An Appropriate Esclation of Cognitive Burden in Phase-I Integerated Mecicine Curriculum_OSPEs_ Dr Kumar Ponnusamy BIO-GEN INNOVISION 2012_USMLE Preparatory Re-Usable on-Line Resources

7/31/2019 An Appropriate Esclation of Cognitive Burden in Phase-I Integerated Mecicine Curriculum_OSPEs_ Dr Kumar Ponnusamy BIO-GEN INNOVISION 2012_USMLE Preparatory Re-Usabl

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2/31

(Answer the following questions in one or two sentences).

A. Name the biomedical instrumentation.

(Ans: Centrifugation).

B. Name ONE biomedical application (usage ) of the instrument.

(Separation of cells / cell organales / protein / serum ect.,.).

Q . Observe the pictures of the biomedical instrumentation shown

below.


3/31


A. Name the biomedical instrumentation.

(Ans: Electrophorosis).

B. Name ONE biomedical application (usage ) of the instrument.

(Separation of proteins / macromolecules / charged particles/ IGs).

Q . Observe the pictures of the biomedical instrumentation shown

below.


4/31

Q19. Observe the picture the patient who is suffering from

photophobia.


A. Name the likely congenital defect of the patient. (Albinism /Oculocutaneous albinism)

B. Name the enzyme deficiency associated with the patients

disorder. (Tyrosinase).

Dr PK & JK Bio-Gen 2012


5/31


A. Name the possible metabolic disorder of the above patient (Ans:

Gout syndrome).

B. Name ONE biochemical test will be helpful to diagnose the clinicalcondition. (Serum uric acid / CRP ect.,.).

(Or)

C. Name the possible drug of choice to treat this clinical condition.

Ans: Allopurinol.

Q14. Observe the pictures of the patient presented below.


6/31

2. Note the signs and symptoms of BA and LA severely retarded, institutionalizedbrothers suffering from a typical inborn errors of amino acid metabolism.

(Answer the following questions in one or two sentences).A. Name the likely clinical condition of the patient.

(Ans: Phenylketonuria).

A. Name ONE management option to treat this disorder.

(Ans: Diet devoid of phenylalanine).

Dr PK & Ms Jega Bio-Gen 2012


7/31Dr PK & Ms Jega Bio-Gen 2012

1.56-year-old postmenopausal female with sudden onset of acute pain in her right toeand knee as shown in the picture. The patient reported that she has had 3 previousepisodes of the same symptoms lasting 4-5 days and treated by ED physicians. PMHxHTN treated with thiazide diuretic and patient is trying to lose weight and currently onthe Atkins diet. BP 138/86 BMI 32 PE remarkable for swollen and tender right great toe

and knee. UA 8.3mg/dL, aspiration of her knee demonstrated cell count of 15K.

A). Name ONE metabolic serum biomarker of the patients clinical condition. (1mark). Ans: Uric acid estimation.

B). Name ONE drug of choice which acts as a competitive inhibitor of xanthineoxidase will be helpful for the treatment of the patient. (1mark).Ans: Allopurinol.

(Or)

C). Name any TWO complications associated with thepatients pathology / noncompliance. (1mark).

Ans: Renal failure, ARF can be caused by hyperuricemia,chronic urate nephropathy, nephrolithiasis, Joint deformityand recurrent gout.


8/31

Q20. A newborn baby characterized by very high levels of

unconjugated bilirubin in the blood and by yellow staining and

degenerative lesions in the cerebral gray matter under treatment.


A. Name the likely clinical condition the patient is suffering (1 mark).(Ans: Neonatal jaundice).

B. Name the enzyme deficiency associated with this clinical condition.

(Ans: UDP-Glucuronyl Transferase (UDP-GT) deficiency).

Fluorescent light.

