Renal Disorders, Endocrine Disorders, Sexually Transmitted Diseases, and Cancer. GPAT/NIPER, AIIMS Pharmacist, Railway Pharmacist, SSC, ESIC, and State Pharmacist examinations level MCQs with Explanations

Revision notes for quick recall before attempting MCQs

Quick Revision Notes for Competitive Examinations

1. Acute Kidney Injury (Acute Renal Failure)

• Sudden decline in kidney function occurring over hours to days.

• Characterized by increased serum creatinine and reduced urine output.

• Causes are remembered as pre-renal, renal, and post-renal.

  • Prerenal: Reduced blood flow to kidneys (dehydration, shock).

  • Renal: Damage to kidney tissue (acute tubular necrosis, nephritis).

  • Post-renal: Obstruction to urine flow (stones, enlarged prostate).

• Common complications: hyperkalemia, metabolic acidosis, fluid overload.

Memory Tip:
"PRP = Perfusion, renal tissue, and passage blockage."

2. Chronic Kidney Disease (Chronic Renal Failure)

• Progressive and irreversible loss of nephron function for more than 3 months.

• Most common causes:

  1. Diabetes mellitus

  2. Hypertension

• Major complications:

  • Anemia (↓ erythropoietin)

  • Bone disease (↓ Vitamin D activation)

  • Hyperkalemia

  • Metabolic acidosis

Memory Tip:
"Kidney fails slowly: Blood, Bone, and Blood Pressure suffer."

3. Urinary Tract Infection

• Infection anywhere in the urinary tract.

• Most common organism: Escherichia coli.

• Symptoms:

  • Dysuria

  • Frequency

  • Urgency

  • Suprapubic pain

• Kidney involvement causes pyelonephritis with fever and flank pain.

Memory Tip:
"3 Fs of UTI: Frequency, Fever, Flank pain."

4. Diabetes Mellitus

• Chronic disorder characterized by hyperglycemia.

• Type 1: Autoimmune destruction of pancreatic beta cells.

• Type 2: Insulin resistance with relative insulin deficiency.

Classical symptoms:

• Polyuria

• Polydipsia

• Polyphagia

Memory Tip:
"Three Ps = Pee more, Drink more, Eat more."

Important complications:

• Retinopathy

• Nephropathy

• Neuropathy

Exam Pearl:
HbA1c reflects average blood glucose over approximately 3 months.

5. Hypothyroidism

• Deficiency of thyroid hormones.

• Common features:

  • Weight gain

  • Cold intolerance

  • Constipation

  • Bradycardia

  • Fatigue

Memory Tip:
"Everything becomes SLOW in hypothyroidism."

6. Hyperthyroidism

• Excess production of thyroid hormones.

• Common features:

  • Weight loss

  • Heat intolerance

  • Tachycardia

  • Tremors

  • Anxiety

Memory Tip:
"Everything becomes FAST in hyperthyroidism."

7. Goiter

• Enlargement of the thyroid gland.

• Most common worldwide cause: iodine deficiency.

• May occur with normal, low, or high thyroid hormone levels.

Memory Tip:
"Goiter = Growth of thyroid size."

8. Polycystic Ovary Syndrome

• Common endocrine disorder in women of reproductive age.

• Features:

  • Irregular menstruation

  • Hyperandrogenism

  • Multiple ovarian cysts

  • Infertility

Memory Tip:
"PCOS = Period problems + Cysts + Obesity + Hair growth."

Exam Point:
An increased LH:FSH ratio is commonly observed.

9. Human Immunodeficiency Virus Infection and AIDS

• Caused by Human Immunodeficiency Virus (HIV).

• Virus attacks CD4+ T lymphocytes leading to immunodeficiency.

• Major routes of transmission:

  • Sexual contact

  • Blood transfusion

  • Needle sharing

  • Mother to child

Memory Tip:
"HIV attacks the body's COMMANDER cells — CD4 cells."

10. Syphilis

• Caused by Treponema pallidum.

• Disease progresses in stages:

  1. Primary — painless chancre.

  2. Secondary — rash and systemic symptoms.

  3. Tertiary — cardiovascular and neurological involvement.

Memory Tip:
"Syphilis starts with a sore and may end with the heart and brain."

11. Gonorrhea

• Caused by Neisseria gonorrhoeae.

• Produces urethritis with purulent discharge and dysuria.

• Organism is a Gram-negative intracellular diplococcus.

