MEDICINE Dally Test Day 02
101. A 50-year-old woman is referred with a two week history of difficulty walking and weakness in her arms. On examination there was proximal and distal limb weakness which is more marked in the legs than the arms. All tendon reflexes were absent and the plantar responses were flexor. There was no sensory loss. Blood pressure in the supine position was 140/78 mmHg (lying) and was 110/70 mmHg on standing. What is the most likely diagnosis?
Polymyositis
Cervical cord compression
Guillain-Barré syndrome
Myasthenia gravis
102. A 25-year-old male presents to casualty with weakness of his right hand. Examination reveals weakness of right wrist and finger extension. What is the most likely diagnosis?
Axillary nerve palsy
C8 nerve root lesion
Proximal median nerve lesion
Radial nerve lesion
103. Which one of the following statements is true of B cell CLL?
Autoimmune thrombocytopenia is uncommon
Reduced immunoglobulins a risk of recurrent viral infections
Stage A disease should be treated with chemotherapy
Late transformation to ALL occur in the majority of patients
104. Which of the following is true regarding Depersonalisation Syndrome?
Is a feeling that other people have changed
Is associated with depression
Is an indication for Electrocunvulsive Therapy (ECT)
Characteristically precedes derealisation
105. Which statement is true regarding Gabapentin?
Is a potent hepatic enzyme inducer
Side effects typically include visual field defects with long-term use
Is of particular value as monotherapy in absence attacks (petit mal)
Requires dose adjustment in renal disease
106. Which one of the following cardiac enzymes would be expected to begin to increase between 12-24 hours after a myocardial infarction?
Aspartate transaminase
Creatine kinase
Troponin I
Troponin T
107. Which of the following concerning the use of intravenous bicarbonate in cardiorespiratory arrest is correct?
Exacerbates intracellular acidosis
Has a positive inotropic effect on ischaemic myocardium
Improves oxygen release to the tissues
Increases cerebral blood flow
108. Which of the following relate to Dopa-decarboxylase inhibitors?
Reduce the extracerebral complications of L-dopa therapy
Have anticholinergic activity
Should not be given in combination with dopamine agonists
Prevent L-dopa associated dyskinesias
109. A 62 year old male is noted to have a broad-based ataxic gait.This is characteristic of which of the following?
A basal ganglia lesion
Cerebellar vermis lesion
Osteomalacia
Phenytoin toxicity
110. Which of the following statements about the spinal cord is true?
A lesion of the left side of the spinal cord at C5 causes pyramidal weakness of the right leg
Centrally placed spinal cord lesions affect joint position sense before other modalities of sensation
Conus medullaris lesions characteristically cause mixed upper and lower motor neurone signs in the legs
The spinothalamic tracts are supplied principally by the anterior spinal artery
111. In herpes simplex encephalitis which of the following statements is correct?
Brain MRI is characteristically normal
Temporal lobe involvement is common
Fits are uncommon
Viral identification by PCR on cerebrospinal fluid is non-specific
112. Regarding pneumonia caused by Legionella pneumophilia, which of the following is true?
Is associated with hyponatremia
Is best treated with intravenous amoxycillin and clavulanic acid
Is common in AIDS patients
Is readily diagnosed by standard aerobic culture of sputum
113. An individual is said to be overweight if his BMI is in the range of –
24.0
24.0-27.9
25.0-28.9
25.0-29.9
114. A 28 year old man presented with acute stiffness and swelling of his knees and ankles, and a painful rash on his legs. The ESR was 86 mm in the first hour. Chest X-ray showed hilar lymphadenopathy. What is the most likely outcome?
Chronic arthritis
Pulmonary fibrosis
Renal failure
Spontaneous improvement
115. A 52-year-old male is admitted after taking an overdose. Which single feature best suggests a high risk of future suicide?
Making plans before the overdose to avoid discovery
Ingestion of alcohol with the overdose drug
Ingestion of more than one drug
Ingestion of more than 100 tablets
116. Which of the following features is most strongly suggestive of a diagnosis of somatisation disorder?
Below average intelligence
Female gender
Having a close relative with a physical illness
Many admissions to medical wards as an adult
117. A 45-year-old man returned from a two-week trip piligrimage to various religious places in North India. Fourteen days later he presented with fever, headaches and a widespread rash. On examination there was generalised lymphadenopathy and a widespread maculopapular rash. What is the most likely diagnosis?
Acute HIV infection
Schistomsomiasis
Strongyloidiasis
Typhoid fever
118. A 30-year-old female presents to the eye clinic with an acute history of pain and blurring in the right eye. Examination reveals a visual acuity of 6/36 in the right eye but 6/6 in the left eye, a central scotoma in the right eye, with a right swollen optic disc. What is the most likely diagnosis?
