Test Prep Test Prep Certifications MCQS Questions & Answers

• Question 1:

  Most appropriate initial therapy for Postpartum Endometritis is:

  A. Clindamycinandmetronidazole

  B. Vancomycinandgentamycin

  C. Ceftriaxoneandazithromycin

  D. Clindamycinandgentamycin

  Correct Answer: D

  The prevention of endometritis is important. Infection prevention practices, including avoiding unnecessary caesarean section, appropriate management of prolonged labour, fewer vaginal examinations during labour, use of good sterile techniques and meticulous operative procedures during delivery, and providing appropriate prophylactic antibiotics during caesarean section should be routinely practiced. FIRST CONTACT (PRIMARY CARE LEVEL) The diagnosis of endometritis should be considered when a postpartum woman has febrile morbidity (oral temperature 38.0癈 or on two occasions between day 1-10 after birth) abdominal pain or foul smelling lochia. Careful physical examination to detect the source of infection is crucial. Once endometritis is diagnosed, appropriate antibiotic treatment should be started. If clindamicin is not available, or not affordable, the WHO-recommended regimen of ampicillin plus gentamicin plus metronidazole should be used. If fever is still present 72 hours after treatment, the patient should be carefully re-evaluated and the diagnosis revised. If complication(s) (such as pelvic abscess, peritonitis, septic shock, etc.) are suspected the patient should be referred to higher level of health care immediately.

  Reference:

  http://apps.who.int/rhl/pregnancy_childbirth/care_after_childbirth/ccguide/en/

• Question 2:

  7-year-old boy with red color urine. Which initial test is necessary?

  A. culture

  B. microscopy

  C. dipstick

  Correct Answer: C

• Question 3:

  A patient with gross hematuria after blunt abdominal trauma has a normal appearing cystogram after the intravesical instillation of 400 ml of contrast. You should next order:

  A. A retrograde urethrogram.

  B. A voiding cystourethrogram.

  C. A cystogram obtained after filling, until a detrusor response occurs

  D. An intravenous pyelogram.

  Correct Answer: A

• Question 4:

  A 54-year-old man, newly diagnosed with type- 2 diabetes mellitus, presents to the clinic for his first assessment. He is found to have changes in his eyes on fundoscopy.

  Which of the following is most likely to need immediate referral to the ophthalmologist?

  A. few dot and blot haemorrhages

  B. some hard exudates > 1 disc diameter from the fovea

  C. New vessels on the disc

  Correct Answer: C

  New vessels on the disc Background diabetic retinopathy consists of dot and blot haemorrhages and hard exudates. Patients do not need to be referred to the ophthalmologist unless these are within 1 disc diameter of the fovea. This can be monitored annually at the routine clinic. Cataracts appear about 10 years earlier in type-2 diabetes than in non-diabetic patients. If the vision is significantly affected the patients warrant routine and not urgent referral to the ophthalmologist. Soft exudates suggest retinal ischaemia, which would require routine referral to the ophthalmologist. New vessels anywhere in the fundus are a feature of proliferative retinopathy and, as new vessels have a risk of haemorrhage and can threaten sight, they should be referred urgently to the ophthalmologist.

• Question 5:

  Cervical cancer diagnostic test:

  A. Cone biopsy

  B. Punch biopsy

  C. FNAC

  D. Pap smear

  Correct Answer: A

  In this procedure, also known as conization, the doctor removes a cone-shaped piece of tissue from the cervix. The base of the cone is formed by the exocervix (outer part of the cervix), and the point or apex of the cone is from the endocervical canal. The tissue removed in the cone includes the transformation zone (the border between the exocervix and endocervix, where cervical pre-cancers and cancers are most likely to start). A cone biopsy can also be used as a treatment to completely remove many pre-cancers and some very early cancers. Having had a cone biopsy will not prevent most women from getting pregnant, but if a large amount of tissue has been removed, women may have a higher risk of giving birth prematurely. The methods commonly used for cone biopsies are the loop electrosurgical excision procedure (LEEP), also called the large loop excision of the transformation zone (LLETZ), and the cold knife cone biopsy. Loop electrosurgical procedure (LEEP, LLETZ): In this method, the tissue is removed with a thin wire loop that is heated by electrical current and acts as a scalpel. For this procedure, a local anesthetic is used, and it can be done in your doctor's office. It takes only about 10 minutes. You might have mild cramping during and after the procedure, and mild-to-moderate bleeding for several weeks. Cold knife cone biopsy: This method uses a surgical scalpel or a laser instead of a heated wire to remove tissue. You will receive anesthesia during the operation (either a general anesthesia, where you are asleep, or a spinal or epidural anesthesia, where an injection into the area around the spinal cord makes you numb below the waist) and is done in a hospital, but no overnight stay is needed. After the procedure, you might have cramping and some bleeding for a few weeks.

