Property:AnswerCExp
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'''Incorrect'''-Increasing the morning dose of insulin will be necessary only if there was an increase in early morning blood glucose without a hypoglycemic episode during night, which is Dawn phenomenon. +
'''Correct'''-Hypothalamic hamartomas may cause symptoms referable to the hypothalamus and its neuroendocrine functions. Most often they lead to either precocious puberty or acromegaly due to overproduction of growth hormone releasing hormone. Patients may also experience paroxysms of laughter along with facial contractions, known as gelastic seizures. If the vocalization has a crying quality, it is called as dacrystic seizures. Cognitive impairments like memory and learning disabilities along with hypothalamic rages might occur. Hypothalamic rages are different form temper tantrums in the sense they occur without any provocation. Pallister Hall syndrome is a rare genetic disorder where large hypothalamic hamartomas can occur along with polydactyly and cutaneous syndactyly. Hypothalamic hamartomas may be cured surgically. +
'''Correct'''-Transdermal estrogen avoids the first pass hepatic metabolism and thus attenuating the increase in triglycerides. +
Septate hyphae with V-shaped branching is a feature of ''Aspergillus fumigatus'' infections. +
Hairy leukoplakia is caused by Epstein-Barr virus (EBV) and is most commonly seen in HIV-infected patients. +
Beta-pleated sheets are observed in brain biopsies of patients with Creutzfeldt-Jakob disease (CJD). +
Reactive gliosis and vascular proliferation is the typical histological appearance of a glial scar that appears 1-2 weeks following ischemic stroke. +
'''Incorrect''' : Patients with the tenosynovitis, dermatitis, polyarthralgia form of DGI are more likely to have positive blood cultures than those presenting with purulent arthritis. +
'''Correct''' : A triad of tenosynovitis, dermatitis, and polyarthralgias without purulent arthritis or purulent arthritis without associated skin lesions is one of the presenting syndromes of disseminated gonococcal infection +
'''Correct'''-The patient has a euvolemic hypotonic hyponatremia secondary to inappropriate antidiuretic hormone secretion (SIADH). SIADH has a persistently elevated ADH level in the absence of an appropriate stimulus. NSAID’s potentiate the action of ADH and thus it is a cause of SIADH. Before SIADH diagnosis, it is appropriate to rule out hypothyroidism and adrenal insufficiency. The diagnostic test is the simultaneous measurement of serum and urine osmolality, which will be low (<285 mOsm/Kg of water) and inappropriately high (>300 mOsm/Kg of water) respectively. The low serum uric acid (<3.6 mg/dl in men) is due to hemodilution. +
'''Incorrect'''-Normal T3 and T4 with increased TSH level is seen in subclinical hypothyroidism. +
'''Incorrect'''-Periodic calcium measurement is useful for screening patients with parathyroid hyperplasia in MEN I and MEN IIa. +
'''Incorrect'''-High serum sodium will guide you to arrive at the diagnosis, but can not be specific for the diagnosis since it may be normal in milder forms of primary hyperaldosteronism. +
Alport's syndrome is a familial cause of deafness, ocular disturbances, and nephritis. Microscopic hematuria is the most common presenting sign of patients with Alport's syndrome. Hematuria is usually present before patients experience symptoms of renal failure (eg. hypertension) and before an elevation in serum creatinine is observed. +
'''Incorrect''' : This option gives suboptimal control. This can be used if facilities for starting insulin drip are not available. +