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Question 1
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A 38-year-old male complained of painless, right sided testicular enlargement for 4 months. The size has been gradually increasing. On examination, there was no tenderness or redness. It was firm in consistency and not transilluminating. The most likely diagnosis is?
Your Answer: Testicular tumour
Explanation:History is suggestive of testicular tumour due to the gradual onset, non tender, firm mass. Hydroceles transiluminate and a varicocele has a bag of worms texture. Epididymo-orchitis is tender and often red or inflamed. An ependymal cyst is confined to the epididymis.
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This question is part of the following fields:
- Men's Health
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Question 2
Incorrect
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A 60-year-old woman presents to the oncology clinic with a general feeling of being unwell and temperature of 38.1°C. She is a known case of neuroendocrine cancer of the cervix, treated with carboplatin and etoposide. Her last treatment was eight days ago.
Blood cultures are taken and she is started on neutropenic sepsis protocol.
What will gram-staining of the blood cultures most likely show?Your Answer: Gram-negative cocci
Correct Answer: Gram-positive cocci
Explanation: -
This question is part of the following fields:
- Haematology & Oncology
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Question 3
Correct
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A 35-year-old female admitted with heat intolerance, neck pain, palpitations and recent onset weight loss despite increased appetite. Which of the following is most likely to be associated with diagnosis of thyroiditis associated with viral infection?
Your Answer: Reduced uptake on thyroid isotope scan
Explanation:Subacute thyroiditis (De Quervain’s thyroiditis) is a self-limiting thyroid condition presenting with three clinical courses of hyperthyroidism, hypothyroidism, and return to normal thyroid function. In subacute thyroiditis serum thyroglobulin (TG) levels are elevated. ESR is usually greater than 50 mm/h, often exceeding 100 mm/h. Radio-iodine uptake is low or nil. Antithyroperoxidase antibodies are associated with autoimmune thyroiditis
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This question is part of the following fields:
- Endocrine System & Metabolism
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Question 4
Correct
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A 17-year-old Jewish girl presents with primary amenorrhoea. On examination, she looks a little hirsute and has evidence of facial acne. She is within her predicted adult height and has normal breast and external genitalia development, however, there is excess hair over her lower abdomen and around her nipple area.
Investigations were as follows:
Hb 13.1 g/dl
WCC 8.6 x109/l
PLT 201 x109/l
Na+ 139 mmol/l
K+ 4.5 mmol/l
Creatinine 110 µmol/l
17-OH progesterone 1.4 times the upper limit of normal
Pelvic ultrasound: bilateral ovaries and uterus visualised.
Which of the following is the most likely diagnosis?Your Answer: Non-classical congenital adrenal hyperplasia
Explanation:Mild deficiencies of 21-hydroxylase or 3-beta-hydroxysteroid dehydrogenase activity may present in adolescence or adulthood with oligomenorrhea, hirsutism, and/or infertility. This is termed nonclassical adrenal hyperplasia.
Late-onset or nonclassical congenital adrenal hyperplasia (NCAH) due to 21-hydroxylase deficiency is one of the most common autosomal recessive disorders. Reported prevalence ranges from 1 in 30 to 1 in 1000. Affected individuals typically present due to signs and symptoms of androgen excess.
Treatment needs to be directed toward the symptoms. Goals of treatment include normal linear growth velocity, a normal rate of skeletal maturation, ‘on-time’ puberty, regular menstrual cycles, prevention of or limited progression of hirsutism and acne, and fertility. Treatment needs to be individualized and should not be initiated merely to decrease abnormally elevated hormone concentrations.
Normal Ultrasound rules out Turner’s syndrome. -
This question is part of the following fields:
- Endocrine System & Metabolism
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Question 5
Incorrect
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A 45-year-old male, came to the OPD with a complaint of severe headache on the right side with right-sided jaw pain and additional blurred vision in the right eye. The headache was throbbing in character. What is the single most appropriate investigation?
Your Answer: CT head
Correct Answer: ESR
Explanation:The age of the patient, one sided headache and loss of vision on that side suggest temporal arteritis, also known as giant cell arteritis. The laboratory hallmark of this condition is a raised ESR.
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This question is part of the following fields:
- Nervous System
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Question 6
Correct
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An 18-year-old young lady is brought to the ER by her mother. She was found, lying on the floor having consumed an unidentified quantity of her mother's prescription pills with alcohol. The patient's mother is a known hypertensive under treatment. On examination, the patient was found to be lethargic, hypotensive with a BP of 70/50 mmHg, and bradycardic with a pulse rate of 38 bpm. A finger prick glucose is 3.2 mmol/L. Which TWO among the following are the most appropriate steps for the initial management of this patient?
