Senior Medillectuals, an academic medical quiz held in Synapse 2018, Maulana Azad Medical College.

1. SENIOR MEDILLECTUALS

2. PRELIMS

3. 1.
• Pulmonary hypertension is defined as elevation of mean pulmonary
artery pressure _____a___ at rest or ______b______ on exercise in
the absence of a _______c__________.
FITBs.
(10*3=30)

4. 2.
• A 27 year old primigravida with history of exposure to some drug X
delivered a child with bilateral 7th nerve palsy along with bilateral 6th
nerve palsy.
ID X
(10)

5. 3.
• The original three criteria used to diagnose infarction in patients with
LBBB are:
•
Concordant ST elevation > 1mm in leads with a positive QRS complex
(score 5)
• Concordant ST depression > 1 mm in V1-V3 (score 3)
• Excessively discordant ST elevation > 5 mm in leads with a -ve QRS
complex (score 2).
Name the criteria.
(10)

6. 4.
• Calculate the GCS in an intubated patient who seems to be able to
talk, opens eyes only on verbal command, and withdraws on
application of painful stimulus.
(10)

7. 5.
• This is a case of alopecia
areata. How do you explain
the presence of hair in the
alopecic patch?
(10)

8. 6.
• A 23 year male, driving while returning from medicine em duty was
involved in a head on collision. There was no external injury. Air
balloons, seat belt prevented any external injury to skull. GCS - 15/15.
• Which X ray can be performed to check injury to C2 vertebra.
• Ix of choice to identify cervical spine injury after RTA
(10*2=20)

9. 7.
• Question: True or false.[usg finding to detect fgr]
• 1.femur length is effected both in symmetric and asymmetric fgr.
• 2.femur length is the single most sensitive parameter to detect fgr
• 3.fl/ac ratio greater than 23.5 suggest fgr
• 4.fl/a.c. ratio is 22 at all gestational age from 28 wks to term
(10*4=40)

10. 8.* (10 IF YOU GET ALL CORRECT)
Match (more than one correct)
• A. Lysosomal storage disorder
• B. Peroxisomal disorder
• C. Aminoacidopathy
• D. Mitochondrial dysfunction
• 1. Leighs disease
• 2. Adrenoleukodystrophy
• 3. Refsums disease
• 4. Metachromatic leukodystrophy
• 5. Canavans disease
• 6. Krabbes disease

11. 9.*
Diabetes insipidus (DI) is defined as the passage of large volumes (>3
L/24 hr) of dilute urine.
• Out of the types of diabetes insipidus, which one(s) do(es) sarcoidosis
cause?
(10 IF YOU GET ALL RIGHT, NO MARKS IF ANY EXTRA WRONG ONE IS
WRITTEN)

12. 10. (10*2=20)
• 72-year-old female presented to emergency room with
generalized weakness predominantly in lower limbs. She
was apparently normal until 1 week ago after which she
developed watery diarrhea, four to six times a day. Stool
was non-bloody. There were no associated symptoms
such as nausea, vomiting, fever or abdominal pain.
Patient denied history of sick contacts, travel and use of
laxatives. She had a past medical history of mild
persistent bronchial asthma and uses albuterol (inhaler
and nebulizer) as needed. Patient looked dehydrated.
Her heart rate was 96 beats per minute and blood
pressure was 136/76 mm of Hg. Neurological exam and
the reminder of physical exam was normal. Because of
generalized weakness and dehydration, she was started
on intravenous dextrose plus normal saline after which
she developed the following ECG finding.
• What exactly happened? (ECG PATTERN +

13. 11. (10)
As per SLICC criteria, you need to fulfil 4, 1 each at least from lab and
clinical to dx SLE. However, one criteria can be used to dx SLE even if it
is the only one positive.
• Which criteria is this?

14. 12. (10*2=20)
For a ventilated patient with ARDS, tidal volume is to be maintained at
6ml /kg of the person's actual body weight.
T/F.
• If true, what is the rationale for keeping it 6ml/kg?
• If false, what is the corrected statement?

