-
Question 1
Incorrect
-
A 29 year old female presented at her 38th week of gestation to the ER with severe hypertension (210/100) and proteinuria (+++). Soon after admission, she developed generalized tonic clonic fits. What is the first line of management in this case?
Your Answer:
Correct Answer: Magnesium sulphate IV
Explanation:Magnesium Sulphate is the drug of choice in eclamptic patients. A loading dose of 4g magnesium sulphate in 100mL 0.9% saline IVI over 5min followed by maintenance IVI of 1g/h for 24h. Signs of toxicity include respiratory depression and jerky tendon reflexes. In recurrent fits additional 2g can be given. Magnesium should be stopped when the respiratory rate is <14/min, absent tendon reflexes, or urine output is <20mL/h.
-
This question is part of the following fields:
- Obstetrics
-
-
Question 2
Incorrect
-
A young boy presents with a soft swelling in the midline neck that moves with tongue protrusion. The swelling is present between the thyroid cartilage and the tongue. Which of the following is the most likely diagnosis?
Your Answer:
Correct Answer: Thyroglossal cyst
Explanation:The thyroglossal duct cyst is the most common congenital anomaly of the central portion of the neck. The thyroglossal duct cyst is intimately related to the central portion of the hyoid bone and usually elevates along with the larynx during swallowing. Thyroglossal cysts can be defined as an irregular neck mass or a lump which develops from cells and tissues left over after the formation of the thyroid gland during the developmental stages.
-
This question is part of the following fields:
- Mental Health
-
-
Question 3
Incorrect
-
A female palliative cancer patient has painful bone metastases. Which breakthrough dose of morphine would you prescribe, if she has been taking long acting morphine tablets (120mg) every 12 hours?
Your Answer:
Correct Answer: 40 mg
Explanation:To calculate the breakthrough dose for oral morphine solution, you need to find the dose she should receive every 4 hours, according to the total amount of morphine she receives. If she is receiving 120 mg every 12 hours, then she should receive 40 mg every 4 hours as a breakthrough dose.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 4
Incorrect
-
A 60-year-old patient was admitted to the surgery department for elective herniorrhaphy. Due to a problem in his history, his operation was postponed. Which of the following is the most likely cause for this postponement?
Your Answer:
Correct Answer: MI 2 months ago
Explanation:After an MI, elective surgeries are recommended to be delayed for at least 6 months. This will help the patient become physically fit for the stress of surgery. Any surgery before this can carry a significant increased risk of mortality.
-
This question is part of the following fields:
- Cardiovascular
-
-
Question 5
Incorrect
-
A 35-year-old African female presents with a history of heavy menstrual bleeding and dysmenorrhoea for 4 months. Which of the following could be the most likely cause for this presentation?
Your Answer:
Correct Answer: Fibroid
Explanation:History of heavy menstrual bleeding and amenorrhoea favour the diagnosis of a fibroid uterus. All the given responses are causes for subfertility. Ectopic pregnancy presents with abdominal pain has an acute presentation. Endometriosis and adenomyosis usually don’t present with amenorrhoea or heavy bleeding respectively. PID presents with chronic pelvic pain and is not related to menstruation.
-
This question is part of the following fields:
- Gynaecology
-
-
Question 6
Incorrect
-
A 45-year-old male complains of angina pain. Which of the following features on exercise testing would have the strongest predictive value for ischaemic heart disease?
Your Answer:
Correct Answer: Decline in systolic BP by 20 mmHg in stage 1 of the Bruce protocol
Explanation:The classic criteria for visual interpretation of positive stress test findings include the following:J point (the junction of the point of onset of the ST-T wave; it is normally at or near the isoelectric baseline of the ECG), ST80 (the point that is 80 msec from the J point), depression of 0.1 mV (1 mm) or more and ST-segment slope within the range of ± 1 mV/sec in 3 consecutive beats
-
This question is part of the following fields:
- Cardiovascular
-
-
Question 7
Incorrect
-
Tumour suppressor genes MLH1 and MSH2 are affected in which familial cancer?
Your Answer:
Correct Answer:
Explanation:In hereditary non-polyposis colonic carcinoma (HNPCC), mutations in MSH2, MSH6, PMS2 or MLH1 genes are found.
Ataxia telangiectasia – ATM gene is affected.
Familial adenomatous polyposis – APC gene is affected.
