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Rheumatoid arthritis in children is known as:

 # Rheumatoid arthritis in children is known as:
A. Still’s disease
B. Kamura’s disease
C. Hansen’s disease
D. Degenerative joint disease


The correct answer is A. Still's disease.

Inflammatory arthritis occurs rarely in children. Several distinct subtypes are recognised. Systemic
juvenile idiopathic arthritis (JIA; formerly known as Still’s disease) is a systemic disorder characterised by fever, rash, arthritis, hepatosplenomegaly and serositis in association with a raised ESR and CRP. Autoantibody tests are negative.

Reference: Davidson’s Principles and Practice of Medicine, 22nd Edition 2014, Page no: 1104

Diabetes insipidus occur due to lack of:

# Diabetes insipidus occur due to lack of:
A. Insulin
B. Antidiuretic hormone
C. ACTH
D. Thyroxin



The correct answer is B. Antidiuretic hormone.

The neurohypophysis, or posterior pituitary, is formed by axons that originate in large cell bodies in the supraoptic and paraventricular nuclei of the hypothalamus. It produces two hormones: ( 1 ) arginine
vasopressin (AVP), also known as antidiuretic hormone, and (2) oxytocin. AVP acts on the renal tubulω to reduce water loss by con centrating the urine. Oxytocin stimulates postpartum milk letdown in response to suckling. A deficiency of AVP secretion or action causes diabetes insipidus (DI),a syndrome characterized by the production of large amounts of dilute urine. Exιessive or inappropriate AVP production impairs urinary water excretion and predisposes to hyponatremia if water intake is not reduced in parallel with urine output.

Reference: Harrison's Principles of Internal Medicine, 19th Edition, Page no: 2274

In jaundice there is an unconjugated hyperbilirubinemia which is most likely due to:

 # In jaundice there is an unconjugated hyperbilirubinemia which is most likely due to:
A. Hepatitis
B. Cirrhosis
C. Obstruction of bile in canaliculi
D. Increased breakdown of red cells



The correct answer is D. Increased breakdown of red cells.

Hemolysis Increased destruction of erythrocytes leads to increased bilirubin turnover and unconjugated hyperbilirubinemia; the hyperbilirubinemia is usually modest in the presence of normal liver function.
In particular,the bone marrow is only capable of a sustained eightfold increase in erythrocyte production in response to a hemoIytic stress. Therefore, hemolysis alone cannot result in a sustained hyperbilirubinemia of more than -68 μmol/L (4 mg/dL) . Higher values imply concomitant hepatic dysfunction. When hemolysis is the only abnormality in an otherwise healthy individual, the result is a purely unconjugated hyperbilirubinemia,with the direct-reacting fraction as measured in a typical clinical laboratory being less or equal to 15% of the total serum bilirubin.

Reference: Harrison's Principles of Internal MEDICINE, 19th Edition Page no: 2000

Pernicious anemia is due to deficiency of:

# Pernicious anemia is due to deficiency of:
A. Iron
B. Cobalamine
C. Folic acid
D. Niacin



The correct answer is B. Cobalamine.

Pernicious anemia is a relatively common chronic hematologic disease. It is an adult form of anemia that is associated with gastric atrophy and a loss of intrinsic factor production in gastric secretions and a rare congenital autosomal recessive form in which intrinsic factor (IF) production is lacking without gastric atrophy. The term pernicious anemia is reserved for patients with vitamin B12 deficiency due to a lack of production of IF in the stomach. Intrinsic factor in gastric secretions is necessary for the absorption of dietary vitamin B12. Vitamin B12, a substance now thought to be synonymous with the ‘erythrocyte-maturing factor’ or ‘hemopoietic principle’ and present in many foods, particularly liver, beef, milk and dairy products. Body stores of the vitamin usually exceed 1000 mcg and the daily requirement is about 1 mcg.

Reference: Shafer’s Textbook of ORAL PATHOLOGY, Seventh Edition, Page 762

Common site of carcinoma of tongue is:

 # Common site of carcinoma of tongue is:
A. Apical
B. Lateral borders
C. Dorsum
D. Posterior 1/3rd 



The correct answer is B. Lateral borders.

The typical lesion develops on the lateral border or ventral surface of the tongue. When, in rare cases, carcinoma occurs on the dorsum of the tongue, it is usually in a patient with a past or present history of syphilitic glossitis. In a series of 1,554 cases of carcinoma of the tongue reported by Frazell and Lucas, only 4% occurred on the dorsum. The lesions on the lateral border are rather equally distributed between the base of the tongue, the anterior third and the mid portion, although in the above series 45% of cases occurred on the middle third. Lesions near the base of the tongue are particularly insidious, since they may be asymptomatic until far advanced. Even then the only presenting manifestations may be a sore throat and dysphagia. The specific site of development of these tumors is of great significance, since the lesions on the posterior portion of the tongue are usually of a higher grade of malignancy, metastasize earlier and offer a poorer prognosis, especially because of their inaccessibility for treatment.

Reference: Shafer’s Textbook of ORAL PATHOLOGY, Seventh Edition, Page no: 116


What is best for factor VIII replacement in Hemophilia A:

 # What is best for factor VIII replacement in Hemophilia A?
A. Fresh frozen plasma
B. Cryoprecipitate
C. Whole blood
D. Platelets




The correct answer is B. Cryoprecipitate.

Cryoprecipitate is a source of fibrinogen, factor VIII,and von Willebrand factor (VWF). It is ideal for supplying fibrinogen to the volume-sensitive patient. When factor VIII concentrates are not
available, cryoprecipitate may be used because each unit contains approximately 80 units of factor VIII. Cryoprecipitate may also supply VWF to patients with dysfunctional (type II) or absent (type III) von Willebrand's disease. 

Reference: Harrison's Principles of Internal Medicine, 19th Edition, Page no: 138e-3

Which deficiency affects tooth development?

 # Which deficiency affects tooth development?
A. Vitamin A
B. Carbohydrates
C. Vitamin E
D. Vitamin B



The correct answer is A. Vitamin A.

In vitamin A deficiency the ameloblasts fail to differentiate properly. Consequently, their organizing influence on the adjacent mesenchymal cells is disturbed, and atypical dentin, known as osteodentin, is formed.

Reference: Orban’s Oral Histology and Embryology, Thirteenth Edition, Page no 46