Your Answer: Glucagon and isoprenaline
Explanation:The most appropriate steps of initial management include iv glucagon and iv isoprenaline.
The most likely diagnosis in the above scenario (decreased conscious level, profound hypertension, and bradycardia) is β-blocker toxicity/overdose.
Bronchospasm rarely occurs in an overdose of β-blockers, except where there is a history of asthma.Immediate management is to give iv glucagons (50-150μg/kg) followed by infusion to treat hypotension and isoprenaline or atropine to treat bradycardia.
Where patients fail to respond to these measures, temporary pacing may be required.
If the patient is seen within the first 4 hours of the overdose, gastric lavage may be of value. -
This question is part of the following fields:
- Emergency & Critical Care
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Question 7
Correct
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A 72-year-old male with a history of type II diabetes mellitus and hypertension for 15 years, presented with gradual onset difficulty in breathing on exertion and bilateral ankle swelling for the past 3 months. On examination he had mild ankle oedema. His JVP was not elevated. His heart sounds were normal but he had bibasal crepitations on auscultation. Which of the following clinical signs has the greatest sensitivity in detecting heart failure in this patient?
Your Answer: Third heart sound
Explanation:The presence of a third heart sound is the most sensitive indicator of heart failure. All of the other signs can be found in heart failure with varying degrees.
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This question is part of the following fields:
- Cardiovascular System
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Question 8
Incorrect
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A 30-year-old male patient presented with palpitations that occur randomly at rest. There have however been episodes of fast palpitations and dizziness on exertion. On examination there was a systolic murmur at the apex as well as a prominent apex beat and the chest was clear. Which of the following is LEAST likely to suggest a diagnosis of hypertrophic cardiomyopathy?
Your Answer: Mitral regurgitation on echocardiography
Correct Answer: A history of hypertension for 10 years
Explanation:Hypertrophic cardiomyopathy is an autosomal dominant condition. Patients present with sudden cardiac death, dyspnoea, syncope and presyncope, angina, palpitations, orthopnoea and paroxysmal nocturnal dyspnoea, Congestive heart failure and dizziness. Physical findings include double or triple apical impulse, prominent a wave in the JVP, an ejection systolic crescendo-decrescendo murmur and a holosystolic murmur at the apex and axilla of mitral regurgitation.
ECG shows ST-T wave abnormalities and LVH, axis deviation (right or left), conduction abnormalities (P-R prolongation, bundle-branch block), sinus bradycardia with ectopic atrial rhythm, atrial enlargement, abnormal and prominent Q wave in the anterior precordial and lateral limb leads.
2D echocardiography shows abnormal systolic anterior leaflet motion of the mitral valve, LVH, left atrial enlargement, small ventricular chamber size, septal hypertrophy with septal-to-free wall ratio greater than 1.4:1, mitral valve prolapse and mitral regurgitation, decreased midaortic flow, partial systolic closure of the aortic valve in midsystole -
This question is part of the following fields:
- Cardiovascular System
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Question 9
Correct
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Which of the following types of reactions are a part of the phase II metabolism of a drug?
Your Answer: Conjugation
Explanation:Drug metabolism can be broadly classified into:
Phase I (functionalization) reactions: also termed non-synthetic reactions, they include oxidation, reduction, hydrolysis, cyclization and de-cyclization. The most common and vital reactions are oxidation reactions. (Of the given enzymes only Alcohol dehydrogenase is involved in phase I drug metabolism. Succinate dehydrogenase, is a vital enzyme involved in the Kreb’s cycle and the mitochondrial electron transport chain). They are mainly catalysed by Cytochrome P-450 enzyme.Phase II (conjugation) reactions: occur following phase I reactions, they include reactions: glucuronidation and sulphate conjugation, etc. They are mostly catalysed by UDP-glucuronosyltransferase enzyme. Other phase II enzymes include: sulfotransferases, N-acetyltransferases, glutathione S-transferases and methyltransferases.
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This question is part of the following fields:
- Pharmacology
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Question 10
Correct
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A 55-year-old female with a history of hypertension presented with severe central chest pain for the past one hour, associated with sweating and vomiting. Her ECG showed ST elevation myocardial infarction, evident in leads V2-V4. Which of the following is an absolute contraindication for thrombolysis?