Memory Tip:
"GONO = Gonococcus causes Gonorrhea."

12. Cancer: Etiology and Pathogenesis

• Cancer is uncontrolled and abnormal cell proliferation.

• Development involves:

  1. Initiation

  2. Promotion

  3. Progression

Important terms:

• Oncogenes: Promote cell growth.

• Tumor suppressor genes: Inhibit cell growth.

• Metastasis: Spread of cancer to distant sites.

• Angiogenesis: Formation of new blood vessels to feed tumors.

Memory Tip:
"Cancer survives by Growing, Spreading, and Feeding."

High-Yield Facts:

• p53 = "Guardian of the Genome."

• RB gene controls the G1-S checkpoint.

• VEGF promotes angiogenesis.

• Bcl-2 inhibits apoptosis.

Exam Points:
The two most frequently tested cancer concepts in GPAT and NIPER are p53 mutation and angiogenesis mediated by VEGF.

MCQs

1. Acute renal failure is currently referred to as
A. Chronic kidney disease
B. Acute kidney injury
C. Nephrotic syndrome
D. Glomerulonephritis

Answer: B

2. The most common cause of prerenal acute kidney injury is:
A. Urinary obstruction
B. Glomerulonephritis
C. Reduced renal perfusion
D. Nephrotoxic drugs

Answer: C

3. Which of the following is a postrenal cause of renal failure?
A. Severe dehydration
B. Acute tubular necrosis
C. Ureteric obstruction
D. Septic shock

Answer: C

4. The hallmark laboratory finding in chronic renal failure is:
A. Hypoglycemia
B. Elevated serum creatinine
C. Decreased blood urea
D. Hypercalcemia

Answer: B

5. The major pathological feature of chronic kidney disease is:
A. Reversible nephron injury
B. Progressive nephron loss and fibrosis
C. Increased erythropoietin production
D. Increased glomerular filtration rate

Answer: B

6. The most common causative organism of urinary tract infection is:
A. Staphylococcus aureus
B. Pseudomonas aeruginosa
C. Escherichia coli
D. Klebsiella pneumoniae

Answer: C

7. Painful urination is medically termed as
A. Hematuria
B. Dysuria
C. Polyuria
D. Oliguria

Answer: B

8. Infection involving the kidney parenchyma is called
A. Cystitis
B. Urethritis
C. Pyelonephritis
D. Nephrosis

Answer: C

9. Type 1 diabetes mellitus primarily results from:
A. Insulin resistance
B. Autoimmune destruction of beta cells
C. Excess glucagon secretion
D. Excess cortisol secretion

Answer: B

10. The classical triad of diabetes mellitus includes:
A. Polyuria, polydipsia, polyphagia
B. Bradycardia, edema, cyanosis
C. Fever, cough, dyspnea
D. Hematuria, dysuria, oliguria

Answer: A

11. The major defect in Type 2 diabetes mellitus is:
A. Autoimmune beta-cell destruction
B. Insulin resistance
C. Lack of glucagon
D. Excess thyroid hormone

Answer: B

12. Glycosylated hemoglobin used for long-term monitoring of diabetes is:
A. HbA1c
B. HbF
C. HbS
D. HbA2

Answer: A

13. The most common cause of hypothyroidism in iodine-sufficient regions is:
A. Graves' disease
B. Hashimoto thyroiditis
C. Pituitary adenoma
D. Thyroid carcinoma

Answer: B

14. Which symptom is commonly associated with hypothyroidism?
A. Weight loss
B. Heat intolerance
C. Bradycardia
D. Tremors

Answer: C

15. Graves' disease is a common cause of:
A. Hypothyroidism
B. Hyperthyroidism
C. Diabetes mellitus
D. Addison disease

Answer: B

16. Exophthalmos is characteristically seen in:
A. Hashimoto thyroiditis
B. Graves disease
C. Thyroid adenoma
D. Cretinism

Answer: B

17. The most common cause of endemic goiter worldwide is:
A. Selenium deficiency
B. Vitamin D deficiency
C. Iodine deficiency
D. Iron deficiency

Answer: C

18. Enlargement of the thyroid gland is termed:
A. Thyrotoxicosis
B. Goiter
C. Myxedema
D. Thyroiditis

Answer: B

19. PCOS is commonly associated with:
A. Hypoglycemia
B. Hyperandrogenism
C. Hypercalcemia
D. Hypotension

Answer: B

20. A characteristic ovarian finding in PCOS is:
A. Ovarian atrophy
B. Multiple immature follicles
C. Ovarian abscess
D. Corpus luteum cyst only