Dr PK & Jega Bio-Gen 2012


9/31Dr PK & Ms Jega Bio-Gen 2012

1.56-year-old postmenopausal female with sudden onset of acute pain in her right toeand knee as shown in the picture. The patient reported that she has had 3 previousepisodes of the same symptoms lasting 4-5 days and treated by ED physicians. PMHxHTN treated with thiazide diuretic and patient is trying to lose weight and currently onthe Atkins diet. BP 138/86 BMI 32 PE remarkable for swollen and tender right great toe

and knee. UA 8.3mg/dL, aspiration of her knee demonstrated cell count of 15K.

A). Name ONE metabolic serum biomarker of the patients clinical condition. (1mark). Ans: Uric acid estimation.

B). Name ONE drug of choice which acts as a competitive inhibitor of xanthineoxidase will be helpful for the treatment of the patient. (1mark).Ans:Allopurinol.

(Or)

C). Name any TWO complications associated with thepatients pathology / noncompliance. (1mark).

Ans: Renal failure, ARF can be caused byhyperuricemia, chronic urate nephropathy,nephrolithiasis, Joint deformity and recurrent gout.


10/31

2. Note the signs and symptoms of BA and LA severely retarded, institutionalizedbrothers suffering from a typical inborn errors of amino acid metabolism.

(Answer the following questions in one or two sentences).A. Name the likely clinical condition of the patient. (1 mark).

(Ans: Phenylketonuria).

B. Name ONE management option to treat this disorder. (1 mark).

(Ans: Diet devoid of phenylalanine).



11/31

3. Note the signs and symptoms of a patients vertebrae shown in the below picture,who is suffering from an inborn errors of amino acid metabolism.

(Answer the following questions in one or two sentences).A. Name the likely clinical condition of the patient.

(Ans: Alkaptonuria).

B. Name the enzyme deficiency associated with this clinical

condition. (Ans: Homogentisate dioxygenase).Dr PK & Ms Jega Bio-Gen 2012


12/31Dr PK Bio-Gen 2012

4. RT is a 56-year-old man who presents to his family physician for follow-up ofhypertension control. During his history, he reports significant erectile dysfunction (ED)that has progressed over the past 8 months. This has been distressing to him and tohis wife and has caused significant marital strife. He has been treated for hypertensionfor 4-5 years and is currently taking a combination of hydrochlorothiazide and atenolol

with good blood pressure control. His past history includes obesity and a sedentarylifestyle. His BP is moderately controlled (146/92 mm Hg). At 69 inches tall, he weighs248 pounds.He reports no morning erections, nocturnal erections, or spontaneous erectionssatisfactory for vaginal penetration. He has normal ejaculatory function withoutpostejaculatory pain or hematospermia. Physical examination is normal with normal

genitalia, prostate examination, but a rotund abdomen that is nontender.

A). Name ONE drug which will be helpful for him tosay Now for his wifes question. (1 mark).Ans: Sildenafil citrate.

B). Name the mode of action of the drug. (1 mark).Ans: Phosphodiesterse inhibitor.


13/31Dr PK Bio-Gen 2012

5. RT is a 38-year-old non-compliance diabetic man of conservative ethnic group, whopresents to his family physician for follow-up of hypertension control. During his history,he reports significant erectile dysfunction (ED) that has progressed over the past 8months. This has been distressing to him and to his wife and has caused significantmarital strife and ultimately end up in divorce. He has been treated for hypertension for

4-5 years and is currently taking a combination of hydrochlorothiazide and atenolol withgood blood pressure control. His past history includes obesity and a sedentary lifestyle.His BP is moderately controlled (146/92 mm Hg). At 69 inches tall, he weighs 248pounds.He reports no morning erections, nocturnal erections, or spontaneous erectionssatisfactory for vaginal penetration. He has normal ejaculatory function without

postejaculatory pain or hematospermia. Physical examination is normal with normalgenitalia, prostate examination, but a rotund abdomen that is nontender.

A). Name ONE psychosocial phenomena the patient mayexperience.Ans: Loneliness, / Solitary / Depression / Dejection.

B). Name ONE ethics of a consultant physician in this case.(Ans: Counceling / Management of the disease / Motivation /Referrel to specialist clinic).

