Internal Medicine Videos & books

Bromsulphalein test (BSP) is the diagnostic test for Dubin-Johnson Syndrome. Biliary
excretion of numerous anionic compounds such as Bromsulphalein (BSP) is compromised
in Dubin-Johnson Syndrome (DJS). In this test, BSP is administered as IV bolus and its
clearance from plasma is determined. BSP levels show a characteristic rise in patients with
DJS after 90 minutes of injection, due to reflux of conjugated BSP into the circulation from
the hepatocyte.
Ref: Davidson's principles and practice of Medicine, 20th Edition, Chapter 23, Page
945; Harrison's Principles of Internal Medicine, 16th Edition, Page 1821; Digestive
Diseases and Sciences Vol/17 numbers 6.

orrect Answer -C
The definitive diagnosis of PNH is based on the demonstration that a
substantial proportion of the patient's red cells have an increased
susceptibility to complement (C), due to the deficiency on their
surface of proteins (particularly CD59 and CD55).
Reference: Harrisons Principles of Internal Medicine, 18th Edition,
Page 884

Correct Answer-D
Leukoerythroblastosis refers to the presence of immature nucleated RBCs, immature white
blood cells, and megakaryocyte fragments on the peripheral blood smear. It occur due to
bone marrow infiltration.


When marrow infiltration causes anemia or pancytopenia, it is referred to as
myelophthisic anemia. The most common cause of myelophthisis includes metastatic
carcinoma of the lung, breast, or prostate. Other causes include hematologic malignancies
(leukemia, lymphoma), infections (tuberculosis, fungi), and metabolic diseases (Gaucher
disease, Niemann-Pick disease). Thalassemia is not associated with leukoerythroblastosis.


Ref: CURRENT Diagnosis & Treatment in Family Medicine, 3rd Edition, Chapter 31

Correct Answer -C
The choking lessens the rate of spread of shot after it leaves the
muzzle, increases the explosive force and increases the velocity
Shotguns have variable choke adapters.
Different degrees are known as full-choke, half-choke and
quarter-choke or improved cylinder.
Ref: The Essentials of Forensic Medicine and Toxicology by K S
Reddy, 27th edition, Page 184

Correct Answer - B
Amongst the options provided, gastrinomas are the most common enteropancreatic tumors
associated with MEN I with insulinomas being the second most common.
Ref: Harrison's Principles of Internal Medicine, 17th Edition, Page 2358 & 2359; 16th/
2232; Davidson's principles and practice of Medicine, 20th Edition, Chapter 20, Page 803

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