Medicine Clinics 2020 batch B

Regarding fever all are true except

• Hyperpyrexia is body temperature of more than 106F

• Normal rectal temperature is more than axillary temperature which itself is more than oral temperature

• Normal diurnal variation is less than 1°C

• Normal peak temperature is at 4pm and nadir is at 6am

Regarding Leptospirosis all are true except

• It is caused by Gram negative Spirochete

• Human to human spread via urine is the most common route of infection

• Leptospira can't penetrate intact skin

• Frequency increases in monsoon and after floods

Regarding Malaria all are true except

• Clinical features may include fever, malaise, pallor, icterus, hepatosplenomegaly

• Indigenous malaria is common in Kerala

• Vector is female Anopheles mosquito

• Severe illness may cause respiratory distress, seizures, renal failure, hypoglycemia

Regarding Auscultation of Respiratory system, false is

• Wheeze are continuous musical sounds caused due to narrowing of airways

• Crackles are continuous, non-musical sounds due to sudden snapping/opening of small airways and/or bubbling of air through secretions.

• Bronchial breath sounds are hoarse, and expiration is higher pitched, louder and longer than usual, with a pause between inspiration and expiration.

• Vesicular breath sounds are rustling quality, and inspiration is longer, higher pitched than expiration sound. No gap between the two.

Caused by

• Neisseria Gonorrhoea

• Cytomegalovirus

• Varicella virus

• Staphylococcus aureus

All of the following are true regarding Dengue fever except

• Positive tourniquet test is an indication for platelet transfusion

• Complications are Hemorrhage, Shock syndrome, DIC, encephalitis, Hepatitis, myocarditis

• Warning signs are – Abdominal pain, persistent vomiting, hepatomegaly >2cm, Fluid accumulation, lethargy, rapid rise in hematocrit with fall in platelets, mucosal bleed,

• Severe Dengue is – Shock, Respiratory Distress, severe haemorrhage, severe organ involvement

A 54 year old, presented with altered sensorium, fever, and headache of 5 days. Lumbar puncture revealed turbid CSF showing 250 cells 90% polymorphs, protein 100mg/dl, glucose csf/serum ratio- 0.2, likely diagnosis is –

• Viral Meningitis

• Bacterial Meningitis

• TB meningitis

• Fungal Meningitis

All are components of pre-test counselling for HIV except –

• Discuss meaning of positive and negative test results

• Maintain confidentiality

• Obtain informed consent, after explaining test procedure

• Identify person(s) to whom results may be disclosed

• Transmission and risk reduction need not be discussed

Most common cause of anaemia is

• Iron deficiency

• B12 deficiency

• Folate Defieciency

• Thalassemia

False regarding history and clinical examination in patient with pallor –

• History of melena, hematochezia or hematemesis suggests GI loss

• Vegan diet, total gastrectomy, history of autoimmune disease (vitiligo, hashimotos, graves disease, etc) point to possible folic acid deficiency

• Sensory neuropathy, angular cheilosis and bald tongue are features of B12 deficiency

• Icterus, splenomegaly, abdominal pain and dark urine suggest hemolytic anemia.