guan-wang/ReDis-QA huggingface dataset:
Question: Cutaneous (skin) Tuberculosis secondary to underlying tissue eg lymph node is called as
A. Lupus Vulgaris
B. Scrofuloderma
C. Spina Ventosa
D. Tuberculous Verrucosa Cutis
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Tuberculosis
Question: Under the revised National Tuberculosis Control Programme, schedule of treatment for category I patients is -
A. 2 (HRZE)3 + 4(HR)3
B. 2 HRZE+ 4 HRE
C. 2(HRZES)3 + 1(HRZE)3 + 5(HRE)3
D. 2(HRZ)3 + 4 (HR)3
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Tuberculosis
Question: National Tuberculosis Institute is located at
A. Bangalore
B. Chingelput
C. New Delhi
D. Chennai
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Tuberculosis
Question: True about Tuberculosis HIV patientsa) ↑ Sputum positivityb) INH prophyaxis prevent development of T.Bc) Lack characteristics feature of T.Bd) Highly positive PPD reactione) Atypical radiological features
A. ce
B. b
C. ac
D. ae
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Tuberculosis
Question: What are the minimum number bacilli for Sputum positive Tuberculosis?
A. 10
B. 102
C. 103
D. 104
Correct option (0=A, 1=B, 2=C, 3=D): 3
Rare disease: Tuberculosis
Question: The MOST common site of Tuberculosis in female genital tract is?
A. Cervix
B. Endometrium
C. Ovaries
D. Fallopian tubes
Correct option (0=A, 1=B, 2=C, 3=D): 3
Rare disease: Tuberculosis
Question: Most common presentation of Renal Tuberculosis is:
A. Renal colic
B. Sterile Pyuria
C. Intractable urgency
D. Painful micturition
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Tuberculosis
Question: In Revised National Tuberculosis Control programme the silent features are to achieve ?
A. Cure rate 85% & diagnosis 85%
B. Cure rate 85% & diagnosis rate 70%
C. Cure rate 80% & diagnosis 85%
D. Cure rate 80% & diagnosis rate 80%
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Tuberculosis
Question: It is probable that physician have a higher index of suspicion for tuberculosis in children without BCG scar that those with BCG scar. If this is so and an association is found between Tuberculosis and not having BCG due to -scar, the association may be
A. Selection bias
B. Interviewer bias
C. Surveillance bias
D. Non-response bias
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Tuberculosis
Question: Triad of Tuberous Sclerosis includes all, except:
A. Epilepsy
B. Low intelligence
C. Hydrocephalus
D. Adenoma sebaceum
Correct option (0=A, 1=B, 2=C, 3=D): 2
Rare disease: Tuberous Sclerosis
Question: DOC for the treatment of Tularemia is:
A. Kanamycin
B. Neomycin
C. Streptomycin
D. Chloramphenicol
Correct option (0=A, 1=B, 2=C, 3=D): 2
Rare disease: Tularemia
Question: Tularemia belongs to which category of bioterrorism agents -
A. A
B. B
C. C
D. D
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Tularemia
Question: All the following are characteristic of Turner Syndrome EXCEPT:
A. Webbing of Neck
B. Cubitus valgus
C. Umbilical Hernia
D. Coarctation of Aorta
Correct option (0=A, 1=B, 2=C, 3=D): 2
Rare disease: Turner Syndrome
Question: All the following are characteristic of Turner Syndrome EXCEPT-
A. Webbing of Neck
B. Cubitus valgus
C. Umbilical Hernia
D. Coarctation of Aoa
Correct option (0=A, 1=B, 2=C, 3=D): 2
Rare disease: Turner Syndrome
Question: All the following are characteristic of Turner Syndrome EXCEPT
A. Webbing of Neck
B. Cubitus valgus
C. Umbilical Hernia
D. Coarctation of Aoa
Correct option (0=A, 1=B, 2=C, 3=D): 2
Rare disease: Turner Syndrome
Question: Typhoid carriers are detected by following except ?
