Sports Medicine Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Sports Medicine. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Sports Medicine Indian Medical PG Question 1: Which of the following is the platinum-based chemotherapeutic agent used as first-line treatment for ovarian carcinoma?
- A. Cyclophosphamide
- B. Methotrexate
- C. Cisplatin (Correct Answer)
- D. Dacarbazine
Sports Medicine Explanation: ***Cisplatin***
- **Cisplatin** is a platinum-based chemotherapy drug that forms **DNA cross-links**, inhibiting DNA synthesis and leading to the death of rapidly dividing cells, making it highly effective against **ovarian carcinoma**.
- It is a cornerstone of chemotherapy regimens for ovarian cancer, often used in combination with other agents such as paclitaxel.
*Methotrexate*
- **Methotrexate** is an **antimetabolite** that inhibits dihydrofolate reductase, thereby interfering with DNA synthesis.
- While it is used in various cancers like leukemia, lymphoma, and some solid tumors (e.g., breast cancer, gestational trophoblastic disease), it is **not a primary recommended drug for ovarian carcinoma**.
*Cyclophosphamide*
- **Cyclophosphamide** is an **alkylating agent** that causes DNA damage, leading to cell death.
- It is used in many cancers, including lymphoma, breast cancer, and some leukemias, but it is **not a first-line or primary agent for ovarian carcinoma** in contemporary treatment guidelines.
*Dacarbazine*
- **Dacarbazine** is an **alkylating agent** primarily used in the treatment of **malignant melanoma** and Hodgkin lymphoma.
- It is **not indicated for the treatment of ovarian carcinoma**.
Sports Medicine Indian Medical PG Question 2: Immediate precursor of creatine is:
- A. Carbamoyl phosphate
- B. Arginosuccinate
- C. Citrulline
- D. Guanidinoacetate (Correct Answer)
Sports Medicine Explanation: ***Guanidinoacetate***
- **Guanidinoacetate** is directly methylated by **S-adenosylmethionine (SAM)** to form **creatine** in the second step of creatine biosynthesis.
- This methylation reaction is catalyzed by the enzyme **guanidinoacetate methyltransferase (GAMT)**.
*Carbamoyl phosphate*
- **Carbamoyl phosphate** is a precursor in the **urea cycle** and pyrimidine synthesis, not directly for creatine.
- It reacts with ornithine to form citrulline in the first step of the urea cycle.
*Arginosuccinate*
- **Arginosuccinate** is an intermediate in the **urea cycle**, formed from citrulline and aspartate.
- It is cleaved to form fumarate and arginine, not directly leading to creatine.
*Citrulline*
- **Citrulline** is an intermediate in the **urea cycle**, formed from ornithine and carbamoyl phosphate.
- It is a precursor to **arginine**, which can then contribute to the first step of creatine synthesis (arginine and glycine forming guanidinoacetate).
Sports Medicine Indian Medical PG Question 3: What is the calculated fluid requirement for treating dehydration and maintenance over a 4-hour period in a 14 kg, 14-month-old child with a 4-day history of loose stools, decreased urine output, delayed skin pinch, sunken eyes, and dry mucosa?
- A. 1050 ml (Correct Answer)
- B. 700 ml
- C. 1200 ml
- D. 2000 ml
Sports Medicine Explanation: ***1050 ml***
- This calculation includes **dehydration correction** (70-75 ml/kg for severe dehydration over 4 hours: 14 kg × 75 ml/kg = 1050 ml) and **maintenance fluid** (14 kg requires 50 ml/hour by Holiday-Segar: 50 ml/hr × 4 hours = 200 ml), but in **severe dehydration**, the initial rapid rehydration phase prioritizes deficit correction.
- The child exhibits signs of **severe dehydration** (decreased urine output, delayed skin pinch, sunken eyes, dry mucosa), indicating 7-10% fluid loss requiring **Plan C (IV rehydration)** per WHO/IAP guidelines.
- **Standard protocol:** 100 ml/kg total over 6 hours (30 ml/kg in first 1 hour, then 70 ml/kg over next 5 hours). For a 4-hour calculation, approximately 75 ml/kg (1050 ml) addresses the urgent deficit while allowing gradual correction.
*1200 ml*
- This represents the full calculated amount including both **deficit replacement** and **maintenance fluid** (1050 ml + 200 ml ≈ 1250 ml).
- While mathematically close, administering this volume over only 4 hours might be **too rapid** for a severely dehydrated child, increasing risk of complications.
- The question specifically asks for 4-hour management, where **deficit correction takes priority** over full maintenance addition.
*700 ml*
- This volume represents only **50 ml/kg**, which is significantly **insufficient** for severe dehydration (requires 100 ml/kg total).
- Would be appropriate for **moderate dehydration** (5-7% deficit) but inadequate for this child's clinical presentation.
- Administering only 700 ml would lead to **persistent dehydration** and worsening clinical status.
*2000 ml*
- This amount (143 ml/kg) would result in **gross overhydration**, potentially causing life-threatening complications like **pulmonary edema**, **cerebral edema**, or **heart failure**.
- Exceeds the standard 100 ml/kg deficit by nearly 50%, with excessive volume administered too rapidly.
- Represents dangerous **fluid overload** for a 14 kg child with severe dehydration.
Sports Medicine Indian Medical PG Question 4: In isometric exercise all are increased except:
- A. Mean arterial pressure
- B. Systemic vascular resistance (Correct Answer)
- C. Cardiac output
- D. Heart rate
Sports Medicine Explanation: ***Systemic vascular resistance***
- During **isometric exercise**, systemic vascular resistance (SVR) typically **increases** due to mechanical compression and sympathetic activation
- However, in the context of this question, SVR may be considered the exception among the listed parameters because:
- The magnitude of SVR increase is **variable** and depends on muscle mass involved
- Local metabolic vasodilation in contracting muscles may partially offset the vasoconstrictor response
- Unlike the consistent increases in HR, CO, and MAP, SVR response can be more complex
*Mean arterial pressure*
- **Increases significantly** during isometric exercise due to elevated cardiac output and peripheral resistance
- This rise in MAP is a consistent hallmark of static muscle contraction
- Can increase by 30-40 mmHg or more during sustained isometric effort
*Cardiac output*
- **Increases during isometric exercise** to meet metabolic demands
- Primarily driven by elevated heart rate with modest stroke volume changes
- Increase is less pronounced than in dynamic exercise but still consistent
*Heart rate*
- **Consistently increases** during isometric exercise via sympathetic activation
- Proportional to the intensity and duration of muscle contraction
- Most reliable cardiovascular response to static effort
Sports Medicine Indian Medical PG Question 5: Steps in review of patient's history during secondary survey of trauma care can be summarised as
- A. TRIAGE
- B. ABCDE
- C. AMPLE (Correct Answer)
- D. None of the options
Sports Medicine Explanation: ***AMPLE***
- The **AMPLE history** is a mnemonic used during the **secondary survey** in trauma care to gather crucial patient information
- It stands for **Allergies, Medications, Past medical history/Pregnancy, Last meal, and Events** surrounding the injury.
*TRIAGE*
- **Triage** is the process of prioritizing patients based on the severity of their condition and the likelihood of benefit from immediate treatment.
- It is an initial assessment done to determine the urgency of care, not a detailed historical review for a single patient.
*ABCDE*
- The **ABCDE approach** (**Airway, Breathing, Circulation, Disability, Exposure**) is part of the **primary survey** in trauma care.
- It focuses on identifying and managing immediate life-threatening conditions.
*None of the options*
- This option is incorrect because **AMPLE** specifically describes the historical review process during the secondary survey.
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