Your Answer: Intracranial neoplasm
Explanation:Absolute contraindications for fibrinolytic use in STEMI
Prior intracranial haemorrhage (ICH)
Known structural cerebral vascular lesion
Known malignant intracranial neoplasm
Ischemic stroke within 3 months
Suspected aortic dissection
Active bleeding or bleeding diathesis (excluding menses)
Significant closed head trauma or facial trauma within 3 months
Intracranial or intraspinal surgery within 2 months
Severe uncontrolled hypertension (unresponsive to emergency therapy)
For streptokinase, prior treatment within the previous 6 months -
This question is part of the following fields:
- Cardiovascular System
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Question 11
Incorrect
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A 43-year-old woman complains of a greenish foul smelling discharge from her left nipple. She has experienced the same case before. What is the most likely diagnosis?
Your Answer: Breast abscess
Correct Answer: Duct ectasia
Explanation:Mammary duct ectasia occurs when the lactiferous duct becomes blocked or clogged. This is the most common cause of greenish discharge. Mammary duct ectasia can mimic breast cancer. It is a disorder of peri- or post-menopausal age.
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This question is part of the following fields:
- Women's Health
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Question 12
Correct
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A 35-year-old chronic smoker complains of pain in the calf while walking. This symptom has been increasing in severity for 4 months. There is a painful ulcer at the base of left first toe, which despite treatment has not improved. Dorsalis pedis and posterior tibial pulses were absent on the same side. What is the most compatible diagnosis of this presentation?
Your Answer: Thromboangitis Obliterans
Explanation:Thromboangitis obliterans or Buerger’s disease is an inflammatory vasculopathy which is characterized by an inflammatory endarteritis and mainly affects small and medium-sized arteries as well as veins of the upper and lower extremities. It is caused by a prothrombotic state and subsequent obstruction of blood vessels. Ischemic pain, features of inflammation along the vein affected, Raynaud’s phenomenon and painful non-healing ulcers are common presentations.
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This question is part of the following fields:
- Emergency & Critical Care
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Question 13
Incorrect
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A son has brought his 72-year-old mother to clinic. He is concerned about her short-term memory problems for the past 10 months. He has to remind her to take her medications and she has had two incidents of falling over in the last 10 months. Which of the following assists in the diagnosis of above condition?
Your Answer: Disinhibition
Correct Answer: Progressive loss of function
Explanation:The clinical presentation is dementia. To differentiate Alzheimer disease and vascular dementia, the progressive loss of function is important. Progressive loss of function is usually associated with vascular dementia and rest of the responses are associated with Alzheimer disease.
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This question is part of the following fields:
- Geriatric Medicine
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Question 14
Incorrect
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A 30-year-old man has been unwell for the last 3 weeks and now developed a rash. Chickenpox is diagnosed.
What is the appropriate treatment?Your Answer: Erythromycin
Correct Answer: Acyclovir
Explanation:You may treat chickenpox with acyclovir if it is commenced within the first 24 hours of the rash’s appearance. Erythromycin, doxycycline, and ampicillin would not help because it’s a viral infection (Varicella) not a bacterial infection.
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This question is part of the following fields:
- Infectious Diseases
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Question 15
Correct
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A 4-year-old girl is diagnosed with acute lymphoblastic leukaemia after presenting with lethargy and easy bruising. Which of the following is a marker of a bad prognosis in this disease?
Your Answer: Philadelphia chromosome positive
Explanation:Philadelphia translocation, t(9;22), is a marker of poor prognosis in acute lymphoblastic leukaemia (ALL).
ALL is the malignancy of lymphoid progenitor cells affecting B or T cell lineage. This results in the arrest of lymphoid cell maturation and proliferation of immature blast cells (lymphoblasts), leading to bone marrow and tissue infiltration.
ALL is the most common type of childhood cancers. Its peak incidence is between two to three years of age.
Acute B lymphoblastic leukaemia (B-ALL) is the most common type of ALL, involving overproduction of B-cell lymphoblasts. It is manifested by low initial WCC and is associated with a good prognosis.
Poor prognostic factors for ALL include:
1. Pre-B cell or T-cell ALL (T-ALL)
2. Philadelphia translocation, t(9;22)
3. Age <2 years or >10 years
4. Male sex
5. CNS involvement
6. High initial WBC (e.g. >100 x 10^9/L)
7. non-Caucasian -
This question is part of the following fields:
- Haematology & Oncology
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Question 16
Correct
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A 47-year-old woman diagnosed with oestrogen receptor positive breast cancer three months back was started on treatment with tamoxifen. Which of the following is most likely a complaint of this patient during her review today?
