DrUSMLE

1076) B) Although multiorgan involvement, liver and spleen enlargement, and skeletal abnormalities are common to all the mucopolysaccharidotic (MPS) diseases, each encompasses features that allow for specific diagnosis.Hurler syndrome is characterized by progressive multiorgan failure and premature death.Hallmark features include enlargement of the spleen and liver, severe skeletal deformity, and coarse facial features (which are associated with the constellation of defects referred to as dystosis multiplex). The disease results from a defect in alpha-L-iduronidase activity, which leads to intracellular accumulations of heparan sulfates and dermatan sulfates. The accumulation of these GAGs (glycosaminoglycan) in Hurler syndrome patients severely affect development of the skeletal system leading, primarily, to defective long bone growth platedisruption. Hunter syndrome (choice A) has features similar to that of Hurler with a lack of corneal clouding. Additionally, symptoms progress slower, with onset of symptoms occurring between 2 and 4 years of age.Maroteaux-Lamy syndrome (choice C) encompasses symptoms similar to Hurler but with normal mental development. Morquio syndrome (choice D) comprises two related disorders, both of which are characterized by short-trunk dwarfism, fine corneal deposits,and a skeletal dysplasia (spondyloepiphyseal) distinct from other MPS. Sanfilippo syndrome(choice E) comprises four recognized types characterized by severe CNS degeneration with only mild involvement of other organ systems.Symptoms do not appear until 2–6 years of age. For More questions join @drusmle

1076) A 30-month-old child presents with coarse facialfeatures, corneal clouding, hepatosplenomegaly,and exhibiting disproportionate short-trunk dwarfism. Radiographic analysis indicates enlargement of the diaphyses of the long bones and irregular metaphyses, along with poorly developed epiphyseal centers. Other skeletal abnormalities typify the features comprising dystosis multiplex. The child’s physical stature and the analysis of bone development indicate the child is suffering from which of the following disorders? # dr.Usmle

1075 ) (D) Rhinoviruses (choice D) are common cold viruses that belong to the picornavirus group.They are small (28–30 nanometers), have a positive-sense linear RNA genome, and no lipid envelope. The viral receptor is located in a groove or canyon in the capsid coat where the cellular receptor (ICAM-1) attaches in the initial cell infection process. The incubation period is brief (1–2 days), allowing many infections to occur in a crowded or closed living situation. Coronaviruses (choice A) are also common cold viruses but larger than 50 nm and has a lipid envelope. Influenza viruses (choice B) are also larger than 50 nm and possess lipid envelopes.RSV (choice C) and rubella virus (choice E) are similar, being larger than 50 nm with lipid envelopes. For More questions join @drusmle

1075 ) . A similar virus was isolated from several students in a day-care school that experienced a respiratory disease outbreak. This virus passes through a 50 nm filter, grows best in human diploid fibroblasts at 33° C, is not inactivated by chloroform, is inactivated at pH 3, and is inhibited by compounds that interact with the interior of grooves on the viral surface thatattach to cell receptor molecules. Which of the following is the most likely virus based upon its identifying characteristics? # dr.Usmle

1074 ) (C) Postpartum mood disorders are much more common than previously believed. Postpartum blues (also called maternity blues or baby blues) occurs in most women within the first 2 weeks of delivery and is characterized by irritability, mood lability, and anxiety. This condition is generally resolved within 2 weeks. Hypothyroidism can mimic postpartum depression or contribute to it, but this diagnosis is based on laboratory studies and is not as common as postpartum depression itself. Psychosis is a very seriouscondition that occurs in up to 0.2% of deliveries and is marked by confusion, bizarre behavior, disordered thoughts, delusions, and hallucinations. There is a high risk of suicide or harm to others and immediate psychiatric care is required. Postpartum mood disorders are more common in adolescents but cannot be blamed on “typical teenage adjustment.” This patient’s case fits most closely the definition of postpartum depression, using the same DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition) criteria as major depression. Five lakh postpartum women in the United States have postpartum depression annually. Treatment should include antidepressant therapy (generally using SSRIs) and psychotherapy as indicated. For More questions join @drusmle

1074 ) A 17-year-old G1P1001 is now 5 weeks postpartum after a routine vaginal delivery. She calls your office to report a 3-week history of difficulty sleeping and “feeling blue.” On further questioning, she reports difficulty con- centrating, very poor appetite, occasional wishes that she had never become pregnant, and feelings of guilt about those wishes. She has not left her home in more than a week because she “just can’t find the energy to go anywhere.” This patient’s symptoms are most consistent with: # dr.Usmle

1073 ) (C) Calcitriol [1,25-(OH)2 -D] is the hormonally active form of vitamin D and functions in concert with PTH and calcitonin to regulate serum calcium and phosphorous levels. The major function of calcitriol is the induction of synthesis of an intestinal calcium-binding protein, calbinden, which facilitates intestinal absorption of calcium. Oral administration of calcitriol will increase intestinal calcium uptake, but the hormone does not enter the peripheral circulation in significant amounts. Therefore, patients with renal osteodystrophy may need intravenous administration of calcitriol. Antidiuretic hormone (choice A) is responsible for renal water readsorption in response to increased extracellular Na+ concentrations, which lead to increased plasma osmolarity. Calcitonin (choice B) acts to block bone resorption when there are sufficient levels of calcium in the serum. Growth hormone (choice D) does not influence calcium homeostasis and would therefore not be useful in the treatment of renal osteodystrophy. PTH (choice E) acts to increase bone resorption, in concert with calcitriol, when serum calcium levels fall. For More questions join @drusmle

