PRES MCQs

10/16/2014 PRES 2 Past Papers - MEDICAL REGISTRATION EXAMS.
for doctors
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PRES Level 2
MEDICAL REGISTRATION EXAMS. FOR
DOCTORS
GYNAE / OBS
1: E.D.D.
L.M.P. more reliable than USG T
L.M.P. reliable even if periods are prolonged T
L.M.P. reliable when breast feeding T
L.M.P. when pregnancy due to pill failure T
Calculated as 12 months minus 3 months plus 7 days T
2: TERM
40 weeks T
>36 weeks F [37 to 42 wks]
<42 weeks T
38-41 weeks T
37-42 weeks T
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10/16/2014 PRES 2 Past Papers - MEDICAL REGISTRATION EXAMS. for doctors
3: TERM
>42 weeks F [37 to 42 wks]
40 weeks T
>36 weeks F
4:INCREASED SERUM PROLACTIN LEVELS MAY RESULT FROM
Stress T
Chronic renal failure T
Infection with HIV T
Hypothyroidism T
Sheehans syndrome F
5:: IN NORMAL PREGNANCY
Increase of 100kcal is required by the mother per day for normal development of the fetus F
300mg folic acid is required daily F
Iron absorption increases with meals F
10% of dietry iron is absorbed from the gut T
Hb falls by 1g/dl due to haemodilution F
6: IN NORMAL MENSES
Secretory endometrium is associated with corpus leuteum T
After menarche the cycles are usually ovulatory F
Ovulation occurs at the 7th day of the cycle F
LH peaks after ovulation F
Secretory endometrium secretes estrogen F
7: IN THE LUTEAL PHASE OF THE CYCLE THE FOLLOWING ARE TRUE
Increased progesterone T
Increased LH F
Decreased body temperature
Implantation T
Increased FSH F
8: IMPLANTATION
Occurs before LH surge F
Occurs 2 weeks after fertilization F
Fertilization occurs in the ampulla T
Fertilization occurs 48 hrs after ovulation F
9: IN IMPLANTATION
Fertilization occurs in the ampullary oviduct T
It occurs before LH surge F
It occurs 2 weeks after fertilization F
Fertilization occurs within 48 hrs of ovulation T
It occurs with watery mucous secretions F , [This is luteal phase so progesterone makes cervical mucus scanty,viscid,cellular,non stretchable and gives a negative
fern test,where as in follicular phase oestrogen makes cervical mucus excessive ,watery ,cellur,clear and stringy {like raw egg white} and if allowed to dry on a
slide produces ferning pattern due to its high salt content ]
10: PLACENTAL FORMATION
Cytotrophoblast is in direct contact with the maternal blood F
Divided cells are formed from endometrial stroma F
Sinusoidal spaces are in direct contact with the uterine artery F
Each cytotrophoblast is formed from a primary villous F
Each cotyledon is a separate primary villous stem T[Cotyledon is tree villus branches,there are 20 cotyledons in placenta]
The placenta is attached to the myometrium F
Decidual cells are formed from the endometrial cells T
11: AMNIOTIC FLUID
Has the same protein content as maternal blood ?
Is formed by maternal filterate in the 2nd trimester F
A-fetoprotein increases through out pregnancy T [only till 30 wks]
Bilirubin is highest in the last trimester ?
Has high ureas than maternal blood T
12: THE FOLLOWING INCREASE IN NORMAL PREGNANCY
Fibrinogen T
Plasminogen activator T
Factor V F
Factor VIII T
Fibrinogen degradation products F
13: THE FOLLOWING INCREASE DURING PREGNANCY
Sodium F
Cardiac out put because of increased heart rate T
Haematocrit F
Serum aldosterone T
Renal blood flow increases by 50% T
14: THE FOLLOWING ARE INCREASED IN PREGNANCY
Sodium F
Cholesterol T
Fibrinogen T
Fasting blood glucose
Factor VIII T
15: NAUSEA AND VOMITING
In late pregnancy is related to eclampsia T
In early pregnancy it is among the troublesome symptoms
Can be presenting feature of hydatiform mole T
Is early pregnancy is due to high estrogen level T
Can be treated safely by antihistamines T
16: VOMITING IN EARLY PREGNANCY
Is due to high estrogen T
Associated with pre eclampsia F
Hydatiform mole T
Can be safely treated by anti histamines T
With nausea is symptom of pregnancy T
17: IN PREGNANCY
Decreased TLC F
No change in vital capacity T
Increased respiratory rate
18: SUPPORTS OF UTERUS INCLUDE
Levator ani muscles F
Utero sacral ligaments T
Pubo cervical ligaments T
Round ligaments F
Infundibulo pelvic ligaments F
19: UROGENITAL RIDGE GIVES RISE TO
Urinary bladder F
Uterus T
Cervix T
Vulva F
Fallopian tubes T
20: NORMAL FETAL GROWTH AND SIZE
Recognizable external genitalia develop by 6 weeks
By 28 weeks is more than 1kg
Is closely related to mothers weight F
Can be successfully assessed by pubis fundus height F
21: THE FOLLOWING CAN BE DETECTED BY USG
Heart pulsation at 8 weeks T
Crown rump can be measured by 8 weeks T
Gestational sac can be detected at 5 weeks T
May not differentiate between molar pregnancy and fibroid T
It can diagnose Ectopic pregnancy T
22: FETAL ULTRASOUND
Crown rump measurement is accurate up to 14 weeks F
Biparietal diameter measurement can be done at 8 weeks F
Generally fetal heart rate detected at 2 weeks F
Twins cannot be diagnosed until 14 weeks gestation F
Early scan is more accurate than late scan for gestational age estimation F
23: FETAL GROWTH
Is accurately assessed by abd palpation F
Is best assessed by US T
Is closely related to mother weight F
May be usefully screened by fundal height T
Is different according to race T
24: FETAL CIRCULATION
Umbilical artery carries oxygenated blood F
Ductus venosus short circuits capillaries in the liver T
Foramen ovale connects the 2 ventricles F
Ductus arteriosus joins the aorta proximal to the arch F
The right atrium contains mixed oxygenated blood T
25: NORMAL FERTILIZATION****
Implantation occurs 1 week after it T
Blastocyst divides to give rise to morula T
Diploid sperm and ovum fuse together F
LH surge initiates meiosis in the ovarian follicle F
26: FOUR WEEKS AFTER FERTILIZATION
The fetus is 2 cm long F [less than 2 cm]
The neural tube is closed F [closes at 6 wks]
The limb bud has already developed F [at 6 wks]
It has circulation F [at 6 wks]
The face is already developed F [at 6 wks]
27: IN SPERM DEVELOPMENT
Takes 120 days F [74 DAYS]
Haploid number of chromosomes formed early F
Mature sperm with acrosomal membrane formed T
Fructose is main source of energy T
Maturation takes place in the seminal vesicles F
28: SPERMETOGENESIS
Occurs within the leydig cells F
Primary spermatocytes under go reduction division T
Production of new spermatozoa takes 35 days F
After vasectomy sperm production ceases F [ reduced but not stoped]
In normal fertile person ejaculate does not contain malformed sperms F
29: UROGENITAL DEVELOPMENT IN FETUS
Gonads start to develop at 5-6 weeks
Female genitalia formed from urogenital sinus F
Male fetus secretes mullerian inhibiting factor T
Clitoris develops from genital tubercle T
Female genitalia develop from wolfian ducts F
COCS/HRT/FERTILITY
30: FOR FERTILITY THE FOLLOWING ARE RELIABLE
FSH F
LH F
Sperm T
Hysterosalpingogram F
31: IN THE USE OF COCs
Breast feeding is contraindicated T
Breast cancer is a contraindication T
Is contraindicated in smoking women > 35 years T
Erythema nodosum is a complication T
They interact with broad spectrum antibiotics T
32: THE FOLLOWING DRUGS USED FOR CONTRACEPTION MAINLY CAUSE SUPPRESSION OF OVULATION
COCs F
Intrauterine levoprogesterone F
Depo-medro progesterone F
POPs F
Billing method F
33: COCs PILL INCREASE THE INCIDENCE OF THE FOLLOWING
Ovarian cancer F [decreases it]
Endometrial carcinoma F [decreases it]
DVT T
Ectopic pregnancy F [ protects from its occurring]
Endometriosis F [decreases it]
34: ABSOLUTE CI OF COCs
Aids F
Pregnancy T
Patient on renal dialysis program F
Cervical carcinoma F
Smoking F[if age more than 35 yrs]
35: COCs PILLS ASSOCIATED WITH
Osteoporosis F
Endometrial carcinoma F
Protection against IHD F
Prevention of implantation T
36: ORAL CONTRACEPTIVE PILLS
In crease the risk of breast carcinoma T
Can cause erythema nodosum T
Can predispose to DVT T
37: A 28 YEAR FEMALE PRESNETED TO A&E COMPLAINING OF UNILATERAL TEMPORAL MIGRAIN AND PHOTOPHOBIA , SHE IS ON OCPs
OCPs should be stopped immediately T
Blood ESR should be done F
Anti depressant can be used F
If associated with transient hemiparesis , has no prognostic value F
Suma tryptan and other 5HT agonists can be used F [is contraindicated pg 450 ]
38: IUCD MIRENA
Is inserted under GA F
Should not be kept for more than 10 years T
39: FEMALE STERILIZATION
Lower failure rate than vasectomy F
Complicated by Ectopic pregnancy T
Best method of sterilization F
CI if there is history of DVT
40: MALE INFERTILITY CAN BE CAUSED BY
Excessive masturbation F
Chlamydia infection T
Maldescended testes T
Alcohol consumption T
Impotence T
41: MENOPAUSE
Most common at 55years F
Increased FSH and LH F
Increased FSH and decreased LH F[FSH increases bt LH not decreased]
In 1% before 40years F
Increased level of HDL F
42: THE FOLLOWING ARE ASSOCIATED WITH MENOPAUSE
Increased incidence of IHD T
Increased incidence of renal disease T
Increased incidence of osteoporosis T
Increased incidence of vaginal discharge F
43: HRT
Is indicated in all women after menopause F
CI in breast cancer T
If used for more than 10 years increases the risk of breast cancer T
If uterus intact both estrogen and progesterone should be given T
Is contraindicated in smokers F
Decreases the risk of IHD T
Smoking is CI F
44: COMPLICATIONS OF HRT
Osteoporosis F
Increased incidence of IHD F
Pregnancy F
Vaginal bleeding T
Ovarian cancer T
45: HRT
CI in breast cancer T [+breast feeding ]
Should be given only to females after menopause F
Decrease the risk of IHD T
CI in smokers F
CI in cervical cancer F
46: ABSOLUTE CI OF HRT*******
Untreated breast cancer T
Undiagnosed vaginal bleeding T
Hypertension F
Heavy smoking F
IHD F
Past history of DVT T
PREGNANCY
47: ANTEPARTEM CARE
Is primarily a screening process T
Involves routine paternal blood group typing F
At least 10 visits should be done T
No advice on smoking is included F
In developed countries results in lower maternal and perinatal mortality and morbidity T
48: A PREGNANT LADY OF 35 WEEK GESTATION REFFERED FOR UREGENT OPINION BECAUSE OF CEASED FETAL MOVEMENT, CTG SHOWED HEART RATE OF
85beats/min AND NO UTERINE CONTRACTIONS , THE FOLLOWING ARE POSSIBLE
Maternal heart rate of 85bpm and fetal death F
Maternal heart rate of 85bpm and normal fetus F
Possible malfunction of CTG T
Normal mother and fetal tachycardia F
Massive abruption placentae is a possible diagnosis T
49: IN NORMAL PREGNANCY AT 28 WEEKS ADVICES TO THE MOTHER INCLUDES***********
Reduction of sexual intercourse F
Stop smoking to reduce incidence of low birth weight babies T
Fetal growth can be accurately measured by fundus pubis height F
Folic acid should be given in a dose of 60 mg per day F
Fetal growth can be missed by US T
50: DURING PREGNANCY THE FOLLOWING ADVICES SHOULD BE GIVEN TO THE PREGNANT LADY**********
Alcohol is associated with fetal malformations T
Folic acid should be given in a dose of 40 mg to all pregnant ladies F
A mother with previous fetal malformations should not go to work F
Reduce frequency of sexual intercourse F
Reduce smoking because it is associated with reduced average fetal weight T
51: ECTOPIC PREGNANCY
Is never associated with IVF F
The presence of gestational sac in the uterus on abd US always excludes the diagnosis of Ectopic pregnancy F
Surgery is the only treatment F [methotrexate is also a treatment]
Can cause maternal death T
Can be excluded by US T
52: MULTIPLE PREGNANCY
Increased incidence in older women T
Increased incidence of APH T
Associated with fertility treatment T
Associated with polyhydramnios T
Is of race origin T
LABOUR
53: SECOND STAGE LABOUR
Starts with full dilatation of cervix T
Ends with delivery of placenta F
Oxytocin is never used F
Is longer in multipara than nullipara F
Should complete in 30 minutes F
54: 3rd STAGE OF LABOUR
Is completed with the delivery of the baby F
Prolonged in primigravida F
55: ANALGESIA IN FIRST STAGE OF LABOUR
Opioids T
Paracetamol oral
Epidural analgesia F
Intravenous nitrous oxide plus oxygen F[By inhalation OR S/C]
Perineal infilteration F
56: EPIDURAL ANALGESIA
Prolongs the first stage of labour F
Increases the risk of instrumental delivery T
The baby will be born with severe acidaemia
Causes decelaration on CTG
57: PRETERM LABOUR
May be caused by enancephaly T[risk increased]
Can always be stopped by beta blockers F
Can rarely be caused by twin pregnancy F
Twin pregnancy can rarely precipitate it F
Often induced by obstetrician due to maternal disease or fetal distress ?
58: PRETERM LABOUR
Could be due to APH T
Defined as bleeding at less than 32 weeks F
If it occurs in the mid trimester should be managed by purse string suture
May be due to the obstetricians decision T
59: DRUGS USED TO STOP PREMATURE LABOUR
Oxytocin F
Pethidine F
Ritrodine T
Salbutamol T
Nifedipine T
Steroids F
60: IN CTG THE FOLLOWING ARE NORMAL FINDINGS
Rate >160/min F
Rate <110/min during a contraction F
Beat variability = 20/min T
Prolonged late decelerations F
4 accelerations / min T
61: THE FOLLOWING CAUSE FETAL TACHYCARDIA
Maternal hypothyroidism F
Chorioamnionitis T
Maternal hyperthermia T
Maternal tachycardia T
Prematurity T [due to immature nervous system]
62: APGAR SCORE CONSTITUTES
Heart rate T
Respiratory rate T
Can assess severity of birth asphyxia T
Moro reflex F
Colour T
63: FETAL BLOOD SAMPLING
Done to show if baby is acidotic T
Can only be done if cervix more than 5 cm dilated F
In labour done for blood sampling F
Most often done after abnormal cardiotocography T
64: FAILURE OF PROGRESSION OF LABOUR
Means delay in cervical dilatation and failure of head to descend T
Is due to cephalo-pelvic disproportion T [ Large head of baby to pass through small pelvis so caesarean section is indicated]
Oxytocin is CI F
Always indicates caesarian section F
65: IN THE FIRST TRIMESTER OF PREGNANCY
Pain and bleeding may suggest Ectopic pregnancy T
Dilated cervix and heavy bleeding indicate inevitable abortion T
It is treated with tetracycline F
Excessive vomiting means there is threatened abortion F [Cervix closed]
66: VENTOUSE EXTRACTION
Can be done at anytime after cervix is >6cm dilated F [ It is not done if head is above ischial spines and it is done when cervix fully dilated in primi and >6 cm in
multi]
Is sometimes needed for breach extraction T[Not usually]
Is always needed for breach extraction F[Not always]
Can be used for rotation of fetal head T
ABORTION
67: RECURRENT ABORTION
Karyotyping of parents should be done T
In Ireland 15% are due to uterine malformation
68: SPONTANEOUS ABORTION
Occurs in > than 20% of all cases T
Common cause of maternal death in Ireland
Can be prevented by progestin injection F
Associated with congenital anomalies T
69: SPONTANEOUS ABORTION
Occurs in more than 20% normal conceptions T
Can occur with malaria T
Is associated with fetal abnormality T
70: INEVITABLE ABORTION
Is bleeding from vagina in pregnancy with cervical os open T
Can result in incomplete abortion T
Rarely needs hospital admission F
Can be associated with significant haemorrhage T
71: 28 YEAR OLD LADY HAS A MISCARRIAGEAT 14 WEEKS, THE FOLLOWING DAY SHE BECAME VERY SICK WITH HIGH FEVER, THE RELEVANT DIAGNOSIS
MAY BE
Recently she had a pet kitten T
She lives in a sheep farm T
She ate soft cheese T
She had IDDM
She has a history of vulval herpes
72: MISCARRIAGE
More after 35 years of age T
Uterine abnormalities account for 15% of the cases
Can be prevented by progestin injection F
Parental Karyotyping should be done T
Due to anovulation F
CARCINOMAS
73: CA ENDOMETRIUM
Most common gynecological carcinoma T
Increased with smoking F
Presents with post menopausal bleeding T
Increased by unopposed progesterone F
Is more common in women taking estrogen and progesterone preparations F
74: VULVAL CARCINOMA
Ulcerates late in the disease T
Occur in women aged 40-50 years F
Can be treated by tropical creams T
75: VULVAL CARCINOMA
25% of the gynaecological carcinomas F [4% to 5%]
Ulcerates only in advanced disease
Are Histologically anaplastic F [various types of cells involved]
Commonly occurs in women aged 40-50 years F
Initially spreads to the iliac nodes via the vaginal lymphatics F
76: ENDOMETRIAL CARCINOMA
Stage II metastasize to bladder and rectum F
Stage II treated by Wertheims hysterectomy F
Is less in women who have late menopause F
Common in urban areas T
More than 50% are Squamous type F [Adenocarcinomatous]
77: THE DIAGNOSIS OF ENDOMETRIAL CARCINOMA DEPENDS ON
Cervical smear T
Endometrial curettage T
Hysterectomy F
Ionizing radiation F
Chemotherapy F
78: ENDOMETRIAL CARCINOMA
Is rare (5%) in pre menopausal women F
Can lead to post menopausal bleeding T
If in early stage treatment is hysterectomy with preservation of ovaries F
79: REGARDING OVARIAN TUMOURS
Most are secreting hormones F
Spreading is primarily by lymphatics F
Common in post menopausal women F
80: REGARDING MALIGNANT OVARIAN TUMOURS
Most are secreting tumours F
Spread predominantly by lymphatics F
Common in post menopause F
81: TUMOURS SECRETING ESTROGEN
Serous cyst adenoma F
Thecoma T
Arrhenoblastoma F [produces Androgen]
Dysgerminoma F
82: CERVICAL CARCINOMA
Can cause offensive discharge T
Can cause post coital bleeding T
Presents with infertility F
May present with post menopausal bleeding T
There is shoulder tip pain F
83: CERVICAL CARCINOMA
Common in smokers T
Associated with herpex simplex infection F
Common in 70-80 years of age F [30 to 50 yrs]
CA cervix is a sexually transmitted disease F
Associated with human papilloma virus T
PERINATALMORTALITY
84: PERINATAL MORTALITY
Calculated as births after 28 weeks gestation which die in 1st 28 days F[1st 7dys]
Calculated as per 1000 total births T
Increased if weight more than 4500g T
Decreased if weight less than 2500g F
Is no. of deaths after 28 weeks gestation and within 28 days post birth F
Is expressed in per 1000 births T
Increases with low birth weight T
Increases with birth weight more than 4500g T
Is 1 in 1000 in Europe F
Is more common in women <20 years of age than > 35 years T
Calculated as still births + neonatal death/1000 F
Calculated as still birth + neonatal deaths in 1st 7 days /1000 T
Includes abortion >20 weeks gestation F [24 Wks]
It is 6 in Ireland ?
