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  • Question 1 - Which among the following genetic conditions, does NOT present with cataracts? ...

    Correct

    • Which among the following genetic conditions, does NOT present with cataracts?

      Your Answer: Neurofibromatosis type 1 (NF1)

      Explanation:

      Neurofibromatosis Type 1 (also known as von Recklinghausen disease) does not present with cataracts.The eye findings in NF1 are Lisch’s nodules, which are pigmentary lesions seen on the iris and constitute one of the major diagnostic features in this condition. Note:Interestingly, in another syndrome closely related to it, Neurofibromatosis type 2 (NF-2), cataracts can occur. Early detection in family members may be made by finding lens opacities (both congenital polar cataracts and posterior lenticular opacities). Other options:- Incontinentia pigmenti is an X-linked dominant disorder with pigmentary skin changes, mental retardation and eye involvement in 40% of cases. – Myotonic dystrophy is a triplet-repeat disorder with neurological symptoms and cataracts. – Lowe syndrome (oculo-cerebro-renal syndrome) is an X-linked recessive condition. Males with this X-linked recessive condition have cataracts, hypotonia, mental retardation, generalised aminoaciduria and renal tubular acidosis with hypophosphatemia. – Wilson disease is an inborn error of copper metabolism. The clinical features include hepatic involvement, progressive neurological features, eye involvement, including Kayser–Fleischer rings and cataracts.

    • This question is part of the following fields:

      • Genetics And Dysmorphology
      14.2
      Seconds
  • Question 2 - In Psoriasis, the following is true with regards to topical treatment: ...

    Incorrect

    • In Psoriasis, the following is true with regards to topical treatment:

      Your Answer: Calcipotriol is available topically, orally, and subcutaneously

      Correct Answer: Topical corticosteroid associated side effects include striae, atrophy of the skin, telangiectasia, acneiform rash, and easy bruising

      Explanation:

      Topical treatments are useful in the treatment of mild Psoriasis, or as adjuvant therapy in ultraviolet and systematic treatments. These treatments include moisturisers, dithranol, coal tar, salicylic acid, topical immunomodulators such as calcineurin, topical retinoids, Vitamin D analogues and topical steroids. Topical steroids are known to have a number of side effects such as striae, atrophy of the skin, telangiectasia, acneiform rash, and easy bruising. Localised pustular psoriasis is also associated with topical steroids in higher doses. Use of more than 500 g of hydrocortisone or 50 g clobetasol propionate have been shown to suppress adrenal function. Calcitriol, a vitamin D analogue, is only available as an ointment and does not stain clothes and skin the way dithranol and coal tar are known to.

    • This question is part of the following fields:

      • Dermatology
      36.4
      Seconds
  • Question 3 - An 11-year-old boy presents to the emergency department after being assaulted with a...

    Correct

    • An 11-year-old boy presents to the emergency department after being assaulted with a baseball bat. The soft tissue around his left eye shows significant swelling that obstructs the child's vision. A CT scan shows a fracture at the floor of the left orbit. This injury will most likely lead to an abnormal communication between the orbit and which of the following areas of the face?

      Your Answer: Maxillary sinus

      Explanation:

