MCQ 08/09/2017

1. A three -year old was brought to your specialist clinic with history to suggest severe mental retardation, special interest in water,  and always laughing, he has had several episodes of seizure.
Notable on examination include facial hypolasia,severe hypotonia and tremor.
The following are likely to be true about this patient.
a) This patient has a microdeletion on a  paternity derived  chromosome.
b) This patient has paternal uniparental disomy.
c) The prognosis is good.
d) this patient speech is expected to be affected.
e)  The patient has Down syndrome.

2. A twenty-day old baby was rushed into the special care baby unit unconscious,  he has being vomiting for three days,  has not being thriving since birth,  examination revealed a child who appeared small for age,  with sunken eye balls.
Random blood sugar was elevated with a value of 26mmol/l, urinalysis yielded ketonuria of +
The following are correct about this patient.
a).   He has a chance of spontaneous cure.
b). Abnormality of this type is mostly associated with mutation on chromosome  6p24.
c. Permanent diabetes may result in up to 60 percent of patients with this condition
d). Ketonuria is the hallmark of diagnosis
e) soluble insulin is of choice in active phase.

3. A 6yr old boy presented in OPD with history of progressive generalised body swelling of a month duration, urine output has reduced, bedside urinalysis yielded 4+ of protein, serum albumin was 1.8mg/dl
The following are likely to be correct of this patient and his condition.
A) Most patient with steroid responsive type have repeated relapses
B) A relapse is defined as proteinuria 3+ or 4+ for 3 consecutive days after initial remission.
c)immunenoflorescence microscopy is typically negative
D)children who continue to have proteinuria after 4 weeks of steroid therapy are considered steroid resistant.
E) in congenital type ,  cure rate is hundred percent after transplantation.

4. Concerning Proteinuria
A) Glomerular proteinuria should be suspected in any patient with a first morning urine protein : creatinine ratio >1.0.
B) microalbuminuria in children has been found to be associated with obesity and to predict, with reasonable specificity, the development of diabetic nephropathy in type 1 dmicroalbuminuria in children has been found to be associated with obesity and to predict, with reasonable specificity, the development of diabetic nephropathy in type 2 diabetes mellitus.
C. The dipstick may  be falsely positive in patients with highly concentrated urine.
d) orthostatic proteinuria occurs in less than 60% of patient with persistent proteinuria
E)Nephrotic range if greater than 960mg/metre square/ day.

5. Anti neutrophilic cytoplasmic antibody associated vasculitis include the following :
A). Kawasaki disease.
B) henoch schonlein purpura.
C.Takayasu disease.
D) churg Strauss syndrome.
E). Microscopic polyangitis.