Major congenital abnormalities are not included F
INFECTIONS
87: CHLAMYDIA INFECTION
Is the commonest sexually transmitted disease T
50% are asymptomatic T
Sensitive to metronidazole F
Can cause neonatal pneumonia T
Is intracellular T
88: TRICHOMONAS VAGINALIS
Usually sexually transmitted T
Increased in pregnancy T
Characterized by greenish frothy discharge T
Treated with anti fungal cream F [Metronidazole]
Treated with metronidazole T
89: VAGINAL CANDIDIASIS INCREASES BY
Pregnancy T
Steroids T
Broad spectrum antibiotics T
Diabetes mellitus T
Vaginal delivery F
Oral contraceptives T
90: DYSURIA WITH PREGNANCY
May be caused by Chlamydia T
Cephalosporins are the treatment of choice F
Treated by antibiotics for 10 days F [At least 2 wks]
IVU is mandatory in all cases F
91: ASYMPTOMATIC BACTERIURIA
Occurs in 10% of normal pregnancies F [7%]
Can cause UTI in 30%
Associated with genitourinary malformations T
May be associated with high WBCs T
92: ACUTE PELVIC INFLAMMATORY DISEASE
Commonest cause is neiseria gonorrhea F [Chlamedia]
40% incidence of infertility following attack F[Occurs after 3rd episode of attack]
Ectopic pregnancy can occur T
Can occur with signs of peritonism T
Can occur following retained products of conception T
93: ASYMPTOMATIC E.COLI IN PREGNANCY
Occurs in 10% normal pregnancy T [7%]
The incidence is the same in non pregnant as in pregnant ladies T
Can be treated by a single dose of amoxicillin F
Investigations should include IVP F
It can increase premature labour risk T
94: A WOMAN WITH PELVIC MASS 10x10 DISCOVERED BY ROUTINE EXAMINATION
If hydro salpinx can be left safely
Repeat examination within 3 months
She needs laproscopy T
She needs colposcopy T
Can be well diagnosed by E.U.A
95: THE FOLLOWING INFECTIONS ARE TRANSMITTED TRANSPLACENTALLY TO THE FETUS*******
Malaria T
Toxoplasmosis T
CMV T
Herpes simplex T
Rubella T
Echovirus F ?[Occurs during delivery]
Coxsackies virus F ? [occurs during delivery]
96: THE FOLLOWING ORGANISMS CAUSE CONGENITAL DISEASES
Rubella T
Toxoplasmosis T
CMV T
HIV T
Treponema pallidum T
97: CONGENITAL TOXOPLASMOSIS CAN CAUSE
Phocomelia F [Limb abnormality]
Cerebral calcification T
Hepatosplenomegaly T
Chorioretinitis T
Cataract ? [vision problem occurs]
[Hydrocephalus,microcephaly,macrocephaly,anaemia,jaundice,skin rashes] T
98: THE FOLLOWING SHOW TRANSPLACENTAL SPREAD
Staph aureus F
CMV T
Toxoplasmosis T
HIV T
VARICELLA ZOSTER T
99: THE FOLLOWING CONDITIONS TEND TO IMPROVE WITH PREGNANCY
Migraine F ?
Multiple sclerosis F
Rheumatoid arthritis T
Asthma F
Epilepsy F
Graves disease T
Sarcoidosis F
100: SECONDARY AMENORRHEA
When associated with high FSH and LH indicates pregnancy F
Is present in testicular feminization syndrome F
Is part of polycystic ovary syndrome T
If complicating OCP may fatal in small number of patients ?
101: APH
Rh-ve mother should be given anti-D T
Cervical erosion can be a cause T
The mother can be safely managed at home F
It is associated with increased incidence of PPH T
In abruption placnetae the severity is indicated by the amount of blood F
102: A.P.H.
When from placenta praevia is of maternal origin T
When from vasa praevia is of maternal origin F[Bleeding from fetal vessels in fetal membranes]
When from placenta praevia is more common in nulliparous women F
Is most commonly from lower urogenital tract F
103: APH
Is bleeding from urogenital tract in pregnancy F
Can be complicated by hyper fibrinogenemia F
Vaginal assessment should be done F [p/v is not done]
104: IN APH
Cervical erosion is the cause T
In abruption external bleeding is a good indicator of severity F
If the cervix is closed the patient can be safely managed at home F [Always admit in hospital]
Associated with increased incidence of PPH T
Patient should be given anti-D T
105: PPH*******
More common in African women T
Treated with misoprostol F [it is PGE1 dilator and used for Os ripening]
Common in primipara than multipara F
Commonest cause is atony uterus T
PPH is defined as more than 1000 ml blood loss F
106: : SECONDARY PPH ASSOCIATED WITH
Uterus rupture F [Occurs in primary PPH]
Occurs with retained products of conception T
DIC frequently occurs F
Can cause infection T
Retained placenta T
Haematomas of broad ligament F [Occurs in primary PPH]
107: IN BLEEDING WITH PREGNANCY
APH is bleeding from vagina during pregnancy T
CA cervix can be a cause T
Iron deficiency anemia leads to anemia in the fetus
108: ANTI D SHOULD BE GIVEN TO
Rhesus negative mother sustained trauma during pregnancy T
Rhesus negative mother having ante partum hemorrhage T
Rhesus negative baby to a rhesus negative mother F
109: ERGOMETRINE ********
Contraindicated in hypotension F
As effective as Oxytocin F
Cannot be used with Oxytocin F
Can induce vomiting/emesis T
Is usually used in the oral form F [IM given in third stage of labor]
110: OVARIAN TORSION
Frequently presents as a gynecological emergency with acute abdominal pain T
Should be treated conservatively F
Can some times occur in adolescence T
Rarely leads to fallopian tube and ovarian necrosis F
Needs urgent laparoscopy and laprotomy T
111: FIBROIDS
Commonest tumour over 35 year aged women T
Frequently atrophies after menopause T
Should always be removed F
Red degeneration can occur in pregnancy T
112: FIBROIDS********
May present with heavy bleeding T
Should be removed if found in the first trimester F
May present as a mass rising out of the pelvis T
50% are malignant F [less than 0.2 ]
More common in nullipara T[less common in multipara]
113: THE FOLLOWING ARE TRUE ABOUT FIBROIDS*********
Common in blacks T
Characteristically present with pain F
Undergo sarcomatous change in 5% of cases F
Should be excised if > 2cm F
Common in nullipara T
114: ENDOMETRIOSIS
Commonly occur outside uterus T
Usually treatment is hysterectomy F
Is premalignant T
Is treated by high dose progesterone T
Commonly associated with dysmenorrhia T
115: ENDOMETRIOSIS CAN BE TREATED BY
High dose progesterone T
COCs T
Gonadotrophin releasing hormones T[if analog]
Surgical removal T
Laser ablation T
116: HYDATIFORM MOLE
Causes high fundal height for gestational age T
Associated with normal pregnancy F
Can be diagnosed by ultrasound T
Is followed by serial HCG assays T
Causes thyrotoxicosis T
117: IN COMPARISON TO NORMAL MULTIPAROUS WOMEN PET IS MORE COMMON IN WOMEN**********[PRE-ECLAMPTIC TOXEMIA
Who smoke F
Have 1st pregnancy T
Have triplets T
Married to cousin T
Molar pregnancy T
118: A LADY 30 YEAR OLD AT 37 WEEKS PREGNANCY HAS BLOOD PRESSURE OF 160/100 THE FOLLOWING MAY SUPPORT THE DIAGNOSIS OF PRE-
ECLAMPSIA
Mild ankle edema F
Bp of 160/100 at 16 weeks F
Proteinuria of 3g/day T
Epigastric pain T
Parity of 4 F[more in nullipara]
119: GESTATIONAL DIABETES MELLITUS
Is found more in cases of hyper emesis gravidarum F
Almost always leads to IDDM F
Leads to fetal macrosomia T
Increases the chances of PET F [ pre-eclamptic toxemia]
Increases the incidence of vaginal candidiasis T
120: DOUBLE BLIND TRIAL CAN BE USED IN COMPARING THE FOLLOWING
Methyldopa and labetalol in the treatment of PET T
Clomiphene and tamoxifen in the induction of ovulation T
Hysterectomy and endometrial resection in the treatment of menorrhagia F
Aspirin and placebo in the prevention of PET T
Outpatient and in patient management of asymptomatic placenta praevia F
121: FIBROCYSTIC DISEASE OF THE BREAST
Pain increases during the cycle T
Green discharge indicates malignancy F
Can be treated by excision T
122: SMOKING IN PREGNANCY********
Premature labour T
Intrauterine growth retardation T
Preeclamptic toxemia F
Placental abruption T
Iron deficiency anemia F
123: COW MILK CONTAINS THE FOLLOWING IN HIGH CONCENTRATIONS THAN BREAST MILK
Sodium T
Lactate F
Phosphate T
Fat F
Protein T
124: REGARDING BREAST FEEDING
Contains more fat than cows milk T
Contains more proteins than cow milk F
Contains secretory IgA T
125: HUMAN BREAST MILK
Is CI in Galactosemia T
Is rich in secretory IgA T
Is CI in congenital fructose intolerance
Low phosphate than in cows milk T
Is produced by Prolactin T
126: THE FOLLOWING ARE CI TO BREAST FEEDING
OCPs T
TCAs F
Digoxin F
Phenytoin F
127: IN BREAST FEEDING THE FOLLOWING ARE CONTRAINDICATIONS
Mothers taking TCAs F
Digoxin F
COCs T
PKU [phenylketonurea]
Tongue tie T
128: COWS MILK
Can be started safely in an infant of 3-9 months of age F
Can be diluted with water and given safely F
The child who is bottle fed can be given high casein-protein formula
Can be replaced by goat milk if allergic to cows milk F
129: 63: IN DEVELOPED COUNTRIES MATERNAL MORTALITY IS STILL INFLUENCED BY
Anemia F
Smoking T
Illegal abortion T
Malnutrition F
AIDS F
130: MRS X HAS 3 CHILDREN WITH A TWIN AND A MISSCARIAGE AND IS PREGNANT
Calculate her gravidity and parity
131: IN A PREGNANT LADY WITH DIABETES THE FOLLOWING CAN HAPPEN
risk of congenital anomalies is reduced by proper control prior to conception T
Can be safely monitored at home by blood tests T
Increases the risk of ceasarean section T
The size of the baby will not increase if there is good control T
Increases the risk of polyhydramnios T
132: DIABETES WITH PREGNANCY
Serum fasting blood glucose is decreased through pregnancy F
Oral GTT is altered late in pregnancy
133: DIABETES WITH PREGNANCY
Serum fasting blood glucose increases throughout the pregnancy F
Oral GTT is altered late in pregnancy ?
24 hrs after GTT insulin levels should return to fasting level ?
Glycosuria is an indicator of carbohydrate intolerance F
Insulin concentration remains constant until late pregnancy F
134: THE FOLLOWING ARE CAUSES OF FETAL MACROSOMIA
Diabetes mellitus T
Well built mother T
Fetal pancreatic tumour T
Post maturity T
Rh incompatibility T[Hydropsfetalus]
135: COMPLICATIONS OF MATERNAL DIABETES IN THE NEW BORN INCLUDE
Hyperglycemia in the baby F
Respiratory distress T
Macrosomia T
Hypercalcaemia ? [Ca decreases]
Hyperbilirubinemia T
136: THE OFFSPRING OF A DIABETIC MOTHER IS MORE PRONE TO
Hypocalcemia T
Jaundice T
Anemia F
Shoulder dystocia T
Congenital malformation T
137: IN DIABETES IN PREGNANCY THERE IS INCREASED INCIDENCE OF
Multiple pregnancy F
Congenital abnormalities T
Shoulder dytocia T
Pre eclampsia F
Metabolic acidosis ?
138: IN AFRICANS THERE IS INCREASED INCIDENCE OF
Pre eclampsia T
Fibroids T
Ectopic pregnancy T
Sickle cell anemia T
Osteoporosis F
GYNAE/OBS SURGERY
139: AFTER VAGINAL HYSTERECTOMY WITHOUT REPAIR YOU CAN TELL THE PATIENT
Not to drive for 6 weeks T
That she has to stay at hospital for atleast 5 days ?
Uterine packing and catheterization may be needed for a while T
Should have vaginal vault smear after 1 year ?
140: UROGENITAL PROLAPSE
There is sensation of something coming down T
After hysterectomy there is no recurrence T
Can be treated by vaginal pessaries T
Occurs more in nullipara F
141: COMPLICATIONS OF TOTAL HEYSTERECTOMY
Rectocele T
Anuria ?
UTI T
Hypertension F
Depression T
142: URINARY INCONTINENCE
Can occur due to detrusor muscle weakness T
More common in parous women T
Cholinergic drugs can be used F[ Anticholenergics are used]
143: DETRUSOR MUSCLE INSTABILITY IS A CAUSE OF
Stress incontinence T
Urgency T
Frequency T
Nocturia T
Faecal incontinence F
144:ERBS PALSY
Damage to lower root of the brachial plexus F [Upper root]
Damage to muscles supplied by C5 T [Deltoid,supraspinatus and teres major]
Paralysis of extensors of the forearm F [ Flexors]
Paralysis of deltoid muscle T
Commoner in breach than cephalic presentation T
PAEDIATRICS
GENETICS/GENETIC DISEASES
1: GENETICS
In recessive disorders if one baby is affected risk in next pregnancy is less than 1:4 F[1:4 ] 25%]
In achondroplasia as it is caused by a dominant gene at least one parent must have the disease F [Majority occurs due to new mutation]
Gene of classical hemophilia is transmitted only to males F
2: GENETIC DISEASES
Gene of classic hemophilia transmitted only to males F
Recessive disease when affects one child then subsequent chances of disease are 1 in 4 F
No Barr bodies in the buccal mucosa of a normal male is diagnostic of kleinfelters syndrome F
3: ABNORMAL KARYOTYPE IS FOUND IN
Testicular feminization syndrome F [ X-linked recessive condition]
Marfans syndrome F [Autosomal dominant disease]
Cystic fibrosis F [Autosomal recessive disease]
Kleinfelter syndrome T [46 XY,47 XXY,48XXYY]
Edwards syndrome T [18 trisomy]
Turner syndrome T [45 X]
Nooonans syndrome F [IS MALE ,Has Normal karyotype but it shares the features like turner syndrome]
4: THE FOLLOWING DISEASES ARE AUTOSOMAL RECESSIVE
Achondroplasia F [autosomal dominant]
Cystic fibrosis T
Sickle cell anemia T
Down syndrome F [Trisomy]
Haemophilia F [x-linked female carrier but disease occurs in males]
5: THE FOLLOWING ARE APPROPRIATELY PAIRED
47xxy and tall stature T
47xo and turner syndrome F [45 XO,46 XX ,47 XXX]
48xxyy/47xxy and Kleinfelter mosaic F ?
47chromosome+18 and down syndrome F [IF +21]
45q5 and cri du chat syndrome F [5P 15.3]
6: SHORT STATURE CAN OCCUR WITH
XO karyotype T
XXY karyotype F
XYY karyotypeF
Hyphosphatemic vit D resistant rickets T[it is x-linked dominant triat]
Caeliac disease T
7: THE FOLLOWING MAY BE USED TO IDENTIFY GENDER RELIABILITY
Chromosomes T
Gonads T
ABO blood groups F
Finger prints F
Hormones T
8: A PATIENT WITH 45XO
May be phenotypically male T
May be phenotypically female with male hair distribution at puberty F
May present with short stature T
Hormonal treatment is appropriate T [ Growth hormone is given]
May present with systemic hypertension T [ Often presents with hypertension]
9: THE FOLLOWING ARE AUTOSOMAL DOMINANT INHERITANCE
Duchene muscular dystrophy F [x linked]
Galactosemia F [recessive]
Phenylketonuria F [recessive]
Rickets T [can be x-linked or autosomal dominant]
Adult polycystic kidney disease T
10: CYSTIC FIBROSIS ************
Is x- linked disease F [ AUTOSOMAL RECESSIVE]
Can present with intestinal obstruction T
Can cause lung disease and bronchiectasis T
Patient usually gets DM by teen age F [not usually]
Regular physiotherapy is required T
11: CYSTIC FIBROSIS**********
Occurs in 1:4000 Caucasians F [1:2000]
Is autosomal recessive T
Genetic studies show specific gene T
Tetracycline should be used for prophylaxis F
Pancreatic enzymes are used for treatment T
Daily immunoglobin injections are used F
Multivitamin are needed T
12: DOWNS SYNDROME
Non dysjunction is commonest underline mechanism T
In a young lady translocation is more likely the cause than nondysjunction F?
The incidence is increased if both parents are affected F
More common in Caucasian than non Caucasian T
46 chromosomal number excludes the diagnosis F
If both parents have balanced translocation the risk is increased ?
13: DOWN SYNDROME DIAGNOSTIC FEATURES ARE
47XY+21 karyotype T
47XY+(21+14) karyotype T
Brushfield spots T
Duodenal atresia T
Single palmer crease T
14: DOWN SYNDROME
Characterized by brushfields spots T
Have special growth chart for development T
Associated with hypothyroidism T
Associated with deafness T
Translocation represents 99% of the cases F
15: CHARACTERISTIC FEATURES OF DOWN SYNDROME IN A NEW BORN INCLUDE
Single palmer crease T
Thickening of the skin at the back of the neck T
Umblical hernia T
Prolonged jaundice F
Hypothyroidism T ?
16: DOWNS SYNDROME
Hypothyroidism is more common than in normal children T
Risk of epilepsy increases significantly T
6% of the cases are due to translocation F [4%]
80% of the cases have cardiac defects F [50%]
Prevelance is 1:2000 F [1:800 to1000]
17: CYSTIC FIBROSIS
Is X-linked recessive disease F [Autosomal recessive]
Diabetes mellitus may develop in teenage T
Can cause bronchiatasis T
Can be complicated by meconium ileus in a newborn T
Can delay puberty T
18: CYSTIC FIBROSIS
Is an X-linked disease F [Autosomal recessive]
Presents with intestinal obstruction T
May present with bronchiectasis T
Is associated with osteomalacia T
Can lead to distal intestinal obstruction syndrome T
19: IN CYSTIC FIBROSIS
It is autosomal recessive T
More common in African than Chinese T [1in 65 african and1 in 90 in Asian]
Carrier rate is 1:100 in UK F [1:22]
It occurs in 1:400 n Caucasians F [1:2000]
Vitamin supplements are given T
20: CYSTIC FIBROSIS CAN CAUSE
Meconium ileus T
Erythema nodosum F
Bronchial asthma and diarrhea in toddlers F
Hyponatremia when exposed to heat wave T
Rectal prolapse T
21: COMPLICATIONS OF CYSTIC FIBROSIS
Diabetes T
Cirrhosis T
Heat exhaustion T
Feeding problem in first 2 years of life T
Female in infertility F
22: UNTREATED PHENYLKETONURIA CAN LEAD TO
Blue eyes T
Eczema T
Heart defects T ? [If maternal]
Salaam spasm T
Tourette syndrome T [motor tics or verbal tics(abnormal movements)]
23: REGARDING CYSTIC FIBROSIS OF THE PANCREASE
It is autosomal dominant F
May present with intestinal obstruction in the new born T
Is associated with fat embolism F
Is associated with generalized dysfunction of the mucous glands T
Chloride in the sweat is 80mmol/L T [Above 70]
MILESTONES
24: THINK OF DISABILITY IN CHILD
If cant crawl T
If cant sit on plane surface without support F
Has pincer grip F
Cant support trunk while lying prone F
Cant hold head up while lying supine F
25: 6 WEEKS BABY CAN
Smile and vocalize T
Fix and follow T
Turn from prone to supine F
Normal moro reflex T [Disappear in 3 months]
Can hold with pincer grip F [12 months]
26: THINK OF HANDICAP IF THE PATIENT PRESENTED WITH
Moro reflex at 6 months T[Usually disappears in 3 months]
Easily elicited asymmetric tonic neck reflexes ?
Hand preference F
Toy mouthing at 18 months T
Hand regards at 3 months F [recognize hands own hands at 15 wks]
27: YOU WILL THINK OF HANDICAP IF THE CHILD BY THE AGE OF
18month cannot walk T
6months still has moro reflex T
2 years has hand preference F (Right or left hand preference at 2 to 3 years)
18month has toy mouthing T
28: YOU WILL BE WORRIED IF A CHILD BY THE AGE OF
7months can sit alone F [CAN SIT WITHOUT SUPPORT]
18months can say a sentence F [Can say 10 words]
6months has head lag when lifted from supine position T [ No head lag at six months when on pulling from sitting position]
10.5 months has a good pincer grip F [Pincer grasp occur at 12 months]
29: THE FOLLOWING CAN BE DONE BY A 7 MONTH CHILD
Rollover , pivot and crawl F
Can hold with pincer grasp and forefingers F [12 month ]
Can move object from hand to hand T[Can transfer things from one hand to other at six months]
Can sit with support to the lower back T
Can point to objects F [ Point to with index in 12 months]
30: A 6 WEEKS BABY CAN
Can reach objects and has pincer grasp F [ can reach out objects at six months pincer grip occurs at 12 months]
Can follow objects and sounds T
Vocalize and smile T
Normal moro reflex T
Can roll from prone to supine F [can occur in 5 months]
31: THE FOLLOWING MILESTONES ARE TRUE
Hand preference at first year F
Pincer grip at 12-15 months T
Drawing triangle at 3 years F [5 Years]
Babies who are bottom shuffled walk later T
Reaching out objects at 2 months [4 months and 6 months]
32: PUBERTY
In girls 1st sign of puberty is menarche F
In boys first sign is increased testicular volume T
Peak height velocity is earlier in boys than girls F
33: PRECOCIOUS PUBERTY
Results in taller final height F ?
Can be a presenting feature of congenital adrenal hyperplasia T
Hypothyroidism can be a cause T
Mostly idiopathic T
34: REGARDING PUBERTY
If it started before 9 years it is precocious puberty T
In girls it starts with growth of breast bud T
Growth of sexual hair is due to adrenal androgens T
Chemotherapy can delay puberty T
Gynaecomastia in males is always pathological F
CARDIOVASCULAR
35: REGARDING CONGENITAL HEART DISEASES
In ASD there is right to left shunt F [Left to right shunt]
Coarctation of aorta leads to right to left shunt F [Left to right shunt]
Transposition of great vessels leads to cyanosis T
AV canal defects are associated with downs syndrome/trisomy 21 T
VSD may close spontaneously T
36: HEART FAILURE IN INFANCY
Never occurs in the first day of life F
Present with lower limb edema F ?