A. Isolation of bacteria from urine
B. Isolation of bacteria from bile
C. Vi antigen
D. Widal test
Correct option (0=A, 1=B, 2=C, 3=D): 3
Rare disease: Typhoid
Question: Typhoid revaccination is recommended every ... years in endemic area-
A. 1
B. 3
C. 5
D. 10
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Typhoid
Question: Typhoid Vi polysaccharide vaccine is usually administered in children above the age of-
A. 6 months
B. 1 year
C. 2 years
D. 1 year 6 months
Correct option (0=A, 1=B, 2=C, 3=D): 2
Rare disease: Typhoid
Question: Typhoid in first week of illness is best diagnosed by:-
A. Serum widal test
B. Stool culture
C. Urine test
D. Blood culture
Correct option (0=A, 1=B, 2=C, 3=D): 3
Rare disease: Typhoid
Question: Typhoid oral vaccine is given ?
A. 1, 3, 5 days
B. 1, 2, 3 days
C. 1, 2, 4 days
D. 1, 7, 14 days
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Typhoid
Question: Typhoid carriers harbor bacteria in
A. Gallbladder
B. Urinary bladder
C. Pancreas
D. Spleen
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Typhoid
Question: Typhoid investigation of choice in 1st week
A. Blood culture
B. Widal test
C. Stool culture
D. Urine culture
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Typhoid
Question: All are a complication of Typhoid ulcer, EXCEPT -
A. Perforation
B. Stricture
C. Haemorrhage
D. Sepsis
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Typhoid
Question: Following are true regarding Typhoid ulcer EXCEPT
A. Bleeding common
B. Commonly in ileum
C. Perforation occurs
D. Stricture occurs
Correct option (0=A, 1=B, 2=C, 3=D): 3
Rare disease: Typhoid
Question: Typhoid ulcer ruptures at
A. 1st week
B. 2nd week
C. 3rd week
D. 4th week
Correct option (0=A, 1=B, 2=C, 3=D): 2
Rare disease: Typhoid
Question: THEME AND FOCUS: METABOLISM OF NUCLEOTIDES Case Study: A 17- month- old girl suffered from recurring respiratory infections. Injection of Diphtheria-Peussis-Tetanus (DPT) and Typhoid vaccine produced only a minimal response. The lysate of girl's erythrocytes were found to lack detectable adenosine deaminase activity. Her mother and father both showed approximately 50% of the normal red cell adenosine deaminase activity. Lead Question: Diagnose the disease.
A. SCID
B. Crushing Muscular Trauma
C. Lesch -Nyhan Syndrome
D. Hypokalemia
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Typhoid
Question: Typhoid Mary his known in history to cause more than 1300 cases in her lifetime. This is an example of which of the following epidemic?
A. Common source single exposure epidemic
B. Common source continuous or repeated exposure epidemic
C. Long term or secular trend epidemic
D. Propagated epidemic
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Typhoid
Question: Typhoid perforation is diagnosed by-
A. Plain X-ray of abdomen in erect posture
B. Rectal examination
C. Gastric aspiration
D. Barium enema
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Typhoid
Question: When should you perform Widal test in a case of Typhoid?
A. 1st week
B. 2nd week
C. 3rd week
D. 4th week
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Typhoid
Question: Macrophage, granuloma, erythrophagocytosis are found ina)  Ulcerative colitisb) Necrotising enterocolitisc)  Regional ileitisd)  Typhoid
A. ab
B. bc
C. cd
D. ac
Correct option (0=A, 1=B, 2=C, 3=D): 2
Rare disease: Typhoid
Question: Typhoid in 1st week is best diagnosed by
A. Blood culture
B. Antigenic test
C. Stool culture
D. Urine culture
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Typhoid
Question: All are true about Typhoid except -
A. Incubation period 10-14 years
B. Most common among males
C. Carrier are treated by ampicillin
D. Highest incidence occur in 30-40 years age group
Correct option (0=A, 1=B, 2=C, 3=D): 3
Rare disease: Typhoid
Question: Typhoid is treated by all except ?
