-
Question 1
Correct
-
Question 2
Correct
-
A 26-year-old student has been brought to the emergency department in a confused state. His friends report that he has been complaining of headaches for the past few weeks. He has a low-grade fever and on examination is noted to have abnormally pink mucosa. What is the most likely diagnosis?
Your Answer: Carbon monoxide poisoning
Explanation: -
This question is part of the following fields:
- Emergency & Critical Care
-
-
Question 3
Correct
-
A 50-year-old male presented with episodes of collapse during the last month. Each episode persisted for about 2-3 minutes. They were self-limiting and associated with twitching of the limbs. There was no associated tonic-clonic movements, tongue biting, urinary or faecal incontinence. On examination he had reversed splitting of S2 and an ejection systolic murmur at the right sternal border. His electrocardiogram (ECG) showed left ventricular hypertrophy with strain pattern. CXR showed an area of calcification over the cardiac silhouette. Which of the following is the most probable diagnosis of this patient?
Your Answer: Aortic stenosis
Explanation:The classic triad of symptoms in patients with aortic stenosis is chest pain, heart failure and syncope. Pulsus parvus et tardus, pulsus alternans, hyperdynamic left ventricle, reversed splitting of the S2, prominent S4 and systolic murmur are some of the common findings of aortic stenosis. A calcified aortic valve is found in almost all adults with hemodynamically significant aortic stenosis.
-
This question is part of the following fields:
- Cardiovascular System
-
-
Question 4
Correct
-
A 40-year-old lady who underwent a recent subtotal gastrectomy for peptic ulcer disease has now developed anaemia with a haemoglobin of 6.4, tiredness, fatigue and loss of vibration sensation in both legs. What is the underlying cause of her symptoms?
Your Answer: B12 deficiency
Explanation:Vit B12 needs intrinsic factor to be absorbed, which is secreted in the stomach. Its deficiency is characterised by macrocytic anaemia with peripheral neuropathy.
-
This question is part of the following fields:
- Gastrointestinal System
-
-
Question 5
Incorrect
-
A woman presents with pallor and jaundice. History reveals she has been taking medication to treat her acne. Which of the following medication has she been taking?
Your Answer: Tetracycline
Correct Answer: Erythromycin
Explanation:Oral erythromycin is used to treat acne, and has been known to cause various degrees of hepatotoxicity in many patients. It is believed to cause liver lesions leading to hampered bile formation and cholestasis. This presents as jaundice due to the increased movement of bile into the blood instead of into the duodenum. All the other drugs mentioned here are not known to cause such hepatotoxicity.
-
This question is part of the following fields:
- Hepatobiliary System
-
-
Question 6
Correct
-
A 28-year-old male was admitted with severe central abdominal pain managed as an acute pancreatitis due to his serum amylase being markedly elevated. He is a known epileptic patient and has been on anti-epileptics. What would be the antiepileptic drug responsible for this clinical presentation?
Your Answer: Sodium valproate/Carbamazepine
Explanation:Both Sodium valproate and Carbamazepine are correct. These drugs can cause drug induced pancreatitis however more cases have been reported with Sodium valproate.
-
This question is part of the following fields:
- Gastrointestinal System
-
-
Question 7
Correct
-
A 30-year-old lawyer presents with non-specific symptoms of tiredness.
Blood tests reveal normal thyroid function, cortisol, growth hormone and gonadotropins. Pituitary MRI reveals a 0.8cm microadenoma.
Which of the following represents the most appropriate course of action?Your Answer: Observation and reassurance
Explanation:The patient has a non-functioning pituitary tumour as her hormone profile is normal.
Non-functioning pituitary tumours are relatively common. A large number of these tumours are incidentally found pituitary microadenomas (<1 cm) and are usually of no clinical importance. -
This question is part of the following fields:
- Endocrine System & Metabolism
-
-
Question 8
Correct
-
A 25-year-old woman is found to have a blood pressure of 170/100 mmHg during a routine medical check. She is otherwise well and her physical examination is unremarkable.
Blood tests show:
Na+ 140 mmol/l
K+ 2.6 mmol/l
Bicarbonate 31 mmol/l
Urea 3.4 mmol/l
Creatinine 77 µmol/l
Which one of the following investigations is most likely to be diagnostic?Your Answer: Renin:aldosterone ratio
Explanation:Primary aldosteronism now is considered one of the more common causes of secondary hypertension (HTN).
Individuals with primary aldosteronism may present with hypokalaemia metabolic alkalosis; however, as many as 38% of patients with primary aldosteronism may be normokalaemia at presentation.
Routine laboratory studies can show hypernatremia, hypokalaemia, and metabolic alkalosis resulting from the action of aldosterone on the renal distal convoluted tubule (DCT) (i.e., enhancing sodium reabsorption and potassium and hydrogen ion excretion).
Plasma aldosterone/plasma renin activity ratio is used for screening because it is fairly constant over many physiologic conditions.The patient is clinically free, so Cushing diseases can be exclude.
-
This question is part of the following fields:
- Endocrine System & Metabolism
-
-
Question 9
Correct
-
A 60-year-old male was diagnosed with advanced intestinal carcinoma with metastasis. His doctor prescribed him NSAIDs and tramadol initially but his pain was not responding to it. Which of the following drugs is the most suitable alternative option?
Your Answer: Oramorph
Explanation:According to WHO, initial pain management for patients with malignancy involves NSAIDs and weak opioids. After their pain stops responding to them, stronger opioids such as oxycodone and morphine are prescribed.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 10
Correct
-
A 66-year-old baker presents to the oncology clinic with six-month history of weight loss and anorexia. Tumour marker profile shows an elevated level of bombesin.
Out of the following, which is the most likely cancer to account for this result?Your Answer: Small cell lung carcinoma
Explanation:Bombesin is a tumour marker elevated in small cell lung carcinomas, as well as in gastric carcinomas and retinoblastomas.
Tumour markers can be divided into:
1. Monoclonal antibodies
CA 125: Ovarian cancer, primary peritoneal cancer
CA 19-9: Pancreatic cancer
CA 15-3: Breast cancer2. Tumour specific antigens
Prostate specific antigen (PSA): Prostatic carcinoma
Alpha-feto protein (AFP): Hepatocellular carcinoma, teratoma
Carcinoembryonic antigen (CEA): Colorectal cancer
S-100: Melanoma, schwannomas
Bombesin: Small cell lung carcinoma, gastric cancer3. Enzymes
Alkaline phosphatase (ALP)
Neuron specific enolase (NSE)4. Hormones
Calcitonin
Antidiuretic hormone (ADH)
Human chorionic gonadotropin (hCG) -
This question is part of the following fields:
- Haematology & Oncology
-
SESSION STATS - PERFORMANCE PER SPECIALTY