Li-Fraumeni syndrome – mutation of the TP53 tumour suppressor gene. Neurofibromatosis – mutation in or a deletion of the NF1 gene -
This question is part of the following fields:
- Gastrointestinal
-
-
Question 8
Incorrect
-
A 64 year old woman who is of Asian descent and is diabetic (controlled by diet) presents with generalized body aches and difficulty rising from sitting for the last few months. Her blood glucose levels are in the normal range. Lab examination reveals normal blood cell count, low serum phosphate, calcium at the lower range, and raised alkaline phosphatase levels. Radiological examination shows which of the following?
Your Answer:
Correct Answer: Linear areas of low density
Explanation:Osteomalacia is a condition due to defective mineralization of osteoid. Occurs as a result of Vitamin D deficiency secondary to poor dietary intake and sun exposure, malabsorption e.g., inflammatory bowel disease and gastrointestinal bypass surgery. Radiological findings include reduced bone mineral density (a non specific finding), inability to radiologically distinguish vertebral body trabeculae (the film appears poor quality), looser pseudo fractures, fissures, or narrow radiolucent lines (these are the characteristic findings). Osteolytic or punched out lesions may be seen with multiple myeloma and bony metastases. Areas of sclerosis may be observed with conditions like osteosclerosis and Paget disease. A Brodie abscess is a subacute osteomyelitis, which may persist for years before progressing to a chronic, frank osteomyelitis.
-
This question is part of the following fields:
- Rheumatology
-
-
Question 9
Incorrect
-
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:
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.
-
This question is part of the following fields:
- Dermatology
-
-
Question 10
Incorrect
-
Which of the following vaccines do not contain live organisms?
Your Answer:
Correct Answer: Polio (Salk)
Explanation:Live virus vaccines include: Vaccinia (smallpox), Measles, Mumps, Rubella (MMR combined vaccine), Varicella (chickenpox), Influenza (nasal spray), Rotavirus, Zoster (shingles) and Yellow fever. Inactivated vaccines are Polio (IPV), Hepatitis A and Rabies.
-
This question is part of the following fields:
- Infectious Diseases
-
-
Question 11
Incorrect
-
A 7 day old baby weighed 3.5kg when born. His weight is now 3kg. Choose the most appropriate next step for this child.
Your Answer:
Correct Answer: Continue regular child care
Explanation:In the first week after birth, it is normal for the baby to lose weight and then gain it again. Therefore, regular child care should be maintained.
-
This question is part of the following fields:
- Child Health
-
-
Question 12
Incorrect
-
A 30 year old house wife developed thoughts of having dirt on her hands, which lead her to wash her hands repeatedly. She couldn't remove that thought from her mind. Whenever she tried to resist those thoughts, she developed palpitations. Which of the following is the most likely diagnosis?
Your Answer:
Correct Answer: OCD
Explanation:The patient has obsessive thoughts followed by a compulsive act. She is also unable to resist the thoughts even though she realizes they are useless. This is a common presentation of Obsessive Compulsive Disorder.
-
This question is part of the following fields:
- Mental Health
-
-
Question 13
Incorrect
-
A 58 year old male patient complains of emesis, fatigue, palpitations and weight loss. His blood group is type A. Clinical examination revealed an enlarged liver, ascites and a left supraclavicular lump which is palpable. What is the most probable diagnosis?
Your Answer:
Correct Answer: Gastric carcinoma
Explanation:Gastric carcinoma may present as atypical general symptoms including emesis, fatigue and weight loss. It may also result in anaemia which might be responsible for the palpitations. The left supraclavicular swelling is referring to Virchow’s node, strongly associated with gastric cancer. Ascites and hepatomegaly generally appear late in the course of the disease and Blood group A has been shown to be associated with gastric cancer.
-
This question is part of the following fields:
- Gastrointestinal
-
-
Question 14
Incorrect
-
A 45 year old male complains of abdominal pain and loose stools. On endoscopy, multiple ulcers were seen from the oesophagus until the stomach. What will be the next best investigation for this patient?
Your Answer:
Correct Answer: Serum gastrin estimation
Explanation:Serum gastrin level will helps in the diagnosis of Zollinger-Ellison syndrome, which is characterised by a history of recurrent and multiple gastric ulcers, due to increase gastrin secretion by the cells.
-
This question is part of the following fields:
- Gastrointestinal
-
-
Question 15
Incorrect
-
A young nurse in the hospital believes that the surgical specialist is in love with her and often sends her gifts and flowers at her home. However, actually there is nothing like this happening. Which condition is this nurse suffering from?