Presents with hepatomegaly T
Digoxin is never used F
Leads to feeding difficulty T
The JVP is helpful F
Liver enlarged by 2cm F
37: INNOCENT MURMER IN CHILD IS FAVOURED BY*******
Pan systolic F
Parasternal thrill F
Radiation to neck F
Change in posture T
Intensity increase with change of posture ?
38: THE FOLLOWING CAUSE CYANOSIS IN CHILDREN**********
Fallots tetralogy T
VSD F
Transposition of great vessels T
Coarctation of aorta F
Tricuspid stenosis T ?[SHUNT A/S TRICUSPID STENOSIS]
39: FALLOTS TETRALOGY
Heart failure is a common complication F
Child always cyanosed at birth F [Not always]
Functional anemia present despite normal Hb for that age ?
Squatting to relieve cyanosis after exercise is a common observation T
An ejection systolic click is heard over pulmonary area with a single S2 F ?
40: PROGRESSIVE CYANOSIS IN AN INFANT WITH PULMONARY PLETHORA AND ENLARGED HEART
TGA F ?
PDA T ?
ASD T ?
Tricuspid atresia T ?
Fallots tetralogy F ?
NEUROLOGY
41: INCREASED CHANCE OF EPILEPSY IN CHILDREN IF THERE IS
Partial febrile convulsion T
Positive family history of febrile convulsion T
If febrile convulsion occurs before the age of 12 month F
Has bad prognosis if occurred early in childhood F
42: FEBRILE CONVULSION*******
If occurs for 20-30 minutes can be benign F
Occurs in children between 6months-6 years T
If atypical and for longer period can lead to epilepsy in adult hood T
EEG is needed for diagnosis F
Needs anticonvulsants for prophylaxis F
43: SIMPLE FEBRILE CONVULSION
Most typically present within the first year of life F
Occur at the onset of illness F
Characterized by hyperthermia T
Recur in 30% T
Majority are focal F [Majority are generalized tonic clonic]
Are tonic clonic T
44: FEBRILE CONVULSION
Can occur without fever F
Recurrence during the first 24 hrs is most frequently simple ?
Can be focal T
It is always mandatory to do a lumber puncture F
Usually occur between 5months and 6years of age T
45: CHILDREN WITH FEBRILE CONVULSIONS ARE MORE LIKELY TO DEVELOP SPILEPSY IN ADULTHOOD IF
Family history of febrile convulsion T
Prolonged seizures T
Depend on number of seizures in single febrile illness T
Occurrence of seizures before 12 months of age F
If it is partial epilepsy T
46: FEBRILE CONVULSIONS
Can be less than 15 minutes duration T
Rectal diazepam should be given F ? [it is given]
Are mostly tonic clonic T
Characteristically presented by signs in areas other than CNS ?
47: CAUSES OF NEONATAL SEIZURES
Hyperkalemia F
Hypernatremia T
Hypothyroidism ?
Hypocalcemia T
Asphyxia T
48: CAUSES OF NEONATAL SEIZURES
Hypernatremia T
Congenital toxoplasmosis T
Rubella encephalitis T
Hypercalcemia F
Hyponatremia T
49: NEONATAL FITS ARE CAUSED BY
Hypoglycemia T
Hypocalcemia T
Hyperkalemia F
Hyperbilirubinemia T
Bottle feeding T
50: IN PETIT MAL EPILEPSY********
Teachers regard it as daydreams T
Carbamezapine is the drug of choice F
Never develop epilepsy in adult life F
Can be induced by over breathing T
Retrograde amnesia is characteristic F
51: CEREBRAL PALSY
Is a non progressive lesion with static clinical state F
Does not cause sensory problems ?
Fixed dorsiflexion of ankle occurs F
Hemi paresis more conspicuous in arms than in legs F
52: YOU WILL CONSIDER CEREBRAL PALSY
If there is hand preference at2 years F
No change in incidence for mature babies in the last 30 years ?
Intrapartum trauma is as a cause as perinatal asphyxia T ?
Can definitely be diagnosed at 6 months of age F
20% are due to intrapartum causes F
53: ABNORMAL EEG CHANGES USUALLY FOUND IN A CHILD WITH
Petit mal epilepsy T
Intervals between breath holding attacks F
Behavioral disorders F
Infantile spasm T
Jacksonian fits T
INFECTIONS/VACCINES
54: ACUTE EPIGLOTITIS
Red swelling is seen at laryngoscopy T
Always needs hospital admission T
Can cause sudden laryngeal obstruction T
Caused by influenza virus F
Confined only to infants less than 1 year old F
55: PERTUSSIS
It is usually caused by bordetella pertussis T
Never occurs before 3 months of age because of breast milk immunity F
Is mildly contagious F
Is characterized by recurrent bouts of cough followed by vomiting T
Is associated with sub conjuctival hemorrhage T
56: CLINICAL WHOOPING COUGH
Is caused by clostridium perfringens F
Is associated with vomiting T
Is caused by para influenza virus F
Involves epiglottis ?
57: IN NEONATAL SEPSIS
Hypoglycemia T
Hyperglycemia F
Decreased temp T
Fits T
Jaundice T
58: WARTS
Common in children T
Caused by adenoviruses F
Can be pre malignant T
59: ACUTE BRONCHIOLITIS
90% cases are due to respiratory syncitial virus T
If RSV is the cause ribavirin should be given T
Most commonly occur around the first birthday F ?
If there is associated pulmonary dysplasia it would be more troublesome T
Chest x-ray opacity indicates bacterial superinfection T
60: PERTUSSIS
It can occur in the first month of birth T
Mortality is more common between1-3 years of age T
Polymorph leukocytosis is characteristic F
Should not be diagnosed in the absence of whoop F
Should not be diagnosed in the absence of bacteriological evidence F
61: RECURRENT PNEUMONIA IN CHILD MAY BE DUE TO
PKU T
Cystic fibrosis T
Asthma ?
62: THE FOLLOWING VACCINES ARE EITHER GIVEN I/M OR SC
Measles T
Tetanus T
Poliomyelitis T
Small pox T
Tuberculosis F
63: IN VACCINATION
MMR cannot be given with hepatitis B F
DPT is contraindicated in eczema F
Oral polio and BCG are live vaccines T
MMR is a killed vaccine F
Hib [Haemophilus influenza B] is a live vaccine F
64: VACCINATION
BCG is CI in HIV positive cases T
MMR should not be given to children with egg allergy T
Meningitis vaccine is against strain B F[STRAIN C]
Patients with cystic fibrosis should be given influenza vaccine T
Preterm babies should have their vaccination delayed T ?
65: THE FOLLOWING ARE LIVE VACCINES
Typhoid(monovalent) F
TB T
Rubella T
Measles T
Oral polio T
66: COMMON VIRAL INFECTIONS
Koplicks spots is a prodrome of measles F
Microcephaly can occur in rubella T
Mumps can be asymptomatic ?
Chickenpox is classically maculopapular and vesicular T
67: THE FOLLOWING INCUBATION PERIODS ARE TRUE
Measles 8-11 days F
Chicken pox 2-3 days F
Rubella 3-5 days F
Mumps 5-7 days F
Malaria 9-30 days T
GIT
68: HIRSCHSPRUNGS DISEASE
80% of cases present within the first year of life T
Presents mainly with constipation T
The aganglionic segment extends distally for a variable distance from the spleenic flexure F
Is commoner in females F [Common in males]
Can be relieved by rectal examination ?
69: FRANK BLOOD STAINING OF THE STOOL IN A 6 MONTH CHILD MAY BE DUE TO ****************
Acute appendicitis F
Intususception T
Meckels diverticulum T
Shigella dysentery T
Anal fissure T
70: CONSTIPATION IN CHILDREN
Relieved by PR exam in Hirschprungs disease T
Associated with low fiber diet in those under 1 year of age T
Can defined as difficulty in defecation T
Can be defined as painful defecation T
Can be defined as delayed defecation T
71: JAUNDICE IN NEW BORN
Acoholic faeces in biliary atresia ?
Surgery should be done by 5 years in biliary atresia T
Surgery for biliary atresia by 6 months is associated with more than 90 % survival F
Physiological jaundice can occur T
Hypothyroidism needs to be excluded T
72: PHYSIOLOGICAL JAUNDICE
More common in preterm deliveries T
Is caused by biliary atelectasis F
73: PHYSIOLOGICAL JAUNDICE
More in preterm babies T
Experienced within the first 18 hours F [2nd day]
Always treated by phototherapy F [Always in pathological]
Associated with indirect hyperbilirubinemia T
Associated with haemolysis and reticulocytosis ?
74: THE FOLLOWING ARE CAUSES OF BULKY DIARRHOEA
Diverticulosis T
Cystic fibrosis T
Chronic pancreastitis T
Primary biliary cirrhosis T
Irritable bowel syndrome F
75: ENTRITIS IN CHILDREN IS MANAGED BY
Fluid electrolyte balance T
Oral antibiotics F
Motility depressing drugs F
Antiemetics F
Stopping normal feed T
76: CELIAC DISEASE
Presents with epistaxis F
X-xylose is found in urine F [D-XYLOSE]
Is premalignant condition of bowel T
77: CONGENITAL PYLORIC STENOSIS*****
Develop at 4-6 weeks of life T
More in the first born female F [more in male 4 times]
Cause hypochloremic alkalosis T
Diagnosed by barium enema F
The bowel is distended with feeding T
78: CONGENITAL PYLORIC STENOSIS
Is due to thickening of the muscle T
Associated with metabolic acidosis F
Associated with bilious vomiting F
Presents at 3weeks to 2 months of age T [3 TO 8 WKS]
Is autosomal recessive disease T
79: INTUSSUSCEPTION
Should be diagnosed early T
Most common cause of intestinal obstruction in infants T
80: INTUSSUSCEPTION***********
Commonly occurs in the first 6-9 months of the life T
Presents with motions of mucus mixed with blood T
Pain is characteristically continuous F[COLIC]
Barium enema is the best tool for diagnosis F[AIR ENEMA]
Treatment is surgical F
RENALSYSTEM
81: IN EVERY CHILD WITH ENURESIS THE FOLLOWING SHOULD BE DONE
Family history T
Physical examination T
IVU F
Urine culture T
Renal function tests T
82: ENURESIS
Is associated with a psychiatric disorder in majority of the cases F
Can be treated with anti depressants T[Imipramine or amitriptyline]
Runs in families T
Occurs during non-rem sleep T
Occurs in 1% of the teenagers T[3% in 15 yrs and 15% in 5 yrs]
83: REGARDING ENURESIS
More common in males than females T
Has bad prognosis if occurred early in childhood F
Commonly leads to encoparesis F [Fecal soiling]
Can be treated by bell and pad technique T [Bell and pad machine,alarms if wet]
Can be treated by amityptiline inhalation F
84: REGARDING ENURESIS
It has bad prognosis if occurs early in childhood F
Commonly leads to encoparesis F
Can be treated by bell and pad technique T
Can be treated by amitriptyline inhalation F
85: WILMS TUMOUR[5TH MOST COMMON PAEDRIATIC TUMOR]
Usually presents as an abdominal mass T
Never occurs bilaterally F [unilateral in 95%]
Can be a cause of hypertension T[+haematuria , anaemia,fever]
May be associated with hemihypertrophy T[+ectopic,solitary,horse shoe kidney]
Spreads to bones through lynmphatics by the time it is diagnosed F
86: REGARDING POLYCYSTIC DISEASE OF THE KIDNEY
Autosomal recessive T [It occurs in infants where as it is autosomal dominant in adults]
Associated with interstitial hemorrhage ?
Is premalignant T
Causes renal failure T
87: CIRCUMCISION
Indicated if older brother is already circumcised ?
In balantitis F
If foreskin cant be retracted at birth F?
If obstruction to urine T
In paraphimosis T
88: UNDESCENDED TESTIS
Never occur bilaterally F
Associated with inguinal hernia T
Should be treated in the first 6 months of life F[6 to 12 months]
Liable to torsion after trauma T
Spermatogenesis can be preserved if treated surgically at adolescence F
ORTHO/ACCIDENTS
89: PAGETS DISEASE OF BONE
Causes deafness T
Causes osteogenic sarcoma T
High alk phosphatase is due to excessive osteoclastic activity F
Causes heart failure of low cardiac output F[High cardiac out put]
90: COMPLICATIONS OF PAGETS DISEASE OF BONE INCLUDE
Pathological fractures T
Osteosarcoma T
Chondrosarcoma T
Cardiac failure T
Optic atrophy T
Osteoporosis F
91: PERTHES DISEASE*********
Common in males than females T [4:1]
Prognosis is better in the younger patients T
Present with pain limp ? [ limp is Often painless ]
92: IN RICKETS
There is gum bleeding F
Low serum calcium T
Low alk. Phosphatase F
Low phosphate T
Broaden epiphysis T
93: IN A LIMPING CHILD
Flat foot is a common cause F
Perths disease is a cause T
Slipped femoral epiphysis occurs at the pubertal growth spurt T
Upper respiratory infections associated with transient synovitis of the hip T
Tumor is a rare cause T
94: LIMP IN A CHILD MAY BE DUE TO
Perthes disease T
Rarely an underlying tumour T
Transient synovitis of the hip may follow upper respiratory tract infection T
Slipped femoral epiphysis occurs during growth spurt at adolescence T
95: CONGENITAL DISLOCATION OF THE HIP JOINT
Occurs in girls more than boys T [FM:6:1]
Should be treated surgically F
Incidence increases in children with spina bifida T
Cannot be diagnosed at birth F
May cause apparent shortening of the leg T
96: ACCIDENTS
Commonest cause of death in school children T
Fear less toddlers (1-2years) are at most risk of road accidents F
Children usually affected in road accidents when on foot?
Over all incidence has increased worldwide ?
There is increase in incidence world wide ?
97: ACCIDENTS
40% of deaths in 1-4 year aged T
Most injuries in childhood and adolescence are due to motor vehicles ?
In sexual abuse usually it is the care giver T
Drowning is uncommon in unintentional accidents F
98: COT DEATH
>50% are preventable F
If occurred in 1 sibling incidence increases in the following siblings T
Usually the cause is parental failure F ?
Cause is identified in 90% of the cases F
Is related to parental smoking T
99: SUDDEN INFANT DEATH SYNDROME (COT DEATH)
More than 50% are preventable F
Usually the cause is parental failure F?
The finding of cause of death is negative in > 90% of the cases at autopsy T
If it occurred in an infant the risk in the other sibling also increases T
Is related to parental smoking T
100: CHILD ABUSE
Sexual abuse is related to violence or tendency to violence T
Physical abuse is common in preschool children T
Rare in teenage girls F
In IRELAND u must notify the child abuse society T
101: SIGNS OF ABUSE IN A CHILD INCLUDE
Slipped femoral epiphysis ?
Bruising of finger tips T
Aphthous ulcers at the angle of the mouth T ?
Tear of the lingual frenulum T
Retinal haemorrhages T
MISCELLANEOUS
102: IN CHILD HOOD ASTHMA
First treatment is with beclamethasone inhaler F
Advise patient for home nebulizer T
There is increased prevalence ?
In common practice inhalers are more effective than oral beta agonists T
Steroid inhaler can be used if 2 puffs of beta agonist are taken twice daily T
103: DIABETES IN CHILDREN
If below 14 years the bolus dose should be omitted F
May present with poor school performance T
Associated with growth failure T
Associated with HLA DR8 F [DR4,DR3,HLAB8]
104: GALACTOSEMIA
Reducing sugar in urine T
Can cause cataract T
E. coli evolve after ingestion of milk F
It does not come apparently after ingestion of milk ?
There is increases level of lactose F
105: PAEDIATRIC SURGERY
Torsion of testis always need to be explored T
Un descended testis increase risk of malignancy T
Ileocolic intussuception diagnosed and reduced by barium and air enema T
Intususception can be treated by enema and inflation of air T
Malrotation of the bowel is treated conservatively F
106: CONGENITAL HYPOTHYRODISM
Is more common than PKU T
Can be detected by biochemical tests in the first week T
Can be assessed easily clinically T
107: HENOCH SCHNOLEIN PURPURA*********
Common in young children T [It also occurs in old age but not common]
Can lead to haematuria T
Resolves spontaneously T
Can lead to arthritis in big joints T
The rash is more on the flexor surface of the arm F
Common in females F
>80% of patients present within the first year F
Always present with constipation F
Causes intestinal obstruction in the new born F
108: IN HENOCH SCHONLEIN PURPURA THERE IS
A flitting arthritis involving the large joints T
Thrombocytopenia F
Bloody diarrhea T
Erythema nodosum F
Edema of lower limbs T
109: HENOCH SCONLEIN SYNDROME
Rarely occur before 1st year of age T [ 2 to 11 75%]
Characterized by rash on the flexor aspect of the arm F
Causes intussusception T
Causes thrombocytopenia F
Abdominal symptoms respond effectively to steroids T
110: LIGHT FOR TERM BABY IS MORE PRONE TO
Physiological jaundice T
Milk aspiration T
Hypoglycemia T[+Hypocalcaemia]
Apnoeic attacks T
Haemolytic disease of newborn ?
111: IN ACUTE LEAUKEMIA IN CHILDREN RECOGNISED FEATURES ARE
Fever T
Pallor T
Purpura T
112: SIGNS OF DEHYDRATION INCLUDE
Increased skin turgor F
Sunken eyes T
Prostration(collapse) T
Sunset appearance F ?
Depressed fontanelle T
113: NAPPY RASHES *****
Due to exposure to urine T
Is part of seborrheic dermatitis T ?
In candidiasis skin flexures are involved T
114: GLUE EAR
The drum is dull, blue and congested F [GREY,DULL,YELLOW]
Can present with hearing difficulty in childhood T
Can result in sensory neural deafness F
Associated with congenital deafness F
115: GLUE EARS
Most common cause of deafness in children T
Can be treated by inserting gourmets T
Can ultimately lead to nerve deafness F
Tympanic membrane has cloudy appearance T
116: IN GLUE EARS
The drum is cloudy and dull T
Can present with learning difficulty in childhood T
Leaves to nerve deafness F
Commonest cause of complete deafness in children T
Treated by gourmets T
117: INFANTILE ECZEMA
Increases by frequent bathing T
On the face is never treated by tropical fluorinated steroids F
Improves with cow milk free feeding T
Improves with hot weather F
Associated with eosinophilia T
Presents at birth F
Causes itching between 2-12 months T
MEDICINE/GP
DERMATOLOGY
1: MALIGNANT MELANOMA
Caused in young by sun burn T
Lentigo maligna is the commonest F [Superficial spreading melanoma]
Superficial spreading usually on palms and soles F [Acral ]
Poor response to chemotherapy T
In the lower limb is of poor prognosis than in the neck and trunk F
Can arise in any pigmented tissue of the body T
Commonly metastasize through lymphatics F
Broslow s staging depends on depth spread T
Itching is an alarming symptom T
Is caused by sunburn in young adults T
Lentigo maligna is the commonest type F
Sensitive to chemotherapy T
Prognosis is related to the depth of the lesion T
Of superficial type spreads through lymphatics T ?
4: REGARDING MALIGNANT MELANOMA
Depth correlates with prognosis T
Amelanotic melanomas have good prognosis F
Doppler ultrasound is useful diagnostic tool F
Is extremely rare in dark skinned people T
Is more common in females T
Occurs only in skin F
Is staged by virchows classification F
Is due to sun exposure T
Is more in the lower limbs of the females T
Can effect the choroids plexus T
Of the acral tentigenous type effects the sole and palms T
Of the superficial type involves the sole, palms and per-ungual area F
7: SKIN MOLE
With itching suspect malignancy T
Bleeding is characteristic of malignancy T
Early increase in size without other changes is of no clinical value F
Presence of hallos around the mole indicate malignancy T
Radiotherapy is the treatment of 1st choice F
8: CONCERNING BASAL CELL CARCINOMA
Metastasize through lymph nodes F
Occurs exclusively on the head and neck F
May be clinically confused with malignant melanoma ?
Histologically is characterized by keratin pearl formation T ?
Responds to radiation therapy T
Is called marjolin ulcer F
Is called rodent ulcer T
9: DERMATOLOGICAL LESIONS
Satellite lesions are found in candidiasis T
After treatment of acne with antibiotics you can tell the patient to expect improvement in less than 2 weeks F
In scabies itching disappears within 2-4 days of treatment F
Impetigo is caused by staph aureus T [+Streptococcus,streptococcus pyogens]
10: PSORIASIS
Has a genetic predisposition T
Made worse by sun exposure ?
Rash is dry and scaly T
Scalp is rarely effected F
Nail pitting is seen T
11: PSORIASIS
Occurs on extensor surfaces T
Characterized by silver scales T
Pruritis is characteristic T ?
