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Question 1
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A young child is successfully treated for meningitis. Two months later his parents take him to their GP, worried that he isn't communicating with them like he used to.What is the most likely complication of meningitis that he developed?
Your Answer: Sensorineural deafness
Explanation:Possible complications include:- Hearing loss (which may be partial or total)- problems with memory and concentration- problems with coordination and balance- learning difficulties (which may be temporary or permanent)- epilepsy (Seizures)- cerebral palsy- speech problems- vision loss (which may be partial or total)As hearing loss is the most common complication of meningitis people recovering from the condition are usually given a hearing test to assess their hearing.
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This question is part of the following fields:
- Emergency Medicine
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Question 2
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A boy with atopic eczema presents with a flare up. In which of the following situations would you suspect herpes simplex virus versus a bacterial infection?
Your Answer: Lesions were present at different stages
Explanation:Lesions caused by herpes simplex virus may appear in various clinical stages. They are usually the result of an HSV-1 infection and they may appear on the face and neck. They start as fluid-filled blisters which eventually erupt into small painful ulcers.
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This question is part of the following fields:
- Dermatology
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Question 3
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Which of the following features is true of Alport syndrome?
Your Answer: It is caused by defects in collagen
Explanation:Alport syndrome is a genetic condition characterized by kidney disease, hearing loss, and eye abnormalities. Alport syndrome can have different inheritance patterns. About 80 percent of cases are caused by mutations in type IV collagen genes (COL4A5) and are inherited in an X-linked autosomal recessive pattern, although other inheritance patterns exist. Alport syndrome has autosomal dominant inheritance in about 5 percent of cases.
People with Alport syndrome experience progressive loss of kidney function. Almost all affected individuals have blood in their urine (haematuria), which indicates abnormal functioning of the kidneys. Many people with Alport syndrome also develop high levels of protein in their urine (proteinuria). The kidneys become less able to function as this condition progresses, resulting in end-stage renal disease (ESRD).
People with Alport syndrome frequently develop sensorineural hearing loss, which is caused by abnormalities of the inner ear, during late childhood or early adolescence. Affected individuals may also have misshapen lenses in the eyes (anterior lenticonus) and abnormal coloration of the light-sensitive tissue at the back of the eye (retina). These eye abnormalities seldom lead to vision loss.
Significant hearing loss, eye abnormalities, and progressive kidney disease are more common in males with Alport syndrome than in affected females.
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This question is part of the following fields:
- Nephro-urology
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Question 4
Correct
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A 15-year-old girl with acute Guillain-Barre syndrome has developed worsening weakness of her proximal muscles. Which of the following tests should be used to monitor her respiratory function?
Your Answer: Vital capacity
Explanation:One-third of patients with Guillain-Barre syndrome suffer from diaphragm weakness which can lead to further respiratory complications if there is involvement of the tongue, palate, and neck muscles. Forced vital capacity (FVC) is the best way to monitor respiratory muscle function by assessing it repeatedly. Admission for ITU is suggested when FVC is below 20ml/kg and intubation recommended when FVC is 15ml/kg or below. FVC is used in any neurological disorders wherein the respiratory muscles are affected.
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This question is part of the following fields:
- Respiratory
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Question 5
Correct
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A 16-year-old female presents to the physician with nausea, vomiting and abdominal swelling. Physical examination also reveals digital clubbing and linea nigra on her abdomen. Which of the following is the most likely diagnosis?
Your Answer: Pregnancy
Explanation:Clinical signs of early pregnancy-Amenorrhoea-Nausea and vomiting -Breast enlargement and tenderness -Hyperpigmentation of the areola and formation of linea nigra: Most likely due to increased levels of melanocyte-stimulating hormone produced by the placenta -Increased urinary frequency-Fatigue-Cravings for or aversions to certain foods-Abdominal bloating and constipation
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This question is part of the following fields:
- Adolescent Health
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Question 6
Incorrect
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Toe walking is NOT a feature of which of the following conditions?
