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Question 1
Incorrect
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An 18-year-old homosexual male presents 36 hours after having unprotected sex with his partner whose HIV status is not known. He is concerned about his risk of acquiring HIV. He is feeling well and shows no symptoms. The physician offers him a post exposure prophylaxis, which consists of 3 different antiviral drugs. Two of these drugs act by which of the following mechanisms?
Your Answer: CCR5 antagonism
Correct Answer: Inhibition of viral reverse transcriptase
Explanation:Recommended regimens3 NRTI (e.g., zidovudine, lamivudine, abacavir) OR2 NRTI (e.g., lamivudine + abacavir) AND1 NNRTI (e.g., efavirenz) OR1 PI (e.g., lopinavir) OR1 INI (e.g., raltegravir)
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This question is part of the following fields:
- HIV
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Question 2
Correct
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A 1-day-old baby started having pallor and jaundice. The mother's first child did not have jaundice at birth. On clinical investigations, direct Coombs test is positive. Mother's blood group is A negative. Baby's blood group is O positive. What is the most probable cause of the condition of this new-born?
Your Answer: Rhesus incompatibility
Explanation:Jaundice in a new-born on the day of delivery is most likely due to Rh incompatibility. This occurs when the mother is Rh-negative and the baby is Rh-positive. Antibodies in the mother against the Rh factor in the baby will destroy the red blood cells in the baby, increasing the bilirubin in the blood. Breast milk jaundice and Galactosemia do not occur immediately after birth, and congenital rubella syndrome and formula feeding does not cause jaundice in babies.
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This question is part of the following fields:
- Gastroenterology And Hepatology
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Question 3
Incorrect
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A 6 year old girl with a history of polyuria and polydipsia undergoes a water deprivation test. Previous urine dipstick results were negative for blood, glucose, or protein. The test is started and once the girl loses 3% of her body weight, her serum osmolarity is more than 300 whereas her urine osmolarity is less than 300. Doctors administer desmopressin but osmolarity levels do not change. What is the most likely diagnosis?
Your Answer: Diabetes Mellitus
Correct Answer: Nephrogenic Diabetes Insipidus
Explanation:Nephrogenic Diabetes Insipidus is an acquired or hereditary condition that affects the water balance. It presents with polyuria and polydipsia, leading commonly to dehydration.
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This question is part of the following fields:
- Nephro-urology
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Question 4
Incorrect
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A young female presents with vaginal discharge and itching. She is diagnosed with prepubertal atrophic vaginitis. What is the pathophysiology behind prepubertal atrophic vaginitis?
Your Answer: Lack of vaginal oestrogen causing infection-prone acidic environment
Correct Answer: Lack of vaginal oestrogen causing infection-prone alkaline environment
Explanation:Prepubertal atrophic vaginitis is due to a lack of vaginal oestrogen. The pathophysiology behind prepubertal atrophic vaginitis:1.The proximity of the vagina to the anus2.Lack of oestrogen – leads to thinning of the vaginal mucosa3.Lack of pubic hair to protect the area4.Lack of labial fat pads
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This question is part of the following fields:
- Nephro-urology
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Question 5
Incorrect
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Which of the following is true regarding female puberty?