Compression of the optic nerve
Cavernous sinus thrombosis
Optic neuritis
Retinal vein occlusion
119. A 48 year old man presented with a two week history of recurrent severe right-sided peri-orbital headache, frequently nocturnal and occurring at least once daily, usually lasting an hour. He had noticed lacrimation from the right eye and blockage of the right nostril during the headache. At the time of the examination he was free from headache and there were no abnormal physical signs. Which of the following is the most likely diagnosis?
Cluster headache
Intracranial aneurysm
Orbital pseudotumour
Trigeminal neuralgia
120. A 72-year-old lady has 4 months of memory loss, urinary incontinence and falls. On examination she has mild memory loss and a broad-based, slow gait. Muscle tone is normal and both plantar reflexes are downgoing. What is the likely diagnosis?
Alzheimer's disease
Frontal lobe dementia
Multi-infarct dementia
Normal-pressure hydrocephalus
Which of the following is a recognised feature of polymyalgia rheumatica:
Weakness of distal muscle groups
Elevated serum creatine phosphokinase activity
Weight loss
A peak incidence in the fourth decade of life
122. A 72-year-old woman has a five year history of worsening mental functioning with trouble remembering things. She has no problems with movement. She is noted on an MRI scan of the brain to have symmetrically increased size of the lateral ventricles along with cerebral cortical atrophy in a mainly frontal and parietal distribution. A lumbar puncture reveals a normal opening pressure, and analysis of the clear, colorless cerebrospinal fluid reveals a glucose and protein which are in normal ranges. Cell count on the CSF shows 3 WBCs (all lymphocytes) and 1 RBC. A fundoscopic examination is normal. Which of the following findings is most likely associated with her underlying disease process?
Loss of Betz cells
Loss of gamma aminobutyric acid (GABA)
Perivascular mononuclear inflammation
Presence of the e4 allele of apolipoprotein E
123. A 62-year-old lady is suffering from pain and stiffness of her shoulders and difficulty getting out of a chair. Which of the following would support a diagnosis of polymyalgia rheumatica?
Ankle stiffness
Low grade fever
Muscle tenderness
Proximal muscle weakness
124. A 78-year-old man presented with an unsteady gait. He was noted to be becoming impaired with his memory and agitated at nights. His GP started an antidepressant. He was incontinent of urine. He was a heavy smoker and had lost 2 stones in weight over 2 months. His blood sugar was 10 mmol/l. Which is the next best investigation?
CT Head
CXR
Glycosylated Hb
Thyroid function test
125. A 65-year-old man has IgG paraproteinaemia with plasma cells in his bone marrow aspirate. Which of the following is most likely with his underlying condition?
Renal failure is the commonest cause of death
Sclerotic bone lesions are characteristic
Biphosphonates are first line therapy for the treatment of associated hypercalcaemia
Treatment with interferon alpha improves survival
126. Which of the following micro-organisms is generally sensitive to Benzylpenicillin?
Bordetella pertussis
Mycoplasma pneumonia
Legionella pneumophila
Streptococcus Pneumonaie
127. A 50 year old woman presents with episodic toe and finger problems characterized by pallor, cyanosis, suffusion and pain of the fingers and toes in response to cold. She later develops difficulty in swallowing and dyspnoea. Which of the following immunological investigations is the most specific for this lady's condition:
Anticentromere antibody
Antitopoisomerase I antibody
Rheumatoid factor
Anti-ds DNA antibody
128. Which of the following is true of the the T cell response to antigen?
A process of affinity maturation of the T cell receptor occurs.
Co-operation with other cell types is required for T cell recognition of antigen.
Gamma/delta + T cells respond to antigen presented in association with MHC class II molecules.
Interactions of the TcR with an appropriate Ag/MHC complex activates a resting T cell.
129. In HIV disease, patients first become susceptible to infection with Pneumocystis carinii when the CD4 cell count falls to:
<1000 cells/mm3
<500 cells/mm3
<350 cells/mm3
<200 cells/mm3
130. Which of the following statements is true about immunological reactions?
Serum sickness is caused by a type II reaction.
Grave's Disease is caused by a type IV reaction.
Angio-neurotic oedema is the most severe form of type I reaction.
Urticaria usually responds to Cimetidine.
131. Which of the following cell types have a prime role in recognizing and destroying virus infected cells in an HLA class I-restricted manner.
Macrophages
B cells
Dendritic cells
CD8+ T lymphocytes
132. Which of the following statements concerning the thymus is true?
The majority of cortical thymocytes express either CD4 or CD8.
CD4/CD8 double positive cells are eliminated by a process of negative selection.
Thymocytes whose TcR bind with high affinity to self Ag/MHC complexes are clonally deleted.
