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NEET MDS Quiz - Practice Test
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Practice Test

medicine - 3 Questions

1
Medicine
The treatment of choice in pauci immune crescentic glomerulonephritis is
1. Methylprednisolone + cyclophosphamide
2. Oral prednisolone
3. Immunoglobulin
4. Cyclophosphamide

๐Ÿ“ Explanation:

Pauci-immune crescentic glomerulonephritis (GN) is typically associated with ANCA-associated vasculitis. The standard treatment for this condition involves a combination of high-dose corticosteroids (such as methylprednisolone) and an immunosuppressive agent, most commonly cyclophosphamide, to induce remission. This combined approach is more effective than monotherapy with either agent alone.

2
Medicine
A boy was diagnosed to have vitamin D resistant rickets. His serum Ca2++ was 9 mg/dL and PO42- was 2.4 mg/dL and alkaline phosphatase was 1041 IU/L. The parathormone level was 59 units. The diagnosis is most likely to be
1. Hypophosphatemic rickets 
2. Vitamin D dependant rickets 
3. Hyperparathyroidism 
4. Distal renal tubular acidosis

๐Ÿ“ Explanation:

Hypophosphatemic rickets, also known as vitamin D resistant rickets, is characterized by renal phosphate wasting, leading to low serum phosphate levels (hypophosphatemia), while serum calcium levels and parathyroid hormone levels typically remain normal. The high alkaline phosphatase level is consistent with bone disease (rickets). 

The lab values provided (Ca++ 9 mg/dL, PO4-- 2.4mg/dL), PTH (59units) fit this profile.      

Vitamin D dependent rickets (Type 1 and 2) typically presents with hypocalcemia (low calcium) and hypophosphatemia. 

Hyperparathyroidism is characterized by hypercalcemia (high calcium) and hypophosphatemia. 

Distal renal tubular acidosis can cause rickets, but it usually involves hypercalcemia and metabolic acidosis.

3
Medicine
A patient has history of recurrent hemoptysis, truncal obesity and cushingoid habitus and has increased ACTH not suppressible by Dexamethasone suppression test. Which of the following is most likely to be the diagnosis?   
1. Adrenal adenoma
2. Pituitary tumor           
3. Ectopic ACTH secreting tumor
4. Carcinoma thyroid

๐Ÿ“ Explanation:

The patient's clinical presentation points to Cushing's syndrome, characterized by truncal obesity and cushingoid habitus. The key diagnostic features leading to the specific diagnosis are:

Increased ACTH levels: Rules out primary adrenal causes like an adrenal adenoma (option 1), where ACTH levels would be suppressed.

Lack of suppression by dexamethasone: In Cushing's disease (pituitary tumor, option 2), high-dose dexamethasone typically suppresses ACTH and cortisol production. The absence of suppression suggests an ectopic source of ACTH.

Recurrent hemoptysis: This symptom (coughing up blood) is a strong indicator of a pulmonary source, such as a small cell lung carcinoma, which is a common cause of ectopic ACTH secretion.

Therefore, an ectopic ACTH-secreting tumor is the most likely diagnosis.

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