A. Erythromycin
B. Ceftriaxone
C. Amikacin
D. Ciprofloxacin
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Typhoid
Question: Which of the following is true regarding Typhoid in children -
A. Leukochyosis is characteristic
B. Encephalitis is common
C. Mild splenomegaly is usual
D. Urine culture is positive in 4 to 6 days
Correct option (0=A, 1=B, 2=C, 3=D): 2
Rare disease: Typhoid
Question: Typhoid vaccine efficacy is -
A. 85%
B. 50%
C. 95%
D. 100%
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Typhoid
Question: Typhoid revaccination is recommended very ___ years in endemic area -
A. 1
B. 3
C. 5
D. 10
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Typhoid
Question: Typhoid Vi polysaccharide vaccine is usually administered in children above the age of :
A. 6 months
B. 1 year
C. 2 years
D. 1 year 6 months
Correct option (0=A, 1=B, 2=C, 3=D): 2
Rare disease: Typhoid
Question: Typhoid oral vaccine is given -
A. 1, 3, 5 days
B. 1, 2, 3 days
C. 1, 2, 4 days
D. 1, 7, 14 days
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Typhoid
Question: Which of the following Px is true for Typhoid carriers?
A. Ciprofloxacin + azithromycin
B. Cotrimoxazole
C. Amoxicillin + probenecid
D. None
Correct option (0=A, 1=B, 2=C, 3=D): 2
Rare disease: Typhoid
Question: All of the following statements are about Non Typhoid Salmonella (NTS) are true, EXCEPT:
A. Humans are the only reservoir
B. Transmission is most commonly associated with eggs, poultry and undercooked meat
C. Common in Immunocompromised individuals
D. Resistance to fluroquinolones has emerged
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Typhoid
Question: Typhoid intestinal perforation is usually occurs in which week of typhoid fever?
A. 2nd - 3rd week
B. 4th - 5th week
C. 5th - 7th week
D. 6th - 8th week
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Typhoid
Question: Which of the following is not true regarding Typhoid carrier?
A. Convalescent carriers excrete the organism for 6 - 8 weeks
B. Chronic carriers excrete bacilli for many years
C. Chronic carrier state is associated with presence of bacilli in gall bladder
D. Urinary carrier is more common than fecal carrier
Correct option (0=A, 1=B, 2=C, 3=D): 3
Rare disease: Typhoid
Question: All are complication of Typhoid ulcer except ?
A. Perforation
B. Stricture
C. Haemorrhage
D. Sepsis
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Typhoid
Question: Features of Typhoid Ulcers include all of the following Except:
A. Bleeding
B. Perforation
C. Stricture and obstruction
D. Longitudinal orientation
Correct option (0=A, 1=B, 2=C, 3=D): 2
Rare disease: Typhoid
Question: Which of the following is true regarding Typhoid in children :
A. Leukochyosis is characteristic
B. Encephalitis is common
C. Mild splenomegaly is usual
D. Urine culture is positive in 4 to 6 days
Correct option (0=A, 1=B, 2=C, 3=D): 2
Rare disease: Typhoid
Question: Typhoid perforation occurs during
A. Ist week
B. 2nd week
C. 3rd week
D. 4th week
Correct option (0=A, 1=B, 2=C, 3=D): 2
Rare disease: Typhoid
Question: Typhoid ulcer perforation mostly occurs in: March 2005, March 2013
A. 1 -2 week
B. 2 -3week
C. 3-4 week
D. 4 -5week
Correct option (0=A, 1=B, 2=C, 3=D): 2
Rare disease: Typhoid
Question: Most common complication of Typhoid:
A. Paralytic ileus.
B. Otitis media.
C. Oophoritis.
D. Rheumatic fever.
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Typhoid
Question: All are true about Typhoid EXCEPT:
A. Incubation period 10 to 14 days
B. Most common among males
C. Carrier are treated by Ampicillin
D. Highest incidence occurs in 30-40 years age group
Correct option (0=A, 1=B, 2=C, 3=D): 3
Rare disease: Typhoid
Question: Early surgery is indicated in -a) Amoebiasis peritonitisb) Biliary peritonitisc) Typhoid peritonitisd) All
A. a
B. bc
C. ac
D. ad
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Typhoid
Question: Typhoid is treated by all except
A. Erythromycin
B. Ceftriaxone
C. Amikacin
D. Ciprofloxacin
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Typhoid
Question: All are complication of Typhoid ulcer EXCEPT -
A. Perforation
B. Stricture
C. Haemorrhage
D. Endocarditis
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Typhoid
Question: Most immunogenic Typhoid antigen
A. O antigen
B. H antigen
C. Vi antigen
D. Somatic antigen
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Typhoid
Question: Increased Monocytic count is seen in Typhoid and which of the following conditions?