Affects mucous membranes T
Kobners phenomena occurs T [Associated with other skin diseases]
12: ERYTHEMA NODOSUM IS FOUND IN
Sarcoidosis T
Leprosy T
TB T
Aminoglycoside therapy F
Schistosomiasis F
NEUROLOGY
13: THE FOLLOWING ARE CORRECTLY PAIRED
Alcohol peripheral neuropathy rarely develops painful neuropathy F
UMN lesion and upper limb fasciculation with wasting F
Pseudo bulbar palsy and wasting with tongue fasciculation F
Facial nerve palsy and hemi facial anesthesia F
14: HEAD INJURY
There is diminished BP due cerebral vasoconstriction F
There is bradycardia T
15: RECOGNIZED FEATURES OF PARKINSONISM ARE
Rigidity T
Hypokinesia T[bradykinesia is same]
Dementia T
Severe sensory loss F
Intention tremor F [Resting tremor]
16: PARKINSONISM FEATURES
Micrographia T
Festinant gait T
Clasp knife rigidity F [Occur lead pipe rigidity or cog weel rigidity]
Echolalia F
Oculogyric crisis F [Side effects of medicine]
Pill rolling tremors T
17: MULIPLE SCLEROSIS
Is a demyelinating disease T
Is exacerbated by hot baths T
Is characterized by pill rolling tremors F
Now a days treatment is potentially effective by beta-interferons T
Causes frequently LMN lesions in the cranial nerves F [Causes upper motor neuron lesion]
18: POLYMYOSITIS
EMG is associated with low amplitude action potentials T [In myositis action potential decreases where as neuropathic action potential increases]
Distal muscles are affected more than the proximal F
19: TEMPORAL ARTERITIS
ESR >80 mm/hr T
Treatment of first choice is NSAIDS F
There is irreversible loss of vision T
Normal biopsy of temporal artery excludes the diagnosis F
Treatment should be delayed until the results of histopathology comes back F
20: IN CEREBRAL EMBOLISM
Occurs in patients with mitral stenosis and atrial fibrillation T
Can be secondary to hypertensive heart disease T
Can be caused by cor pulmonale T
Infective endocarditis is a cause T
21: 3RD NERVE PALSY CAUSES THE FOLLOWING ON THE SAME SIDE OF THE LESION
Pupil dilatation T
Ptosis T [ Also occurs in horners syndrome ]
Absence of facial sweating F
Loss of lateral gaze F
Loss of accommodation T
22: THE FOLLOWING CRANIAL NERVE LESIONS AND SIGNS ARE CORRECTLY PAIRED
3rd nerve + unilateral Ptosis and meiosis F [Midriasis]
6th nerve + external deviation F [NORMAL FUNCTION]
5th nerve + corneal sensation loss T
12th nerve + tongue wasting and fasciculations T
7th nerve + hemi facial sweating loss F
Choreoform movements on the face with huntingtons chorea ?
23: THE FOLLOWING ARE TRUE
Vitamin B12 deficiency leads to sub acute degeneration of the cord with decreased reflexes and up going toes T
Pagets disease of the bone occurs with preservation of the skull F
Osteomyelitis of the vertebral bodies spares the vertebral discs ?
Pseudo bulbar palsy causes wasting and fasciculations of the tongue F [ Caused by LMN Where as Pseudo bulbar palsy occurs in UMN,Stroke ]
Normal temporal biopsy rules out cranial arthritis F
24: CAUSES OF SWELLING OF OPTIC HEAD
Retrobulbar neuritis?
Respiratory failure T
Raised intracranial pressure T
Post occipital tumour ?
Smoking ?
25: PTOSIS
Partial 7th nerve palsy can cause Ptosis ?
If due to 7th nerve palsy it is associated with meiosis F
Can be congenital T
In horners syndrome there is complete Ptosis F [ Partial ptosis ]
Can be caused by posterior communicating artery aneurysm T
If due to 3rd nerve lesion is associated with meiosis F [ Midriasis ]
In 7th nerve palsy there is difficulty in opening the eye F
In 3rd nerve palsy the eyeball is internally rotated F [ Down and out ]
Subarachnoid hemorrhage can lead to signs of meningism T
There is no brain injury if the Glasgow coma scale is 15 F
27: FEATURES OF UMN LESION OF FACIAL NERVE INCLUDE
Patient cannot wrinkle forehead F
Drooling of saliva from mouth T
Ptosis ?
Weakness of masseter muscle F
Meiosis F
28: FACIAL NERVE
Sensory supply to face F
Supply to muscles of mastication F
Sensory supply to tongue T
Damaged in parotid gland swelling T
Damage in otosclerosis ?
29: FEATURES OF CEREBELLAR DISEASE INCLUDE
Pendular nystagmus F
Scanning dysarthria T
Increased muscle rigidity F [ Decreases,hypotonia ]
Past pointing T
30: ABSENCE ATTACKS (PETIT MAL EPILEPSY)
On EEG there is 3 cycles/sec waves T
Usually last for more than 1 min F [Less than 10 sec]
80% respond to valproate ?
Can be precipitated by hyperventilation T
31: IN COMATOSE PATIENT RAPID DECREASE IN ICP IS ACHIEVED BY************
Urea infusion F
Mannitol infusion T
Dexamethasone ?
Saline frusemide infusion F
Hyperventilation ?
32: SIGNS OF EXPANSION OF INTRACRANIAL LESION INCLUDE
Tachycardia F
Hypertension T
Small pupils ?
Increasing GCS score F
Deteriorating level of consciousness T
33: SIGNS OF RAISED ICP INCLUDE
Contralateral meiosis ?
Tachycardia F
CSF rhinorrhea F [Basal fracture]
Hypertension T
Battles sign F
34: THE FOLLOWING ARE RELIABLE IN UMN LESIONS
Extensor planters T
Increased abdominal reflexes F [ Decreased abdominal reflexes ]
Persistent ankle clonus T
Hyper reflexia T
Positive babinskis sign T
Mycoplasma and tympanic membrane bullae ?
Alcohol and the rarely prevalent painful neuropathy ?
Motor neuron disease and UMN signs in the upper limb F
Facial nerve palsy and hemifacial anesthesia F [ Hyperasthesia,very painful]
TB and 6th nerve palsy F
36: TRANSIENT VISUAL LOSS IS CHARACTERISTIC OF***************
Migraine T
Papilloedema ?
Optic neuritis ?
Amurosis fugax T
Retinitis pigmentosa F
37: FOLLOWING OCULAR DISEASES ARE CORRECTLY PAIRED
Anterior uveitis + Sarcoidosis T
Optic atrophy + multiple sclerosis ?[Causes optic neuritis]
Cerebral aneurysm rupture + sub hyaloid hemorrhage T
Pituitary tumors + bitemporal hemianopia T
38: PAPILLOEDEMA IS CAUSED BY
Migraine ? [Increases intracranial pressure but no papilloedema]
Retinal vein thrombosis ?
Cavernous sinus thrombosis T
Glaucoma F
CARDIOVASCULAR
IHD is the leading cause of death in Ireland T
LDL are protective in heart disease F
With DM , IHD can lead to silent MI T
40: MYOCARDIAL INFARCTION
Silent in a significant number of diabetic patients T
CK reaches the peak in 72 hours F
Chest pain is increased by the change in posture F [ occurs Angina,pleurisy]
There is ST segment elevation T
There are Q waves T
Digoxin overdose and atrial tachycardia with block T
Complete obstruction of the right coronary artery and Q-waves in lead I ,aVL and V3-V6 F
ASD and RBBB T
Ventricular aneurysm and persistent ST segment elevation T
Flat T wave and U wave with Hyperkalemia F
ASD and right bundle branch block T
42: DUKE JONES MAJOR CRITERIA INCLUDE
Arthritis T
Chorea T
ESR F
Fever F
Erythema nodosum F
43: FEATURES OF INFECTIVE ENDOCARDITIS
Conjuctival haemorrhage F[Retinal haemorhage]
Erythema nodosum F
Polycythemia F
Haematuria T
Cardiac murmur T
44: CHARACTERISTIC FEATURES OF INFECTIVE ENDOCARDITIS INCLUDE
High ESR T
Leucocytosis T
Normocytic anemia T
Splinter haemorrhages T
Microscopic haematuria T
45: IN SEVERE TIGHT AORTIC STENOSIS THERE IS
Left ventricular hypertrophy T
Peripheral vasodilation F
Loud 2nd heart sound F
Adam-stoke syncope T
Late systolic murmur F
46: AORTIC INCOMPETENCE*************
Is associated with soft systolic murmur in the aortic area F[Early Diasystolic murmur]
Is associated with sero-negative arthritis T
Is associated with Argyll-robertson pupils T
There is low pulse pressure F
Carries little risk of infective endocarditis F
47: TRICUSPID REGURGITATION
Giant a-wave is found F [GIANT V WAVE]
Should be corrected surgically
Liver congestion occurs T
Can occur due to MI ?
48: IN MITRAL REGURGITATION
If there is mid systolic click it is due to mitral valve prolapse T
If accompanied with mitral stenosis it is commonly due to rheumatic heart disease T
If due to papillary muscle rupture it will present with acute pulmonary edema T
The first heart sound will be muffled T
There is pulsation of the liver ?
Third heart sound is rarely heard F
49: FEATURES OF MITRAL STENOSIS
Opening snap T
Mid diastolic murmur T
Mid systolic apical murmur ?
Haemoptysis T
Loud 1st heart sound T
50: SYSTOLIC BRUIT IN SUPRASTERNAL NOTCH IS FOUND IN
Pulmonary stenosis F
Aortic stenosis T
Coarctation of aorta F
Mitral incompetence F
Aortic regurgitation F
51: MITRAL STENOSIS
Tapping apex beat T
Loud 1st heart sound T
Fixed splitting of 2nd heart sound F
Opening snap T
Malor flush T
Aortic regurgitation + decrescendo systolic murmur F
Aortic stenosis + mid diastolic murmur F
Tricuspid regurgitation + murmur increasing in intensity with inspiration ?
Tricuspid regurgitation + pulsatile liver T
Aortic stenosis + wide pulse pressure F
53: THIRD HEART SOUND IS FOUND IN THE FOLLOWING
Mitral stenosis F
Pulmonary stenosis F
Constrictive pericarditis T
Normal child T
Mitral regurgitation T
54: THE FOLLOWING ARE TRUE ABOUT NON VALVULAR ATRIAL FIB
Warfarin is contraindicated in >70 years patients
Aspirin and warfarin can be used for prophylaxis
If paroxysmal reassure the patient and no need for prophylaxis
Echo is needed in the investigations
Thyroid function can be investigated
Echo is the initial investigations to exclude valvular diseases
55: NON VALVULAR ATRIAL FIBRILLATION
Aspirin and warfarin can be used for prophylaxis
It can occur due to hypertension
Treatment is with quinidine and Amiodarone
It can occur due to CA bronchus
Low dose bets blocker should be given
56: RECOGNIZED FEATURES OF ESSENTIAL HYPERTENSION INCLUDE
A/V nipping on fundoscopy T
Low serum potassium F [ Occurs in conns syndrome or primary hyperaldosteronism ]
50% of patients are unrecognized ?
57: IN BP MEASUREMENT
Systolic pressure is accurately measured by palpating radial artery F
Diastolic pressure is measured better at kortkovs 5th sound T
Reading is taken while the patient is sitting ?
The arm should be supported T
It is accurately taken by the average of lower limb and upper limb measurements F
58: BP MEASUREMENT
Small cuff overestimates the BP T
Treatment of moderate hypertension will prevent 1 death in every 70 patients ?
In postural hypotension the systolic BP drops and the diastolic BP rises on standing F
59: B.P
Should be measured in sitting position T ?
Systolic BP is best assessed with radial pulse F [BRACHIAL ARTERY ]
Diastolic BP is measured at the end of 5TH KORATKOF STAGE T [KORATKOF is 4 taken only in pregnant and children ]
Aneroid is better than mercury apparatus F
60: SIGNS OF ANAPHYLAXIS******************
Bronchodilation F
Laryngeal spasm T
Diarrhea T
Wheezes T
Hypertension F
Hypotension T
Itching , Erythema , Urticaria , Oedema , Cyanoses, Tachycardia T
61: CARDIOGENIC SHOCK CAN BE CAUSED BY
AF T
MI T
Cardiac temponade T
Ruptured aortic aneurysm F [ Aortic dissection ]
Pulmonary embolism T
62: THE FOLLOWING ARE CHARACTERISTIC FEATURES OF
CARDIOGENIC SHOCK
Hypotension T
Bilateral basal crepitations T
Vasodilatation F
Cyanosis T
Increased anion gap T
63: IN CARDIOGENIC SHOCK THERE IS
Peripheral vasodialation F
Polyuria F
Hypotension T
Increased pulmonary capillary wedge pressure T
Increased anion gap T
64: BASIC LIFE SUPPORT
In 2 rescuers the compression/ventilation ratio should be 2/15 F [ In TWO rescuers it is 5/1 but if rescuer is ONE than it is 2/15 ]
Compression rate is 60/min F [ 100/min ]
If a choked patient is coughing normally it is inappropriate to slap his back ?
Pulse should be checked after the 6th cycle of CPR F [5th cycle ]
2-3 decreases indicate deterioration ?
65: PERICARDIAL TEMPONADE
Tachycardia T
Decrease in JVP on inspiration F [Increases]
Pulsus alternans F [ Occurs Pulsus Paradoxus ]
Decreased BP T
Decreased pulse pressure T
RESPIRATORY SYSTEM
66: ASTHMA
Pneumothorax is recognized complication T
Absence of wheeze when symptomatic is a good prognostic factor F
Inhaled steroids give prompt effect F
Nasal polyps are associated with NSAIDS allergy T
67: ASTHMA
Is characterized by reversible airway obstruction T
Flowmetry at home is of no advantage F
I/V steroids should be given in acute asthma T
Is a characteristic feature of extrinsic allergic alveolitis in farmers lung F ?
68: 36YEAR FEMALE KNOWN ASHTHMATIC PRESENTED WITH WHEEZE AND COUGH UNABLE TO COMPLETE A SENTENCE THE FOLLOWING ARE EXPECTED
Pulsus paradoxus T [Normal variation in pules which decreases in inspiration and increases during expiration ie in constrictive peridcarditis & pericardial
effusion]
Cyanosis F [+silent chest,bradycardia,exhaustion,confusion,feeble respiratory effort,PEFR <50% Occurs in ASTHMA in life threatening attack conditions ]
Beta agonist nebulizer is not effective F
PER <50% T
69: THE FOLLOWING ARE USED IN THE MANAGEMENT OF ACUTE ASTHMA
Inhaled steroids F [ it is given iv in acute and inhaled in chronic ]
Sodium cromoglycate F [ Given in chronic conditions ]
Inhaled beta agonist T
Ipratropium T [ It is given in life threating conditons along with nebulized beta agonist ]
Oxygen T
70: SEVERITY OF ASTHMA CAN EASILY BE ASSESED BY**************
Loudness of the wheeze F
Degree of tachycardia T
Duration of symptoms F ?
PEFR expressed in % T [ Less than 50% ]
71: ASSESSMENT OF ASTHMA INCLUDES
Presence of tachycardia F ? [ Occurs in severe asthma ]
Increased sputum production T
PEFR expressed in the percentage of predicted value T
Prolonged duration of attack F ?
Presence of wheezes T
72: IN THE MANGEMENT OF ASTHMA PATIENTS
Beta blockers can be used in the treatment of anxiety F
Inhaled hydrocortisone is used after the use of salbutamol twice F [I/V GIVEN]
PEFR of 70% indicates good prognosis T
73: IN ACUTE SEVERE ASTHMA
Beta blocker nebulized can be given safely F [ Beta agonist are given]
PEFR is of no value F
Hydrocortisone IV should be given instantly T
High concentration of oxygen is CI F
The patient should be given a sedative if he is seriously anxious F
74: ACUTE SEVERE ASTHMA
Is reversible by bronchodilator T
High flow oxygen should not be given F
I/V steroids should be given T
PEFR is of no value in the management of chronic cases F
Is a feature of extrinsic allergic alveolitis in farmers lung ?
75: COPD
Is reversible by bronchodilators F
Unusual in nonsmokers T
Restrictive pattern on lung function tests T
Is associated with premature death T
Usually responds to inhaled steroids ? [ First orally given if gives response than inhaled steroids given ]
76: IN A PATIENT WITH WHEEZE THE FOLLOWING SUPPORT THE DIAGNOSIS OF ASTHMA THAN COPD
Reversal of obstruction T
History of atopy T
Reduction of reducing capacity ?
Hyperinflation at chest x-ray ? [ occurs in both ]
Reduced FEV1/FVC ? [Occurs in both ]
77: THE FOLLOWING ARE CAUSES OF DIMINISHED BREATH SOUNDS
Pneumothorax T
Pleural effusion T
Consolidation F
Lung collapse due to foreign body obstruction T
Bronchiectasis ?
78: BRONCHIAL BREATHING IS FOUND IN THE FOLLOWING
Consolidation T
Pneumothorax F
Emphysema F
On top of pleural effusion T
Empyema T
Fibrosis T
79: RECOGNIZED CAUSES OF WHEEZES
Foreign body in the bronchi T
Tracheal stenosis T ? [ Less common but occurs ]
Bronchopulmonary dysplasia T
Can be caused by bronchial asthma T
80: HAEMOPTYSIS IS CAUSED BY
Bronchiectasis T
Bacterial pneumonia T
Viral pneumonia F ?
Mitral stenosis T
Aortic stenosis F
81: PULMONARY FIBROSIS
Restrictive type of lung function tests are seen T
Can be diagnosed reliably by chest x-ray F [ By CT scan ]
Respond to steroids T
Can be caused by occupational abestosis T
82: IN A PATIENT WITH TRANSUDATIVE PLEURAL EFFSUION
Uraemia T
CCF T
Sarcoidosis F [ Exudate ]
Pulmonary embolism F [Exudate]
TB F [ Exudate ]
83: PULMONARY EMBOLISM
Typically associated with bypass surgery ?
Can cause metabolic acidosis F
Can be diagnosed by venograph T
The cause is clinical DVT in > 80% of the cases F ?
Typically associated with biliary bypass surgery ?
Can be prevented by compressing the calves T ?
84: THE FOLLOWING ARE FEATURES OF SARCOIDOSIS
Bilateral parotid gland enlargement T
Cranial nerve palsy T
Polyarthropathy T
Caseating granuloma F [ Non causeating granuloma ]
Positive mantoux test F [ Negative in two third ]
85: THE FOLLOWING ARE ACCEPTABLE CONTRAINDICATIONS FOR RESECTION OF CA BRONCHUS*************
Forced expiratory volume <1L T
Hoarseness of voice T
Collapsed right middle lobe F
Secretion of antidiuretic hormone F
Elevation of the diaphragm T ?
86: IN BRONCHIAL CA
OAT cell cancer is of good prognosis T
Patient may present with haematuria ?
Oat cell type can secrete ADH T
If the diaphragm is paralyzed it is lifted when the patient sniffs T
If apical can lead to horners syndrome T
87: ASPIRATION PNEUMONIA CAN OCCUR IN
Bronchiectasis F
Acilia syndrome F
Achalasia T
Gastro esophageal reflux T
88: ASPIRATION PNEUMONIA IS CAUSED BY
Bronchiectasis F
Dental sepsis T
Pseudobulbar palsy T
Acilia syndrome F
Excessive alcohol ingestion T
89: THE FOLLOWING ARE RELATED TO EACH OTHER
Sugar cane and byssinosis T
Tin mining and siderosis F [ Causes stannosis] where as siderosis is caused by iron oxide dust ]
Metal grinding and silicosis T
Farming and extrinsic allergic alveolitis T
Plastic and rubber and bronchial asthma T
90: THE FOLLOWING ARE CORRELATED
Sugar cane and bagassosis T
Sandgrinder and silicosis T
CA bronchus and asbestosis T
91: TENSION PNEUMOTHORAX PRESENTS WITH
Low voltage ECG T
Raised JVP T
Cyanosis T
Increased expansion of the affected side T
Associated with high creatinine kinase ? [ If occurs with trauma]
92: CAUSES OF EOSINOPHILIA INCLUDE
Strongyloidosis T [ also called helminthes]
Polyarteritis nodosa T [ PAN=Polyarteritis nodosa,asthma,atopy,parasitic infections[Invasive helminthes],pemphigus,urticaria,lymphomas,eosinophilic
leukaemia,adrenal insufficiency,irradiation,lofflers syndrome[sarcoidosis]
Farmers lung F [ Leucocytosis and Neutrophilia ]
Sarcoidosis T
ENDOCRINOLOGY
93: THE FOLLOWING ARE ANTERIOR PITUITARY HORMONES
Prolactin T [ SECRETED BY ACIDOPHIL CELLS BY APH ]
Insulin F
Estradiol F
Oxytocin F [ posterior pituitary hormone ]
LH T [Secreted by Basophil cell Other APH are ACTH,FSH,,TSH HGH human growth hormone all are secreted by basophil except GH and Prolactin of APH ]
94: RECOGNIZED FEATURES OF ACROMEGALY
Hypotension F [Causes hypertension]
Hypoglycemia F [ causes hyperglycemia]
Dry skin F [oily skin]
Homonymous hemianopia F [bitemporal hemianopia]
Carpal tunnel syndrome T
95: ACROMEGALY
Growth hormone is secreted by basophils F [ secreted by Acidophil ]
Is supported by a normal GTT F
Causes enlarged heart T
Effects skin as well as bones T
Glycosuria occurs T
96: IN ACROMEGALY THERE IS
Widely separated teeth T
Hypertrophy of frontal tissue T
Homonymous hemianopia F [Mostly bitemporal hemianopsia due to pressure on optic chiasm ]
Hyperglycemia T
Galactosemia in male patients F [causes infertility in females due to amnorhea]
97: THYROTOXICOSIS
Signs reverse immediately after first dose of carbimazole F
Exophthalamos is associated with graves diasease always F
TSH is high F
Radioiodine is given to males only F
98: THE FOLLOWING ARE CLASSICAL FEATURES OF HYPERTHYROIDISM
High TSH F
Myopathy T
Dyspnoea T
Pretibial myxoedema T
Carpal tunnel syndrome F
99: RECOGNIZED FEATURES OF THYROTOXICOSIS
Glycosuria T
Deafness F
Ataxia F
Unilateral exophthalamos F
Peripheral myxoedema T
100: RADIOISOTOPE IODINE THERAPY
Associated with high incidence of thyroid carcinoma F
Associated with peptic ulceration F
Absolute CI in pregnancy T
Treatment of choice in patients under 25 years of age F
Causes hypoparathyroidism F
101: PHEOCHROMOCYTOMA
Caused by adrenocortical tumour F
The tumour is malignant in 50% F [10%]
First line treatment is alpha blockers T
The tumour is multiple in 10% T
Raised HLAA in urine is found F [VMA =Venyl mandelic acid]
102: ACUTE ADRENAL INSUFFICIENCY
Inferior vena cava thrombosis ?
