Test Prep MCQS Online Practice Questions and Exam Preparation

Test Prep MCQS Online Questions & Answers

• Question 211:

  65years man had a bowel resection 5days ago. He is anuric and breathless. His BP=150/110mmHg.He has lung bases and sacral edema. Bloods: K+=6.8mmol/l, urea=58mmol/l, creatinine=600umol/l.

  What is the single immediate management?

  A. Bolus of 20U insulin
  B. 5% dextrose infusion
  C. Calcium resonium enema
  D. 10U insulin, 50ml of 50% dextrose infusion
  E. Dextrose-saline infusion
  D. 10U insulin, 50ml of 50% dextrose infusion

• Question 212:

  The best test for diagnosis of adenomyosis:

  A. Ultrasound
  B. Laproscopy
  C. Hystroscopy
  D. MRI
  D. MRI

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  Adenomyosis is a non-cancerous condition of the uterus that can mimic many of the signs and symptoms of fibroids. This condition results from the lining cells of the uterus growing directly into the muscle wall of the uterus. When the lining cells of the uterus bleed at the time of the menstrual period, these misplaced cells in the muscle bleed as well. And bleeding directly into the muscle causes pain. As the blood accumulates, the surrounding muscle swells and forms fibrous tissue in response to the irritation. This swollen area within the uterine muscle wall, called an adenomyoma, feels very much like a fibroid on examination and is often confused with a fibroid on a sonogram. Adenomyosis may be mild and cause no symptoms at all, or, in more severe forms, it may lead to heavy bleeding and severe cramping during menstrual periods. Adenomyosis is present in about 10 percent of women and, therefore, is less common than fibroids. However, now that women with adenomyosis can be diagnosed by MRI, careful examination of the cellular changes of the uterus suggests that there are many reasons why adenomyosis could cause infertility. These new studies will also be very important in helping scientists figure out what type of treatments might cure adenomyosis, or better yet, prevent it from developing at all.

• Question 213:

  A 5-year-old boy suddenly begins coughing while eating peanuts. He is choking and gagging. When he is brought to the emergency department, but he is awake and is able to give his name. On physical examination, his vital signs are stable. On examination of the chest, inspiratory stridor and intercostal and suprasternal retractions are apparent.

  Which of the following is the most appropriate initial step in management?

  A. Position patient and perform back blows
  B. Clear or oropharynx with multiple blind sweeps with finger
  C. Stand behind patient and perform abdominal thrusts
  D. Allow patient to clear foreign object by spontaneous coughing
  E. Perform emergency tracheostomy and take to surgery.
  D. Allow patient to clear foreign object by spontaneous coughing

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  Since the patient can cough and breathe, he should be allowed to clear the foreign object spontaneously, if possible. In the management of foreign object obstruction, if the patient can cough and breathe, it is best to initially observe and allow spontaneous resolution, since intervention may actually be damaging.

• Question 214:

  A 57-year-old man having hypertension on oral anti-HTN. However, he is finding it difficult to mobilize as he tries to get up.

  What is the most appropriate investigation for him?

  A. ECG
  B. CXR
  C. Ambulatory BP
  D. CT SCAN
  E. MRI
  C. Ambulatory BP

  ---

  Ambulatory BP. Ambulatory BP to document low BP as cause of presenting symptom. The case sees hypotension and low BP as a result of given anti-hypertensive.

• Question 215:

  An elderly man comes to the emergency department with fever, headache, a stiff neck, and photophobia. He is HIV positive with < 50 CD4 cells and a history of pneumocystis pneumonia. His head CT is normal. CSF shows 2,500 white cells that are all neutrophils; Gram stain is normal.

  What is the best initial therapy?

  A. Cefoxitin and mefloquine
  B. Fluconazole
  C. Ceftriaxone, ampicillin, and vancomycin
  C. Ceftriaxone, ampicillin, and vancomycin

  ---

  Listeria monocytogenes is a cause of meningitis that is not adequately treated by any form of cephalosporin. Ampicillin is added to the usual regimen of ceftriaxone and vancomycin to cover Listeria. This cannot be fungal meningitis, because the CSF is characterized exclusively by a high number of neutrophils; neutrophils are not consistent with fungal meningitis.

• Question 216:

  60 years old patient has only HTN best drug to start with:

  A. Diuretics
  B. ACEI
  C. ARB
  D. Beta blocker E-Alpha blocker
  A. Diuretics

  ---

  Antihypertensive therapy has been shown to reduce morbidity and mortality in older patients with elevated systolic or diastolic blood pressures. This benefit appears to persist in patients older than 80 years, but less than one third of older patients have adequate blood pressure control. Systolic blood pressure is the most important predictor of cardiovascular disease. Blood pressure measurement in older persons should include an evaluation for orthostatic hypotension. Low-dose thiazide diuretics remain first-line therapy for older patients. Beta blockers, angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, and calcium channel blockers are second-line medications that should be selected based on comorbidities and risk factors.

  Reference: http://www.aafp.org/afp/2005/0201/p469.html

• Question 217:

  A patient presented to you who is known case of hypothyroidism and on thyroxin, he also has increase PT normal Vitamin D, Creatinine is very high. On examination tapping of the angle of jaw produce facial spasms, what diagnosis?

  A. Pseudohypoparathyroidism
  B. DiGeorge syndrome
  C. Chronic renal failure
  D. Uncontrolled thyroid functions
  C. Chronic renal failure

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  Secondary hyperparathyroidism Hypocalcemia, hyperphosphatemia, inc creatinine.

• Question 218:

  Condition not associated with increased alpha fetoprotein:

  A. Myelomeningocele
  B. Down syndrome
  C. Spina bifida
  D. Gastroschisis
  B. Down syndrome

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  Down syndrome associated with DECREASED levels of alpha fetoprotein. Not increased. Reference: https://en.m.wikipedia.org/wiki/Triple_test

• Question 219:

  A 37-year-old lady strongly believes that a famous politician has been sending her flowers every day and is in love with her. However, this is not the case.

  What is the most likely diagnosis?

  A. Erotomania
  B. Kleptomania
  C. Pyromania
  D. Trichotillomania
  A. Erotomania

  ---

  Erotomania is a type of delusion in which the affected person believes that another person, usually a stranger, high-status or famous person, is in love with them]. Kleptomania is the inability to refrain from the urge to steal items. Grandiosity refers to an unrealistic sense of superiority. Pyromania is an impulse control disorder in which individuals repeatedly fail to resist impulses to deliberately start fires, in order to relieve tension or for instant gratification. Trichotillomania is an impulse disorder characterized by the compulsive urge to pull out one's hair, leading to noticeable hair loss and balding

• Question 220:

  Female with recently inserted IUCD coming with watery brownish vaginal discharge and abdominal pain what is the most likely diagnosis?

  A. Bacterial vaginosis
  B. D-ectopic pregnancy
  C. Uterine rupture
  D. Ovarian torsion
  A. Bacterial vaginosis