Mature thymocytes express surface IgM and IgD
133. Which one of the following statements concerning T-lymphocytes is correct?
Are the primary host response in bacterial infection
Compose the majority of lymphocytes in plasma
Are infected by Epstein-Barr virus in infectious mononucleosis
T cell lymphoma has a better prognosis
134. Which of the following statements is true of Xenotransplantation?
Is the transfer of organs between species
Is the transfer of tissue grown in-vitro
Requires a close HLA match
Is characterised by a vigorous early cell -mediated immune response
135. Which of the following statements is true of the immunology of rheumatoid arthritis?
It is an example of an organ-specific disease.
Joint damage is the consequence of mast cell degranulation.
Rheumatoid factor is detected by a test utilising the patients B lymphocytes.
Rheumatoid factor is an antibody with reactivity to the heavy chain of IgG.
136. Which one of the following statements regarding T cells in their recognition of antigen is correct:
By TcR interaction with antigen in the extracellular fluid.
As linear peptide sequences bound covalently to self MHC class I or class II at the cell surface
Derived from protein only
Only when presented by "professional" antigen presenting cells
137. The Mantoux reaction is an example of which type of hypersensitivity reaction ?
Type I hypersensitivity
Type II hypersensitivity
Type III hypersensitivity
Type IV hypersensitivity
138. Regarding bronchial asthma
Leukotriene concentrations are influenced by genetic factors
Similar concordance in monozygotic and dizygotic twins
Genetic linkage is to a single chromosome 13
There is a contribution from HLA alleles
139. Which of the following concerning IgG is correct?
It has a molecular weight of 50,000 kd.
It is monovalent.
It comprises the majority of circulating antibody in serum.
It differs from other isotypes in not being able to cross the placental barrier.
140. All of the following are potentially cured by chemotherapy except –
Hodgkins
All
Wilm’s tumour
Chondrosarcoma
141. A 35-year-old man returned from a two-week holiday complaining of pain in the loins and painful swollen knees. On examination he was afebrile and had significant bilateral knee effusions. Mild penile erythema was also noted. Laboratory investigations showed. Hb 15.6 g/dL; WBC 16.2 x 109/l; Neutrophils 14.1 x 109/l; ESR 65 mm/h; Rheumatoid factor 10 IU/L; Urinalysis No cells, casts or bacteria seen. What is the most likely diagnosis?
Arthritis due to Neisseria gonorrhoeae infection
Lymphogranuloma venereum
Reactive arthritis
Reitter's syndrome
142. Deficiency of T-cells is found in
Wiscott-Aldrich syndrome
Hereditary angio-oedema
Chediak-Higashi syndrome
Congenital agammaglobulinaemia
143. A 35-year-old man presented with cellulitis of his right leg. On examination he was mildly confused and febrile (40.1°C) with a pulse was 120 / minute and BP 80/55 mmHg. He was treated with intravenous benzylpenicillin and flucloxacillin. Group A Streptococcus was isolated from two sets of blood cultures. There was no significant clinical improvement after 24 hours. What antibiotic should be added?
Ciprofloxacin
Clindamycin
Gentamicin
Vancomycin
144. A 42-year-old man with advanced HIV disease presented with a tonic-clonic seizure. He had been diagnosed with HIV 10 years previously, but had elected not to take antiretroviral therapy. A CT scan of his brain showed a 2 cm ring-enhancing lesion in the right parietal lobe. What is the probable causative agent?
Cryptococcus neoformans
Mycobacterium avium intracellulare
Mycobacterium tuberculosis
Toxoplasma gondii
145. A 23-year-old man presents with visual loss in his right eye and this is diagnosed as optic neuritis. Which one of the following statements would be seen in an afferent pupillary defect?
Accommodation response is unaffected
Irregular pupil of the affected eye
Pupil of affected eye larger than the unaffected eye
Pupil of affected eye smaller than the unaffected eye
146. A 70-year-old man presented to his GP with a two-day history of increasing confusion. He also complained of a headache. He was febrile on examination; nuchal rigidity was noted. A lumbar puncture was performed and CSF microscopy revealed: WBC 800 cells/mL (<5) 90% neutrophils. A few Gram-positive diplococci were also noted. What is the cause of his meningitis?
Cryptococcus neoformans
Haemophilus influenza
Listeria monocytogenes
Streptococcus pneumonia
147. A 45-year-old woman was diagnosed with bacterial endocarditis. What is the characteristic fundoscopic feature of this disease?
Janeway lesions
Macular star
Retinal artery aneurysms
Roth's spots
148. A teenage girl presents with Guillain-Barre syndrome. Her weakness continues to worsen after admission to hospital. Which of the following should be used to monitor her?