      The injury described in question leads to an abnormal communication between the orbit and the ipsilateral maxillary sinus – this is termed as a blow-out fracture of the orbit.The maxillary sinuses are found in the maxillary bone, inferior to the orbit. They are the largest of the paranasal air sinuses. The maxillary bone forms the floor of the orbit. This layer of bone separates the orbit from the maxillary sinus. As such, fractures of the floor of the orbit can be associated with herniation of the orbital contents into the maxillary sinus. Other options:- The ethmoidal air cells are a collection of smaller air cells in the ethmoid bone. They lie lateral to the anterior superior nasal cavity. They are separated from the orbit by a very thin plate of ethmoid bone called the lamina papyracea, which is found on the medial wall of the orbit. The thin nature of this bone means it is commonly fractured in orbital trauma. However, this is the incorrect answer to the above question as a communication between the ethmoidal air cells, and the orbit is associated with fractures of the medial wall of the orbit, not the floor. – The frontal sinuses are found in the frontal bones, above the orbits on each side of the head. A large portion of the roof of the orbit is composed of the frontal bone and separates the orbit from the frontal sinus. Fractures of the roof of the orbit can be associated with communication between the frontal sinus and orbit. The frontal bones are strong, and so fracture is associated with high-impact anterior trauma, such as a road traffic accident. – The sphenoid sinuses are found in the posterior portion of the roof of the nasal cavity. The pituitary gland lies nestled within the hypophyseal fossa, with only a thin wall of bone separating it from the sphenoid sinus below. As such, neurosurgeons can gain access to the pituitary gland via the sphenoid sinus, in a procedure called transsphenoidal hypophysectomy. – The nasal cavity extends from the nares to the nasopharynx. It is found more medial and inferior than the orbits. It does not lie adjacent to the orbit at any point and so is unlikely to be involved in an orbital fracture.

    • This question is part of the following fields:

      • ENT
      47.5
      Seconds
  • Question 4 - A 10-year-old boy sustained a fracture of his right elbow, which damaged the...

    Incorrect

    • A 10-year-old boy sustained a fracture of his right elbow, which damaged the ulnar nerve behind the medial epicondyle of the humerus. A month later, he still has a total ulnar nerve paralysis. Which of the following can be observed on examination?

      Your Answer: Sensory loss over the ulnar 3½ digits on the ulnar side of the hand

      Correct Answer: Inability to grip a sheet of paper between his fingers when the hand is placed flat on the table

      Explanation:

      Among the given options, the inability to grip a sheet of paper between his fingers when the hand is placed flat on the table is the feature of ulnar nerve injury. Rationale:The ulnar nerve (usually) supplies sensation to the skin of the fifth and the ulnar side of the fourth finger, front and back. Following the injury of the nerve, the following functions are impaired:- There is a sympathetic interruption, with the absence of sweating in the affected area. – The thenar muscles are supplied by the median nerve and are therefore spared. – The ulnar nerve also supplies the muscles of the hypothenar eminence. – Although the ring and little fingers are held in the clawed position when the nerve is injured at the wrist, a high lesion paralyses the long flexors to these two fingers and results in the loss of this sign. The test for paralysis of the palmar interossei, supplied by the ulnar nerve, is the inability to adduct the fingers and thus to be unable to grip a sheet of paper between them.

    • This question is part of the following fields:

      • Anatomy
      43.1
      Seconds
  • Question 5 - Which of the following signs suggests an absence seizure instead of a partial...

    Incorrect

    • Which of the following signs suggests an absence seizure instead of a partial complex seizure?

      Your Answer: The presence of aura

      Correct Answer: Induction by hyperventilation

      Explanation:

      Absence seizures are induced by over breathing or hyperventilation, while the other features suggest partial seizures.

    • This question is part of the following fields:

      • Neurology
      31
      Seconds
  • Question 6 - A new-born baby is found to have a loud heart murmur but is...

    Incorrect

    • A new-born baby is found to have a loud heart murmur but is otherwise well 6-hour baby after birth.Which one of the following is the most likely cause?

      Your Answer: Atrial septal defect

      Correct Answer: Tetralogy of Fallot

      Explanation:

      Tetralogy of Fallot usually is diagnosed after a baby is born, often after the infant has an episode of turning blue during crying or feeding (a tet spell). A loud heart murmur is usually present.An atrial septal defect is present at birth, but many babies do not have any signs or symptoms.Coarctation of the aorta is usually diagnosed after the baby is born. How early in life the defect is diagnosed usually depends on how mild or severe the symptoms are. New-born screening using pulse oximetry during the first few days of life may or may not detect coarctation of the aorta.In babies with a more serious condition, early signs usually include:pale skinirritabilityheavy sweatingdifficulty breathingBabies born with pulmonary atresia will show symptoms at birth or very soon afterwards. They may be cyanotic. However, it is not uncommon for a heart murmur to be absent right at birth.