Solitary metastatic nodule in adrenal T
Septicemia T
Sudden withdrawal of steroids in a patient on high steroid therapy T
TB T
Cushings disease and hypo pigmentation F
Celiac disease and osteomalacia T
Posterior sub capsular cataract and diabetes mellitus F [Caused by steroid]
Hepatic encephalopathy and constructional apraxia T
Portal hypertension and pancytopenia T
104: GLYCOSURIA IS PRESENT IN
DM T
Thiazide diuretics T
Raised levels of GH T
105: DIABETES MELLITUS COMPLICATIONS
lipoid dystrophica T
Retinitis proliferens T
Impotence T
106: IN DIABETES THE FOLLOWING MAY BE FOUND
Retinitis proliferens T
Nocturnal diarrhea T
Necrobiosis lipodica diabeticorum T
Increased risk of nephritic syndrome F
107: THE FOLLOWING ARE TRUE ABOUT THE COMPLICATIONS OF LONG STANDING DM
Selective loss of pain and temp sensation F[+Vibrations,proprioception,painless loss of sense of touch are also included but not only pain or temp]
No sperms in seminal vesicle fluid F
Postural hypotension T
Excessive sweating T
A vascular necrosis of the femoral head F
108: DKA
Hyperventilation T
Raised intraocular pressure T
Hypokalemia on treatment T
Can be treated with oral hypoglycemics F
HCO3 is 28 mmol/l F
109: THE FOLLOWING ARE CAUSES OF DEATH IN DKA
Aspiration of gastric contents T
K+ level is disturbed T
Septicemia T
Cerebral edema T
Thrombo embolic phenomena
110: THE FOLLOWING ARE SIGNS OF HYPERGLYSEMIC SHOCK
Stridor F
Cyanosis F
Sweating [Hypoglycemia]
Thirst T
Cold clammy skin [Hyoglycemia]
111: HYPOTHYROIDISM
Slowly relaxing reflexes T
Proximal muscle wasting T [ Also Occurs in hyperthyroidism ]
Onycholysis T
112: IN NIDDM
Patients should get their glycosylated Hb measured twice daily F
10% decrease in glycosylated Hb will lead to 50% decrease in mortality and morbidity F
When discovered for the first time the patient should be referred to the endocrinologist T
Can result in silent heart ischemia T
Can cause paradoxical rise in BP on standing F
Can be treated by combined care between GP and consultant T
Hepatitis A transmitted by blood F
Alcohol cirrhosis can lead to hepatoma T
NIDDM can cause non ketotic hyperglycemic coma T
Girls reach puberty earlier than boys T
GASTROENTEROLOGY
114: CHRONIC PANCREATITIS
Continuous abdominal pain is a persistent feature ?
Treatment includes small amount of alcohol F
Should have fat free diet F [Low fat diet should be given]
115: THE FOLLOWING ARE INCLUDED IN THE RANSONS CRITERIA*************
WBC s >15000/cm cube T
Serum Alfa amylase F
Hyperglycemia T
PaO2 T
Hypocalcaemia T
116: ACUTE PANCREATITIS***************
Is often diagnosed by ERCP F
Is difficult to distinguish from peptic ulcer T
Can cause pigmentation of the flanks T
Is associated with hyper parathyroidism T
In IRELAND the common cause is alcohol and gall stones T
117: IN SUSPICION OF CA PANCREASE THE FOLLOWING ARE USEFUL INVESTIGATIONS
Upper endoscopy T
Serum gastrin levels T
USG T
Blood glucose T
118: IN BLEEDING ESOPHAGEAL VARICES EMERGENCY TREATMENT
CONSISTS OF
Hypertonic saline F
Excessive potassium infusion F
Sengstaken blake more tube T
Posterior pituitary extract F
119: FOLLOWING ASSOCIATIONS ARE TRUE
Pyloric stenosis and acidosis F [Alkalosis]
Celiac disease and clubbing T
Pancreatitis and black stools F [ Occurs Pale stool ]
120: PEPTIC ULCER IS ASSOCIATED WITH
Hypocalcaemia F
Head injury T
Burns T
Iron deficiency anemia T
Acute pancreatitis T ?
121: IN PEPTIC ULCER DISEASE
Most patients present with shock F
Perforation occurs more in antral ulcers F
In stomach ulcers are more common on the greater curvature F [More common on lesser curvature]
X-ray air under the diaphragm F
122: CROHNS DISEASE
Commonly effects the terminal ileum T
Is more common in males F
Effects the mucosa and sub mucosa only F
There are no skip lesions F
Causes fistula in ano T
123: CROHNS DISEASE IS CHARACTERIZED BY
Skip lesions T
Cobble stone lesions T
Affects only mucosal layers F
124: COMPLICATIONS OF CROHNS DISEASE
Perianal abscess T
Iritis T
Ascending cholangitis F
Polyarthropathy T
Pyoderma gangrenosum T
125: WELL RECOGNIZED FEATURES OF CROHNS DISEASE
Iritis T
Hydronephrosis F ?[It occurs but it is not well recognized feature]
Erythema marginatum F
Cholangiocarcinoma T
126: CROHNS DISEASE
Can present with polyarthritis T
The distal small bowel is the commonest type T [also called terminal ileum]
Recurrence is less than 10% if resection and anastomosis is performed ?
Skip lesions are present T
Bypass and pouch surgery is not performed because of high rate of recurrence T
127: CLASSICAL FEATURES OF ULCERATIVE COLLITIS INCLUDE***************
Rose thorn ulcers F
Anterior uveitis T
Sclerosing cholangitis T
Sparing of rectum F
Dermatitis herpetiformis F
128: RECOGNIZED COMPLICATIONS OF ULCERATIVE COLITIS ARE****************
Carcinoma of the colon T
Erythema nodosum T
Ascending cholangitis F
Spondyloarthritis T
Dermatitis herpetiformis F
129: THE FOLLOWING FEATURES ARE MORE SUGGESTIVE OF CROHNS THAN ULCERATIVE COLITIS
An abdominal mass T
Rectal bleeding F
Severely inflamed rectum F
Flesh anal skin tag T
Pneumaturia T [Air in urine]
130: CAUSES OF ASCITES INCLUDE
Gram +ve rather than gram-ve if found infected F
Aortic aneurysm F
Ovarian tumor T
Heart failure T
Appendicitis F
Peptic ulcer disease F
Constrictive pericarditis T
131: SPLEENOMEGALY CAN BE FOUND IN THE FOLLOWING
Gauchers disease T
Crohns disease F
Stills disease T
Sickle cell disease T
132: IN PRIMARY BILIARY CIRHOSIS
There is osteoporosis and osteomalacia T
Recurrent rigors occur ?
Pruritis only occurs if the patient is jaundiced F
Serum smooth muscle antibodies are present in high titer F
Middle age males are affected F
Erythema marginatum occurs in the majority of the patients F
133: HEPATIC ENCEPHALOPATHY IS PRECIPITATED BY
Surgical operations T
Oral neomycin F
Hypokalemia T
Barbiturates T
Constipation T
134: PRIMARY BILIARY CIRRHOSIS
Remission does not occur F ?
Associated with high levels of KLM antibodies F
More common in males F
May be associated with portal hypertension T
There is Pruritis followed by jaundice T
135: HAEMOCHROMATOSIS
Is autosomal recessive T
Is associated with low ferritin F
>50% patients are diabetic T
Predispose to hepatoma T
Is caused by ingestion of iron F
136: IN OBSTRUCTIVE JAUNDICE
There is hypocalcemia F
Increased urobilinogen in the urine F[occurs in prehepatic jaundice]
Markedly raised alkaline phosphatase T
Serum transaminases raised in the intial disease T
PT time raised T
137: GASTRIC ACID SECRETION IS INCREASED BY
Pentagastrin T
Secretin F
Histamine T[Acetylcholine,pgE2]
Omeprazol F
Atropine F
RHEUMATOLOGY
138: RECOGNIZED FUNCTIONS OF PTH INCLUDE
Increased absorption of calcium from the gut T
Increased absorption of vitamin D from gut F ?
Increased formation of 1,25 vitamin D in the kidney T
Increased osteoclastic resorption of the bone T
Increased reabsorption of calcium from kidneys T
139: IN A PATIENT WITH PRIMARY HYPERPARATHYROIDISM
Serum calcium is low F
PTH is usually high T
Mostly due to thyroid adenoma F
50% of patients present with renal stones F ?
There is short QT interval on ECG T
140: OSTEOMALACIA
Associated with high serum calcium F
Associated with low serum phosphate T
Associated with high alk. Phosphatase T
Associated with nephrocalcinosis T
Loosers zone is seen on x-ray T [Loss of cortical bone+ partial fracture with out displacement]
141: IN OSTEOMALACIA
Increased calcium F
Decreased phosphate T
Increased PTH T
Decreased alkaline phosphatase F
Causes pathological fractures T
142: OSTEOPOROSIS
May complicate thyrotoxicosis T
Characterized by bone pain F [osteomalacia]
Complicates heparin therapy T
There is loosers zone F[Osteomalacia]
There is high alkaline phosphatase F
143: RECOGNIZED FEATURES OF RHEUMATOID ARTHRITIS
Hypertrophied lymph nodes T
Osteoarthrosis in later stages F ?
Acute febrile illness T
Early involvement of sacro-iliac joint F
Granulomatous disease of the sclera F ?
144: FEATURES OF SLE INCLUDE
Equal incidence in males and females F
Leucocytosis F
Butterfly rash on the face is characteristic T
Renal failure T
May be caused by sulphonamides T [ Quinine,salicylates,chlorpromazine]
145: FEATURES OF SLE
Leucopenia T
Butterfly rash T
Deforming arthropathy T
More in males F[9:1]
Pleural effusion T
146: RHEUMATOID ARTHRITIS
Affects males > females T
Usually present before the age of 30 years F
Synovial membranes are usually swollen and inflamed together with the overlying connective tissue T
Usually leads to the destruction of the articular cartilage T
Associated with HLA-DR4 T
147: THE FOLLOWING ARE CLASSICAL FEATURES OF RHEUMATOID ARTHRITIS
Symmetrical bilateral joint involvement T
Nodes in the olecranon bursa T ?
Distal interphalengeal joints are affected F
Positive family history T
Z deformity of the thumb T
148: ANKYLOSING SPONDYLITIS
More common in females than males F[ More occurs in males 16yrs 6:1 MF ratio,30 yrs 2:1]
Associated with pulmonary fibrosis T
HLA B27 positive T
INFECTIOUS DISEASES
149: IN COMMON PRACTICE THE FOLLOWING ARE TRUE ABOUT SORE THROAT
Commonly caused by virus T
Erythromycin is the treatment of choice if the patient is allergic to penicillin T
Throat swab should be taken from every patient ?
It is possible to differentiate between viral and bacterial infection clinically F
May the presenting feature of bone marrow failure T
150: SORE THROAT**********************
At least more than 60% are due to viral infections T
It is easy to distinguish between viral and bacterial illness F
Should be treated by penicillin V F
Throat swab should be taken before starting treatment T
Bone marrow failure occurs in patients taking chloramphenicol T
151: TB MOTHER WHO LIVES IN HOSTEL WITH HER 6 YEAR OLD CHILD DEVELOPING WEIGHT LOSS AND COUGH
Tuberculin test is diagnostic F
Tuberculin negative test excludes TB F
His brother may need treatment even if he is asymptomatic ?
Can be admitted in the general ward because of low infectivity of TB F
Chest x-ray and mantoux test must be done for the other hostel inhabitants T
152: H.I.V.
Pneumocystis carinie usually occurs when CD4+ count is below 200/cmmm T
Antiretroviral agents are more affective in later stages F
Low CD4+ count is diagnostic F
Globally blood transfusion is the most common cause of transmission F [Sexually is the commonest]
153: FOLLOWING STATEMENTS REGARDING HIV ARE TRUE
Always treated with triple therapy after seroconversion F
Always treated with triple therapy after needle prick F
A CD count less than 200 is related with poor prognosis T
154: IN HIV
The commonest fatal opportunistic infection is PCP T
The commonest opportunistic GIT infection is Oropharyngeal candidiasis F[Oesophageal]
Toxoplasmosis is the commonest CNS infection T
CMV is the commonest cause of retinitis T
Milliary pattern is the commonest presentation of TB F
155: TETANUS
Incubation can be more than 20 days T
Wound should be excised T
Intravenous anti tetanus toxin should be given F
Can be prevent by tetanus toxoid T
Scalp wounds are associated with it more than the peripheral limb wounds F
156: HEPATITIS A
Associated with chronic hepatitis B F
Incubation period 2-3 months F [SIX WEEKS]
Can be transmitted by saliva droplets F
Can present within a minimum of 30 days T
157: HEPATITIS A
No carrier state T
Prevented by passive immunization T
Is an entero virus T
Incubation period is 6 weeks T
Aerosol spread F[Oral Faecal]
158: CHARACTERISTIC FEATURES OF LEPTOSPIROSIS INCLUDE
Jaundice T
Meningitis T
Conjunctivitis F
Renal failure T
159: INCUBATION PERIOD OF 7-21 DAYS INCLUDES FOLLOWING DISEASES
Polio T
TB ?
HIV F?
Syphilis F
HBV F
160: PETECHIAL RASH IS SEEN IN
Meningococcemia T
Haemolytic uremic syndrome T
Henoch-schonlein Purpura T
Mycoplasma infection T
161: THE FOLLOWING VIRUSES ARE CORRECTLY PAIRED
EBV + burkitts lymphoma T
EBV + laryngeal carcinoma F [NASOPHARYNGEAL]
Papiloma virus + vaginal cancer T
HTLV1 + leukemia T
CMV + hepatoma F
EPIDEMIOLOGY
162: IN DISEASE SCREENING IT SHOULD BE
Chronic F
Ultimately fatal F
Treatable T
163: SCREENING WILSON CRITERIA
Chronic F
Serious F
Treatable T
Ultimately fatal F
Common F
164: IN DISEASE PREVENTION
Screening is an example of secondary prevention T
Has no side effects ?
Health education is part of primary prevention T
Tertiary prevention means prevention of complications T
PHARMACOLOGY
165: THE FOLLOWING CONSEQUENCES ARE CORRECTLY PAIRED
Amiodarone and thyroid dysfunction T
Warfarin and pin point pataechial hemorrhages F
Aspirin and platelet aggregation F
Isoniazid and SLE like syndrome T
Beta blockers and tachycardia F
166: THE FOLLOWING ARE IMPORTANT IN ASPIRIN PRESCRIPTION
With precaution if prescribed to a patient with nasal polyps T
In over dose treat promptly with forced alkaline diuresis F
When given to a patient with thrombotic tendency the dose given is 6 hourly prophylactically F
When it affects the stomach it is only due to its direct effect on the mucosa F
In children the adult dose should be given F
167: ANALGESIC NEPHROPATHY
Caused only by phenacetin and aspirin F
Can cause papillary necrosis T
Can present as UTI T
Can cause renal failure T
168: CI OF THROMBOLYSIS ARE
Systolic BP of >200mmhg and diastolic BP >120mmhg T
Previous MI F
Recent strokes and previous TIA T
Chest pain within 4 hours F
Prolonged CPR T
169: HEPATOCELLUALR DAMAGE CAUSED BY THE FOLLOWING DRUGS
Methyldopa T
Isoniazid T
Halothane T
Tetracycline T
Paracetamol T
170: ANTIBIOTICS
Amoxycillin is no longer the treatment of choice of community acquired pneumonia F
If given with contraceptive pills may reduce their efficacy T
May cause candidiasis T
Are important to be given to a patient of 3 days history of cough ?
171: NSAIDS
Can cause Hypokalemia F
Can cause GI hemorrhage T
Are disease modifying in rheumatoid arthritis F
172: THE FOLLOWING TREATMENTS ARE TRUE
Salicylate poisoning and forced alkaline diuresis T
Heparin and vitamin k F
Generalized angioneurotic edema and s/c adrenaline F [IM given]
Osteomalacia and bisphosphonate F
Established acute anuric renal failure and 2-3 liters of water/day ?
173: PHENYLBUTAZONE CAUSES
Edema T
Haematemesis T
Alopecia F
Agranulocytosis T
Nausea and vomiting T
174: THE FOLLOWING POTENTIATE THE EFFECTS OF WARFARIN
Cimetidine T
Rifampicin F
Barbiturates F
Vitamin K F
Macrolides antibiotics T
175: IN SNAKE BITE
Anti venom can reverse the action of the venom F
Anti venom should always be given F
The type of snake should always be known F
Arterial tourniquet should always be applied over the site of the bite F
Anti tetanus toxoid should always be given T
ELECTROLYTES
176: A PATIENT WITH SERUM SODUM OF 122mmol/L, THE FOLLOWING ARE THE LIKELY CAUSES
DKA T
Hypoadrenalism T
Prolonged infusion of dextrose 5% T
SIADH T
In young lady psychologically disturbed and drinks water excessively T
177: THE FOLLOWING ARE CAUSES OF HYPERKALEMIA
Cushings syndrome F
ACE inhibitors T
Rhabdomyolysis T
Spironolactone T
Conns syndrome F [Hypokalemia along wih hypertension]
178: HYPERKALEMIA
Inverted T waves F
179: INCREASED ANION GAP
CRF T
COPD F
Metformin T[Causes lactic acidosis]
Ethylene glycol intake T
180: HYPOKALEMIA
Occurs in primary hyperaldosteronism (conns disease) T
In vomiting more than in diarrhea F
There is peaked T-wave on ECG F
Occurs in spironolactone therapy F
181: HYPERCALCEMIA IS ASSOCIATED WITH
Sarcoidosis T
Thiazide diuretics F
Pancreatitis T
Multiple myeloma T
Malignancy T
MISCELLANEOUSE/MEDICINE
182: KAPOSIS SARCOMA CAN OCCUR IN
Lymph nodes T
Lungs T
Skin T
Stomach T
Brain F
183: HAEMOGLOBINURIA CHARACTERISTIC IN
Henoch schonlein Purpura F
Post streptococcus glomerulonephitis F
Sickle cell disease T[G6PD-Deficiency,malaria,severe burn,]
Thalasaemia T
Spherocytosis T
184: RECOGNIZED CAUSES OF CLUBBING
Chronic bronchitis T
Aortic aneurysm F
Fibrosing alveolitis T
Crohns disease T
Infective endocarditis T
185: RECOGNIZED FEATURES OF CHRONIC MYELOID LEUKAEMIA
Increased neutrophil alkaline phosphatase F[Decreased]
Frequent nucleated RBC's in the peripheral blood F
WBCs count of 50,000/cm cube T
Philadelphia chromosomes T
Anemia T
186: PREDISPOSING FACTORS TO CANCER INCLUDE
Thread worms F
X-radiation T
Chronic lead ingestion ?
Sunlight T
Smoking T
187: VIT B12 MALABSORPTION CAN BE FOUND IN
Total gasterectomy T
Crohns disease T
Ulcerative colitis F
Bacterial colonization of small bowel T
Diverticulosis F
188: IN TERMINALLY ILL PATIENT
The patient should always know the diagnosis F
Morphine should not be always given to relieve pain in order to prevent dependence F
Hospital admission is indicated if the relatives are not able to take care of the patient T
The rest of the staff should aware of the what you told the patient T
Denial is an unhealthy response ?
