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MEDICINE HUBs

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May 23, 2026, 07:46 AM

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May 23, 2026, 07:46 AM

132. Explanation

Correct Answer - C
Answer is C (Reactive Arthritis):
Keratoderma Blenorrhagica is the charachteristic skin lesion seen in
patients with Reactive Arthritis.
'The charachteristic skin lesions in Reactive Arthritis, Keratoderma
Blenorrha2ica, consist of vesicles that become hyperkeratotic,
ultimately forming a crust before disappearing. In patients with HIV
infection, these lesions are often extremely severe and extensive
sometimes dominating the clinical picture '-

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May 23, 2026, 07:46 AM

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May 23, 2026, 07:46 AM

133. Explanation

Correct Answer - D
Answer is D (Desferrioromine is treatment of choice):
The therapy of hematochromatosis involves removal of excess body
iron.
Iron removal is best achieved by periodic phlebotomies which is the
treatment of choice for Hematochromosis.
Chelating agents like desferoxamine are less effective and indicated
when anemia or hypoproteinemia is severe enough to preclude
phlebotomy.
Chelating agents are not the treatment of choice for Hematochromatosis

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May 23, 2026, 07:46 AM

130. Explanation

Correct Answer - B
Answer is B (SLE):
Bilateral parotid enlargement is not a feature of SLE.

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May 23, 2026, 07:46 AM

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May 23, 2026, 07:46 AM

131. Explanation

Correct Answer - D
Answer is D (Sarcoidosis):
Pernio is a typical cutaneous manifestation of Sarcoidosis.
Lupus Pernio is the most typical and easily recognizable skin lesions
of Sarcoidosis. It is characterized by the presence of violaceous,
purple blue shiny swollen lesions over the bridge of nose, beneath
the eyes and over the cheeks. This specific complex of involvement
of the bridge of nose, the area beneath the eyes and the cheeks is
considered diagnostic for a chronic form of Sarcoidosis.

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May 23, 2026, 07:46 AM

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May 23, 2026, 07:46 AM

129. Explanation

Correct Answer - D
Answer is D (Antihistone Antibodies):
The most commonly used marker for drug induced lupus is
Antihistone Antibodies.
Drug Induced Lupus is characterized serologically by the presence
of Anti-Histone Antibodies and the absence of antibodies against
double stranded DNA (dsDNA Antibody Negative; Anti-Histone
Antibody Positive). Anti-dsDNA
Serology in Drug Induced Lupus Erythematosus
Almost all patients with Drug Induced Lupus will test positive for
Antinuclear Antibodies (Positive ANA Test)
The spectrum of Antinuclear antibodies in Drug Induced Lupus
includes
Positive Antihistone antibodies (most common; not specific; also
seen in SLE)
Positive autoantibodies against single stranded DNA (common ; not
specific; also seen in SLE)
Negative (absence of) autoantibodies against double stranded
DNA(dsDNA)
The presence of autoantibodies against dsDNA strongly suggests a
diagnosis of SLE
Drug Induced Lupus is typically associated with a HomogeneousANA pattern due to the presence of Antihistone Antibodies
Antibodies are seen in less than 5 percent of patients with Drug
Induced Lupus
The presence of Antihistone antibodies alone is not a specific test
for diagnosis of Drug Induced Lupus as Antibodies to histones may
also be seen in up to 50 to 80 percent of patients with idiopathic
SLE.
Note : Hypocomplementemia is uncommon in Drug Induced Lupus
but not in SLE.

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May 23, 2026, 07:46 AM

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May 2, 2026, 01:10 AM

134. Explanation

Correct Answer - D
Answer is D (Polyarteritis nodosa)
Amongst the options provided renal artery stenosis is least likely to
be seen in association with Polyarteritis nodosa.
Atherosclerosis and Fibromuscular disease
- Renal artery stenosis is produced predominantly by
atherosclerotic occlusive disease (80% to 90% of patients) or
tibromuscular dysplasia (10-15% of patients).- CMDT'06 p 460
- he common cause of renal artery stenosis in the middle aged and
elderly is an atheromatous plaque at origin of renal artery. Harrison
- In younger women stenosis is due to intrinsic structural
abnormalities of the arterial wall caused by a heterogenous group of
lesions called 'fibromuscular dysplasia'. - Harrison 16`" /1707
PAN or Takayasu arteritis ?
CMDT do not mention PAN or Takayasu arteritis as a cause for
renal artery stenosis.
However, Takayasu arteritis is certainly a more common cause of
renal artery stenosis than PAN.
Takayasu arteritis (Aorto-arteritis) is beleiveds to be the most
common of renovascular hypertension in India and China. –
Diseases of Kidney and Urinary Tract 8th/1279
A number of research publications, however show Takayasu arteritis as a cause for renal artery stenosis.
PAN
Although renal involvement is seen in upto 60% of patients with PAN
its pathology does not involve renal artery stenosis.
The pathology involves arteritis without glomerulonephritis and is
characterised by aneurysms of small and medium sized arteries.
Stenosis of main renal artery is an unusual association'.
Causes of Renal artery stenosis :
1. Atherosclerosis
2. Fibromuscular dysplasia
3. Non specific Aorto arteritis
4. Takayasu arteritis and giant cell arteritis (Takayasu > Giant cell)
5. Antiphospholipid syndrome
6. Transplant renal artery stenosis
7. Renal artery embolism
8. Dissecting aneurysm of aorta
9. Radiation arteritis

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