Mixed / Miscellaneous Topics MCQs

Ascending aortic aneurysms can indeed occur in various conditions, including vasculitis and syphilis, but they can also be caused by other factors such as atherosclerosis, genetic conditions (e.g., Marfan syndrome), bicuspid aortic valve, or as a complication of cardiac surgery. These aneurysms involve the section of the aorta that rises from the heart and can be serious if they rupture. Early detection and management are crucial.

Cholera, septicemia, and sunstroke lead to an increase in body temperature in the first two hours following death. It is due to postmortem caloricity. Postmortem caloricity is the condition in which the temperature of the body remains raised for the first two hours or so after death. This occurs: When the regulation of heat production has been severely disturbed before death, as in sunstroke, pontine hemorrhage and in some nervous disorders. When there has been a great increase in heat production in the muscles due to convulsions, as in tetanus and strychnine poisoning, or increased muscular activity as in cases of violent asphyxial deaths (struggle prior to death) etc. When there has been excessive bacterial activity, as in septicemic conditions like cholera and other fevers. Reference: The Essentials of Forensic Medicine & Toxicology by KS Narayan Reddy, 35th Edition, Page Number-114.

Cardiolipin which is the phospholipid with antigenic properties is responsible for this discrepancy. VDRL contains cardiolipin -cholesterol - lecithin mixtures to detect serum antibodies formed against treponema pallidum. This lady who is undergoing further evaluation for her prior miscarriage probably has an anti-cardiolipin antibody. Here, serum that cross-reacts with the component of the VDRL reagent resulting in the biological false positive VDRL. However, the confirmatory test suggests that anti cardiolipin antibody is not due to infection with treponema pallidum but due to some other reason. Reference: Harper's Illustrated Biochemistry, 32nd Edition, Page Number-200.

LMP-1 prevents apoptosis by activating BCL2. Thus, the virus 'borrows' normal B-cell activation pathways to expand the pool of latently infected cells. Other options - One EBV gene, latent membrane protein-1 (LMP-1), is an oncogene capable of inducing B-cell lymphomas in mice. LMP-1 behaves like a constitutively active CD40 receptor, a key recipient of helper T-cell signals that stimulate B-cell growth. LMP-1 activates the NF-κB and JAK/STAT signaling pathways and promotes B-cell survival and proliferation, all of which occur autonomously (i.e., without T cells or other outside signals) in EBV-infected B cells. Reference: Robbins and Cotran Pathologic Basis of Disease, 10 th Edition, Page Number-325.

Fixation of hypostasis occurs 6 - 12 hours after death. Purple or reddish-purple discoloration of the skin due to collection of blood in toneless capillaries in dependent parts of the dead body is called postmortem hypostasis/ post mortem staining/suggillation. Timing of development of postmortem hypostasis: 0 - ½ hour → Absent ½ - 2 hours → Appear as mottled patches 2 – 4 hours → Patches coalesce with each other 4 hours → Well developed. 6 – 12 hours → Fixes (Average: 8 hours) Hypostasis persists till putrefaction sets in. Reference: The Essentials of Forensic Medicine & Toxicology by KS Narayan Reddy, 35th Edition, Page Number-114; Textbook of Forensic Medicine & Toxicology by Anil Aggrawal, 2nd Edition, Page Number-177.

Answer- B. Intestinal obstruction Stepladder sign represents the appearance of gas-fluid distended small bowel loops that appear to be stacked on top of each other, typically observed on erect abdominal radiographs in the setting of small bowel obstruction.

Biliary microlithiasis refers to gallstones The investigation of choice for biliary microlithiasis is EUS. Reference: Sorrentino, S., El-Feky, M. Gallstones. Reference article, Radiopaedia.org. https://doi.org/10.53347/rID-20125

For transvaginal evaluation, the urinary bladder should be emptied Reference: Callen's Ultrasonography in Obstetrics and Gynecology, sixth edition page number - 847