189: HENOCH SCHONLEIN PURPURA
Is usually self limiting T
Can cause arthritis of large joints T
May present with haematuria T
190: IN PURE PRE-RENAL UREMIA THERE IS
Low urinary sodium T
Severe hypotension T
Normochromic normocytic anemia F
Granular casts are present F
Raised urea/creatinine ratio T
191: SICKLE CELL ANEMIA
More severe in boys than girls T
Cross country running can precipitate a sickle cell crises ?
Severe jaundice in neonates F
Folic acid addition therapy has been proved of no benefit F
Osteomyelitis is recognized cause of bone pain T
192: POLYCYTHAEMIA IS FOUND IN
Infective endocarditis F
Acute renal failure F [Occurs in Chronic renal failure]
Renal artery stenosis T
Congenital heart disease T
Perinephric abscess ?
193: ESR MORE THAN 100 MM/HR IN THE 1ST HOUR IS SEEN IN
Congestive cardiac failure F [occurs Less than 1mm/hr]
Polycythemia rubra vera F [Less than 1mm/hr]
Polymyalgia rheumatica ? [>4Omm/hr]
[acute and chronic inflammatory diseases,cancerous conditions,multiple myeloma,tuberculosis,temporal arteritis] T
Polyarteritis nodosa ? [ raised but around 67 mm/hr in first hr]
Cryoglobinuria ?
194: CAUSES OF GYNAECOMASTIA INCLUDE
Kleinfelter syndrome T[+Congenital anorchia,testicular trauma,testicular torsion]
Gastric carcinoma T
Spironolactone therapy T
Testicular tumour T[viral orchitis,kallmann syndrome,pituitary tumor,malnutrition,renal failure,hyperthyroidism,androgen insensivity syndrome]
Hickman line and bacterial endocarditis T [Mainly causes Fungal endocarditis]
NG aspiration and metabolic acidosis F
CVP line and Pneumothorax T[+Infection,haemothorax,air embolism,catheter embolisation,cardiac dysarthmia]
Abdominal paracentesis and ?
SURGERY
GIT
1: THE FOLLOWING INCREASE THE INCIDENCE OF ESOPHAGEAL CARCINOMA
Columnar metaplasia in the esophagus T
Achalasia T
Smoking T
Blood group A F [Causes blood group O]
Helicobacter pylori F
2: ESOPHAGEAL STRICTURE
The commonest cause is reflux esophagitis T
Frequently responds to dilatation T
May be due to lye ingestion T
Usually needs colonic replacement F
May present with aspiration pneumonia T
3: REGARDING ESOPHAGUS
Varices are caused by portal hypertension T
Reflux is commonly treated by Nissans fundoplication F
Compression can be caused by rolling hiatus hernia T
Common malignancy is adenocarcinoma F [it is squamous cell carcinoma]
Reflux can cause aspiration T
4: THE FOLLOWING ARE FOUND IN PYLORIC STENOSIS
Metabolic acidosis F
Succusion splash T
Bilious vomiting F
Visible peristalsis T
Discoloration of the urine ?
Discoloration of the flanks ?
5: IN PYLORIC STENOSIS
There is hypokalemic alkalosis T
PH of 7.4 F [ PH <7.35 is Acidosis and more >7.45 is Alkalosis ]
Hyperkalemia F
There is thickening of the circular layer of the muscle in pylorus T
Needs radiograph for complete diagnosis F [By barium meal or u/s]
6: CONGENITAL PYLORIC STENOSIS*********************
Develop at 4-6 weeks of life T[ 3 to 8 ]
More in the first born female F [first born bottle fed boys {M:F=4:1} with an incidence of about 3:1000 and there is familial risk]
Can cause hypochloremic acidosis F
Diagnosed by barium enema F[Barium Meal which shows enlarged stomach increased gastric peristalsis and elongated narrowed pyloric canal ,U/S shows the
thickened pyloric muscle and increased muscle to lumen ratio with decreased movement of fluid through the narrow canal < 2mm . it is also done on physical
examination by Palpating pyloric mass in RUQ during feeding]
Baby is uninterested in food F [ Baby is malnourished but active and hungry]
7: PERFORATED PEPTIC ULCER CAN BE INDICATED BY
Haematemesis ?
Increased bowel sounds F[absent bowel sounds]
Rigid abdomen T[ patient also has pain,pale,tachycardia,tachycardia]
Decreased liver dullness T[ Liver dullness Often reduced due to presence of Gas in peritoneum anterior to the liver,also patient may report shoulder tip pain ]
Colicky abdominal pain F [ Contineous sharp ]
8: THE FOLLOWING ARE ASSOCIATED WITH ACUTE PANCREATITIS
Hypoglycemia F [Hyperglycemia]
Sentinel loop on x-ray T [ it is solitary air filled dilatation ]
Hypercalcemia T[Hyperlipedemia,tachycardia,fever,jaundice,shock,ileus,rigid abdomen, + local or generalized tenderness ]
Grey-turner sign T [ it is discoloration at flanks and periumblical discolouration is called cullens sign ]
CA pancrease ? [ Often found in chronic pancreatitis ]
9: ACUTE PANCREATITIS CAN BE PRECIPITATED BY
Pregnancy T
Biliary tract disease T
Hyperlipidaemia T
10: THE FOLLOWING ARE TRUE ABOUT ACUTE PANCREATITIS
Can cause tetany T
Commonest cause in Ireland is gallstones and alcohol T
Difficult to differentiate from ischaemic bowel disease T
Can lead to Hypokalemia, hypocalcemia and hypoalbuminemia T
Associated with hypercalcaemia T
11: THE FOLLOWING ARE ASSOCIATED WITH ACUTE PANCREATITIS
Alcohol ingestion T
CA head of pancrease ? [ Often Found in chronic pancreatitis ]
Hyperglycemia T
Hypoglysemia F
Sentinel loop on x-ray T
12: PANCREATITIS IS ASSOCIATED WITH
Mumps T
ERCP T
Hypercalcemia T
Alcohol consumption T
Biliary disease T
13: CHRONIC PANCREATITIS
Can be caused by mumps ? [ Often causes acute pancreatitis ]
Early surgical intervention improves the out come T
Patient can develop diabetes mellitus T
Patchy calcification supports the diagnosis T
Commonly caused by gallstones F [ In chronic it is commonly caused by alcohol ]
14: RECOGNIZED CAUSES OF ACUTE PANCREATITIS
Biliary disease T
Hyperlipidaemia T
Hypocalciuria T ? [Also called as familial hypercalciuric hypercalcaemia ]
Pregnancy T
Thiazide diurectics T
15: GASTRIC CARCINOMA
Associated with pernicious anemia T [ H.Pylori,atrophic gastritis ]
Associated with blood group A T [ smoking,familial ]
Is a cause of iron deficiency anemia T [due to upper GI bleeding]
The lesser curvature is the commonest site F [50% involve PYLORUS,25% involve THE LESSER CURVATURE,10% CARDIA ]
Mostly will be cured by surgery F [Around > 60% patients have obvious metastasis so in more patients even curative surgery is contraindicated ]
16: LATE COMPLICATIONS OF PARTIAL GASTERECTOMY INCLUDE
Dumping syndrome T[It is characterized as feeling of faintness, sweating,and general weakness after eating due to food of high osmotic potential being dumped in
the jejunum, causing oligaemia{deficiency in amount of blood in body,hypovolemia} from of rapid fluid shifts ]
Osteomalacia ?
Iron deficiency anemia T [Also occurs Osteoporosis,{vit B12 deficiency which requires maintenance vitamin B 12 injections every 3 months} ]
Recurrence of ulcer at the site of anostomosis T [May be due to an inadequate antrectomy or incomplete vagotomy and revsional surgery should always be
preceded by.
Diarrheoa T [ It particularly associated with VAGOTOMY ]
Bile reflux and Vomiting T [This is due to reflux of bile irritating the gastric antrum ]
17: IN BLIND LOOP CONDITIONS
The ileocaecal valve should be competent F
Diabetic autonomic neuropathy is a recognized cause T
Anemia is typically due to follate deficiency F
Treatment with iv antibiotics is advisable F
Creation of Ileocolic fistula should considered F
18: REGARDING CA COLON
More common in rectum then caecum T [ 45% ]
Proctitis is common presentation F
Commonly treated by abdomino perineal resection F [ A-P resection is done for the tumors low in the rectum , where as ca colon is done by Rt or Lt
Hemicolectomies ]
19: COLORECTAL CARCINOMA
Most common in rectum than in other part of the colon T [ 45% ]
Staged by TNM F [ Dukes classification ]
Commonly present with obstruction F [If involve ascending ,proximal or transverse colon of Rt other wise in decending colon rectum it is nt mentioned in Lt ]
Long standing ulcerative colitis is a predisposing factor T
Of the caecum can be treated by colectomy T ? [ Rt Hemicolectomy ]
20: IN CARCINOMA RECTUM
It usually presents with intestinal obstruction F
Metastasize to the inguinal lymph nodes F
Cancer cells are usually adenocarcinoma T [ well or poorly differentiated adenocarcinoma ]
It responds to radiotherapy T
It constitutes 45% of the large bowel carcinomas T [Rectum 45%]
21: IN COLORECTAL CARCINOMA
Dukes stage C indicates liver metastasis F [ Regional nodal involvement ]
Most commonly are poorly differentiated F [ Colon ca cells are mostly adinocarcinomatous while rectal cells are poorly differentiated ]
Are resected by abdomino-perineal approach F
Usually arise from adenomatous polyps F ?[It is predisposing factor to colonic cancer ]
In 10% of the patients there is synchronized tumuor growth ?
22: SCREENING FOR CA COLON SHOULD BE DONE IN
HNPCC
History of UC
23: CA LARGE BOWEL/RECTUM
Environmental factor is predisposing cause T
Most common site is rectum T
Ca rectum causes stool impaction T
Dukes tumour means local spread ?
Metastasizes through lymph nodes ?
Is treated by an operation T [Along with radiotherapy ,chemotherapy ]
24: IN ACUTE APPENDICITIS
Rovsings sign is positive T
Typically characterized by high grade fever F
Visceral pain occurs in Para umbilical area T
There is tenderness on rectal examination T
25: DIARRHOEA STAINED WITH BLOOD
UC T
Bacillary dysentery T
Small rectal polyps T
Haemorrhoids T
Diverticulosis T
26: COMPLICATIONS OF HAEMORHOIDS
Proctitis ?
Pruritis ani T
Mucus discharge T
Prolapse T
Haemorrhage T
27: ROUND MASS IN UPPER QUADRANT MOVES DOWN WARD WITH INSPIRATION
Gallbladder T
Liver in CCF T
CA of the side of transverse colon ?
Right kidney F ?
CA head of pancreas ?
28: GALLSTONES
When lead to intestinal obstruction show air in the biliary tree T ? [ Air in CBD and small bowel fluid levels ]
Oral cholangiogram is done for diagnosis when the patient is jaundiced F
Can never cause pancreatitis F
Cholecystitis can not occur without stones F
29: GALLSTONES
Commonly associated with dyspepsia T
Commonly formed in CBD F [ commonly formed in bladder ]
Commonly associated with mucocoele F ? [ usually In Chronic conditions but rarely ]
30: THE FOLLOWING ARE COMPOSITION OF GALL STONES
Cholesterol T [+Lecithin,billirubin ]
Cystine F [ it rarely contributes in renal stones but never gall stones ]
Calcium bilirubinate T
Bile salts T
Xanthine F [ it rarely contributes in renal stones but never gall stones]
31: IN PERIANAL FISTULA
It is common above the pelvis diaphragm F
High fistula is common then low fistula F [A fistula tracks near the anal sphincter that controls opening of the bowel .if it runs just inside the sphincter or through a
small part of it,it is called a low fistula.if it runs from well above the sphincter ,it will be right out side the sphincter and is called a high fistula .Low fistula is more
common than high fistula but high fistula is more complex and mostly associated with other associated bowel diseases ie chrons disease.
32: HERNIAS
Femoral hernia can be pushed by pressing above and lateral to pubic tubercle F
Incisional hernia is more common with AAA repair than with colon resection T
Can develop with obstructive uropathy T
Direct hernia passes through deep ring F [Indirect passes through deep ring while direct is through superficial ring due to weakness of processus vaginalis fascia
area of hassle bach triangle {it is formed inferiorly by inguinal canal laterally by inferior epigastric arteries and medially by conjoint tendon} ]
33: HERNIA
Femoral hernia can be controlled by pressure above and lateral to pubic tubercle F [Below and lateral]
Indirect inguinal hernia runs a more benign course than direct hernia F [Direct is more benign because it does not strangulate more than indirect hernia ]
Positive cough impulse is usually present in femoral hernia F [Absent during strangulation and strangulation is very common in femoral hernia ]
Inguinal hernia in child should be treated by surgery before 5years of age T ? [ Herniorrhaphy is done {repair of hernia}but Herniotomy is not done ]
Incisional hernia is more related with AAA repair than colonic resection T
34: THE FOLLOWING ARE TRUE ABOUT GROIN HERNIAS
Symptomatic femoral hernias are irreducible T
The absence of obstruction excludes strangulation F
Scrotal extension is more with indirect hernia than direct hernias T
Small defects do not need repair F ?
They are associated with hypertrophy of the prostate T [Constipation,symptoms of prostatic hypertrophy{BPH},chronic cough and obesity are common conditions
associated with increased tension on the abdominal wall ]
35: INGUINAL HERNIA*******************
20-30% cases are bilateral ? [17%]
Hydrocoele can be a complication F ?
In children the posterior wall should be repaired F [It is not repaired in children ]
36: INGUINAL HERNIA**************
Is more common in males than females T
Rarely strangulate if ever F
It lies above and lateral to pubic tubercle F [It lies above and medial to it ]
In the indirect type the defect is in the internal inguinal ring T
Surgery is avoided in elderly F
37: INGUINAL HERNIA
Indirect hernia can be closed by pressure over the deep ring T
Is associated with undescended testis T
Appears inferior and medial to pubic tubercle F [Above and medial ]
Less likely to strangulate than femoral hernia T
The hernial sac may contain omentum T
38: REGARDING INGUINAL HERNIA
It traverses the inguinal canal T
More common than femoral hernia T
The direct type passes through the deep inguinal ring F
Occurs lateral to the pubic tubercle F [Occurs medial ]
If strangulated can be treated conservatively ?[some cases in children]
39: INGUINAL HERNIA
Indirect can be closed by pressure over the internal ring T
Is associated with un descended testis T
Appears inferior and medial to pubic tubercle F
Less likely to strangulate then femoral hernia T
The hernial sac may contain omentum T
40: THE FOLLOWING ARE CAUSES OF PAINFUL SWELLING IN THE GROIN
Undescended testis F [90% are painless ]
Encysted hydrocoele of the cord f? [they may go un-noticed till size gets bigger]
Septic arthritis of the hip T
Strangulated femoral hernia T[half are painless]
Inguinal lymph adenitis T
The poor wound healing F
41: THE CAUSES OF ENLARGED NODES IN THE GROIN INCLUDE
Testicular tumor F [Para-aortic ]
Uterine and cervical cancer ?[affects Pelvic and para aortic lymph nodes rarely through round ligament to inguinal lymph nodes ]
Lymphoma T
Lower limb cellulites T
Anal canal tumors T
42: INGUINAL LYMPH NODES INVOLVED IN
CA cervix/uteri ?
Colorectal carcinoma F
CA glans penis T
Testicular seminoma F
Anal carcinoma T
CA of rectosigmoid junction F
TRAUMA AND ACCIDENTS
43: COLLES FRACTURE
Diner fork deformity T [A complete transverse fracture of the distal 2 cm of radius called colles fracture or silver fork deformity,fall outstretched limb with the
forearm and hand pronated ]
Dorsal angulation T
6 week immobilization is enough for cure T
Dorsal angulation is characteristic of COLLEs fracture T
Ulnar impaction is seen in smiths fracture F
Scaphoid fracture needs immobilization of the first joint of the thumb T [long arm thumb spica casts is applied for few wks then SAT-Spica applied till union ]
Bennetts fracture involves the radius F [carpometacarpal fracture ]
Frozen shoulder may complicate wrist fracture F
45: UPPER LIMB EXAMINATION
Carpel tunnel syndrome causes thenar muscle wasting T
Dupuytrens contracture usually occurs in males T
Palmer erythema occurs in thyrotoxicosis T
Radial nerve injury cause wrist drop T
Brachial artery usually found medial to biceps muscle T
46: IN LOWER LIMB EXAMINATION*************
Dorsalis paedis pulse is absent in 10-15% T
Posterior tibial artery lies behind the lateral malleolus F [lies medial malleolus]
Long saphenous vein starts posterior to the medial malleolus F[Anterior m.mel]
Injuries of the superficial peroneal nerve results in foot drop F[Common p.nerve]
47: ORHTOPEDICS****************
Fracture neck of femur is commonly treated by skeletal traction F
In Scaphoid fracture avascular necrosis occurs in the proximal fragment T
Fracture neck of femur is common in elderly females T
Lumber disc prolapse can cause paralytic ileus F ??
Comminuted fracture is associated with laceration of the skin F
48: THE FOLLOWING FRACTURES ARE CHARACTERIZED BY SLOW HEALING AND NON UNION
Scaphoid T
Distal tibia T
Trochanteric fracture of the femur F[ Healing is generally good in healthiers ]
Shaft of the humerus T
49: IN FRACTURES**************
Slipping of femoral epiphysis is common before the age of 8years F[10-16Yrs]
Is compound if associated with vascular injury F
In smiths fracture there anterior displacement of the distal radius T
Osteomyelitis is caused by staph albus F
Around the elbow in children may involve the epiphysial line resulting in shortening ?
It is closed if laceration over it is stitched F
50: FRACTURES
Is pathological if the artery is entrapped within the fractured ends F
Is closed if there is laceration above it F
Is open if it involves a joint F [Open fracture is also called compound fracture it involves when skin is open to out side or approaches body cavity ]
Is compound if more than one fragment is present F
Is comminuted if the skin is open F
51: LOWER BACK PAIN
About 90% of the cases are due to mechanical causes F
In the elderly is of degenerative type T
May be the presenting feature of metastatic cancer T
If it is radiating to the posterior side is always due to disc prolapse F
X-ray is diagnostic in all cases F
52: ACUTE LUMBER DISC PROLAPSE
Loss of knee jerk is characteristic of 2nd lumber disc injury F [L3,L4]
Loss of ankle jerk is characteristic of 4th lumber nerve injury F [ S1 ]
Straight leg raising test is usually positive T [ Lasegues sign ]
Plain x-ray is always diagnostic F
Loss of sphincteric control indicates urgent surgery T
53: ACCIDENTS
Child injuries represent > 40% of mortality b/w 1-4 years of age F [11-14 Yrs]
Drowning is uncommon in unintentional accidents F
Motor car accidents are the commonest cause of injuries F [Home accidents ]
54: IN PATIENTS WITH MULTIPLE INJURIES***************
The first preference is for insertion of I/v cannula F
Fracture of iliac bone is a common cause of fat embolism T
Pelvic fracture can cause shock T
Compartment syndrome can be treated by reduction and fasciotomy T
Compound fracture involves multiple bone fragments F
Blunt trauma of spleen should be treated by spleenectomy F
55: IN THE MANAGEMENT OF MULTIPLE INJURED PATIENT********
Stabilization of fractures has priority to air way inspection F
Management of intra abdominal bleeding has priority to stabilization of fracturesT
Rectal examination is mandatory before inserting a urinary catheter T
Blunt trauma of the spleen should be treated by splenectomy F
56: THE FOLLOWING ARE TRUE ABOUT MULTIPLE INJURIES*************
Most thoracic injuries need thoracotomy F
Pneumothorax can be diagnosed by chest X-ray T
Tender left 9th 10th 11th ribs indicate spleenic injuries T
GCS score of 15 excludes brain injury F
IV lines are the first priority F
57: INDICATIONS FOR A PERITONEAL TAP IN A PATIENT WITH MULTIPLE INJURIES INCLUDE
Unexplained hypotension T
Penetrating injuries F [Exploring laparotomy ]
Paralytic ileus T ??