• Question 6:

  Chronic pancreatitis, investigation of choice?

  A. ERCP

  B. MRCP

  C. MRI

  D. CECT

  Correct Answer: A

• Question 7:

  A 6 months old boy with cough and wheezy chest. The diagnosis is:

  A. Bronchiolitis

  B. Foreign body aspiration

  C. Asthma

  D. Pneumonia

  Correct Answer: A

• Question 8:

  Recurrent fourth time 1st trimester pregnancy loss. Likely cause?

  A. Cervical incompetence

  B. Anti-phospholipid syndrome

  C. Chromosomal abnormalities

  Correct Answer: C

  Embryonic chromosomal abnormalities In couples with recurrent miscarriage, chromosomal abnormalities of the embryo account for 30?7% of further miscarriages.

• Question 9:

  Juvenile Idiopathic Arthritis treatment:

  A. Paracetomol

  B. Penicillamine

  C. Hydrocloroquin

  D. Naproxen

  E. Steroid

  Correct Answer: E

  The overall treatment goal is to control symptoms, prevent joint damage and maintain function. The first line of treatment involves a non-steroidal anti-inflammatory drug or NSAID. Examples of NSAIDs, such as ibuprofen (such as Motrin or Advil) or naproxen (Naprosyn), administered in a dose appropriate for the child's weight. Younger children may be given liquid preparations or medications that require less frequent use. Because NSAIDs can cause gastrointestinal distress, such as stomachaches, they should be taken with food. Disease modifying drugs--commonly called DMARDs--are added as a second-line treatment when arthritis does not respond to NSAIDs. DMARDs include methotrexate (Rheumatrex), leflunamide (Arava) and more recently developed medications known as biologics. The biologics include anti-tumor necrosis factor agents such as etanercept (Enbrel); infliximab (Remicade); adalimumab (Humira); abatacept (Orencia); anakinra (Kineret;); canakinumab (Ilaris) and tocilizumab (Actemra). Each of these medications can cause side effects that need to be monitored and discussed with the pediatric rheumatologist treating your child. Most of these treatments are approved for use in children as well as adults. In addition, researchers are developing new treatments. When only a single joint is involved, a steroid can be injected into the joint before any additional medications are given. Oral steroids such as prednisone (Deltasone, Orasone, Prelone, Orapred) may be used in certain situations, but only for as short a time and at the lowest dose possible. The long-term use of steroids is associated with unacceptable side effects such as weight gain, poor growth, osteoporosis, cataracts, avascular necrosis, hypertension, and risk of infection.

• Question 10:

  29 year's Old female has a breast lump in the upper outer quadrant of the left breast, firm, 2 cm. in size, no Lymphnodes enlargement diagnosed as fibroadenoma.

  What is the management for the above patient?

  A. MRI

  B. Percutaneous core biopsy and conservative follow-up

  C. Mammogram

  Correct Answer: B

  Fibroadenoma of the breast is a common benign lesion affecting women during their reproductive years. Despite their benignity, fibroadenomas can cause physical deformity due to large size and may produce discomfort or emotional distress in affected individuals. The traditional management options available to women diagnosed with a fibroadenoma include observation or surgical excision. Two newer approaches, percutaneous excision and in situ cryoablation, have been developed and are less invasive than surgical excision. The purpose of this consensus statement is to put these four management options into perspective for our members and their patients. In most patients with fibroadenoma(s), the ideal approach is confirmation with percutaneous core biopsy and conservative follow-up. Because the malignant potential of fibroadenomas is extremely low, treatment is not required on an oncologic basis. This conservative approach is the least costly in terms of dollars and morbidity. A significant minority of fibroadenomas will disappear without treatment; with the remaining lesions either increasing in size or remaining unchanged.

  Reference: https://www.breastsurgeons.org/new_layout/about/statements/PDF_Statements/Fibroadenoma.pdf