Sleep Apnea MCQs

The central chemoreceptors, located at or near the ventral surface of the medulla, are stimulated to increase ventilation by a decrease in the pH of their extracellular fluid (ECF). The pH of this ECF is affected by the PCO2 of the blood supply to the medullary chemoreceptor area, as well as by the CO2 and lactic acid production of the surrounding brain tissue. The central chemoreceptors are not stimulated by decreases in PaO2 or blood oxygen content but rather can be depressed by long-term or severe decreases in oxygen supply. Reference: Ganong, pp 675-678. Levitzky, pp 206-208.

Referring to the previous question, this patient is also suffering from a pulmonary renal syndrome. If the pathologist wants to stain the basement membrane, he might be suspecting Goodpasteur's syndrome. Jone's Methanamine silver is the stain used for basement membrane. Congo red is used for Amyloid. Masons Trichrome for collagen PAS for staining carbohydrate moiety in the cell membranes. Reference: Harrison's Principles of Internal Medicine, 21 st ed, Ch: 314, Pg: 2336.

Reference: Harrison's Principles of Internal Medicine, 21 st ed, Ch: 160, Pg: 1257

As with MPGN, FSGS is not a specific disease entity, it is a morphology of renal injury in several conditions that presents as nephrotic syndrome. The important ones are: Adaptive response to loss of renal mass as post nephrectomy, in obesity and in hyperfiltration. Hep B, Parvo virus, HIV Reflux nephropathy Sickle nephropathy Analgesics and heroine Hereditary podocytopathies: NPHS mutation, WT1 mutation, Fabrys disease, N acetyl neuraminidase deficiency, PLCE mutation, INF2 mutation, TRPC mutation, ACTN mutation. Reference: Harrison's Principles of Internal Medicine, Ch: 314, Pg: 2342.

Bruns garland syndrome is also known as diabetic amyotrophy/lumbosacral radiculoplexopathy Asymmetrical, painful weakness involving quadriceps, iliopsoas and adductors of thigh; spares the hamstring muscles Most common form of Diabetic neuropathy is the distal symmetric sensorimotor peripheral neuropathy Most common cranial nerve involvement in Diabetes mellitus is Oculomotor nerve followed by abducens and facial nerves. Reference: Harrison's Principles of Internal Medicine 21 st edition page 3124

Chronic bloody diarrhoea in a young patient is very suggestive of a diagnosis of ulcerative colitis (UC) . The time course is too long for an infective cause and whilst Crohn's disease (CD) may cause a colitis, this is less frequent. CD often presents watery diarrhoea. The predominant left sided symptoms (urgency and anatomical distribution of the tendency) should also point towards UC. The answer here therefore is diffuse mucosal inflammation . All the remaining options are histological features of Crohn's disease . Transmural inflammation is seen in CD. Sub serosal lymphoid aggregates are seen in CD Normal crypt architecture is found in CD while crypt abscesses and goblet cell depletion are seen in UC. Reference: Harrison's Principles of Internal Medicine 21 st Ed, Ch: 326 Pg:2474-2475