A. Parasitic infections
B. Sub-Acute Bacterial Endocarditis
C. Hodgkin's Lymphoma
D. None of the above
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Typhoid
Question: Surgery is indicated in Ulcerative Colitis in all except?
A. Toxic megacolon
B. Colonic polyp
C. Colonic obstruction
D. Refractory fistula
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Ulcerative Colitis
Question: Most common Morphological difference between Ulcerative Colitis and Crohn's disease:
A. Crypt abscess
B. Diffuse polyps
C. Mucosal edema
D. Lymphoid aggregates
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Ulcerative Colitis
Question: Earliest pathological change is X-ray in Ulcerative Colitis -
A. Loss of haustration
B. Aphthous ulcerattions
C. Mucosal granularity
D. Skip tensions
Correct option (0=A, 1=B, 2=C, 3=D): 2
Rare disease: Ulcerative Colitis
Question: Most common Morphological difference between Ulcerative Colitis and Crohn's disease
A. Mucosal edema
B. Crypt abscess
C. Diffuse polyps
D. Lymphoid aggregates
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Ulcerative Colitis
Question: Not a feature of Ulcerative Colitis?
A. Fine mucosal granularity
B. Pseudopolyps
C. String sign of Kantor
D. lead Pipe Appearance
Correct option (0=A, 1=B, 2=C, 3=D): 2
Rare disease: Ulcerative Colitis
Question: Ulcerative Colitis and Crohn's diseases are associated with all EXCEPT?
A. Wiskott Aldrich Syndrome
B. Turner's syndrome
C. Glycogen storage diseases Type III
D. Hermansky Pudlak Syndrome
Correct option (0=A, 1=B, 2=C, 3=D): 2
Rare disease: Ulcerative Colitis
Question: When is surgery not done in cases of Ulcerative Colitis?
A. Toxic megacolon
B. Colonic perforation
C. Colonic obstruction
D. Refractory fistula
Correct option (0=A, 1=B, 2=C, 3=D): 3
Rare disease: Ulcerative Colitis
Question: All the following Vasculitis causes necrotizing inflammation
A. Polyarteritis nodosa
B. Wegener's granulomatosis
C. Kawasaki disease
D. Microscopic polyangitis
Correct option (0=A, 1=B, 2=C, 3=D): 2
Rare disease: Vasculitis
Question: Vasculitis involving the Aoic arch is
A. Takayasu aeritis
B. Polyaeritis nodosa
C. Kawasaki disease
D. Churg-Strauss syndrome
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Vasculitis
Question: Vasculitis is seen in-a)  Burger's diseaseb)  HSPc)  Goutd)  Reiteres diseasee)  Behcets syndrome
A. abcd
B. bcde
C. acde
D. abde
Correct option (0=A, 1=B, 2=C, 3=D): 3
Rare disease: Vasculitis
Question: Which of the following is a 'Small Vessel Vasculitis':
A. Polyaeritis Nodosa (PAN)
B. Microscopic polyangitis
C. Giant cell vasculitis
D. Takayasu's Disease
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Vasculitis
Question: Vasculitis not commonly seen in adults-
A. Kawasaki disease
B. Henoch schonlein purpura
C. Temporal arteritis
D. PAN
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Vasculitis
Question: Vasculitis not commonly seen in adults
A. Kawasaki disease
B. Henoch schonlein purpura
C. Temporal aeritis
D. PAN
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Vasculitis
Question: Which of these doesn't present with granulomatous Vasculitis?
A. Polyarteritis nodosa
B. Wegeners
C. Churg strauss syndrome
D. Microscopic polyangitis
Correct option (0=A, 1=B, 2=C, 3=D): 3
Rare disease: Vasculitis
Question: A young female presents with a history of fever and nodular lesion over the shin. Histopathology reveals foamy histiocytes with neutrophilic infiltration. There is no evidence of Vasculitis. Most probable diagnosis is:
A. Sweet's Syndrome
B. Erythema nodosum
C. Erythema nodosum leprosum
D. Behcet's syndrome
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Vasculitis
Question: In Werner Syndrome, most common site of Gastrinoma is?