1073 ) In renal insufficiency, calcium absorption is reduced and leads to increased bone resorption, a condition referred to as renal osteodystrophy. Treatment with which of the following can assist in the amelioration of the symptoms of this condition? # dr.Usmle

1072 ) A patient presented with an acute abdomen including fever, marked abdominal distension, acidosis, and leukocytosis. Laparoscopy revealed that large parts of the small intestine were necrotic and as a consequence, the entire ileum of the patient was resected. It is expected that very soon after the surgery the patient will have considerable problems resulting from the malabsorption of which of the following? # dr.Usmle

1072 ) (B) After a meal about 90 percent of the bile acids and bile salts are absorbed from the lower ileum by way of active transport. They are directed to the liver, from where they can bereleased again via bile into the intestine. This enterohepatic circulation of bile acids between intestine and liver is physiologically veryimportant for normal absorption of fat and fatsoluble vitamins, and if distorted, will lead to GI and other symptoms. The quantity of iron in the body (choice A) is maintained by controlledabsorption from the duodenum, not the ileum.Although sodium (choice C) is actively absorbed in the ileum, there are additional absorption mechanisms available in the jejunum and in the colon. For instance, in the jejunum, sodium is absorbed by cotransport coupled with sugars and neutral amino acids, and in the colon, there are active sodium transport mechanisms as well. Hence, no immediate sodium imbalance is expected. Although vitamin B12 (choice D), complexed with intrinsic factor, binds to a transmembrane receptor in the ileum for absorption, a large amount of vitamin B12 (up to 5 mg) is stored in the liver.This liver storage is thought to be sufficient for 3–6 years so that symptoms from vitamin B12 deficiency will be expected at a later time, but not soon after removal of the ileum. Protein digestion (choice E) occurs in the small intestine, with absorption of amino acids primarily in the jejunum and to a lesser extent in the ileum, and with dipeptide absorption at about equal rates in these two segments. Removal of the ileum will not immediately lead to problems due to protein malabsorption. For More questions join @drusmle

🎯 Ace the Chase with DigiNEET! Your ultimate guide for MBBS and NEET PG prep is here! 💥 📚 What DigiNEET Offers: ✅ 1,490+ Hours of Expert Video Lectures ✅ 12,000+ Questions in QBank ✅ 140+ OSCEs/OSPEs ✅ Drug Charts & Printed Notes 🤖 24x7 Dr. AI Chatbot — perfect for anytime, anywhere doubt-solving 💎 2,800+ GEMS for quick and effective revision 📝 Test series that truly simulate the real exam …and so much more to power up your preparation! 🔥 Start your 12-month plan at just ₹15,999 Use Coupon Code: DIGIUG for an extra 5% off 🎉 📲 Download the DigiNerve App now and kickstart your smart prep journey: 👉 https://app.diginerve.com/download-url

1071 ) (B) The arch of the aorta is formed from the left fourth aortic arch. Part of the right fourth aortic arch becomes the proximal portion of the right subclavian artery, whereas the rest of the fourth arch disappears. However, if it persists, a rightaortic arch is formed passing posterior to the trachea and esophagus. With the formation of the normally occurring left aortic arch, which runs anterior to the trachea and esophagus, a double aortic arch is created. This defect clamps the trachea and esophagus resulting in the res- piratory symptoms. The second pair of aortic arches (choice C) partially form the stapedial arteries in the middle ear of the embryo. The third pair of aortic arches (choice E) form the common carotid arteries and contribute to the internal carotid arteries. The fifth pair of aortic arches (choice A) either does not develop or form primitive vessels, which disappear eventually. The sixth pair of aortic arches (choice D) contribute to the formation of thepulmonary arteries and ductus arteriosus. For More questions join @drusmle

1071) A newborn infant displays wheezing respiration, which is aggravated when she feeds,flexes her neck, and/or cries. Radioimaging studies of her chest reveal a double aortic arch compressing her trachea and esophagus. This rare developmental defect results from persistence of the right dorsal aorta, which normally disappears. The arch of the aorta arises from which of the following structures?For More questions join @drusmle

1070 ) (D) The spinal accessory (eleventh cranial)nerve takes its origins in the neck, but then runscranially into the skull through the foramenmagnum to join with its cranial component.They exit as one through the jugular foramen,along with the glossopharyngeal (ninth cranial) and vagus (tenth cranial) nerves. The abducens (sixth cranial) nerve (choice A) runs through the superior orbital fissure to reachthe orbit. The facial (seventh cranial; choice B) and vestibulocochlear (eighth cranial; choice E)nerves run together through the internalacoustic meatus into the temporal bone. The facial nerve exits the skull through the stylomastoid foramen. The hypoglossal (twelfth cranial; choice C) nerve exits the skull through the hypoglossal canal. For More questions join @drusmle