Your Answer: Hot flushes
Explanation:The most likely complaint of this patient would be hot flushes.
Alopecia and cataracts are listed in the BNF as possible side-effects. They are however not as prevalent as hot flushes, which are very common in pre-menopausal women.
Tamoxifen is a Selective Oestrogen Receptor Modulator (SERM) which acts as an oestrogen receptor antagonist and partial agonist. It is used in the management of oestrogen receptor-positive breast cancer
Adverse effects:
Menstrual disturbance: vaginal bleeding, amenorrhoea
Hot flushes – 3% of patients stop taking tamoxifen due to climacteric side-effects.
Venous thromboembolism.
Endometrial cancer
Tamoxifen is typically used for 5 years following the removal of the tumour.Raloxifene is a pure oestrogen receptor antagonist and carries a lower risk of endometrial cancer.
Although antagonistic with respects to breast tissue tamoxifen may serve as an agonist at other sites. Therefore the risk of endometrial cancer is increased cancer.
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This question is part of the following fields:
- Women's Health
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Question 17
Incorrect
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A 27-year-old patient presents to the OPD with a history of longstanding constipation, blood on the side of stool and extremely painful defecation. Digital rectal examination also results in pain. What is the most likely diagnosis?
Your Answer: UC
Correct Answer: Anal fissure
Explanation:An anal fissure is a longitudinal tear of the perianal skin distal to the dentate line, often due to increased anal sphincter tone. Anal fissures are classified according to aetiology (e.g., trauma or underlying disease) or duration of disease (e.g., acute or chronic). They are typically very painful and may present with bright red blood per rectum (haematochezia). Anal fissures are a clinical diagnosis based on history and examination findings. Management is primarily conservative, and includes stool softeners, analgesia, and possible local muscle relaxation; because of the risk of incontinence, surgical intervention is a last resort.
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This question is part of the following fields:
- Gastrointestinal System
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Question 18
Incorrect
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A 65-year-old male patient presents with a non-explosive cough, muscle twitching on the level of the tongue and aspiration pneumonia. He also claims that occasionally the food he swallows comes back through his nose. What is the most likely cause of dysphagia in this case?
Your Answer: Oesophageal carcinoma
Correct Answer: Bulbar palsy
Explanation:Bulbar palsy and pseudobulbar palsy are rare types of a motor neuron disease that affect the cranial motor nerves. Bulbar palsy is a lower motor neuron palsy that affects the nuclei of the 9th to 12th cranial nerves. Pseudobulbar palsy is an upper motor neuron palsy that affects the corticobulbar tracts of the 5th, 7th and 9th to 12th cranial nerves. Any condition which disrupts or damages the cranial nerve nuclei or corticobulbar tracts can cause bulbar or pseudobulbar palsy (e.g., stroke, multiple sclerosis, infections, brain stem tumours). Both bulbar and pseudobulbar palsy are seen mainly in men over 75 years old and present with progressive dysarthria and dysphagia. In addition, patients with pseudobulbar palsy present with a lack of facial expression, difficulty chewing, and emotional lability. Lower motor neuron signs (atrophy and fasciculations of the tongue, absent gag reflex) differentiate bulbar palsy from pseudobulbar palsy, which presents with upper motor neuron signs (spastic tongue, exaggerated gag, and jaw jerk reflexes). Diagnosis is mainly clinical and treatment mostly supportive with a poor prognosis. Life expectancy is around 1-3 years following diagnosis.
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This question is part of the following fields:
- Haematology & Oncology
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Question 19
Incorrect
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A husband visits the clinic with his wife because he wants to be screened for cystic fibrosis. His brother and wife had a child with cystic fibrosis so he is concerned. His wife is currently 10 weeks pregnant. When screened, he was found to be a carrier of the DF508 mutation for cystic fibrosis but despite this result, the wife declines testing. What are the chances that she will have a child with cystic fibrosis, given that the gene frequency for this mutation in the general population is 1/20?
Your Answer: 1/160
Correct Answer: Jan-80
Explanation:The chance of two carriers of a recessive gene having a child that is homozygous for that disease (that is both genes are transmitted to the child) is 25%. Therefore, the chances of this couple having a child with CF are 25%(1/4) x 1/20 = 1/80.
