III involves symptomatic infections. Therefore, Class II is characterized by individuals being asymptomatic despite being infected with HIV.
A 20-year-old female presents with a 3-month history of fatigue, weight loss, and dyspnea on exertion. Her physical exam reveals a systolic murmur at the left sternal border that increases with standing and decreases with squatting. Which of the following is the most likely diagnosis?
1) Mitral stenosis
2) Mitral regurgitation
3) Aortic stenosis
4) Aortic regurgitation
The description of a systolic murmur that increases with standing and decreases with squatting suggests a condition where the murmur is affected by changes in the flow across the mitral valve. This is characteristic of mitral regurgitation.
What is the most common complication of the nephrotic syndrome?
1) Hyperkalemia
2) Hypocalcemia
3) Thrombocytopenia
4) Hypertension
Hypertension is a common complication of the nephrotic syndrome due to the loss of protein in the urine, particularly albumin, which leads to decreased plasma oncotic pressure and subsequent fluid retention and increased blood volume.
Which of the following is a congenital deficiency associated with a hemorrhagic diathesis?
1) Hageman trait
2) Parahemophilia
3) Hypoprothrombinemia due to liver disease
4) Hemophilia A
Hemophilia A is a congenital defect due to various abnormalities of the gene on the X chromosome that codes for factor VIII, leading to a hemorrhagic diathesis. Hageman trait is also congenital but does not directly cause a bleeding disorder.
The major risk factor for foot ulcers and infections in individuals with diabetes mellitus is:
1) Neuropathy
2) Abnormal foot biomechanics
3) Peripheral arterial disease (PAD)
4) All of the above
Diabetic neuropathy leads to loss of protective sensation, allowing for unnoticed trauma and subsequent ulceration. Abnormal foot biomechanics can cause increased plantar pressure and foot deformities such as hammertoes or calluses that may progress to ulcers. PAD reduces blood flow to the feet, impairing the healing process and making infection more likely. Poor wound healing is a direct consequence of both neuropathy and vascular compromise.
A patient presents with prolonged bleeding following a surgery. His family history reveals that his mother is a carrier of a rare bleeding disorder, but his father does not have it. Which of the following conditions is the patient most likely to have?
1) Hemophilia A
2) Hemophilia B
3) Christmas disease
4) Hageman trait
Hemophilia A is an X-linked recessive disorder, caused by a deficiency of factor VIII. Since the patient's mother is a carrier, she must have one defective X chromosome and one normal X chromosome. The patient, being a male, has a 50% chance of inheriting the disorder from his mother, which is the most likely scenario given the family history and the X-linked inheritance pattern. Hemophilia B is also X-linked but would be mentioned as Christmas disease if it were the correct answer. Hageman trait is an autosomal recessive disorder related to factor XII, which is less common than Hemophilia A and B.