INI-CET 2017 - General Medicine PYQs Practice Questions

Q: A 50-year-old smoker and hypertensive patient presents with the lesion shown below. It is painful and present bilaterally. Peripheral pulses are palpable. What is the diagnosis?

Martorell ulcer. ***Martorell ulcer*** - This is a **hypertensive ischemic leg ulcer** primarily associated with uncontrolled hypertension, often seen in older patients who smoke. - Key features include extreme pain, location on the **anterolateral aspect of the lower leg**, and frequently bilateral presentation, despite palpable peripheral pulses. *Arterial ulcer* - **Arterial ulcers** are typically caused by **peripheral artery disease (PAD)**, leading to reduced blood flow. - While they can be painful, PAD is usually associated with **diminished or absent peripheral pulses**, which are present in this case. *Trophic ulcer* - A **trophic ulcer** is a general term for an ulcer caused by **poor nutrition** to the tissues, often due to neuropathy or chronic venous insufficiency. - While they can be chronic, the specific presentation with palpable pulses, severe pain, and association with hypertension points away from a generic trophic ulcer. *Bairnsdale ulcer* - Also known as **Buruli ulcer**, this is a **mycobacterial infection** caused by *Mycobacterium ulcerans*. - It typically starts as a painless nodule and slowly progresses to a large, often painless ulcer with undermined edges, which is not consistent with the painful lesion described. [Practice more General Medicine PYQs on OnCourse]

Q: In a patient of head injury, the following sign is noted on his handkerchief. Which is the next test to confirm the diagnosis? (AIIMS Nov 2017)

Beta trace protein. ***Beta trace protein*** - The image shows a "double ring" or "halo" sign, where blood spreads in a central area and is surrounded by a clear ring of fluid, indicating the presence of **cerebrospinal fluid (CSF) mixed with blood**. - **Beta trace protein (BTP)**, also known as protoprostaglandin D synthase, is a specific and sensitive marker for the detection of CSF leakage, differentiating it from other body fluids. *Beta 2 micro-globulin* - **Beta 2 micro-globulin** is a protein found on the surface of most nucleated cells and is elevated in various conditions like renal failure, inflammatory diseases, and lymphomas. - While it can be present in CSF, it is not a specific marker for CSF leakage and can be influenced by other factors. *Beta amyloid* - **Beta amyloid** is a protein primarily associated with Alzheimer's disease, forming plaques in the brain. - Its detection is used in the diagnosis and research of neurodegenerative disorders, not acute CSF leaks after head injury. *Beta glucuronidase* - **Beta glucuronidase** is a lysosomal enzyme found in various tissues and bodily fluids. - It is associated with conditions like bacterial vaginosis or urinary tract infections, and it is not a recognized marker for CSF leakage. [Practice more General Medicine PYQs on OnCourse]

Question 1

A 50-year-old smoker and hypertensive patient presents with the lesion shown below. It is painful and present bilaterally. Peripheral pulses are palpable. What is the diagnosis?

Accepted Answer

Martorell ulcer

Answer

Arterial ulcer

Answer

Trophic ulcer

Answer

Bairnsdale ulcer

Question 2

In a patient of head injury, the following sign is noted on his handkerchief. Which is the next test to confirm the diagnosis? (AIIMS Nov 2017)

Accepted Answer

Beta trace protein

Answer

Beta 2 micro-globulin

Answer

Beta amyloid

Answer

Beta glucuronidase

INI-CET 2017 — General Medicine