A. Pancreas
B. Stomach
C. Colon
D. Small Intestione
Correct option (0=A, 1=B, 2=C, 3=D): 3
Rare disease: Werner Syndrome
Question: In Werner Syndrome, the most common site of Gastrinoma is?
A. Pancreas
B. Stomach
C. Small Intestine
D. Colon
Correct option (0=A, 1=B, 2=C, 3=D): 2
Rare disease: Werner Syndrome
Question: All are true about Xeroderma Pigmentosum except
A. It is autosomal dominant inheritance
B. Due to defective DNA repair
C. Associated with squamous cell carcinoma
D. Thymine dimers
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Xeroderma Pigmentosum
Question: In Xeroderma Pigmentosum, defect is in?
A. Base pair defect
B. Nucleotide Excision Repair
C. Mismatch repair defect
D. Protein folding
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Xeroderma Pigmentosum
Question: Yaws is caused by
A. T.pallidum
B. T. Endemicum
C. T. Peenue
D. T. Carateum
Correct option (0=A, 1=B, 2=C, 3=D): 2
Rare disease: Yaws
Question: Causative agent of Yaws is?
A. Treponema pertenue
B. Treponema carateum
C. Treponema pallidum
D. Treponema endemicum
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Yaws
Question: Which of the following statements about Yaws is not TRUE?
A. Spread by sexual transmission
B. Caused by T. peenue
C. Has cross immunity with syphilis
D. Cannot be differentiated serologically from T. pallidum
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Yaws
Question: Causative agent of Yaws is:
A. Treponema peenue
B. Treponema carateum
C. Treponema pallidum
D. Treponema endemicum
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Yaws
Question: All are true about Yaws except
A. Caused by Treponema pertenue
B. Transmitted non-venerally
C. Later stages involve heart and nerves
D. Secondary Yaws can involve bones
Correct option (0=A, 1=B, 2=C, 3=D): 2
Rare disease: Yaws
Question: Which of the following is the causative agent of Yaws?
A. Treponema peenue
B. Treponema carateum
C. Treponema pallidum
D. Treponema endemicum
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Yaws
Question: Which is not true about Yaws?
A. Spread by sexual transmission
B. Caused by T. peenue
C. Has cross immunity with syphilis
D. Cannot be differentiated serologically from T. pallidum
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Yaws
Question: Yaws is caused by -
A. Treponema pallidum
B. Treponema carateum
C. Treponema refringens
D. Treponema pertenue
Correct option (0=A, 1=B, 2=C, 3=D): 3
Rare disease: Yaws
Question: Yellow Fever vaccination stas protection after how many days of injection -
A. 5 days
B. 10 days
C. 15 days
D. 20 days
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Yellow Fever
Question: Ceificate of vaccination of Yellow Fever is valid for how many years: September 2010
A. 1 year
B. 2 years
C. 5 years
D. 10 years
Correct option (0=A, 1=B, 2=C, 3=D): 3
Rare disease: Yellow Fever
Question: To prevent Yellow Fever Aedes aegypti index should be less than?
A. 0.50%
B. 1%
C. 2%
D. 5%
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Yellow Fever
Question: To prevent Yellow Fever Aedes aegypti index should be less than
A. 0.50%
B. 1%
C. 2%
D. 5%
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Yellow Fever
Question: All are true about Yellow Fever except
A. Incubation period is 3-6 days
B. Validity of Int’l certificate of Vaccination lasts up to 10 years
C. Urban form is controlled by 17 D vaccine
D. Aedes aegypti index should not be more than 10% to ensure freedom from yellow Fever
Correct option (0=A, 1=B, 2=C, 3=D): 3
Rare disease: Yellow Fever
Question: A 67-year-old man is hospitalized after several days of fever and increasing shortness of breath. Respiratory viral panel returns positive for influenza A and the patient is started on a standard five day course of oseltamivir. Despite therapy, his shortness of breath continues to worsen and his oxygen saturation decreases to the point where ICU transfer and intubation are required. Chest radiograph shows bilateral infiltrates. Clinical criteria are consistent with development of Acute Respiratory Distress Syndrome (ARDS). After several weeks of supportive therapy, the patient improves with lung function returning to near normal. Which of the following processes is involved in the regeneration of alveolar lining after damage to alveoli occurs?