15. 13. (10*4=40)
• “This report refers to a rare case that had presented at the age of 35 years with
complaint of abdominal mass, primary amenorrhea and infertility to Jimma
University Hospital. A well-developed breast with absence of axillary and pubic hair
was seen on examination. There was also an abdominal mass arising from the
pelvis occupying the hypogastric and right iliac region. Additionally, there was a
reducible mass of 5 by 4 c.m at the left inguinal region. She had a normal female
external genitalia with blindly ending vagina of about 4 c.m long. Laporotomy was
done and a grayish white solid mass of 20 by 10 c.m. was found and removed. The
reducible mass in the left inguinal canal was also removed surgically which was
followed by herinorraphy. There were no ovaries or any other internal female
genital organs identifiable.” –Ethiop Med J
• The above person was diagnosed as androgen insensitivity syndrome
What would be the relevant reproductive hormonal endocrine profile findings of
the individual above? (LH, FSH, estrogen, testosterone)

16. 14.
• Normally in human body, LDH2 isoenzyme is more than LDH1. When
does the reverse occur?
(10)

17. 15.
• Name the
test being
done.
(10)

18. 16. (10*3=30)
• ID diseases A & B.
• Which broader spectrum
are they a part of?

19. 17. (10*2=20)
• “A 66 year old black African patient with a
2 year history of hypertension was admitted
to the emergency department of the Buea
Regional hospital, a semi-urban setting in
Cameroon, after presenting with syncope
while in church. The wife described a similar
episode 2 weeks prior without any further
evaluation. Upon arrival at the emergency,
patient had regained consciousness but
lethargic, tachypneic and diaphoretic. The
blood pressure was 85/61 mmHg; the pulse
was 219/min, weak and thready. He had cold
extremities.” –BMC Res Notes
• A 12 lead electrocardiogram performed
showed the following finding. • ID the pattern.
• What should be the next step in the
management of this patient?

20. 18.* (10)
• A selective vesicular monoamine transporter 2 (VMAT2) inhibitor,
called velbenazine, has been recently approved by FDA in 2017 for
which indication?
(HINT: It is the only approved drug to treat adults with this condition)

21. 19. (10*2=20)
• What is the mechanism of
action of Mullerian Inhibitory
Factor & up to which age
Mullerian Duct is sensitive to
it?

22. 20.* (10 IF YOU GET ALL CORRECT)
• Match the following: (more than 1 correct)
1. Alzheimer’s disease a) A-beta
2. FTLD b) TDP 43
3. Parkinson’s disease dementia c) Tau
4. Steel Richardson Syndrome d) alpha-
synuclein

23. 21. (10*2=20)
• Which drug is associated with the
condition shown?
• What is the condition shown?

24. 22. (10)
• What can be seen in the
magnified version of this Chest X-
Ray?
(SPECIFIC)

25. 23. (10*2=20)
• The BURP manouevre is used in which procedure?
• Give the fullform of BURP.

27. ANSWERS:
1. >=25, >=30, IN THE ABSENCE OF A LEFT TO RIGHT SHUNT
2. MISOPROSTOL
3. SAGRBOSSA CRITERIA
4. 7T
5. POST TREATMENT
6. OPEN MOUTH VIEW FOR C2, NCCT CERVICAL SPINE
7. F,F,T,F
8. A-4,6 B-2,3 C-5 D-1
9. 3 TYPES- PRIMARY/CENTRAL, NEPHROGENIC, DIPSOGENIC/SECONDARY (GESTATIONAL NOT ACCEPTED)
10. TORSADES DE POINTES DUE TO HYPOKALEMIA
11. KIDNEY BIOPSY PROVEN SLE
12. FALSE, PERCEIVED BODY WEIGHT
13. ESTROGEN NORMAL, FSH NORMAL-SLIGHTLY RAISED, LH-HIGHLY ELEVATED, TESTOSTERONE-HIGH
NORMAL TO ELEVATED

28. 14. IN MI, LDH(1) PRESENT IN HEART MUSCLE, LDH2 PRESENT IN RBC
15. DERMATOSCOPY
16. A-CMV, B-TOXOPLASMOSIS, PART OF TORCH INFECTIONS
17. MONOMORPHIC VT, CPR (SHOCK)
18. TARDIVE DYSKINESIA
19. HYALURONIDASE SECRETION INCREASES BY U/L DUCT CELLS AND LOCAL
DESTRUCTION , 8 WKS
20. 1-A,C 2-B,C 3-C,D 4-C
21. METHIMAZOLE, APLASIA CUTIS CONGENTINA
22.MIDLINE STERNOTOMY STEEL SUTURES (FIGURE OF 8 PATTERN)
23. BACKWARD, UPWARD, RIGHTWARD PRESSURE, USED FOR ENDOTRACHEAL
INTUBATION