Your Answer: Prematurity
Correct Answer: Waardenburg syndrome
Explanation:Toe walking refers to a pattern of walking in which the infants walk on the balls of their feet, without putting the heel of the feet on the ground. It is considered normal under the age of 2 years, but if it continues beyond that, it can signify some underlying pathology. The diseases that can be associated with toe walking include unilateral hip dislocation, Spinal tumours, Duchenne muscular dystrophy, prematurity, and cerebral palsy. Waardenburg’s syndrome is an autosomal dominant disorder, causing sensorineural deafness, and heterochromatic irises. Toe walking is not a feature.
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This question is part of the following fields:
- Child Development
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Question 7
Correct
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A 2 month old baby presents to the clinic with vomiting. On examination he has ambiguous genitalia. The lab results are as follows: Na: 125mmol/L, K: 6mmol/L. Which of the following is the most likely diagnosis responsible for this patient's presentation?
Your Answer: Congenital adrenal hyperplasia
Explanation:Congenital adrenal hyperplasia (CAH) comprises a group of autosomal recessive defects in enzymes that are responsible for cortisol, aldosterone, and, in very rare cases, androgen synthesis. All forms of CAH are characterized by low levels of cortisol, high levels of ACTH, and adrenal hyperplasia. The exact clinical manifestations depend on the enzyme defect. The most common form of CAH, which is caused by a deficiency of 21β-hydroxylase, presents with hypotension, ambiguous genitalia, and virilization (in the female genotype), and/or precocious puberty (in both males and females). It is further characterized by hyponatremia, hyperkalaemia, and metabolic acidosis. Increased levels of 17-hydroxyprogesterone confirm the diagnosis of 21β-hydroxylase deficiency. Treatment of CAH involves lifelong glucocorticoid replacement therapy. Patients with a 21β-hydroxylase deficiency also require mineralocorticoid replacement with fludrocortisone. Complications of CAH include severe hypoglycaemia, adrenal insufficiency, and/or a failure to thrive.
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This question is part of the following fields:
- Endocrinology
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Question 8
Correct
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A 7-year-old boy is diagnosed with metabolic acidosis as a result of severe dehydration. Which of the following conditions is most likely to cause severe dehydration and metabolic acidosis?
Your Answer: Severe diarrhoea
Explanation:Diarrhoea is defined as having three or more loose or liquid stools per day, or as having more stools than is normal for that person. Severe diarrhoea, causing fluid loss and loss of bicarbonate, will result in marked dehydration and metabolic acidosis.
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This question is part of the following fields:
- Fluid And Electrolytes
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Question 9
Correct
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A boy with Duchene muscular dystrophy and healthy parents is expecting a new brother. What are the chances that his brother develops the same disease after birth?
Your Answer: 0.5
Explanation:Duchenne muscular dystrophy has an X-linked recessive pattern of inheritance. Since the first son is affected by the disease, it means that the mother is a carrier. The male children will inherit the Y chromosome from their father and the X chromosome from their mother, having 50% chances of inheriting the X chromosome with the affected gene.
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This question is part of the following fields:
- Genetics And Dysmorphology
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Question 10
Incorrect
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Which of the given bioactive factors is NOT a component of normal human breast milk?
Your Answer: IgA
Correct Answer: Basophil
Explanation:Human breast milk composition is best suited to meet all the growth and development requirements of a baby. It contains numerous biochemicals ranging from macronutrients, micronutrients, minerals, immunoglobulins, inflammatory markers, and growth factors. The major bioactive factors found in human breast milk are: immunoglobulins (IgA, IgG, and IgM), cells (macrophages and stem cells), growth factors (epidermal growth factor, tumour necrosis factor-alpha, transforming growth factor-beta, and vascular endothelial growth factor), cytokines, chemokines, hormones, metabolic hormones, glycans, and mucins.
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This question is part of the following fields:
- Nutrition
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