Your Answer:
Correct Answer: Erotomania
Explanation:Erotomania is a condition in which one person, especially ladies, deludes themselves into thinking that there is another person/man, who is in love with them and often sends them gifts and other valuables.
-
This question is part of the following fields:
- Mental Health
-
-
Question 16
Incorrect
-
A 72 year old man presents with sudden and severe pain on the medial aspect of his right calf while walking uphill. Foot extension is normal and there is no associated ankle swelling. Which of the following is the most likely diagnosis?
Your Answer:
Correct Answer: Popliteal cyst
Explanation:A popliteal cyst, also known as a Baker’s cyst, is a fluid-filled swelling that causes a lump at the back of the knee, leading to tightness and restricted movement. The cyst can be painful when you bend or extend your knee.
-
This question is part of the following fields:
- Musculoskeletal
-
-
Question 17
Incorrect
-
In end stage renal disease, deficiency of erythropoietin can lead to which of the following conditions?
Your Answer:
Correct Answer:
Explanation:Erythropoietin is necessary for normal Hb levels. Reduced levels of erythropoietin in renal failure leads to anaemia in these patients.
-
This question is part of the following fields:
- Renal
-
-
Question 18
Incorrect
-
A 15-month-old child is due for his measles, mumps and rubella (MMR) vaccines. He is feverish due to an acute otitis media and the mother gives a family history of egg allergy. What is the most appropriate action?
Your Answer:
Correct Answer: Defer immunization for two weeks
Explanation:Vaccines should not be given to a feverish child.
-
This question is part of the following fields:
- Child Health
-
-
Question 19
Incorrect
-
A 30-year-old epileptic female was admitted with visual field defects. She began a new anticonvulsant three months ago. Depending on her clinical presentation what is the most probable drug she was started on?
Your Answer:
Correct Answer: Vigabatrin
Explanation:Vigabatrin causes visual field constriction in around 30% of users. Most cases are asymptomatic because vigabatrin affects the peripheral visual fields but does not impair central visual acuity.30-50% of patients with long term exposure to vigabatrin have developed irreversible concentric visual field loss of varying severity.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 20
Incorrect
-
A 65-year-old man was seen at autopsy. He had swollen legs and signs of a transudate fluid at his liver. Before passing away, he was treated for bronchitis and TB. What is the most probable cause of the transudate?
Your Answer:
Correct Answer: Cardiac failure
Explanation:The patient most probably experienced congestive hepatopathy and leg oedema due to right sided cardiac failure.
-
This question is part of the following fields:
- Cardiovascular
-
-
Question 21
Incorrect
-
A patient was admitted due to vomiting for further investigations. He noticed blood in his vomit and the physicians decided to perform an esophagogastroduodenoscopy which revealed haemorrhage in the lesser curvature of the stomach. Which artery is responsible for the bleeding?
Your Answer:
Correct Answer: Right gastric artery
Explanation:The right gastric artery arises from the hepatic artery or the left hepatic artery and supplies the pylorus, traveling along the lesser curvature of the stomach anastomosing with the left gastric artery.
The pancreaticoduodenal artery supplies mainly the upper and lower duodenum and the head of the pancreas.
The gastro-omental arteries supply the greater curvature of the stomach. -
This question is part of the following fields:
- Gastrointestinal
-
-
Question 22
Incorrect
-
An soccer player suddenly collapsed on the field and started coughing along with shortness of breath. The investigation of choice in this case would be?
Your Answer:
Correct Answer: Chest x-ray
Explanation:Exercise induced asthma is characterised by sudden onset wheezing, cough and shortness of breath while performing hectic physical activity. The best investigation to perform is a chest X-ray.
-
This question is part of the following fields:
- Respiratory
-
-
Question 23
Incorrect
-
A 19 year old girl suffers from a hereditary disease and presents at her GP with a renal colic. She claims that her mother had this problem too. What type of renal calculus is most likely responsible for the renal colic?
Your Answer:
Correct Answer:
Explanation:The patient seems to have inherited cystinuria which is an autosomal recessive disease. Typical for the disease is the abnormally high concentration of cysteine in the urine, finally causing cystinuria. In a person with cystinuria, the high concentrations of cysteine in the kidney results in the formation of stones with frequent colic pains and complications. If the genotype is partially expressed, then the phenotype might be even asymptomatic, thus the disease has a high variability.
