6- In which of the following is mental retardation an expected finding?
1) Alkaptonuria
2) Cystinuria
3) Glycogen storage disease
4) Lactose intolerance
5) Maple syrup urine disease
Answers-5
MENTAL RETARDATION. Fragile X syndrome-commonest male cause. Hypoxia at birth, intaventricular haemorrhage, rhesus disease, Congenital infections - toxoplasmosis, CMV, rubella, herpes), hypoglycaemia, meningitis, hypothyroidism (cretinism, tuberous sclerosis, Down's, Tay-Sach's, Cornelia De Lange, Hartnup - biochemical, treatable with diet. -homocystinuria, phenylketonuria -maple syrup urine disease, tryptophanuria -galactosaemia
7- Leukotrienes:
1) Are formed from the cyclooxygenase pathway
2) Are synthesized by fibroblasts
3) Decrease vascular permeability
4) Leukotriene D4 has been identified as SRS-A which causes bronchial wall smooth muscle relaxation
5) Stimulate mucus secretion
Answers-5
Leukotrienes are synthesized by leucocytes.They are mediators of allergic reaction.
They increase vascular permeability and attract neutrophils and eosinophils to inflammatory sites. Leukotrienes are synthesised via the lipoxygenase pathway.
Leukotriene D4 has been identified as SRS-A which causes bronchial wall and intestinal smooth muscle contraction (not dilatation). Leukotrienes also stimulate
mucus production, an important consideration in the pathophysiology of bronchial asthma.
8- Serum biochemistry of a 60 year old man revealed calcium of 1.98 mmol/l and phosphate of 0.55 mmol/l with an alkaline phosphatase of 450 IU/l.Which among the following mosts suits with the above serum biochemistry?
1) Osteoporosis
2) Osteomalacia
3) Pagets Disease
4) Secondary Hyperparathyroidism
5) Renal failure
Answers-2
Osteomalacia is associated with low calcium and phosphate with raised alkaline phosphatase. Serum biochemistry is normal in osteoporosis. Pagets disease is
associated with normal calcium and phosphate with raised alkaline phosphatase.
In renal failure when tertiary hyperparathyroidism sets in there is low calcium with raised phosphate.
9- Low uptake of 123I on the thyroid uptake scan would be an expected finding in:
1) A solitary toxic nodule
2) A multi-nodular toxic goitre
3) Amiodarone induced thyrotoxicosis type 1
4) DeQuervain's thyroiditis
5) Graves' thyrotoxicosis
Answers-4
DeQuervain's thyroiditis is classically associated with low or absent 123I (the 131 radioactive isotope of iodine) uptake. The others will have high or normal uptake.
In particular type 1 amiodarone induced thyrotoxicosis may be distinguished from the thyroiditis of type 2 by the normal or high uptake scan.
10- A 55 year-old female complaining of vague tiredness is found to have a serum corrected calcium concentration of 2.9 mmol/l. Examination was unremarkable. Which of the following results confirms the suspected diagnosis of primary hyperparathyroidism?
1) High normal 1,25-dihydroxyvitamin D concentration
2) High normal 24 hour urinary calcium concentration
3) High normal plasma parathyroid hormone concentration
4) Low normal plasma phosphate concentration
5) Low normal serum 25-hydroxyvitamin D concentration
Answers-3
Bit too easy really. A high or even normal PTH concentration in the presence of hypercalcaemia would support the diagnosis of hyperparathyroidism. A high
urinary Calcium concentration may be expected as would a low plasma phosphate but neither confirm the diagnosis. Elevated 1,25 VitD suggests a diagnosis of
hypervitaminosis D.
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1) Alkaptonuria
2) Cystinuria
3) Glycogen storage disease
4) Lactose intolerance
5) Maple syrup urine disease
Answers-5
MENTAL RETARDATION. Fragile X syndrome-commonest male cause. Hypoxia at birth, intaventricular haemorrhage, rhesus disease, Congenital infections - toxoplasmosis, CMV, rubella, herpes), hypoglycaemia, meningitis, hypothyroidism (cretinism, tuberous sclerosis, Down's, Tay-Sach's, Cornelia De Lange, Hartnup - biochemical, treatable with diet. -homocystinuria, phenylketonuria -maple syrup urine disease, tryptophanuria -galactosaemia
7- Leukotrienes:
1) Are formed from the cyclooxygenase pathway
2) Are synthesized by fibroblasts
3) Decrease vascular permeability
4) Leukotriene D4 has been identified as SRS-A which causes bronchial wall smooth muscle relaxation
5) Stimulate mucus secretion
Answers-5
Leukotrienes are synthesized by leucocytes.They are mediators of allergic reaction.
They increase vascular permeability and attract neutrophils and eosinophils to inflammatory sites. Leukotrienes are synthesised via the lipoxygenase pathway.
Leukotriene D4 has been identified as SRS-A which causes bronchial wall and intestinal smooth muscle contraction (not dilatation). Leukotrienes also stimulate
mucus production, an important consideration in the pathophysiology of bronchial asthma.
8- Serum biochemistry of a 60 year old man revealed calcium of 1.98 mmol/l and phosphate of 0.55 mmol/l with an alkaline phosphatase of 450 IU/l.Which among the following mosts suits with the above serum biochemistry?
1) Osteoporosis
2) Osteomalacia
3) Pagets Disease
4) Secondary Hyperparathyroidism
5) Renal failure
Answers-2
Osteomalacia is associated with low calcium and phosphate with raised alkaline phosphatase. Serum biochemistry is normal in osteoporosis. Pagets disease is
associated with normal calcium and phosphate with raised alkaline phosphatase.
In renal failure when tertiary hyperparathyroidism sets in there is low calcium with raised phosphate.
9- Low uptake of 123I on the thyroid uptake scan would be an expected finding in:
1) A solitary toxic nodule
2) A multi-nodular toxic goitre
3) Amiodarone induced thyrotoxicosis type 1
4) DeQuervain's thyroiditis
5) Graves' thyrotoxicosis
Answers-4
DeQuervain's thyroiditis is classically associated with low or absent 123I (the 131 radioactive isotope of iodine) uptake. The others will have high or normal uptake.
In particular type 1 amiodarone induced thyrotoxicosis may be distinguished from the thyroiditis of type 2 by the normal or high uptake scan.
10- A 55 year-old female complaining of vague tiredness is found to have a serum corrected calcium concentration of 2.9 mmol/l. Examination was unremarkable. Which of the following results confirms the suspected diagnosis of primary hyperparathyroidism?
1) High normal 1,25-dihydroxyvitamin D concentration
2) High normal 24 hour urinary calcium concentration
3) High normal plasma parathyroid hormone concentration
4) Low normal plasma phosphate concentration
5) Low normal serum 25-hydroxyvitamin D concentration
Answers-3
Bit too easy really. A high or even normal PTH concentration in the presence of hypercalcaemia would support the diagnosis of hyperparathyroidism. A high
urinary Calcium concentration may be expected as would a low plasma phosphate but neither confirm the diagnosis. Elevated 1,25 VitD suggests a diagnosis of
hypervitaminosis D.
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Page10
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