Answer: B

21. Which hormone is typically elevated in PCOS?
A. Testosterone
B. Aldosterone
C. Calcitonin
D. ADH

Answer: A

22. AIDS is caused by:
A. HBV
B. HIV
C. HPV
D. HCV

Answer: B

23. HIV primarily infects which cells?
A. Neutrophils
B. Eosinophils
C. CD4+ T lymphocytes
D. Platelets

Answer: C

24. The most common route of HIV transmission worldwide is:
A. Airborne spread
B. Sexual contact
C. Mosquito bite
D. Food contamination

Answer: B

25. Syphilis is caused by:
A. Neisseria gonorrhoeae
B. Treponema pallidum
C. Chlamydia trachomatis
D. Candida albicans

Answer: B

26. The primary lesion of syphilis is known as:
A. Chancre
B. Gumma
C. Papule
D. Vesicle

Answer: A

27. Gonorrhea is caused by:
A. Treponema pallidum
B. Neisseria gonorrhoeae
C. HIV
D. Herpes simplex virus

Answer: B

28. The typical microscopic appearance of Neisseria gonorrhoeae is:
A. Gram-positive cocci
B. Gram-negative diplococci
C. Gram-positive bacilli
D. Acid-fast bacilli

Answer: B

29. The uncontrolled proliferation of cells is known as:
A. Hyperplasia
B. Metaplasia
C. Neoplasia
D. Dysplasia

Answer: C

30. Genes that promote cell growth and may lead to cancer when mutated are called:
A. Tumor suppressor genes
B. Proto-oncogenes
C. Housekeeping genes
D. Repair genes

Answer: B

31. The tumor suppressor gene commonly called the "guardian of the genome" is:
A. BRCA1
B. APC
C. p53
D. MYC

Answer: C

32. Which virus is strongly associated with carcinoma of the cervix?
A. HIV
B. HBV
C. HPV
D. EBV

Answer: C

33. Tobacco smoking is a major risk factor for:
A. Cataract
B. Lung cancer
C. Peptic ulcer
D. Appendicitis

Answer: B

34. "Metastasis" refers to
A. Local inflammation
B. Spread of malignant cells to distant sites
C. Benign tumor formation
D. Tissue regeneration

Answer: B

35. The process by which new blood vessels are formed to support tumor growth is called:
A. Apoptosis
B. Angiogenesis
C. Necrosis
D. Fibrosis

Answer: B

36. Which of the following is NOT a complication of chronic renal failure?
A. Anemia
B. Hyperkalemia
C. Osteodystrophy
D. Polycythemia

Answer: D

37. The earliest pathological event in diabetic nephropathy is:
A. Tubular necrosis
B. Glomerular hyperfiltration
C. Ureteric obstruction
D. Renal infarction

Answer: B

38. Heat intolerance, tachycardia, and weight loss are characteristic of:
A. Hypothyroidism
B. Hyperthyroidism
C. Addison disease
D. Cushing syndrome

Answer: B

39. Opportunistic infections in AIDS occur mainly due to reduction in:
A. RBC count
B. Platelet count
C. CD4+ T cells
D. Neutrophils

Answer: C

40. The ability of cancer cells to invade surrounding tissues is primarily due to:
A. Increased insulin secretion
B. Loss of cell adhesion molecules
C. Increased hemoglobin synthesis
D. Reduced angiogenesis

Answer: B

41. Which mediator plays the most important role in the reduction of GFR during prerenal acute kidney injury?
A. Nitric oxide
B. Prostaglandins
C. Angiotensin II
D. Bradykinin

Answer: C
Explanation: Angiotensin II constricts efferent arterioles to maintain GFR during reduced renal perfusion.

42. Acute tubular necrosis is most commonly associated with injury to:
A. Distal convoluted tubule
B. Collecting duct
C. Proximal tubule and thick ascending limb
D. Bowman capsule

Answer: C
Explanation: These segments have high metabolic activity and are particularly susceptible to ischemia.

43. Muddy brown granular casts are characteristic of:
A. Glomerulonephritis
B. Nephrotic syndrome
C. Acute tubular necrosis
D. Pyelonephritis

Answer: C
Explanation: Granular casts are classical findings in acute tubular necrosis.