Sorry, Later


14/31

6. Mrs. Jones is a 48-year-old woman who found a lump as shown in the picture, in herleft breast on routine breast self-examination. She reported this to her family doctor. Sheis an otherwise healthy premenopausal woman with no significant past medical history.Her family physician ordered an ultrasound and mammogram. These investigationsconfirmed a 1.5cm mass at 3 Oclock in the left breast. She subsequently saw a surgeon

who performed a fine needle aspirate. The cytology revealed cells suspicious foradenocarcinoma. Core biopsy confirmed a grade 2 adenocarcinoma. She subsequentlyhad a lumpectomy.

a). Name ONE screening test to confirm the pathologyassociated her clinical condition. (1 mark).Ans: Sentinel node biopsy / tumor markers.

b). Name ONE drug of related to hormone receptorrelated choice to treat her clinical condition.

Ans: Selective estrogen receptor modulator (SERM).

Dr PK Bio-Gen 2012


15/31

7. Mrs. Jones is a 48-year-old woman who found a lump as shown in the picture, in herleft breast on routine breast self-examination. She reported this to her family doctor. Sheis an otherwise healthy premenopausal woman with no significant past medical history.Her family physician ordered an ultrasound and mammogram. These investigationsconfirmed a 1.5cm mass at 3 Oclock in the left breast. She subsequently saw a surgeon

who performed a fine needle aspirate. The cytology revealed cells suspicious foradenocarcinoma. Core biopsy confirmed a grade 2 adenocarcinoma. She subsequentlyhad a lumpectomy.

a). Name the antineoplastic agents used as a combinationtherapy to treat her clinical condition. (1 mark).Ans: Cyclophosphamide, methotrexate and5-fluorouracil (CMF).

b). Name ONE folate antagonist drug of choice related to

treat her clinical condition.Ans: Methotrexate.



16/31

Q19. Observe the picture the patient who is suffering from

photophobia.


A. Name the likely congenital defect of the patient. (Ans: Albinism /Oculocutaneous albinism)


disorder. (Ans: Tyrosinase).


Q A 7 ld i l h i Th th l i th t th b b h b


17/31

QA 7-year-old girl has seizure. The mother explains that the baby has beenvomiting and having difficulty feeding for the past 2 days. There is also a strangesweet smell to her diapers. Physical examination is unremarkable, except forindications of dehydration. Serum test results show normal levels of glucose andammonia. Urinalysis reveals the presence of -keto-isocaproate and -keto-

isovalerate, and colored as shown in the figure.


A. Name the likely congenital defect of the patient suffering from.(Maple syrup urine disease (MSUD).


disorder. (Branched chain -ketoacid dehydrogenase deficiency).



18/31


Answer the following questions in one or two sentences.A. Name the likely endocrine disorder associated with this case?

(Ans: Xanthomatosis ).

B. Name any TWO clinical conditions associated with the above condition.

(Ans: hyperlipoproteinaemia type III and type IIA, and in association with

biliary cirrhosis / Xanthoma tuberosum/Xanthoma tendinosum. )


19/31


(Answer the following questions in one or two sentences).A. Name the likely clinical condition of the patient. (1 mark).

(Ans: Acanthosis nigricans).

B. Name ONE risk factor associated with the above clinical clinical

condition. (Ans: Insulin resistance).

A woman 7 months pregnant with her first child develops anemia Laboratory


20/31



A. Name the likely disorder associated with this case? (1 mark).

(Ans: Megaloblastic anemia).

B. Name the most likely underlying cause of this womans anemia. (1 mark).

(Ans: Folate deficiency). (Or)

B. Name the possible nutritional deficiency associated with the patients ailment.

(1 mark). (Ans: Folate deficiency)

A woman 7 months pregnant with her first child develops anemia. Laboratoryevaluation indicates an increased mean cell volume (MCV), and the europhiles are

appeared as shown in the figure, and altered morphology of several other cell types.


21/31

Q8. Observe the picture of the patient who presents with

hyperglycaemia and hypertension for the last 6 months. He was

given oral hypoglycaemic and antihypertensive medication.