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This question is part of the following fields:
- Respiratory System
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Question 20
Incorrect
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A 74-year-old man with longstanding Waldenström's macroglobulinemia presents to the rheumatology clinic with joint pain and generalised weakness. Which of the following would be most indicative of type I cryoglobulinemia?
Your Answer: Membranoproliferative glomerulonephritis
Correct Answer: Raynaud's phenomenon
Explanation:Cryoglobulins are proteins that precipitate from an individual’s serum or plasma at temperatures lower than 37°C. They can be a mixture of immunoglobulin (Ig) and complement components or immunoglobulins alone. These cryoglobulins deposit in medium and large-sized blood vessels throughout the body, causing endothelial injury and end-organ damage known as cryoglobulinemia.
Cryoglobulinemia can be divided into three main types, depending on which kind of antibody your body produces.
Type I cryoglobulinemia is frequently associated with an underlying health condition, such as cancer of your blood or immune system.
Type II cryoglobulinemia and type III cryoglobulinemia are often seen in people with long-term (chronic) inflammatory conditions, such as autoimmune diseases. Type II cryoglobulinemia is very common in people with hepatitis C virus (HCV). Another name for types II and III cryoglobulinemia is mixed cryoglobulinemia.
People with cryoglobulinemia may or may not experience symptoms. When symptoms are present, they most commonly include a particular rash, usually over the lower legs as well as fatigue and joint pain.
Other cryoglobulinemia symptoms may include:
- Change in the color of your hands and/or feet with cold temperatures, called Raynaud’s phenomenon.
- Weight loss.
- High blood pressure
- Swelling (edema) of ankles and legs.
- Skin ulcers and gangrene.
- Enlarged liver (hepatomegaly) or enlarged spleen (splenomegaly).
Raynaud’s syndrome causes spasms in small blood vessels in your fingers and toes. This limits blood flow and leads to symptoms like skin color changes, cold skin and a pins and needles sensation. Common triggers of Raynaud’s attacks include cold weather and stress. Many people have mild symptoms that they can manage through lifestyle changes.
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This question is part of the following fields:
- Haematology & Oncology
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Question 21
Incorrect
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A 45-year-old female presented with weight loss, night sweats and abdominal pain for 6 months. Abdominal ultrasound scan showed a tubo-ovarian mass. What is the most likely organism, which is responsible for this presentation?
Your Answer: Neisseria gonorrhoea
Correct Answer: Mycobacterium tuberculosis
Explanation:Constitutional symptoms such as weight loss, evening pyrexia and night sweats are associated with Mycobacterium Tuberculosis (TB). TB can affect any system of the body and should be top in the list of differentials particularly if the patient has a history of contact with a known TB patient.
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This question is part of the following fields:
- Infectious Diseases
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Question 22
Correct
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Conjugated bilirubin is converted and metabolised into urobilinogen before excretion. This metabolism takes place in which part of the body?
Your Answer: Large intestine
Explanation:Unconjugated bilirubin is conjugated to glucuronic acid in the hepatocyte. Conjugated bilirubin passes into the enterohepatic circulation and the bilirubin which evades this system is metabolised by bacteria, primarily in the large intestine, to urobilinogen, then stercobilinogen and eventually oxidised to stercobilin. Stercobilin gives faeces its brown colour.
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This question is part of the following fields:
- Gastrointestinal System
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Question 23
Correct
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A 66-year-old gentleman is seen in the Emergency Department complaining of muscle weakness and lethargy. Admission bloods show the following:
Na+ 138 mmol/l
K+ 6.6 mmol/l
Bicarbonate 15 mmol/l
Urea 9.2 mmol/l
Creatinine 110 µmol/l
An ECG is done which shows no acute changes.
What is the most appropriate initial treatment to lower the serum potassium level?Your Answer: Insulin/dextrose infusion
Explanation:Insulin/dextrose infusion will increase the activity of the sodium-potassium pump in the cells, which will in turn decrease serum potassium levels.
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This question is part of the following fields:
- Renal System
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Question 24
Correct
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Which of the following is most consistent with congenital adrenal hyperplasia (CAH)?
Your Answer: Premature epiphyseal closure
Explanation:Exposure to excessive androgens is usually accompanied by premature epiphyseal maturation and closure, resulting in a final adult height that is typically significantly below that expected from parental heights.
congenital adrenal hyperplasia (CAH) is associated with precocious puberty caused by long term exposure to androgens, which activate the hypothalamic-pituitary-gonadal axis. Similarly, CAH is associated with hyperpigmentation and hyperreninemia due to sodium loss and hypovolaemia.