44. The most common cause of chronic kidney disease worldwide is:
A. Hypertension
B. Diabetes mellitus
C. Polycystic kidney disease
D. Glomerulonephritis

Answer: B
Explanation: Diabetic nephropathy is the leading cause of CKD globally.

45. Secondary hyperparathyroidism in CKD occurs primarily because of:
A. Hypercalcemia
B. Increased vitamin D activation
C. Hyperphosphatemia and hypocalcemia
D. Increased calcitonin secretion

Answer: C
Explanation: Reduced phosphate excretion and decreased vitamin D activation stimulate PTH release.

46. Which organism is most commonly responsible for recurrent UTI in women?
A. Proteus mirabilis
B. Escherichia coli with P fimbriae
C. Enterococcus faecalis
D. Staphylococcus epidermidis

Answer: B
Explanation: P fimbriae facilitate adherence to uroepithelial cells.

47. Urease production leading to struvite stone formation is characteristic of:
A. E. coli
B. Klebsiella
C. Proteus mirabilis
D. Enterococcus

Answer: C
Explanation: Urease raises urinary pH and promotes magnesium ammonium phosphate stone formation.

48. Vesicoureteral reflux predisposes primarily to:
A. Cystitis
B. Urethritis
C. Pyelonephritis
D. Nephrotic syndrome

Answer: C

49. The strongest genetic association with Type 1 diabetes is with:
A. HLA-B27
B. HLA-DR3 and HLA-DR4
C. HLA-B51
D. HLA-A3

Answer: B

50. Which autoantibody is commonly detected in Type 1 diabetes mellitus?
A. Anti-TPO antibody
B. Anti-dsDNA antibody
C. Anti-GAD antibody
D. Anti-CCP antibody

Answer: C

51. Hyperosmolar hyperglycemic state differs from diabetic ketoacidosis by the absence of significant:
A. Hyperglycemia
B. Dehydration
C. Ketosis
D. Hypernatremia

Answer: C

52. Diabetic microangiopathy results primarily from:
A. Lipid deposition
B. Nonenzymatic glycosylation of proteins
C. Autoimmune vasculitis
D. Increased glucagon levels

Answer: B

53. Kimmelstiel-Wilson lesions are characteristic of:
A. Acute pyelonephritis
B. Diabetic nephropathy
C. Lupus nephritis
D. Amyloidosis

Answer: B

54. The earliest detectable abnormality in diabetic nephropathy is:
A. Elevated serum creatinine
B. Proteinuria
C. Microalbuminuria
D. Hematuria

Answer: C

55. Graves' disease is classified as
A. Type I hypersensitivity
B. Type II hypersensitivity
C. Type III hypersensitivity
D. Type IV hypersensitivity

Answer: B

56. Thyroid storm is characterized by all except:
A. Hyperthermia
B. Tachycardia
C. Bradycardia
D. Delirium

Answer: C

57. The most common cause of hypothyroidism worldwide is:
A. Graves' disease
B. Hashimoto thyroiditis
C. Iodine deficiency
D. Pituitary adenoma

Answer: C

58. The most common cause of hypothyroidism in developed countries is:
A. Iodine deficiency
B. Hashimoto thyroiditis
C. Pituitary failure
D. Thyroid carcinoma

Answer: B

59. Which histological finding is characteristic of Hashimoto thyroiditis?
A. Psammoma bodies
B. Orphan Annie nuclei
C. Hurthle cells
D. Reed-Sternberg cells

Answer: C

60. Exophthalmos in Graves' disease occurs due to:
A. Increased TSH levels
B. Orbital fibroblast stimulation
C. Orbital infection
D. Pituitary enlargement

Answer: B

61. Endemic goiter is usually associated with a deficiency of
A. Zinc
B. Selenium
C. Iodine
D. Copper

Answer: C

62. Elevated LH:FSH ratio is commonly seen in:
A. Cushing syndrome
B. PCOS
C. Addison disease
D. Hyperprolactinemia

Answer: B

63. Insulin resistance contributes to PCOS by increasing ovarian production of:
A. Progesterone
B. Estrogen
C. Androgens
D. Prolactin

Answer: C

64. Which ultrasound appearance is typical of PCOS?
A. Honeycomb ovary
B. String of pearls appearance
C. Ground-glass ovary
D. Starry sky appearance