Answer the following questions in one or two sentences.A. Name the likely endocrine disorder associated with this case?

(Cushings syndrome, Cushings disease / Hypercortisolism).

B. Name any TWO biochemical investigations will be helpful for clinical diagnosis of

the patient . (Serum cortisol estimation)



22/31

Q2. O .

A. Name the likely disorder the patient is suffering from.(Ans: Xeroderma pigmentosum).

B. Name the enzyme deficiency which causes the above clinical

syndrome . (UV specific nuclease).

Q9. Observe the picture of the patient and answer the following

questions in one or two sentences.



23/31

Q. Observe the picture of the patient and answer the following

questions in one or two sentences at most.


A. Name the likely clinical condition the patient. (Congenital

hypothyroidism).

B. Name TWO biochemical diagnostic tests will be helpful to diagnose

the above clinical condition. (1 mark). (Serum T3, T4, TSH, TBGs).



24/31

Q. Observe the picture of patients eye who is a diabetic patient

with noncompliance.


A. Name the likely clinical condition of the patient. (Diabetic

retinopathy).

A. Name the possible mechanism involved in this pathology.

(Oxidative stress/ Advanced glycation end products/ Protein

aggregation). Dr PK & Jega Bio-Gen 2012


25/31

Q12. Observe the picture of patients eye who is suffering from an

inborn errors of aminoacid metabolism.


A. Name the likely clinical condition of the patient.

Ans: Cystinuria.

A. Name the enzyme defect associated with this clinical condition.

Ans: Cystathionine synthase.


Q Observe the picture of the patient who is on long term


26/31

Q. Observe the picture of the patient who is on long term

phenytoin therapy and answer the following questions in one or

two sentences.

A. Name the likely disorder the patient is suffering from.(Osteopenia).

B. Name the one marker enzyme of diagnostic interest related to the

above case. (Serum alkaline phosphatase).

Dr PK Bio-Gen 2012

b h i f h i d b l


27/31


A. Name the possible metabolic disorder of the above patient (Ans:

Gout syndrome).B. Name ONE biochemical test will be helpful to diagnose the clinical

condition. (Serum uric acid / CRP). (Or)

C. Name the possible drug of choice to treat this clinical condition.

Ans: Allopurinol.

Q. Observe the pictures of the patient presented below.


28/31

Q. Observe the picture of a patient who is suffering from heat

intolerance.


A. Name the likely endocrine disorder of the patient.(Hyperthyroidism).

B. Name TWO biochemical diagnostic tests will be helpful to diagnose

the above clinical condition. (1 mark). (T3, T4, TSH, TBG).

Dr PK Bio-Gen 2012


29/31

Q. Observe the picture of a patient who is suffering from diabetes

mellitus.


A. Name the likely endocrine disorder of the patient. (Acromegaly).

B. Name ONE biochemical diagnostic tests will be helpful to diagnosethe above clinical condition. (Ans: GH, IGF, Somatostatin).



30/31

Q. Observe the picture the patient who is suffering from

photophobia.


A. Name the likely congenital defect of the patient suffering from.(1 mark). (Ans: Albinism / Oculocutaneous albinism).


disorder. (Ans: Tyrosinase).


Q A newborn baby characterized by very high levels of unconjugated


31/31

Q. A newborn baby characterized by very high levels of unconjugated

bilirubin in the blood and by yellow staining and degenerative lesions

in the cerebral gray matter under treatment.


A. Name the likely clinical condition the patient is suffering (1 mark).

(Ans: Neonatal jaundice).

B. Name the enzyme deficiency associated with this clinical condition.

(Ans: UDP-Glucuronyl Transferase (UDP-GT) deficiency).

Fluorescent light.

Dr PK & Jega Bio Gen 2012

An Appropriate Esclation of Cognitive Burden in Phase-I Integerated Mecicine Curriculum_OSPEs_ Dr Kumar Ponnusamy BIO-GEN INNOVISION 2012_USMLE Preparatory Re-Usable on-Line Resources

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