Test Prep Test Prep Certifications MCQS Questions & Answers

• Question 31:

  A 10-year-old boy is admitted to the hospital because of bleeding. Pertinent laboratory findings include a platelet count of 50,000/L, prothrombin time (PT) of 15 seconds (control 11.5 seconds), activated partial thromboplastin time (aPTT) of 51 seconds (control 36 seconds), thrombin time (TT) of 13.7 seconds (control 10.5 seconds), and factor VIII level of 14% (normal 38%-178%).

  Which of the following is the most likely cause of his bleeding?

  A. Disseminated intravascular coagulation (DIC)

  B. Vitamin K deficiency

  C. Immune thrombocytopenic purpura (ITP)

  Correct Answer: A

• Question 32:

  A healthy male misses his work for 3 days, he has many times a bowel movement, and it is difficult to wrest it, laboratory tests have shown very high levels of calcium.

  What is parenteral treatment?

  A. Hydration

  B. Calcitonin

  C. Furosemide

  D. Phosphate

  Correct Answer: A

  First hydration to prevent renal injury secondary to hypercalcemia then diuretics and then calcitonin.

• Question 33:

  Patient with gunshot and part of his bowel spillage out and you decide to give him antibiotic for Bacteroidfragilis, so what you will give?

  A. Gentamicin

  B. Clindamycin

  C. Doxycycline

  D. Amoxicillin

  Correct Answer: B

• Question 34:

  A 10-month-old boy weighing 3 kg has polyuria, polydipsia and delayed motor milestones. His blood pressure is normal. Blood tests reveal: creatinine 80 mmol/l, sodium 128 mmol/l, chloride 90 mmol/l, potassium 3.0 mmol/l, calcium 2.7 mmol/l, bicarbonate 26 mmol/l and pH 7.46. Ultrasonography shows medullary nephrocalcinosis.

  What is the most likely diagnosis?

  A. Renal tubular acidosis

  B. Bartter's syndrome

  C. Pseudohypoaldosteronism

  D. Diabetes insipidus

  Correct Answer: B

  Bartter's syndrome Features of Bartter's syndrome are hypokalemia, metabolic alkalosis and hypercalciuria. It is an autosomal-recessive condition leading to tubular defects in sodium chloride transport and increased intrarenal production of PGE2. The blood pressure is normal while the plasma renin and aldosterone levels are raised. Renal stones and nephrocalcinosis are common in this condition. In diabetes insipidus the loss of water raises sodium and potassium levels. Liddle's syndrome is characterized by potassium wasting, hypokalemia and alkalosis, but is associated with low renin and aldosterone production and high blood pressure. In pseudohypoaldosteronism, the sodium level is decreased and potassium is elevated.

• Question 35:

  A young boy presented with pain, swelling and redness of right side testes and scrotum. Sudden onset pain relieved on uplifting the scrotum.

  What would be the diagnosis?

  A. Torsion testes

  B. Inguinal hernia

  C. Hydrocele

  D. Epididymo-orchitis

  Correct Answer: D

  According to Prehn's sign, the physical lifting of the testicles relieves the pain of epididymitis but not pain caused by testicular torsion. Negative Prehn's sign indicates no pain relief with lifting the affected testicle, which points towards testicular torsion which is a surgical emergency

• Question 36:

  A 73-year-old woman has lymphadenopathy and splenomegaly. She feels well but has had recurrent chest infections recently.

  Choose the single most likely blood film findings?

  A. Plasma cells

  B. Multiple immature granulocytes with blast cells

  C. Atypical lymphocytes

  D. Excess of mature lymphocytes

  Correct Answer: D

• Question 37:

  A 78-year-old woman presents with a two-day history of severe left earache with a burning sensation in the ear, vertigo and loss of taste. There is left-sided weakness of both the upper and the lower facial muscles. Facial sensation is normal.

  What is the most likely diagnosis?

  A. Ramsay Hunt syndrome

  B. Bell's palsy

  C. Acoustic neuroma

  Correct Answer: A

  Ramsay Hunt syndrome is caused by infection of the geniculate ganglion of the facial nerve, together with invasion of the eighth nerve ganglia, by the herpes zoster virus. This produces ear pain, hearing loss, vertigo and facial nerve paralysis. A vesicular rash is usually present in in the outer ear, and sometimes also the soft palate or anterior two thirds of the tongue. Other cranial nerves apart from the VII nerve also be involved. Lymphocytes in the cerebrospinal fluid (CSF) and a mildly elevated CSF protein are recognized.

• Question 38:

  Patient with severe depression on SSRIs. When it will begin to start work?

  A. 4-5 weeks

  B. 1-2 weeks

  C. 3-4 weeks

  D. 2-3 weeks

  Correct Answer: C

• Question 39:

  20-year-old patient with a red lesion on her face. She said this from birth. What is your management?

  A. Topical steroid

  B. Laser

  C. Systemic steroid

  D. Antifungal

  Correct Answer: B

• Question 40:

  3000 gm full term baby, when should you screen for congenital hypothyroidism?

  A. One year after delivery

  B. One day after delivery

  C. One week after delivery

  D. One month after delivery

  Correct Answer: C