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Question 1
Incorrect
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A 11-year-old boy is referred to you following his seventh course of antibiotics in the last six years for lower respiratory tract infections. He also has a history of eczema for which he is currently on a topical steroid cream. His full blood count (FBC) report shows:Hb: 13.9 g/dLPlts: 65 x 10^9/LWCC: 12.3 x 10^9/LWhich of the following genes should you expect an abnormality in?
Your Answer: CFTR
Correct Answer: WASP
Explanation:The combination of frequent infections, eczema, and thrombocytopaenia are characteristic of Wiskott-Aldrich syndrome, which is due to an abnormality in the WASP gene. It is an X-linked recessive disorder that causes primary immunodeficiency owing to a combined B- and T-cell dysfunction.The other listed options are:1. PKD1: polycystic kidney disease2. CFTR: cystic fibrosis3. HFE1: haemochromatosis4. RET: multiple endocrine neoplasia, Hirschsprung’s disease
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This question is part of the following fields:
- Haematology And Oncology
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Question 2
Incorrect
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Which of the following conditions is usually inherited in an autosomal dominant fashion?
Your Answer: Haemochromatosis
Correct Answer: Familial adenomatous polyposis
Explanation:Familial adenomatous polyposis can have different inheritance patterns.When familial adenomatous polyposis results from mutations in the APC gene, it is inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder. In most cases, an affected person has one parent with the condition.When familial adenomatous polyposis results from mutations in the MUTYH gene, it is inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations. Most often, the parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but do not show signs and symptoms of the condition.
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This question is part of the following fields:
- Genetics And Dysmorphology
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Question 3
Correct
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Among the gastrointestinal system pathologies mentioned below, which one does NOT frequently occur in anorexia nervosa?
Your Answer: Hepatosplenomegaly
Explanation:Anorexia nervosa is a serious, psychiatric eating disorder characterized by distorted self-image due to which abnormal eating behaviours are adopted. This disorder affects multiple bodily systems, including the gastrointestinal system. The GI manifestations of anorexia are enlarged salivary glands due to purging behaviour, gastritis, gastroparesis, acute gastric dilatation, superior mesenteric artery syndrome, elevated liver transaminases, which cause hepatocyte apoptosis leading to cirrhosis, and steatosis leading to fatty liver. Hepatosplenomegaly is not a recognized complication of anorexia nervosa.
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This question is part of the following fields:
- Gastroenterology And Hepatology
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Question 4
Correct
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A 9 year old boy was admitted with gastroenteritis. The boy's symptoms started two days ago with profound diarrhoea and emesis. Blood exams show the following: Sodium=148mmol/l, Potassium=2.2mmol/l, Urea=20mmol/l, Glucose=4.3mmol/l. What would be the best management?
Your Answer: V normal saline and potassium supplement
Explanation:The boy needs re-hydration and hydro-electrolytic re-balancing due to fluid losses from the gastroenteritis and subsequent dehydration.
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This question is part of the following fields:
- Gastroenterology And Hepatology
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Question 5
Incorrect
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A neonate was delivered 24 hours ago at the gestational age of 29 weeks. His birth weight was recorded to be 1 kg. Due to his critical state, the baby was intubated and ventilated. Prior to his intubation, the baby was managed with CPAP, but he seemed to get exhausted. He is now on SiMV (spontaneous intermittent mechanical ventilation). The ventilator settings are as follows: targeted tidal volume 9 ml, maximum PIP 30, PEEP 5, rate 40/min, FiO2 0.3. Baby's oxygen saturations are 93%. Blood gas shows pH 7.41, CO2 3.9 kPa, BE -4. Which of the following changes need to be made to the ventilator settings initially?
Your Answer: Increase targeted tidal volume
Correct Answer: Decrease targeted tidal volume
Explanation:Synchronized IMV (SIMV) with pressure support, used in the alert infant. SIMV guarantees a minimum minute volume while allowing the patient to trigger spontaneousbreaths at a rate and volume determined by the patient. Extra breaths are boosted with pressure support. Tidal Volume (Vt) is normally approximately 6-10 mL/kg and 4-6 ml/kg in the preterm.Respiratory rate (RR) is usually 30-60 BPM. Tidal volume and respiratory rate are relatedto respiratory minute volume as follows: Vm(mL/min) = Vt x RR .This baby is overventilated with a low CO2. Tidal volumes should generally be targeted at 4–6 ml/kg and this baby is being targeted at 9 ml/kg which exposes the baby to damage to the distal airways from this ventilation which can lead to bronchopulmonary dysplasia.
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This question is part of the following fields:
- Neonatology
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Question 6
Incorrect
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An 8 year old child complains of pain in his ear. His overall health is normal and clinical examination reveals no discharge, hearing loss or fever. Just by looking at it, the pinna of the ear looks swollen and red. Also, pushing the tragus leads to pain. Otoscopy reveals an erythematous external auditory canal and an otherwise healthy tympanic membrane. The bony external canal courses through which bone?
Your Answer: Zygomatic bone
Correct Answer: Temporal bone
Explanation:The external auditory canal (EAC) extends from the auricle to the tympanic membrane. Its lateral portion is fibrocartilaginous and its medial portion is bony. Its bony portion is formed by the tympanic portion of the temporal bone.
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This question is part of the following fields:
- ENT
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Question 7
Correct
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A 5 year old girl presents with reduced consciousness and metabolic acidosis. Additionally, her mother says that she had abdominal pain, vomiting, thirst, and weight loss, and is now worried that the girl’s twin brother will present with the same illness. Which of the following represents the highest chance of the brother presenting with the same illness?
Your Answer: HLA DR3/DR4 genotype
Explanation:HLA-DR (3 and 4) have been associated with an increased risk for idiopathic diabetes mellitus.Type 1 diabetes has a high heritability compared to type 2Identical twins have a 30-50% risk if their twin has type 1 diabetes
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This question is part of the following fields:
- Endocrinology
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Question 8
Incorrect
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A 9-year-old girl complains of perioral blisters and a burning sensation of her face. Some of the blisters are crusted and some are weeping. What is the most likely diagnosis?
Your Answer: Shingles
Correct Answer: Impetigo
Explanation:Impetigo appears more commonly on the face than other exposed areas like the limbs. Its blisters are clustered and may have a fluid discharge.
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This question is part of the following fields:
- Dermatology
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Question 9
Incorrect
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A 6 month old female is brought by her parents who are concerned regarding her development. Which of the following is expected of developmental milestones at this age?
Your Answer: They are wary of strangers
Correct Answer: They enjoy playing with their parents
Explanation:6 month old babies that go through normal developmental milestones, should enjoy playing with others and especially their parents.The other milestones are expected of a 9-month-old.
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This question is part of the following fields:
- Child Development
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Question 10
Incorrect
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Which of the following conditions is most commonly seen in PANDAS (Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections)?
Your Answer: Depression
Correct Answer: Obsessive compulsive disorder
Explanation:A child may be diagnosed with PANDAS when:- Obsessive-compulsive disorder (OCD), tic disorder, or both suddenly appear following a streptococcal (strep) infection, such as strep throat or scarlet fever.- The symptoms of OCD or tic symptoms suddenly become worse following a strep infection.The symptoms are usually dramatic, happen “overnight and out of the blue,” and can include motor or vocal tics or both and obsessions, compulsions, or both. In addition to these symptoms, children may become moody or irritable, experience anxiety attacks, or show concerns about separating from parents or loved ones.
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This question is part of the following fields:
- Neurology And Neurodisability
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SESSION STATS - PERFORMANCE PER SPECIALTY