Answer: B

65. HIV primarily binds to which receptor?
A. CD8
B. CD4
C. CD19
D. CD34

Answer: B

66. The co-receptor commonly used by macrophage-tropic HIV strains is:
A. CXCR4
B. CCR5
C. CD28
D. ICAM-1

Answer: B

67. Which HIV enzyme converts viral RNA into DNA?
A. Integrase
B. Protease
C. Reverse transcriptase
D. Polymerase III

Answer: C

68. Kaposi sarcoma in AIDS is associated with infection by:
A. EBV
B. HPV
C. HHV-8
D. CMV

Answer: C

69. Pneumocystis jirovecii pneumonia generally occurs when the CD4 count falls below
A. 800 cells/mm³
B. 500 cells/mm³
C. 200 cells/mm³
D. 1000 cells/mm³

Answer: C

70. The diagnostic test commonly used for screening syphilis is:
A. FTA-ABS
B. VDRL
C. ELISA
D. PCR

Answer: B

71. The confirmatory test for syphilis is:
A. ESR
B. VDRL
C. FTA-ABS
D. Gram stain

Answer: C

72. Tertiary syphilis commonly affects:
A. Skin only
B. CNS and cardiovascular system
C. Liver only
D. Lungs only

Answer: B

73. Gonococci are best described as:
A. Gram-positive cocci in chains
B. Gram-negative intracellular diplococci
C. Acid-fast bacilli
D. Gram-positive rods

Answer: B

74. Which virulence factor helps Neisseria gonorrhoeae attach to mucosal cells?
A. Capsule
B. Pili
C. Flagella
D. Endospores

Answer: B

75. Mutation of which gene is most commonly associated with retinoblastoma?
A. BRCA1
B. APC
C. RB gene
D. MYC

Answer: C

76. The hallmark of malignant transformation is:
A. Hypertrophy
B. Loss of growth regulation
C. Atrophy
D. Hyperplasia alone

Answer: B

77. Which oncogene encodes a transcription factor?
A. RAS
B. MYC
C. ERBB2
D. ABL

Answer: B

78. The Philadelphia chromosome results from:
A. t(8; 14)
B. t(9;22)
C. t(11;14)
D. t(15;17)

Answer: B

79. Chronic myeloid leukemia is associated with activation of:
A. HER2
B. BCR-ABL tyrosine kinase
C. EGFR
D. VEGF

Answer: B

80. BRCA1 mutation significantly increases the risk of:
A. Liver cancer
B. Breast and ovarian cancer
C. Thyroid cancer
D. Brain tumors

Answer: B

81. Loss of E-cadherin expression promotes
A. Apoptosis
B. Metastasis
C. Angiogenesis inhibition
D. DNA repair

Answer: B

82. Tumor angiogenesis is primarily mediated by:
A. TNF-α
B. IL-1
C. VEGF
D. Histamine

Answer: C

83. Which carcinogen is strongly associated with hepatocellular carcinoma?
A. Benzene
B. Aflatoxin B1
C. Asbestos
D. Silica

Answer: B

84. Mesothelioma is classically associated with exposure to:
A. Coal dust
B. Silica
C. Asbestos
D. Cotton dust

Answer: C

85. Which DNA repair defect is associated with xeroderma pigmentosum?
A. Base excision repair defect
B. Mismatch repair defect
C. Nucleotide excision repair defect
D. Double-strand repair defect

Answer: C

86. The most common mechanism of activation of proto-oncogenes is:
A. Deletion
B. Point mutation
C. Hypermethylation
D. Histone deacetylation

Answer: B

87. Which tumor suppressor gene regulates the G1-S checkpoint?
A. RB
B. MYC
C. RAS
D. HER2

Answer: A

88. The ability of cancer cells to evade apoptosis is often mediated through overexpression of:
A. Bax
B. Caspase-3
C. Bcl-2
D. p53

Answer: C

89. Warburg effect refers to:
A. Increased fatty acid oxidation in tumors
B. Preference for aerobic glycolysis in cancer cells
C. Increased ketogenesis
D. Increased gluconeogenesis

Answer: B

90. Which of the following is considered a hallmark of cancer according to Hanahan and Weinberg?
A. Increased erythropoiesis
B. Sustained proliferative signaling
C. Increased bile production
D. Increased insulin sensitivity

Answer: B
Explanation: Sustained proliferative signaling is one of the fundamental hallmarks of cancer cells.

Dr. Alok Singh