Plasma Cell Disorders MCQs

The definitive diagnosis of PNH is based on the demonstration that a substantial proportion of the patient's red cells have an increased susceptibility to complement (C), due to the deficiency on their surface of proteins (particularly CD59 and CD55). Reference: Harrisons Principles of Internal Medicine, 18th Edition, Page

Drugs causing Thrombocytopenia Trimethoprim/ sulfamethoxazole Penicillin Vancomycin Rifampin Ethambutol Amphotericin B Quinine Heparin Digoxin Amiodarone Ethanol Quinidine H2 -antagonists NSAIDs Acetaminophen Chemotherapy Reference: Harrison's Principles of internal medicine 21st ed chap 115, pg. 908

The patient in this question has bone pains, hypercalcemia with impaired renal function and AG reversal, all pointing to the diagnosis of Myeloma. Hence the next best step would be a serum protein electrophoresis. 24 hour urine albumin or protein and LFT is of little use in this clinical scenario. Reference : Harrison's Principles of Internal Medicine, 21 st ed, Ch: 111 Pg : 865-867

Thrombotic microangiopathy(TMA) is a pathological lesion characterized by the presence of endothelial injury in the terminal arteriole and capillaries of organs, causing hyaline platelet thrombi, resulting in partial or complete occlusion of vessels. In kidneys it leads to a membranoproliferative pattern in glomerulus. Usually TMA is associated with Micro angiopathic hemolytic anemia(MAHA) characterized by schistocytes and thrombocytopenia. Typical examples of TMA include: Hemolytic uremic syndrome Thrombotic Thrombocytopenic Purpura Malignant hypertension Scleroderma renal crisis APLa syndrome HELLP syndrome HIV infection Radiation nephropathy TMA without MAHA is seen in POEMS Syndrome TMA associated with Myeloproliferative neoplasias Reference: Harrison's Principles of internal medicine, 21 st ed, Ch: 217, Pg: 2364.

Peutz-Jegher syndrome is a condition characterized by perioral pigmentation and numerous hamartomas of the bowel.Originally it was assumed that these did not predispose to malignancy but studies now suggest the contrary.The condition is autosomal dominant. Reference: Harrison's Principles of Internal Medicine, 21 st Ed, Ch: 81, Pg: 638

Macroglossia, Raccoon eyes, hepatomegaly, anemia are features of amyloidosis Crohn's disease can affect any part of the gastrointestinal tract from the mouth to the anus. Aphthous ulceration is common in active disease. Aphthous ulcers and glossitis are both features of celiac disease. Patients with Peutz-Jeghers syndrome have characteristic mucocutaneous pigmentation, that leads to perioral freckling. Reference: Harrison's Principles of Internal Medicine 21 st ed, Ch: 112, Pg: 880

Ans. is 'a' i.e., Chromogranin Small cell carcinoma contains. Polypeptide hormore e.g. PTH like peptide. Neuroendocrine markers -4 chromogranin, Synaptophysin, Leu7 458. Collapse of lung is called - a) Emphysema b) Bronchiactasis c) Atelectasis d) Bronchitis Correct Answer - C Ans. is 'c' i.e., Atelectasis Atelectasis (collapse) Atelectasis refers to:-

Answer is D (Thrombocytopenia, anemia, neurological abnormalities, progressive renal failure and fever) Thrombotic Thrombocytopenic Purpura (TTP) is characterized clinically by the Pentad of Microangiopathic Hemolytic Anemia, Thrombocytopenia. Decreased Renal Function. Disturbed Neurological function and Fever.