A. Squamous cell proliferation.
B. Sweeping of debris out of the alveoli by ciliated cells.
C. Excess mucus production by goblet cells.
D. Proliferation of surfactant-secreting cells.
Correct option (0=A, 1=B, 2=C, 3=D): 3
Rare disease: Acute Respiratory Distress Syndrome
Question: A newlywed couple comes to your office for genetic counseling. Both potential parents are known to be carriers of the same Cystic Fibrosis (CF) mutation. What is the probability that at least one of their next three children will have CF if they are all single births?
A. 0.
B. 1/64.
C. 27/64.
D. 37/64.
Correct option (0=A, 1=B, 2=C, 3=D): 3
Rare disease: Cystic Fibrosis
Question: Two days after delivery, a 4300-g (9-lb 8-oz) newborn has difficulty feeding and has become increasingly lethargic. His cry has become weak. He was born at term. His mother has a history of intravenous drug use. His temperature is 36.4°C (96.5°F), pulse is 170/min, respirations are 62/min, and blood pressure is 70/48 mm Hg. Examination shows midfacial hypoplasia, diaphoresis, and tremor of the lower extremities. Macroglossia is present. There are folds in the posterior auricular cartilage. The left lower extremity is larger than the right lower extremity. Abdominal examination shows an umbilical hernia. The liver is palpated 4 cm below the right costal margin. Neurological examination shows decreased tone in all extremities. Which of the following is the most appropriate intervention?
A. Administer thyroxine.
B. Administer 3% saline.
C. Administer glucose.
D. Administer ampicillin and gentamicin.
Correct option (0=A, 1=B, 2=C, 3=D): 2
Rare disease: Macroglossia
Question: A 27-year-old G3P2002 presents to the clinic for follow up after her initial prenatal visit. Her last period was 8 weeks ago. Her medical history is notable for obesity, hypertension, type 2 diabetes, and eczema. Her current two children are healthy. Her current pregnancy is with a new partner after she separated from her previous partner. Her vaccinations are up to date since the delivery of her second child. Her temperature is 98°F (37°C), blood pressure is 110/60 mmHg, pulse is 85/min, and respirations are 18/min. Her physical exam is unremarkable. Laboratory results are shown below:

Hemoglobin: 14 g/dL
Hematocrit: 41%
Leukocyte count: 9,000/mm^3 with normal differential
Platelet count: 210,000/mm^3

Blood type: O
Rh status: Negative

Urine:
Epithelial cells: Rare
Glucose: Positive
WBC: 5/hpf
Bacterial: None

Rapid plasma reagin: Negative
Rubella titer: > 1:8
HIV-1/HIV-2 antibody screen: Negative

Gonorrhea and Chlamydia NAAT: negative
Pap smear: High-grade squamous intraepithelial lesion (HGSIL)

What is the best next step in management?
A. Colposcopy and biopsy after delivery.
B. Colposcopy and biopsy now.
C. Cryosurgical excision.
D. Loop electrosurgical excision procedure (LEEP).
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Rubella
Question: A 22-year-old gravida 1 presents to her physician at 15 weeks gestation for a prenatal appointment. She complains of a rash involving her chest, face, and arms, a watery nasal discharge, and mild bilateral knee pain. She has had these symptoms for about 5 days. The symptoms do not seem to bother her too much, but she is concerned for the baby. She had contact with her younger sister, who also had a rash and was diagnosed with rubella infection about 10 days ago at a family gathering. She cannot confirm her vaccination history. Her vital signs are as follows: blood pressure, 110/70 mmHg; heart rate, 89/min; respiratory rate, 12/min; and temperature, 37.6℃ (99.7℉). Examination shows a moderately dense maculopapular lacy rash spread over the patient’s trunk, extremities, and face. No lymph node, liver, or spleen enlargement is noted. The knee joints appear normal.