Your Answer: Thelarche follows menarche
Correct Answer: Adrenarche occurs before thelarche
Explanation:Puberty is the general term for the transition from sexual immaturity to sexual maturity. There are two main physiological events in puberty:- Gonadarche is the activation of the gonads by the pituitary hormones follicle-stimulating hormone (FSH) and luteinizing hormone (LH).- Adrenarche is the increase in production of androgens by the adrenal cortex. It is the term for the maturational increase in adrenal androgen production that normally becomes biochemically apparent at approximately six years of age in both girls and boysA number of other terms describe specific components of puberty:- Thelarche is the appearance of breast tissue, which is primarily due to the action of oestradiol from the ovaries. – Menarche is the time of first menstrual bleed. – Pubarche is the appearance of pubic hair, which is primarily due to the effects of androgens from the adrenal gland. The term is also applied to first appearance of axillary hair, apocrine body odour, and acne.The earliest detectable secondary sexual characteristic on physical examination in most girls is breast/areolar development (thelarche). Ovarian enlargement and growth acceleration typically precede breast development but are not apparent on a single physical examination. Oestrogen stimulation of the vaginal mucosa causes a physiologic leukorrhea, which is a thin, white, non-foul-smelling vaginal discharge that typically begins 6 to 12 months before menarche. Menarche occurs, on average, 2 to 2.5 years after the onset of puberty
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This question is part of the following fields:
- Endocrinology
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Question 6
Incorrect
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A 3 year old male presents to the genetics clinic with a history of proximal myopathy. He has missed motor milestones and has pseudohypertrophy of the calves. Doctors suspect it might be Duchenne's muscular dystrophy. Which of the following should you advise the parents?
Your Answer: Cardiac muscle is not affected by DMD| arm and leg muscle weakness is the main concern
Correct Answer: Girl offspring have a less than 10% chance of inheriting the condition
Explanation:Although initially thought to affect only boys, girls with DMD also have an estimated 10% chance of inheriting the condition. In girls, DMD may present with all or some clinical manifestations.
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This question is part of the following fields:
- Genetics And Dysmorphology
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Question 7
Incorrect
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The following is a sleep-related hormone released in an intermittent manner:
Your Answer: Thyroxine
Correct Answer: Prolactin
Explanation:Hormones can be secreted in a number of different ways, thus plasma levels of each may vary throughout the day. Many of these exhibit intermittent secretion related to sleep (growth hormone, and prolactin), while others are released based on circadian rhythms (cortisol). Some are released in a pulsatile fashion throughout the day such as FSH, LH, Thyroxine, while others are stress related like cortisol.
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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 16-year-old athlete presents to the clinic with pain and swelling over the medial aspect of the right knee joint. The pain occurs when climbing the stairs, but is not present when walking on flat ground. Clinically there is pain over the medial aspect of the proximal tibia, and the McMurray test is negative.What is the most probable cause of this patient's symptoms?
Your Answer: Medial meniscus injury
Correct Answer: Pes Anserinus Bursitis
Explanation:The most probable cause for the patient’s symptoms would be pes anserine bursitis.Translated, pes anserinus means goose feet. It is the term used to describe the unified bursa enclosing the tendons of the sartorius, gracilis and semitendinous muscles inserting into the anteromedial proximal tibia.Pes anserine bursitis is common in people doing sports due to overuse injuries. The main sign is of pain in the medial part of the proximal tibia. As the McMurray test is negative, medial meniscal injury is excluded.
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This question is part of the following fields:
- Musculoskeletal
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Question 9
Correct
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Which among the following is a type of acquired anterior pituitary disorder?
Your Answer: Pituitary adenoma
Explanation:Among the given options, pituitary adenoma is an acquired anterior pituitary disorder which represent between 10 and 25% of all intracranial neoplasms.Other options:- Agenesis of the corpus callosum is characterised by the partial or complete absence of the corpus callosum. This condition is associated with pituitary hormone deficiencies.- Congenital disorders such as hydrocephalus or arachnoid cysts may be a cause of precocious puberty.- Pituitary hypoplasia and septo-optic dysplasia are congenital disorders of the pituitary gland.
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This question is part of the following fields:
- Endocrinology
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Question 10
Correct
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A 6 year old boy presented in the emergency department with a cough and knee swelling after falling on the road. He had a non-blanching rash on his buttocks and investigations revealed: PT=13, APTT=71, Hgb=11, WBC=8, Plt=200. Which is the most likely diagnosis?
Your Answer: Haemophilia
Explanation:From the options mentioned here, the closest diagnosis is haemophilia. This is a mixed picture, as a purpuric rash on the buttocks does not correlate with this diagnosis. However, the most appropriate diagnosis is haemophilia.
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This question is part of the following fields:
- Haematology And Oncology
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SESSION STATS - PERFORMANCE PER SPECIALTY
