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1811 Unknown

A 40-year-old man, a known case of diabetes and on medication for the past 10 years comes to OPD with a history of abdominal pain, weakness, lightheadedness, palpitations and shoness of breath. On examination, glossitis along with hyperpigmentation of skin of dorsum of hands and feet and abnormal pigmentation of hair was observed. The family of the patient told that they have observed frequent episodes of increased irritability from the past 1 year. Given below are the laboratory findings and the peripheral blood smear. Later bone marrow aspiration was also done. Hb: 9gm% MCV: 110fl MCH: 36Pg MCHC: 34gm/dl Reticulocyte count: 0.1 x 10^9/L LDH: 600 U/L Indirect bilirubin: 1 mg/dL S. iron: Normal S. Ferritin: Normal WBC: 2 x 10^9/L Platelet count: 90 x 10^9/L PERIPHERAL BLOOD SMEAR BONE MARROW ASPIRATION Which of the following drugs is most likely the person is taking: –

AMetformin
BPioglitazone
CVildagliptin
DExenatide
Unknown
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1817 Unknown

A 8-yrs-old child has a history since early childhood of malabsorption, ataxia, acanthocytes in the peripheral blood, and very low cholesterol and triglyceride levels. In addition, the patient has been developing progressive, bilateral, concentric contraction of the visual fields and loss of central vision. The underlying pathogenesis of this patient’s disease is:

AA degenerative disease involving the cerebellum
BA defect in the synthesis of apolipoprotein B
CDegeneration of the posterior columns, spinocerebellar tracts, and corticospinal tracts
DAn absence of high-density lipoproteins
Unknown
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