-
This question is part of the following fields:
- Urology
-
-
Question 24
Incorrect
-
Due to difficulty at work, a newly qualified nurse constantly seeks reassurance and clings to other staff members. She is also reluctant to work without supervision. Which personality disorder does this describe?
Your Answer:
Correct Answer:
Explanation:The submissive and the clinging behaviour added with the extreme need to be taken care of, are characteristics of a cluster C dependent personality disorder.
-
This question is part of the following fields:
- Mental Health
-
-
Question 25
Incorrect
-
A 1-week-old baby presents with a large blue bruise-like mark on his back. His mother noticed the mark that same morning and she is concerned about its severity. What is the most probable diagnosis?
Your Answer:
Correct Answer: Mongolian spot
Explanation:Mongolian spots, otherwise called congenital dermal melanocytosis, are pigmented birthmarks. They are usually located on the buttocks or back and although they’re usually present at birth, they may appear soon after. They are flat and have a blue-grey colour (bruise-like). They are benign and present no health risk.
-
This question is part of the following fields:
- Child Health
-
-
Question 26
Incorrect
-
Which of the following statements reflects the aetiology and dynamics of schizophrenia most accurately?
Your Answer:
Correct Answer: Schizophrenia is commoner in individuals not in stable relationships
Explanation:According to the survey, schizophrenia is twice as common in individuals who are not in stable relationships or are single/divorced, as compared to happy couples.
-
This question is part of the following fields:
- Mental Health
-
-
Question 27
Incorrect
-
A 4-year-old girl with an abnormal facial appearance has an ejection systolic murmur radiating to between her scapulae. A radio-femoral delay was also found. Which of the following is the most probable cause?
Your Answer:
Correct Answer: Turner's syndrome
Explanation:These cardiovascular findings are suggestive of coarctation of the aorta, which is common among patients with Turner’s syndrome. Physical features of Turner’s syndrome include a short neck with a webbed appearance, a low hairline at the back of the head, low-set ears, and narrow fingernails and toenails that are turned upward.
Atrioventricular septal defect is the most common cardiac anomaly in Down’s syndrome.
Structural heart defects at birth (i.e., ventricular septal defect, atrial septal defect, patent ductus arteriosus) are common in Edward’s syndrome.
Pulmonary stenosis with or without dysplastic pulmonary valve and hypertrophic cardiomyopathy are common in Noonan’s syndrome.
Supravalvar aortic stenosis and peripheral pulmonary stenosis are found in William’s syndrome. -
This question is part of the following fields:
- Child Health
-
-
Question 28
Incorrect
-
A 71-year-old woman residing in a nursing home for a couple of years complains of drooling of saliva and sudden difficulty in swallowing while eating. She is a known hypertensive on treatment. What would be your next step?
Your Answer:
Correct Answer: Endoscopy
Explanation:Dysphagia or difficulty in swallowing. Endoscopy allows for visual examination of the oesophagus and is indicated in patients with dysphagia to determine the underlying aetiology, exclude malignant and premalignant conditions, assess the need for therapy, and perform therapy including dilation.
-
This question is part of the following fields:
- Older Adult
-
-
Question 29
Incorrect
-
A 23-year-old woman complains of numbness in her right hand that improves by shaking it. The surgeon has suggested a surgical option. Ligation of which of the following structures will improve the condition?
Your Answer:
Correct Answer: Flexor retinaculum
Explanation:The most likely cause is median nerve inflammation due to carpal tunnel syndrome. It is treated surgically with ablation of the flexor retinaculum.
-
This question is part of the following fields:
- Neurology
-
-
Question 30
Incorrect
-
An echocardiogram of a 50-year-old male patient showed an infarct in the anterolateral aspect of the left side of the heart and apex. An angiogram was then done. Obstruction of which of the following arteries is the cause of this myocardial infarction?
Your Answer:
Correct Answer:
Explanation:The left coronary artery is responsible for supplying the entire left side of the heart, however, it divides into the left anterior descending artery which supplies the apex of the heart and the interventricular septum, and the left circumflex artery which supplies the posterolateral part of the left ventricle and a portion of the papillary muscle. The infarction is noted at the apex of the heart and the interventricular septum, therefore, the obstruction has occurred in the left anterior descending artery.
-
This question is part of the following fields:
- Cardiovascular
-
SESSION STATS - PERFORMANCE PER SPECIALTY