    • This question is part of the following fields:

      • Cardiovascular
      26
      Seconds
  • Question 7 - A child with a history of developmental delay presents with plaque-like lesions in...

    Incorrect

    • A child with a history of developmental delay presents with plaque-like lesions in the retina. The doctor suspects they are probably hamartomas. Which of the following is the most probable association?

      Your Answer: Neurofibromatosis type 2

      Correct Answer: Tuberous sclerosis

      Explanation:

      Tuberous sclerosis, an autosomal dominant disorder, may present with a variety of symptoms, including seizures, developmental delay, behavioural problems, skin abnormalities, and lung and kidney disease. Hamartomas are often associated.

    • This question is part of the following fields:

      • Genetics And Dysmorphology
      75.9
      Seconds
  • Question 8 - A young boy presents with signs and symptoms consistent with infective endocarditis. He...

    Incorrect

    • A young boy presents with signs and symptoms consistent with infective endocarditis. He has a history of neglect and poor dental hygiene.Which organism is likely to have caused his endocarditis?

      Your Answer: Diphtheroids

      Correct Answer: Streptococci viridans

      Explanation:

      Infective endocarditis occurs when microorganisms enter the bloodstream and infect damaged endocardium or endothelial tissue. It most commonly involves the heart valves (either native or prosthetic), but it may also occur at the site of a septal defect, on the chordae tendineae, or on the mural endocardium. The prototypic lesion is at the site of the infection| the vegetation is a mass of platelets, fibrin, microcolonies of microorganisms, and scant inflammatory cells. Endocarditis is classified as acute or subacute, which applies to the features and the progression of infection until diagnosis.The oral cavity, the skin, and the upper respiratory tract are the primary portals for Streptococcus viridans| Staphylococcus species| and Haemophilus aphrophilus, Aggregatibacter (formerly Actinobacillus) actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae (HACEK) organisms. Streptococcal and staphylococcal organisms are responsible for more than 80% of cases of bacterial IE.Streptococcus viridans accounts for approximately 50-60% of cases of subacute disease.While S aureus infection is the most common cause of IE, including Prosthetic valve endocarditis, acute IE, and IV Drug Abusers IE

    • This question is part of the following fields:

      • Cardiovascular
      43.6
      Seconds
  • Question 9 - A 12 year old boy with type I diabetes was reluctant to go...

    Correct

    • A 12 year old boy with type I diabetes was reluctant to go to school. According to him, he was unhappy at the school. Which of the following is the next appropriate step?

      Your Answer: Clinical psychologist

      Explanation:

      The child’s problem should be assessed properly to find the reason for unhappiness at the school. There can be many reasons such as bullying at school, abuse etc. A clinical psychologist should assess this child to take the necessary details and plan the further management.

    • This question is part of the following fields:

      • Endocrinology
      14.4
      Seconds
  • Question 10 - A 15-year-old boy with type 1 DM is recently started on an insulin...

    Incorrect

    • A 15-year-old boy with type 1 DM is recently started on an insulin pump. There has been better glycaemic control and he now subsequently enjoys a healthy, active lifestyle. During the consultation, he seems to acknowledge the risks of missing out his dose and says that he is comfortable with his new pump. he mentions that he changes his site after every 4 days. However, a random blood sugar analysis reveals it to be 22.3 mmol/L. Which of the following is the most likely reason for the raised RBS level?

      Your Answer: Missed bolus

      Correct Answer: Site change is overdue

      Explanation:

      Insertion sites and sensor sites should be rotated each time the infusion set or glucose sensor is changed. This keeps the tissue healthy and allows previous sites to completely heal before reusing them. Change infusion set every 2 to 3 days to help prevent infection.

    • This question is part of the following fields:

      • Endocrinology
      59.9
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Genetics And Dysmorphology (1/2) 50%
Dermatology (0/1) 0%
ENT (1/1) 100%
Anatomy (0/1) 0%
Neurology (0/1) 0%
Cardiovascular (0/2) 0%
Endocrinology (1/2) 50%
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