McQs 1-5

1. Which one of the listed substances has the following characteristic serum changes following a myocardial infarction: levels begin to increase 4 to 6 h after the onset of chest pain, reach maximal serum concentration in about 12 to 24 h, and remain elevated for about 7 to 10 days?
a. AST (SGOT)
b. CPK-MB
c. LDH (with isotype LDH1 greater than LDH2)
d. Troponin I

2. Which of the following scan will selectively label the infracted area if the patient has MI?
a. Thallium-201
b. Xenon-131
c. Technetium-99 PYP
d. MUGA scan

3. The presence of lipoprotein(a) elevated is also seen. The possible reason for Lp (a) being a risk factor is related to the fact that lipoprotein(a) has kringle regions, which are regions that have structural homology with
a. Cardiolipin, and this homology increases the formation of clots on cardiac valves
b. Plasminogen, and this homology decreases the ability to clear thrombi
c. Lipoprotein lipase, and this homology decreases the ability to metabolize chylomicrons
d. Fibrinogen, and this homology increases the formation of fibrin thrombi

4. A 36 year old male develops high fever with chill and rigor. On examination he was found to have well defined erythematous rashes. Blood and CSF culture were done. CSF was sterile. However it was considered to be a bad prognosis. Three days later he developed shock and died. Autopsy revealed hemorrhagic adrenals. What would the blood culture show?
a. Neisseria meningitidis
b. Vibrio vulnificus
c. Streptococcus viridians
d. Haemophilus influenzae

5. A obese female 47 yrs of age had a H/o calf pain for he past 2 wks. Suddenly she developed excrutiating chest pain. She was admitted and treated for it. She was sent home with some medications. Five days later she noticed darkening of both her breasts. Which drug could have caused this?
a. Streptokinase
b. Aspirin
c. Epsilon amino Caproic Acid
d. Warfarin






Answers:
1. Troponin I
2. Technetium-99 PYP
3. Fibrinogen, and this homology increases the formation of fibrin thrombi
4. Neisseria meningitidis
5. Warfarin