-
Question 1
Incorrect
-
A 28-year-old male was screened for hypertrophic cardiomyopathy (HOCM). His father has passed away recently at the age of 48 and found to have HOCM during post mortem examination. On examination of this patient his BP was 142/84 mmHg and pulse rate was 68 bpm which was regular. There was a mid systolic murmur and a double apex beat. Echocardiography showed a septal wall thickness of 3.3 cm. What is the factor most closely linked to his 20 year risk of sudden cardiac death?
Your Answer: Double apex beat
Correct Answer: Septal wall thickness of 3.3 cm
Explanation:There are five prognostic factors which indicate poor prognosis in HOCM:
-family history of HOCM-related sudden cardiac death
-unexplained recent syncope
-large left ventricular wall thickness (MLVWT > 30 mm)
-multiple bursts of nsVT on ambulatory electrocardiography
-hypotensive or attenuated blood pressure response to exercise -
This question is part of the following fields:
- Cardiovascular System
-
-
Question 2
Correct
-
Which one of the following is the most common cause of hypothyroidism in the UK?
Your Answer: Hashimoto's thyroiditis
Explanation:Hashimoto thyroiditis is the most common cause of hypothyroidism in developed countries. In contrast, worldwide, the most common cause of hypothyroidism is an inadequate dietary intake of iodine. This disease is also known as chronic autoimmune thyroiditis and chronic lymphocytic thyroiditis.
-
This question is part of the following fields:
- Endocrine System & Metabolism
-
-
Question 3
Incorrect
-
A 45-year-old female was diagnosed with a benign ovarian mass on her right side. She complained of inner thigh pain on her right side. Which of the following nerves is responsible for her inner thigh pain?
Your Answer: Pudendal nerve
Correct Answer: Obturator nerve
Explanation:The obturator nerve is compressed due to the ovarian mass, this causes pain in the inner thigh because it innervates this area.
-
This question is part of the following fields:
- Musculoskeletal System
-
-
Question 4
Incorrect
-
A 40-year-old man presents with periorbital and pedal oedema. 24h urine shows 9g of protein/d and serum cholesterol of 7 mmol/L. What would be the most likely diagnosis?
Your Answer: FSGS
Correct Answer: Membranous glomerulonephropathy
Explanation:Membranous glomerulonephritis . However some authors believe FSGS a more commoner cause of nephrotic syndrome.
-
This question is part of the following fields:
- Renal System
-
-
Question 5
Incorrect
-
A 45-year-old female has presented to her doctor with rotational vertigo, nausea, and vomiting (especially when she moves her head). She had a similar incident 2 years ago. It is noted that these vertigo episodes follow a runny nose, cough, cold, and a fever. Given the symptoms, what is the most likely diagnosis for the patient?
Your Answer: Meniere's disease
Correct Answer: Vestibular neuritis
Explanation:In this patient, there is no sensorineural hearing loss (which is often present in Meniere’s disease, labyrinthitis, and acoustic neuroma). Additionally, a runny nose, cold, cough, and fever are all recognised as triggers of vestibular neuritis (but not BPPV).
-
This question is part of the following fields:
- Nervous System
-
-
Question 6
Incorrect
-
A 25-year-old male presented in the emergency room with a history of loose stools which were bloody and mucoid for the last 2 to 3 months. The stools were also associated with abdominal cramps. He undergoes a colonoscopy after which he will start treatment. What is the most suitable drug in this case?
Your Answer: Corticosteroids
Correct Answer: Mesalazine
Explanation:Symptoms are suggestive of inflammatory bowel disease. In this disease mesalazine is very effective as an anti-inflammatory drug.
-
This question is part of the following fields:
- Emergency & Critical Care
-
-
Question 7
Incorrect
-
A 35-year-old gentleman presents to the Emergency Department with abdominal pain. This started earlier on in the day and is getting progressively worse. The pain is located on his left flank and radiates down into his groin. He has no history of this pain or any other condition. Examination reveals a gentleman who is flushed and sweaty but is otherwise unremarkable. What is the most suitable initial management?
Your Answer: Oral ciprofloxacin
Correct Answer: IM diclofenac 75 mg
Explanation:Because of the patient’s presentation with flank pain that radiates to the groin, we are suspecting renal colic. We should follow guidelines for acute renal management and prescribe IM diclofenac for immediate relief of pain.
-
This question is part of the following fields:
- Renal System
-
-
Question 8
Incorrect
-
Which of the following is not an indication for an implantable cardiac defibrillator?
Your Answer: Long QT syndrome
Correct Answer: Wolff-Parkinson White syndrome
Explanation:Class I indications (i.e., the benefit greatly outweighs the risk, and the treatment should be administered): -Structural heart disease, sustained VT
-Syncope of undetermined origin, inducible VT or VF at electrophysiologic study (EPS)
-Left ventricular ejection fraction (LVEF) ≤35% due to prior MI, at least 40 days post-MI, NYHA class II or III
-LVEF ≤35%, NYHA class II or III
-LVEF ≤30% due to prior MI, at least 40 days post-MI
-LVEF ≤40% due to prior MI, inducible VT or VF at EPSClass IIa indications (i.e., the benefit outweighs the risk and it is reasonable to administer the treatment):
-Unexplained syncope, significant LV dysfunction, nonischaemic cardiomyopathy
-Sustained VT, normal or near-normal ventricular function
-Hypertrophic cardiomyopathy with 1 or more major risk factors
-Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) with 1 or more risk factors for sudden cardiac death (SCD)
-Long QT syndrome, syncope or VT while receiving beta-blockers
-Nonhospitalized patients awaiting heart transplant
-Brugada syndrome, syncope or VT
-Catecholaminergic polymorphic VT, syncope or VT while receiving beta-blockers
-Cardiac sarcoidosis, giant cell myocarditis, or Chagas disease -
This question is part of the following fields:
- Cardiovascular System
-
-
Question 9
Incorrect
-
During the peri-infarct period, which of these drug classes have been shown to have the greatest favourable benefit?
Your Answer: Nitrates
Correct Answer: Beta blockers
Explanation:Statins and ACE inhibitors are beneficial initially for the first 24 hours but not proven to have a benefit in the post infarct period. Statins have plaque stabilising functions when activated early following infarction. In contrast, when started immediately, beta blockers are the most beneficial. Nitrates have not been proven beneficial for survival and some calcium channel blockers actually increased the mortality rate.
-
This question is part of the following fields:
- Cardiovascular System
-
-
Question 10
Incorrect
-
A 26-year-old woman is 32 weeks pregnant. She has a history of Sjogren Syndrome. The foetus would be at a risk for which of the following?
Your Answer: Neonatal lupus
Correct Answer: All correct
Explanation:Women with Sjögren syndrome are likely to experience more complications during pregnancy than women without an autoimmune disease as the anti-Ro and anti-La antibodies cross the placenta and lead to various life threatening complications. Studies show a high incidence of poor fetal outcomes for these patients. Congenital heart block, neonatal lupus, congestive cardiac failure, hydrops fetalis can all be caused as a result of Sjogren syndrome.
-
This question is part of the following fields:
- Musculoskeletal System
-
SESSION STATS - PERFORMANCE PER SPECIALTY