Serology performed 1 year ago Current serology
Rubella IgM - negative Rubella IgM - negative
Rubella IgG - 1:128 Rubella IgG - 1:64
Rubella IgG avidity - high Rubella IgG avidity - high
What is the proper next step in the management of this woman?
A. Reassure and recommend vaccination against rubella postpartum.
B. Recommend pregnancy termination.
C. Arrange a chorionic villus sampling.
D. Recommend additional serologic testing for parvovirus B19.
Correct option (0=A, 1=B, 2=C, 3=D): 3
Rare disease: Rubella
Question: A 23-year-old woman, gravida 2, para 1, at 20 weeks of gestation comes to the physician for a routine prenatal exam. Her last pregnancy was unremarkable and she gave birth to a healthy rhesus (RhD) positive girl. Her past medical history is notable for a blood transfusion after a car accident with a complex femur fracture about 3 years ago. Her temperature is 37.2°C (99°F), pulse is 92/min, and blood pressure is 138/82 mm Hg. Examination shows that the uterus is at the umbilicus. Ultrasound examination reveals normal fetal heart rate, movement, and anatomy. Routine prenatal labs show the following:
Blood type A Rh-
Leukocyte count 11,000/mm3
Hemoglobin 12.5 g/dL
Platelet count 345,000/mm3
Serum
Anti-D antibody screen Negative
Rubella IgM Negative
Rubella IgG Negative
Varicella IgM Negative
Varicella IgG Positive
STD panel Negative
Urine
Protein Trace
Culture No growth
Cervical cytology Normal
Which of the following is the best next step in management of this patient?"
A. Administer anti-D immunoglobulin now and repeat antibody screening shortly before delivery..
B. Repeat antibody screening at 28 weeks. Administer anti-D immunoglobulin at 28 weeks and after delivery if the newborn is Rh(D) positive..
C. Repeat antibody screening at 28 weeks and administer anti-D immunoglobulin at 28 weeks. No further management is needed..
D. No further screening is needed. Administer anti-D immunoglobulin shortly after delivery.
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Rubella
Question: An infectious disease investigator is evaluating the diagnostic accuracy of a new interferon-gamma-based assay for diagnosing tuberculosis in patients who have previously received a Bacillus Calmette-Guérin (BCG) vaccine. Consenting participants with a history of BCG vaccination received an interferon-gamma assay and were subsequently evaluated for tuberculosis by sputum culture. Results of the study are summarized in the table below.
Tuberculosis, confirmed by culture No tuberculosis Total
Positive interferon-gamma assay 90 6 96
Negative interferon-gamma assay 10 194 204
Total 100 200 300
Based on these results, what is the sensitivity of the interferon-gamma-based assay for the diagnosis of tuberculosis in this study?"
A. 194/200.
B. 90/100.
C. 90/96.
D. 100/300.
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Tuberculosis
Question: Acute Myeloid Leukemia is a malignant cancer in which myeloid progenitor cells become rapidly dividing and retain their semi-stem cell state. Under normal circumstances, which of the following cell types would arise from this stem cell?? 
A. NK cell
B. Platelet
C. T cell
D. Lymphoid progenitor
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Acute Myeloid Leukemia
Question: Chikungunya has spread widely from Asia and Africa into the Caribbean in recent years. This has been mainly facilitated by:? 
A. Mutation in the virus allowing replication in the mosquito Aedes albopictus
B. Air Travel
C. Climate change
D. Poor mosquito control and the absence of DTT
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Chikungunya
Question: Measles has been controlled in many countries by which of the following?? 
A. By hygiene
B. By MMR vaccine
C. By new molecular peptide vaccines
D. By humanised monoclonal antibodies to F protein
Correct option (0=A, 1=B, 2=C, 3=D): 1
Rare disease: Measles
Question: Ulcerative Colitis
? 
A. Carries a risk of colonic cancer
B. Can be treated with a LOFFLEX diet
C. Can be caused by small intestinal bacterial overgrowth
D. Can be caused by milk intolerance
Correct option (0=A, 1=B, 2=C, 3=D): 0
Rare disease: Ulcerative Colitis