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This question is part of the following fields:
- Endocrine System & Metabolism
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Question 25
Incorrect
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Which the following features is most suggestive of megaloblastic anaemia?
Your Answer: Atrophic gastritis
Correct Answer: Hypersegmented neutrophils in peripheral blood film
Explanation:Hypersegmented neutrophils in the peripheral blood film is suggestive of megaloblastic changes in bone marrow.
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This question is part of the following fields:
- Haematology & Oncology
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Question 26
Correct
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Which of the following features is characteristic of immune thrombocytopenic purpura?
Your Answer: Autoimmune haemolytic anaemia is a recognised association
Explanation:Immune thrombocytopenic purpura (ITP) refers to thrombocytopaenia occurring in the absence of toxic exposure or other diseases associated with low platelets and involves IgG-type antibodies. It is characterised by normal or increased marrow megakaryocytes, shortened platelet survival, and the absence of splenomegaly. Autoimmune haemolytic anaemia (AIHA) occurs commonly in association with ITP. Leukemic transformation, however, does not occur in ITP.
In neonatal ITP, IgG antibodies are passively transferred across the placenta. The infant platelet count may be normal at birth but decreases within 12-24 hours. It is rarely severe enough to induce bleeding diathesis in the infant.
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This question is part of the following fields:
- Haematology & Oncology
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Question 27
Correct
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An 18-year-old girl presents with short history of marked, right hip pain and an associated limp. She has a history of acute lymphoblastic leukaemia for which she completed treatment for last six months.
Your Answer: Avascular necrosis of the femoral head
Explanation:Avascular necrosis (AVN) of the femoral head is a pathological process that results from disruption of the blood supply to the bone and occurs most commonly in the femoral epiphysis. Patients usually present with pain and limited joint motion. The mechanism involves impaired circulation to a specific area that ultimately becomes necrotic. AVN is most frequently associated with high doses of oral and intravenous corticosteroids and prolonged duration of therapy. Cancer patients receiving chemotherapy are usually also treated with corticosteroids.
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This question is part of the following fields:
- Musculoskeletal System
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Question 28
Incorrect
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A social worker has been diagnosed with hepatitis C infection. Which test will conclusively establish the presence of this infection?
Your Answer: HBV DNA
Correct Answer: HCV RNA
Explanation:The most sensitive test for detecting Hepatitis C infection (acute) is HCA RNA; it can be detected 1-2 weeks after infection. Anti-HCV antibodies take at least 6 weeks to develop and be positive.
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This question is part of the following fields:
- Infectious Diseases
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Question 29
Incorrect
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A 62-year-old lady is referred with painless jaundice and weight loss. Bilirubin is 214 mmol/L, alanine transaminase (ALT) 62 U/L, alkaline phosphatase (ALP) 605 U/L, albumin 34 g/L and prothrombin time 17 seconds. Ultrasound of the abdomen shows a grossly dilated biliary tree and a dilated pancreatic duct, but no mass is seen.
What is the next most appropriate step in her management?Your Answer: Endoscopic retrograde cholangiopancreatography (ERCP)
Correct Answer: Abdominal CT scan
Explanation:This scenario is suggestive of a pancreatic head mass with obstructive jaundice and US showing a ‘double duct’ sign. A CT Scan would be recommended to evaluate for a pancreatic head mass. If a mass was found, the next step would then be to do an ERCP with EUS to obtain a biopsy of the mass for tissue diagnosis. Laparoscopy would not be recommended. CA19-9 would not be diagnostic.
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This question is part of the following fields:
- Hepatobiliary System
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Question 30
Incorrect
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A 17-year-old boy presents with tremors. Upon inquiry, the mother reports that the boy has a history of very aggressive episodes. She also reports that he has been hallucinating for some time. On examination, there were needle marks on his arm. What drug has been used?
Your Answer: Amphetamines
Correct Answer: Lysergic acid diethylamide (LSD)
Explanation:Psychedelic drugs, like LSD, bring on a state of altered consciousness, causing thought, audio, or visual changes. Low body temperature and tremors are associated with many drugs but closed-eye hallucinations are strongly associated with LSD and other psychedelic drugs.
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This question is part of the following fields:
- Emergency & Critical Care
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SESSION STATS - PERFORMANCE PER SPECIALTY