Haematuria F
58: MULTIPLE TRAUMA VICTIM**********
Securing the airway is the priority T
Pelvic injury frequently associated with hypovolemic shock T
Stabilization of cervival spine is mandatory T
Distended neck veins indicate pericardial temponade T
Blood in external meatus necessitate immediate catheterization F
59: IN MULTIPLE INJURED PATIENT***********
Thoracic injury always needs thoracotomy F
Tension Pneumothorax can be diagnosed by chest x-ray F
Oropharyngeal airway prevents aspiration F [ Easy of suctioning ]
Management of intra abdominal bleeding has priority to stabilization of fracturesT
Rectal examination is necessary before inserting a catheter T
60: PATIENT WITH MULTIPLE INJURIES***************
Tension Pneumothorax is diagnosed by chest x-ray F
Priority is to I/v fluid replacement F
Pelvis fractures can present with shock T
Oropharyngeal intubation is mandatory F
61: IN CONTAMINATED LACERATION
Tetanus toxoid s/c is always indicated F [ I/M ]
Penicillin is unnecessary in fully immunized F
Primary suture is not to be carried out if more than 12 hrs have elapsed T
Plain catgut is suture material of choice F
X-ray is useful to detect foreign body T
62: IN A PATIENT WITH HEAD INJURY SIGNS SUGGESTING INCREASED INTRACRANIAL TENSION ARE
Small pupils F [unequal pupils first there is constriction then dilatation in one eye]
Deterioration in the level of consciousness T
Hypotension F [Hypertension [In spinal injury at cervical level leads Low Blood pressure and decreased heart rate ]
Tachycardia F [Bradycardia ]
Increasing GCS score F
63: IN PATIENT WITH HEAD INJURY AN INCREASE IN THE SIZE OF INTRACRANIAL HAEMORRHAGE IS INDICATED BY THE FOLLOWING
Hypertension T
Tachycardia F
Battle sign F [ Occurs due to fracture of the base of skull ]
Contra lateral meiosis ?
Rhinorrhea F [ due fracture at the base of skull,also occurs {Racoons eyes} periorbital bruising ]
64: IN CLOSED BRAIN TRAUMA
GCS is reliable indicator F
Classification into primary and secondary is of clinical importance F
Airway obstruction worsens brain damage T
6th nerve palsy is useful lateralizing sign ??
Unilateral 3rd nerve palsy indicate tenorial herniation T
BREAST
65: BREAST CARCINOMA
Is commonly treated by neoadjuvant chemotherapy F
Has a bad prognosis in elderly F [Young female ]
If it is invasive it is of high grade intra ductal carcinoma type T
Can mimic mastitis T
HRT is contraindicated T[HRT also causes endometrial cancer but rarely]
66: BREAST CANCER
Incidence is 1:20 in western countries F [1:13 or 1:12 ]
Chemotherapy is contraindicated in inflammatory carcinoma F
Tamoxifen may be used as prophylaxis in high risk patients T
Post menopausal women with CA breast , node +ve and estrogen receptor +ve should be treated with adjuvant therapy T
67: PAGETS DISEASE OF BREAST**********
Usually preceded by pagets disease of bone F
Usually presents with eczematous change of nipple and areola T
Usually treated by radiotherapy F
Usually treated by chemotherapy F
1 in 25 patients present with breast cancer F [1 in 12 in UK ]
68: BREAST
In case of discharge breast should be explored T ?
If redness around areola the breast should be explored F
69: BREAST IMPLANTS
Reconstruction can be done at the time of mastectomy T
Silicone implants have no side effects F
Tissue enhancers are rarely used T
Tram flap is the gold standard T [transverse rectus abdominis myocutaneous + LD=Lattissimus dorsi muscle both are gold standard ]
70: BREAST LUMPS
Necrosis resembles carcinoma T
If it is painful it is not carcinoma F
Fibroadenosis closely resembles fibroadenoma T
Fibroadenosis are associated with nulliparity T
Microducotomy should be performed on all lumps F
71: A 40 YEARS LADY PRESENTED WITH INTERMITTENT NIPPLE DISCHARGE
Greenish discharge suggestive of fibroadenoma F
Dark discharge mandate exploration F
Bright red mandate exploration F
Eczema of nipple malignancy is suspected T
Mammography is mandatory in all cases T
ULCERS
72: VARICOSE VEINS
Common in small saphenous vein than long saphenous vein F
Injection sclerotherapy for varicose veins above the knee is better than surgeryF
Are associated with edema, ulceration, eczema, and liposclerosis T
Is diagnosed by digital subtraction angiography F
73:VARICOSE VEINS
More common in men than women F [ More in females, F:M 3:1 ]
Common in small than large sephanous vein F
Injection sclerotherapy of varicose veins above knee is better than surgery F [ it is effective for distal varicosities ]
Are associated with eczema, edema, ulceration, and liposclerosis T
Are diagnosed by digital subtraction angiography F [Duplex scan/Doppler ]
74: ACUTE LEG ISCHAEMIA
Commonly caused by tumour emboli F
Blue and painful F
Commonly investigated by angiography F
75: THE FOLLOWING ARE TRUE ABOUT ULCERS
Ischemic ulcers are painless F [ Are painful at night and puched out ]
Malignant ulcers are characterized by everted edges T
Ischemic ulcers occur on the lateral aspect of the leg T
Venous ulcers are punched out F
Margolin ulcers are premalignant T
76: THE FOLLOWING ARE TRUE ABOUT ULCERS***
If edge is everted it indicates carcinoma T
Healing venous ulcer is punched out F
Syphilitic ulcer (chancre) is painless T
If the edge is Rolled in it is due to TB ?
Ulcer of tertiary syphilis is punched out T
77: D.V.T.
Below knee doesnt need treatment F
Is caused by COCs T
It is common after pelvic surgery T
Heparin should be given T
Is best diagnosed by ascending venography F [ Duplex scan ]
78: DVT
Investigation of choice is ascending venography F [ Dupex scan ]
Below knee needs no treatment F
Patient should be mobilized early to prevent T
Stop OCP 4 weeks prior to major surgery T
There is pitting edema T
79: ISCHAEMIC LIMB IMMEDIATE TREATMENT INCLUDES
Heparin T
Embolectomy T ?
Leg elevation F
Treatment of cardiac arrhythmias T
80: IN ACUTE LIMB ISCHAEMIA
Commonly caused by ruptured aortic aneurysm F
The cause is usually emboli T [ 38% ]
The cause is usually thrombi T [ 40% ]
The limb is blue and painful F [ Pale and painful ]
Usually diagnosed by arteriography F [ Duplex Scan , If diagnosis is in doubt ,do urgent arteriography ]
81: AN ISCHAEMIC LIMB
Usually painful T
Claudication distance less than 500 meters requires surgery F
Ankle brachial index more than 1 indcates claudication F
Presence of Dorsalis pedis pulse excludes peripheral vascular disease F
Ankle systolic pressure less than 30mmhg is indicative F [ <50 mmHg]
82: IN ISCHAEMIC LIMB
If gangrene has developed it is treated by iliofemoral by pass F
If due to embolus is commonly treated by embolectomy T [ {Fogarty catheter } or local thrombolysis tpa {balancing risk of surgery with haemorrhagic
complications of thrombolysis} ]
Can be assessed by ankle radial index F [Ankle brachial index ]
If due to small segment atherosclerosis can be treated by pulling out of the catheter balloon ?
83: TRENDELENBERGS SIGN IS POSITIVE IN ***
Varicose veins T
Un united neck of femur fracture T
Un treated congenital hip dislocation T
Leg shorter by 3cm T
Paralysis of abductors of the hip T
Paralysis of obturator nerve F [ occurs in superior gluteal nerve ]
GENITOURINARY
84: IN UROGENITAL MALIGNANCIES
Carcinoma of the prostate usually present with painless haematuria F ?
Bladder CA is usually treated by cystoscopy T [TransUretheral Resection ]
The incidence of penile CA increases if the patient is circumcised F
Testicular CA is usually treated by chemotherapy without the need for orchidectomy F
Renal cell CA can be treated by immunochemotherapy T
85: RENAL CARCINOMA
40% are bilateral F [ 2 % ]
Usually present with Hydronephrosis F
Symptoms present at an early stage T ??
Sensitive to chemotherapy T [Radical nephrectomy is Gold Standard ]
There is polycythemia T
86: RENAL CA
Usually present late F
Sensitive to chemotherapy T
Bilateral in 40% F
Commonly present with hydronephrosis F
There is raised RBC mass T
87: THE FOLLOWING ARE TRUE ABOUT RENAL CALCULI
Commonly detected by plain X-ray T
Haematuria is a common presentation T
Commonly associated with UTI T
Mostly due to calcium oxalate T
Commonly treated surgically F
88: IN RENAL STONES
Cystine type is the most common F
Over 90% are visualized by IVU T [Intravenous urogram also called IVP]
If present with renal colic unlikely to pass spontaneously F
Can cause post renal failure T
89: HYDRONEPHROSIS*****************
It is aseptic dilation of the renal pelvis/calyces T ?
Can be due to congenital pelvo-ureteric constriction T
May be secondary to crohns disease T
IVU is the investigation of choice T [Also called IVP=Intravenous pilogram]
90: UNILATERAL KIDNEY SWELLING
Hydronephrosis T
Renal artery stenosis F [Affected kindney is smaller ]
Amyloidosis T [ Large kidney ]
Renal TB F
Acute glomerulonephitis F
91: THE FOLLOWING ARE TRUE ABOUT RENAL CACULI
Commonly detected by plain x-ray T
Haematuria is a common presentation T
Commonly associated with UTI T
Mostly due to calcium oxalate T
Commonly treated surgically F
92: RENAL CALCULI
Are commonly radio opaque T
Are common in spina bifida T
Pain presents similar to ruptured AAA T
If <5cm can be passed in urine F [ <5mm ]
Are associated with VITAMIN B deficiency F [ However pyridoxine {Vit.B6} used to decrease endogenous Oxalate production in Oxalate Stones ]
93: RENAL STONES
Are commonly treated by lithotripsy F
Cystine stones are the most common types F
Over 90% are visualized by IVU T
If presented with renal colic are unlikely to pass spontaneously F
Can be a post renal cause of renal failure T
94: PAINLESS GROSS HAEMATURIA OCCURS IN
Ca bladder T
Renal cell carcinoma F ?
Urethral stricture F
Posterior urethral valve F
UTI F
95: REGARDING HAEMATURIA
IVU is an urgent investigation F
Cystoscopy is mandatory T [ Not always ]
Can be treated conservatively T
Urethral catheter should be inserted to prevent obstruction F
Urgent CT-scan should be done F USG]
96: THE FOLLOWING ARE TRUE ABOUT CA PROSTATE
Can be diagnosed by rectal examination T
May co-exist with BPH T
Usually arise from medial zone F [Peripheral zone {lateral zones} BPH arise from medial zones ]
Does not metastasize to bone F
Can cause obstructive uropathy T
97: CA PROSTATE
Occur in most men over 80 years of age T
PSA more than 100 is highly suggestive of metastasis T
PSA more than 10 is diagnostic F
Bilateral orchidectomy cures early disease F
A normal x-ray is enough to disregard a bone scan F
98: CA PROSTATE
Acid phosphatase is always high F [it is elevated in 90% of patients with metastasis and 45% with disease confined to the prostate ]
Microscopic carcinoma is common in elderly T
Can present with backache for the first time T
Showed sclerotic metastasis T
Orchidectomy improves the prognosis T
99: STRESS INCONTINENCE
Common during daytime than night T
Is treated by anterior repair F
Is treated by bladder drilling and urethroplasty T
There is increase in daily urine volume F
It may be due to UTI T
100: TESTICULAR TUMOURS
Are characteristically resistant to radiotherapy F
When metastasis occurs the tumour is incurable F
Never occurs bilaterally F
Most patients are below 40 years of age T [ 25 to 34 yrs ]
Treatment is with orchidectomy T
101: TESTICULAR TORSION
Occurs in over 40s F [ 11-30 Yrs ]
Can be easily differentiated clinically from epididiymo-orchitis F
On the affected side the testis is higher than the other T
Patient should be treated surgically within 6 hrs T
Usually treated with orchidectomy F
102: UNDESCENDED TESTIS
Never occur bilaterally F [ 30% cases are bilateral ]
Associated with inguinal hernia T
Should be treated in the first 6 months of life F [ Orchidopexy is done in 6 to 18 months ]
Susceptible to torsion after trauma T
Spermatogenesis can be preserved if treated surgically at adolescence F
103: IN HYDROCOELE
The testis is palpable F [ Difficult to differenciate ]
Translucency on illumination T
Is compressible by squeezing T
Is posterior to the testis F [ Superior and anterior where as spermatocele is superior and posterior ]
It extends upto the external inguinal ring ? [ rarely ]
MISCELLANEOUSE/SURGERY
104: PLASTIC SURGERY
Basal cell carcinoma metastasize to regional lymph nodes F
Squamous cell carcinoma increases in patients with renal transplant T
Burns to face rarely need admission F
Burn to the whole lower limb in an adult represents 10% of body surface area F
Exposed tendons and bones always need split thickness skin graft ??
105: IN DIABETIC PATIENTS
There is resistance to infection F
There is increased insulin requirements perioperatively T
They should be on the top of the operation list T
They should be monitored by urine analysis in the post op period F
106: TONSILECTOMY IS INDICATED IF
Tonsils are persistently enlarged T
Peritonsillar abcess T
Nasal obstruction ??
TB lymphadenitis F
More than 29% absenteeism from school T ?
107: IN NECK EXAMINATION
Thyroglossal cyst ascends with protrusion of the tongue T
Bronchial cyst found behind the lower third of sternocleidomastoid muscle F [Under the anterior border of junction of upper 1/3 with middle 1/3 ]
Virchows s node found in left supraclavicular fossa T
Jugular vein distention occurs with pan coast tumour T
Thyroid swelling may cause stridor T
108: MIDLINE LUMP IN NECK
Cystic hygroma F
Nasopharyngeal carcinoma F
Parotid tumour F
Bronchial cyst F
109: REGARDING NECK LUMPS
Bronchial cysts occur in midline F
Naso pharyngeal CA should be excluded F ?
TB is commonest cause in IRELAND F
LMN lesions of the face occur with benign parotid tumours T [Bells palsy]
Parathyroid tumours are rarely palpable T
110: MIXED PAROTID TUMOURS
Commonly develop in the superficial lobe T [80% ,F:M is 3:2 ]
Usually start as benign and then become malignant F
Facial nerve is early affected F
There is no capsule F
True capsule F [ It has fibrous capsule thin sheet capsule {pseudo capsule} but it has no true capsule in benign conditions,it may have in malignant condition ]
111: THYROID SWELLINGS
Are usually present in the midline F
Move with swallowing T
Common in males F
Often cause dysphagia F
Solitary nodule is most likely to be malignant F [ Only 10% are malignant ]
112: THE FOLLOWING ARE TRUE ABOUT THYROID LUMPS*******
FNA is the initial investigation if available F
Medullary CA is associated with MEN type II T
Papillary CA early spread by lymphatics T [Nodes and lungs but Follicular via blood {bones ,lungs } ]
Solitary nodule is commonly part of multinodular goiter F
Goiter with exophthalamos occurs in graves disease T
113: COMPLICATIONS OF THYROIDECTOMY INCLUDE
Thyroid storm T
Hoarsness of voice T
Hypocalcemia T
Respiratory distress T
114: CARPAL TUNNEL SYNDROME
Usually present with pain and paresthesia T
Causes wasting of the Ulnar side of the hand F
Affects adductor digiti minimi F [ Affects abductor pollicis brevis ]
Tinel test in the wrist is positive T [Tapping over nerve at wrist causes tingling]
Pain awakens the patient from sleep T
115: RUPTURED SPLEEN SIGNS INCLUDE
There is sub diaphragmatic air F
Left diaphragm raised T
Fluid in between gas filled loops of intestine ??
Diaphragm evertation ??
116: SPLEENECTOMY CAN LEAD TO
Leucocytosis T
Increased platelets count T
Increased RBC fragility F
Decreased blood viscosity F [ Increases blood viscosity ]
Increased incidence of thromboembolic phenomena T
117: WITH REGARD TO SPLEEN
Gram ve septicemia is the commonest infection post spleenectomy F
Pneumococcal vaccine should be given prior to elective spleenectomy T
Long life antibiotics are indicated in all asplenic patients F
Asplenic patients are not at increased risk to develop malaria F
Could be injured from left radical nephrectomy T
118: IN PREOPERATIVE PATIENT
A high risk patient must fully anticoagulated T
Aspirin must be stopped 3 weeks before the operation F [ Continue until major bleeding occurs ]
Oral contraceptives must stopped 6 weeks before the operation T [ 4 wks ]
A diabetic patient must receive his regular dose on the day of surgery F
A hypertensive patient must receive his regular medications T
119: PRE OPERATIVE PREPARATION
Aspirin should be stopped 2 weeks before surgery F
COCS should be stopped 6 weeks before surgery T
Normal insulin dose should be given on morning of operation F
Anti hypertensives should be given normally on the day of surgery T
120: INTERNAL CAROTID ARTERY STENOSIS
More common in females F
Successfully assessed pre operatively by duplex scanning T
Commonly lesion is at carotid bifurcation T
If symptomatic needs end arterectomy F ? [>70% Stenosis ]
Can cause Amurosis fugax T
121: STRAW BERRY NAEVI
Are present at birth F
Should be excised F
Are haemangiomas T
Are hamartomas F
Indicate presence of ipsilateral intracranial haematomas T [ Because there is contralateral focal fits ]
122: REPAIR OF AAA COMPLICATIONS
Oliguria T
Spinal infarction T
Right colon infarct: T
123: ANEURYSM OF THE AORTA
Has strong familial pre disposition T
Smoking is strong aetiological factor T
If it is >6cm prediction is rupture T
Endovascular (stenting) or grafting is intervention of choice T
May cause ureteric obstruction T
124: POST OP COMPLICATIONS IN 24 HRS
Pyrexia due to atelectasis T
Subcutaneous heparin contraindicated due high risk of hemorrhage F
Increased ADH T
Diuretic should be given to maintain out put F
125: IN POSTOPERATIVE PERIOD
1degree c rise in temp can be ignored T ?
Po2 is higher in lower abdominal surgery than in upper abdominal surgery F
Pulmonary embolism is clinically evident DVT in > 90% of the cases F
Serosangeous discharge is suggestive of wound dehiscence T
Mucous discharge through the rectum indicates pelvic abcess F
126: POST OP COMPLICATIONS
In a patient with calf pain pulmonary embolism can occur T
Secondary bleeding occurs in the 1st few hours F [Occurs aftr 1 to 2 wks post operatively some times after 48 hrs but primary bleeding occurs with in 24 hrs ]
Widened gap of the wound induces healing F
Po2 level > in the lower abdominal surgery than in upper abdominal surgery F
127: POST OPERATIVE COMPLICATIONS
Dehydration is common cause of renal failure T
In a patient with calf pain pulmonary embolism can occur T
Secondary bleeding occurs in the 1st 6 hrs F
K requirements are reduced in the post operative period F
128: IN THE 1ST 24 POSTOPERATIVE HRS
Fever is usually due to atelectasis T
There is increased ADH T
Oliguria is treated by diuresis F
K requirements are increased T
Normal 2-3 litres /24 hrs are given T
129: IN THE 1ST 24 HRS POSTOPERATIVELY
Fever is usually due to atelectasis T
K requirements are increased T
There is increased secretion of ADH T
Oliguria should be corrected by diuretics F
Heparin is CI postoperatively due to risk of haemorrhage F
130: DAILY NUTRITIONAL REQUIREMENTS
35kcal/kg for an adult T [ 20 to 40 kcal ]
5g/day nitrogen F [10 to 14 g ]
Daily fatty acids are required to prevent deficiency T
Carbohydrates provide 4kcal/gm T
Amino acids in TPN are light sensitive ?
131: FLUIDS
Vomiting is corrected by 5% dextrose F
Dehydration due to diarrheoa should be corrected by K supplements T
Hyponatremia is due to inappropriate ADH secretion T ?
Normal BP excludes hypovolemic shock F [BP is unchanged unless 30% blood loss occurs in young man ]
Gastric out let obstruction is typically associated with hypokalemic metabolic acidosis F
132: HYPOVOLAEMIC SHOCK IS FOUND IN THE FOLLOWING
Pulmonary embolism F
Fracture of the pelvis T
Acute pancreatitis T
5% 3rd degree burns F
Upper GIT obstruction T
133: KELOID SCAR
Keloid extends beyond the wound it self and continues to increase beyond six months than hypertrophic type T
It is usually regressed with in six months F [ beyond six months ]
Its formation is prevented by making incisions along the natural skin creases or langers lines T
Pressure devices are effective in preventing keloid formation T
They are treated by excision of keloid F [excision is avoided ]
PSYCHIATRY
1: IN ANOREXIA NERVOSA
Amenorrhea is more common than in bulimia nervosa T
Weight loss of more than 25% is required to make the diagnosis T[15%]
Patients have distorted body image T
Increased growth hormone levels T
Fear of eating in public is a bad prognostic factor ?
2: ANOREXIA NERVOSA
Is of poor prognosis if affects lower class ?
Dental problems commonly occur T
FSH does not return to normal even after treatment F
There is Hypokalemia T
There is increased level of cortisol T
3: ANOREXIA NERVOSA
Amenorrhea occurs T
More than 15% weight loss T
Women to men ration s 6:2 F [20:1]
Being male is a bad prognosis F
4: ANOREXIA NERVOSA
Never occurs in males F
Drug treatment is the best treatment F
Occurs at an earlier age than bulimia nervosa T
GH level is increased T
5: OVER EATING OCCURS IN*******
Anorexia nervosa F
Bulimia nervosa T
Depression T ?
Puerperal psychosis F
Social phobias F
6: ALCOHOL DEPENDENCE SYNDROME
Is suggested by MCV of 90 F
Is suggested by irregular pattern of drinking ?
Is suggested by altered tolerance of alcohol T
Can be detected by (CAGE) questions T
Ingestion of 15 units per week in adult male is required to make the diagnosis F
7: THE FOLLOWING ARE THE FEATURES OF ALCOHOL DEPENDENCE
Ocular nerve palsies T
Confabulations T
Liver abnormalities in 90% of cases F
Impotence T
Auditory hallucinations in the fully conscious F
8: DELERIUM TREMENS
Onset after 6 hrs of withdrawal F [10 to 72 hrs]
Mortality in 10% of cases F [35%]
Delusions can occur T
Tremor is not a feature F
9: DELERIUM TREMENS ********
Usually treated in dark room F
Increased risk of fits T
Usually Vit B deficiency T
Usually hallucinations are visual T
Hallucinations are usually olfactory F
10: OPIATE DEPENDENCE INCLUDES
Hyper sexuality F
Constricted pupils T
Shivering F
Peripheral neuropathy F ?
Diarrhea F
97: OPIATE ADDICTION
More common in developing countries T
More common in deprived urban areas T
Female tendency for addiction is more than males F
More than 30% of the patients have hepatitis C infection ?
Cross addiction with diazepam occurs T
11: THE FOLLOWING CONDITIONS MAY PRESENT WITH DEPRESSION
Abrupt onset
Sudden behavioral change
Preserved sleep rhythm F
Variable cognitive functions T
Visual hallucinations F
12: THE FOLLOWING CONDITIONS MAY PRESENT WITH DEPRESSION
Hypothyroidism T
Addisons disease T
Pellagra T
Pheochromocytoma F
Cushings syndrome T
13: DRUG RESISTANT DEPRESSION
If more than 2 antidepressant drugs fail
If more than 3 antidepressant drugs fail F
Haloperidol can be used as an adjuvant T
Valproate can be used as adjuvant T
14: FOLLOWING ARE USED AS ANTI DEPRESSANTS
Temazepam F
Haloperidol T
5-HT uptake inhibitor T
Imipramine T
Chlormethiazol F
15: POST NATAL DEPRESSION
Occur in 15% T [PREVALANCE 10% to 15 % and 15% confiremed]
Can be prevented if diagnosed prenatally F ?
Always need medication F
ECT is contraindicated F
16: PUERPERAL PSYCHOSIS
Recurrence rate of 1 in 2 in next pregnancy F [ 20 to 30 %]
Frequently needs hospital admission T
Occurs within 2 weeks of delivery T [80% occur with in frst 2 wks ]
1 in 100 of all pregnancies F [ 1 in 500]
Is usually an affective disorder T [ 80% cases affective in type ]
Is likely to recur in the next pregnancy T
Is of good prognosis T
Occurs 2 weeks postpartum T
ECT is useful treatment T
Lithium may be helpful T
Usually starts 2 weeks after delivery F [80% Occurs with in 2 wks after delivery]
As a rule recurs in subsequent deliveries F
Is of good prognosis T
Usually presents as schizophrenia F[rarely in schizophrenia and often in depression,mania and high suicidal ]
ECT is CI F
19: DEPRESSION MAY PRESENT WITH
Loss of weight T
Disturbance of sleep T
Mild physical illness T
Deliberate self harm T
Alcohol dependence T
20: DEPRESSION IS CHARACTERIZED BY***
Late insomnia F
Loss of weight T
Weight gain T ?
Loss of appetite T
Delusion of poverty F
21: DEPRESSION
Dotheipin in over dose is safe F
MAOIs and tricyclics together are dangerous T
Auditory hallucinations is characteristic F
Lower social class has good prognosis F
Prognosis is bad in the elderly T
Psychotic depression carried good prognosis T
Lithium can be used to augment the actions of tricyclics T
22: REGARDING DEPRESSION
In males is more than females F [1:2]
There is motor retardation F? [Psychomotor retardation occurs page 336]
More than 60% of the patients respond in the first week of treatment F [around many weeks]
Can be caused by calcium channel blockers T
Prevalence is 1% F [7 to 18%]
23: SIDE EFFECTS OF SSRIs INCLUDE
Nausea T [20%]
Sweating T
Tremors T
Sedation T [drowsiness]
Confusion T
Thyroid dysfunction F
Other side effects are Athenia,fever,diarrhea,dry mouth ,appetite loss,dyspepsia,,headache,nervousness,isomnia,anxiety,dizziness,decreased
libido,pharyngitis,dyspnoea,rash or allergic reactions,convulsion,hypomania and mania,sweating ,visual disturbance,billured
vision,agitation,palpitation,tachycardia,hypotension,hypertension,polyurea,taste abnormalities,rhinitis,sinusitis]
24: THE FOLLOWING ARE USED FOR THE TREATMENT OF DEPRESSION
Benzodiazepines T[Hypnotic are used along with antidepressant ]
Tricyclic anti depressants T
Phenothiazines T [is tranquillizing drug with antipsychotic action,is used with other antidepressive drugs]
Lithium T
Phenelzine T [It is MAOIs and used for severe depression]
25: TRICYCLIC ANTIDEPRESSANTS
Hypertension is aknown side effect F
CI in closed angle glaucoma ? [ increases glaucoma risk ]
In over dose leads to arrhythmia T
Shorten the QT interval F [Prolongs]
Causes delayed ejaculation F[ Caused by SSRI]
26: TRICYCLIC ANTIDEPRESSANTS CAN CAUSE
Chest pain T
Blurring of vision T
Constipation T
Hypotension T
Weight gain T
Dry mouth T
27: E.C.T.********
Used in the treatment of puerperal psychosis T
Is better than medication in the treatment of depression T
Is more successful in depression with delusions T
Is of no use in neurotic depression F
Has been validated in double blind trials ?
It causes brief memory disturbance after application T
28: E.C.T.*******
Is CI in patients with pacemaker F
May be given to pregnant women T
Is a treatment of resistant manic depression T
Needs EEG in all cases F
It needs generalized convulsion to be effective F
29: E.C.T.*******
Is safer than TCA T
Is useful in catatonic schizophrenia T
Is particularly useful in severe depression T
Is used in depression with psychotic features T
Consent should be sought T
Causes reversible damage to the mammalary bodies F
30: ECT*****
Consent should always be sought F
Causes amnesia T
There is loss of consciousness F
Significant risk of cardiac arrest F?
Usually refused because of fear of pain F
Analgesia is used F [anesthesia]
31: ANXIETY
Incidence is double in females than males T
Benzodiazepine is the treatment of choice F [Cognitive behaviour therapy+limited use of anxiolytic due to side effects and withdrawal +ssri for social anxiety ie
alcohol abuse syndrome,+ progressive relaxation training + hypnosis ]
32: ANXIETY NEUROSIS
Twins studies proved genetic elements ? [there is genetic disposition but not sure about twin studies ]
Found in men more than women F
Cases of pathological anxiety are usually referred to psychiatric clinic T
33: PANIC ATTACKS
Is a feature of anxiety T
Medications should not be given F
Is associated with agoraphobia T
May be associated with mitral valve prolapse T
May be associated with depression T
34: : MANIA CAN PRESENT WITH
Agitation T
Grandiose delusions T
Affection of mood/mode
Sleep disturbance T
35: THE FOLLOWING ARE USED IN THE PROPHYLAXIS OF MANIA
L-tryptophan T[ D-Tryptophan is incorrect]
Lithium citrate T
Lithium carbonate T
Carbamezapine T
Phenytoin T
36: SYMPTOMS OF MANIA INCLUDE
Irritability T
Loss of judgment T
Primary delusion T
Auditory hallucinations
3rd person hallucinations T
37: POST TRAUMATIC STRESS DISORDER IS ASSOCIATED WITH
Anxiety T
Depression T
Decreased ability to dream F
No sympathetic arousal F
Elated mood F
When the patient sees someone related to the traumatic event it causes severe distress in the patient T
Hypersomnia F
Vivid dreams about the accident T
38: THE FOLLOWING ARE TRUE ABOUT AFFECTIVE DISORDERS
Bipolar disorders are common in females > males F [equal ratio ]
In bipolar disorders recovery is complete between episodes T
In bipolar disorders mania is common in elderly ?
Bipolar disorders are common above the age of 30 F [ usually occur in late adolescence or early adult hood ]
39: THE FOLLOWING ARE TRUE ABOUT PHOBIAS
Agoraphobia is the commonest type T
Agoraphobia is common in females than males T
Chlorpromazine is used for the treatment of panic disorders F
Cognitive therapy is the treatment of choice T
Social phobia is equal in males and females F
Agoraphobiacs usually suffer from depression F
Uncommon in children F
Social phobia is commonly associated with alcoholism T
Simple phobia is considered as delusion
40: BENZODIAZAPINE ADVERSE EFFECTS INCLUDE
Confusion T
Respiratory depression T
Aggression T[Agitation,anger,depression,irritability,depression T ]
41: HALLUCINATIONS**********
Of auditory type involving the third person are characteristic of schizophrenia T
Are misinterpretations of external stimuli F
Of visual type suggest organic disease T
Of smell suggest frontal lobe lesions F
Could be normal experience T
42: HALLUCINATIONS
Can occur with depression T
They are like illusions F
If in the second person it indicates 2nd person commenting on you F
Are misinterpretations of external stimuli F
It should be in keeping with the patients social and cultural back ground F
43: COMPULSIONS
Are not usually resisted F
Checking is rare F
Are usually signal acts F
Are seen senseless by the patient T
44: OBSSESSIVE THOUGHTS
Can usually be resisted T
Are usually acted upon T
Coming from subjects own mind T
Are rituals F
Are associated with depression ?
45: OCD
Is treated with cognitive therapy T
Thought is usually resisted T
Is treated with fluoxetine T
Is about repetitive acts T
Is about rituals T
46: OCD
Is a psybhotic disorder F
Is best treated by psychoanalysis F
Is treated by behavior therapy T
47: SUICIDE*****
70% suffer from depression T
Living alone increases risk T[
Never married are at highest risk F ?[ Highest in divoreced,then in never married then married males]
More in males T
Associated with alcohol abuse T
48: SUICIDE
More common in males T
60% are associated with depression T[70%]
More in never married T
Previous failed attempts decrease the risk of suicide F
49: IN ASSESING SUICIDAL OVERDOSE
Asking relatives is necessary if available T
Suicidal note is of little importance F
The amount of drug can indicate the severity of illness F
Previous attempts increase suicidal risk T
50: DELIBRATE SELF HARM
More common in males F
May lead to suicide in future T
The patient is usually suffering from depression F [Not usually]
May be an attention seeking behavior T
Associated with skin artifact lesion T
51: REGARDING SUICIDE ATTEMPTS
Past of history of suicide is there T
More in females T
All should be hospital admitted T
Drug over dose is the most common mode T
52: IN SCHEZOPHRENIA
Males are affected more than females F [equally affected,men are affected earlier than women,men in late teenage to 20 yrs and females from 20 to 30 yrs ]
Usually presents before the age of 60 T[M-20 to 28 yrs,F-26 to 32 yrs]
Life events may be the precipitating factor T
Amphetamine may aggravate it T
3rd person hallucination is characteristic T
53: REGARDING SCHEZOPHRENIA
Clozapine causes Agranulocytosis T
Clozapine is now the treatment of choice F
Schneiders first rank symptoms are pathognomonic F?
Malignant neuroleptic syndrome has high mortality F
54: IN SCHEZOPHRENIA
There is strong genetic factor T
Increased suicidal risk T
Chlorpromazine is the treatment of choice T ?
Chlorpromazine has anti Prolactin effects F
55: SCHEZOPHRENIA
Visual hallucination is characteristic F
Auditory hallucination is diagnostic T
There is seasonal birth effect T[Winter]
Confusion and disorientation are rare T ?
There is better outcome in the industrialized countries ?
56: IN SCHIZOPHRENIA
Olfactory hallucinations are characteristic F
1st rank symptoms are pathognomonic F [Are diagnostic]
Dilated lateral ventricles on CT scanning T
Catatonia is treated with ECT T
Associated with a genetic defect on chromosome 11[7,11,15] ?
57: SCHEZOPHRENIA**********
Schneiders first rank symptoms are pathognomonic F [Are diagnostic ]
Enlarged ventricles on CT scan T
Analysis is enough for treatment F ?
Has a seasonal prevalence T ? [Seasonal in birth only ]
Treatment is with anticholinergics F
Lesion is on chromosome 11
58: GOOD PROGNOSTIC FEATURES OF SCHEZOPHRENIA INCLUDE
Insidious onset F [Sudden onset]
Old age T
Family history of affective disorders T
Normal premorbid personality T
1st rank symptoms F
59: THE FOLLOWING MAKE THE DIAGNOSIS OF SCHEZOPHRENIA MORE LIKELY
Auditory hallucinations in the third person T
Thought withdrawal T
Catatonic type responds well to ECT T
Disorientation in time and person F
Past history of sexual abuse in child hood T
Clozapine is the treatment of choice F
60: SCHIZOPHRENIA
Increased risk in adopted children when adopting parent have schizophrenia ?
Incidence increases in developed countries T
May respond to psychotherapy T
61: THE FOLLOWING MAKE THE DIAGNOSIS OF SCHIZOPHRENIA MORE LIKELY
Hallucinations in the 2nd person F
Thought withdrawal T
Catatonic type that responds well to ECT T
Past history of sexual abuse T
Tearfulness
62: SCHEZOPHRENIA
In adoptees depends on incidence in adopters
Incidence increasing in developed countries T
May respond to psychotherapy T
63: THE FOLLOWING ARE ANTIPSYCHOTIC DRUGS
Chlorpromazine T
Haloperidol T
Fluoxetine F[SSRI]
Tenzapine F
Imipramine F
64: SIDE EFFECTS OF NEUROLEPTICS********
Dystonia T
Akathasia T[Tardive diskinesia]
Poverty of speech F
Claustrophobia F
Hypotension T
65: THE FOLLOWING ACTIONS OF CHLORPROMAZINE ARE MEDIATED BY D2 RECEPTORS
Anti psychotic T
Anti emetic T
Parkinsonian features F[5HT2 Antagonist]
Postural hypotension F [Alpha1 Antagonist]
Weight gain ?
Akathasia ?
66: FIRST RANK SYMPTOMS OF SCEZOPHRENIA INCLUDE
Thought block T
Elated mood F
Gradual onset F
Primary delusion T
Flight of ideas F
Hallucinations in third person T ?
Delusional perception F
Antipsychotic action of chlorpromazine starts at 20 min ? [By IM 15 to 30 min by oral 30 to 60 minutes and by rectal takes more times]
Korsakofs syndrome resists treatment with massive dose of bismuth IV ?
Clozapine is the treatment of choice for schizophrenia F
Depressive psychosis best treated by monotherapy F
68: CLOZAPINE
Causes Agranulocytosis T
Is used in the treatment of resistant schizophrenia T
Does not cause tardive dyskinesia ?
Acts on D1 receptors F [D4]
69: ANTIPSYCHOTICS
Reduce the thresh hold of seizures T
70: THE FOLLOWING SUGGEST THE DIAGNOSES OF DELERIUM RATHER THAN DEMENTIA
Abrupt onset T
Sudden behavioral change T
Preserved sleep rhythm F
Variable cognitive function ?
Visual hallucinations T
71: VASCULAR DEMNTIA MORE LIKELY THAN ALZHEIMERS IN THE PRESENCE OF********
Step wise progression T
Hypertension T
Carotid bruit T
Plantar extensor T
Short term memory loss ?
72: ALZHEIMERS DISEASE
Affects men more than females F
Delta and beta waves occurring EEG ?
High neurofibrillary tangles correlate with increase in severity F
Commonest cause of dementia at any age T
Is common in patients with DOWNS syndrome T
May be familial in 10% T
Reduction in the biochemical matter correlates with cognitive therapy F ?
73: THE RISK OF ALZHEIMERS DISEASE INCREASES WITH
Trauma T
High educational level F
Low educational level T
Age T
Environmental toxins(aluminum) T
74: DELERIUM IS MORE COMMON WHEN THE FOLLOWING CONDITIONS ARE PRESENT
Hypothyroidism T
Bronchopneumonia T
An unstimulating environment F
Treatment with benzodiazepines T
Increasing age T
75: ORIENTATION TESTS IN PATIENTS WITH DELERIUM THE FOLLOWING PARAMETERS CAN BE USED
Recognition of interviewer T
Name of president T
Name of ward T
Orientation of progress/passage of time T
76: DEMENTIA************
Vascular is most common F
Consciousness is not impaired T
Is progressive T
Usually treated with anti cholinesterase inhibitors T[alzimer dementia is best treated with anti cholinesterase inhibitor ?? check it ]
Picks dementia is the third commonest type F [Lewy body dementia]
Levy body type may present with delirious episodes T ?
77: LIFE EVENTS
Females stand life events more than males before developing endogenous depression T
Threat leads to anxiety more than depression T
Loss of threats precedes relapse of schizophrenia F
Unemployment increases the impact of life events T
Loss of confidence increases the impact of life events T
78: COGNITIVE BEHAVIORAL THERAPY INCLUDES
Cognitive process T
Behavioral process T
Emotional reactions ?
Biophysiological aspects F
Psychological aspects ?
79: PSYCHOTHERAPY
Schizophrenia is treated by psychodynamic therapy T
Autism is treated by cognitive therapy F
Panic attacks are treated by cognitive therapy T
Phobias are treated by cognitive therapy T
Depression is treated by arbitrary interference ?
80: REFUSAL OF SCHOOLING
May present with abdominal pain T
Early return to school is of good prognosis T
It is associated with separation anxiety T
It is associated with depressive illness T
81: IN CHILD AUTISM
Echolalia can occur T
Unwillingness to be touched T
Loss of eye to eye contacts T
Loss of imaginative abilities T
Behavior is stereotyped T
82: AUTISM
There is language speech delay T
Males affected more than females T[4:1]
Obsessive compulsive pre occupied ?
Verbal ticks T
83: IN NORMAL GRIEF WITHIN 1 MONTH OF BEREAVEMENT THERE IS**********
Restlessness T
Antisocial behavior F
Suicidal ideation?
Tearfulness T
Emotional numbness T
84: TEMPORAL LOBE EPILEPSY
De ja vous occurs T
Smell hallucinations occur T
Is followed by paralysis of 1 or 2 limbs for 1 or 2 hours ?
Anti social behavior occurs F
Consciousness is affected T
85: KORSAKOVS PSYCHOSIS
Occurs with alcohol T
Occurs with opiates F
Is caused by vit.B deficiency T
Can precede wernickes enceph F [Korsakov occurs after wernickes enceph]
86: TESTS OF ORIENTATION OF CONFUSED PATIENT CAN INVOLVE
The name of the ward T
The name of the prime minister T
87: EXPOSURE THERAPY
Used in phobias T
Used in OCD T
88: CHRONIC ALCOHOLISM IS ASSOCIATED WITH
Parotitis T
Aspiration pneumonia T
Loss of late event memory F [Recent memory loss]
Restrictive cardiomyopathy T [Dilated cardiomyopathy]
Macrocytosis and increased multilobed neutrophils in peripheral blood film T ?
89: SIGNIFICANT SIDE EFFECTS OF SSRIs INCLUDE
Blurred vision T
Urinary retention F
Confusion T
Sedation T
Tremors T
Erectile dysfunction T
90: DELERIUM MAY BE CAUSED BY
Hypothyroidism T
Acute alcohol withdrawal T
Cushings disease F
VIT B1 deficiency T [THIAMINE]
91: MENTAL ORIENTATION TEST
Disorientation suggests anxiety F [Occurs in delirium]
Preservation suggests mania F
Visual hallucinations suggest dementia F
Mutism suggests malingering F
Stereotypies suggest schizophrenia T
Obsessive disorders are associated with auditory hallucinations F
Stereotyped thinking suggests schizophrenia T
Hallucinations must be in keeping with the patients cultural background F
92: PSYCHODYNAMIC THERAPY************
Deals with conscious cognition and behaviour F
Deals with unconscious T
Transference means expression of therapists emotions for patient F
The basic concept was derived from the works of FREUD and KLEIN T
93: ECT**********
CI in patients not taking fluids F
CI in cardiac ischaemia F
Useful only for psychotic depression F
Cannot be given without consent F
Evokes a tonic clonic fit T
94: AUTISM
Child has obsessional pattern of behaviour T
Onset is usually after 30 months age F[Occurs before 30 ]
Has normal or high IQ level F
95: BLUNT EFFECT IS SEEN IN
Schizophrenia T
Depression T
Parkinsonism T
Dementia T
Antipsychotics T
96: SOMATIZATION SYNDROME
The patient should be advised that the symptoms are imaginary F
Repeated medical investigations should be done to assure the patient F
Reflects unresolved conflicts in unconscious F
Chronicity of symptoms indicates poor prognosis T
Underline depression should be excluded T
98: THE FOLLOWING SEXUAL DYSFUNCTIONS ARE ENCOUNTERED IN PSYCHIATRIC CLINICS
Erectile dysfunction T
Vaginismus T
Transvestism T
Sadomasochism T ?
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10/16/2014 PRES 2 Past Papers - MEDICAL REGISTRATION EXAMS.

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