Arterial blood gases
Chest expansion size
FEV1/FVC ratio
PEFR
149. A 50-year-old man comes to clinic and asks for advice about his risk of infection. Twenty years ago he had been involved in a road traffic accident and had sustained a splenic laceration, requiring an emergency splenectomy. Which of the following options offers the best advice?
He does not need prophylactic antibiotics due to the amount of time that has elapsed since his surgery
He has no increased risk of acquiring malaria when travelling to an endemic region
He has no increased risk of infection since he has been well for 20 years following surgery
He should receive pneumococcal vaccine
150. A 19-year-old intravenous drug user presents to Casualty with a fever (38.5°C), dyspnoea, and right sided pleuritic chest pain. Bilateral cavitating lesions are seen in both lungs on his Chest X-ray. What is the most likely diagnosis?
Aspiration pneumonia
Endocarditis of the tricuspid valve
Pneumocystis carinii pneumonia
Pulmonary tuberculosis
151. A 1 – year old child present with a history of coughing, especially with feedings, and recurrent chest infections –
Pulmonary sequestration
Bronchopulmonary dysplasia
Pulmonary arteriovenous fistula
Tracheo – oesophageal fistula
152. To guide needle thoracentesis to sample a pleural effusion ,which of the following immaging is done–
Chest radiography
Fibre – optic bronchoscopy
Chest ultrasonography
Echocardiography
153. A 76 – year old woman with paroxysmal superaventricular tachycardia presents with impaired vision, cold intolerance and constipation – Potential cause of this drug toxicity is
Lamotrigine
Amiodarone
Lithium
Digoxin
A 40 year – old man presents with worsening limb twitches and facial tics. He has been an inpatient in a psychiatric hospital for the last 5 years. His father had a similar history and died in a psychiatric hospital. What is your diagnosis
What is your diagnosis
Gilbert’s syndrome
Chronic active hepatitis
Primary biliary cirrhosis
155. A 22 – year – old woman with previously normal menstrual cycles begins to have irregular cycles and an ovulation. Serum prolactin levels are elevated –What is next investigation to be done
Measurement of serum prolactin levels
Measurement of TSH levels
Progesterone challenge
Measurement of serum testosterone levels
156. A fit 70– year– old woman with large supraglottic carcinoma –What is the treatment of choice
Total laryngectomy with without neck dissection
Radiotherapy
Hemllaryngectomy (vertical)
Supraglottic laryngectomy with or without neck dissection (horizontal)
157. A 50 – year – old woman presents with thyroid enlargement. Thyroid function tests are normal. The needle biopsy confirms the diagnosis of Hashimoto’s thyroiditis. What is the treatment of choice
Radioactive iodine
Subtotal thyroidectomy
Potassium iodide
Thyroxine
158. Cardiomegaly, prominent right atrium, dilated pulmonary arteries and small aortic knuckle –What is your diagnosis
Mitral stenosis
Fallot’s tetralogy
Longstanding atrial septal defect
Left ventricular failure
159. A 27– year – old walter who becomes rapidly jaundice after a course of ciprofloxacin –What is the diagnosis
Glucose – 6 – phosphate dehydrogenase (G6PD) deficiencdy
Sickle cell anaemia
Hereditary spherocytosis
Thalassaemia major
160. Prolonged partial thromboplasma time (PTT) and bleeding time. Decreased ristocetin cofactor What is the DIAGNOSIS
ρ� – Thalassaemia
Von Willebrand’s disease
Haemophilia A
Glanzmann’s thrombasthenia
161. A 3 – year – old girl presents with a 3 – week history of morning headaches, vomiting and unsteady gait. CT shows a lesion in the cerebellar vermis – What is the DIAGNOSIS
Non Hodgkin lymphoma
Medulloblastoma
Acute non – lymphocytic leukaemia
Neuroblastoma
162. Progressive lengthening of PR interval with one non-conducted beat IS SEEN IN
Right bundle branch block
Second-degree block
Left bundle branch block
Wolff-parkinson-white syndrome
163. A 49-year-old woman with sjogren’s syndrome presents with jaundice and hepatosplenomegaly. Her urine is dark and serum contains antimitochondrial antibody liver biopsy shows ductal destruction. Proliferation and granuloma.
Primary biliary cirrhosis
Chronic active hepatitis
Sclerosing cholangitis
Cholangiocarcinoma
164. A 21-year-old man presents with compulsions and rituals, which he resists. What is the diagnosis
Depression
Schizophrenia
Obsessional neurosis
Depersonalisation
165. A 61-year-old woman presents with stiff joints, myopathy and constipation. Plain radiographs reveal a rihgt renal calculus and evidence of osteitis fibrosa cystica.
Parathyroid adenoma
Multiple endocrine neoplasia type I
MEN type II
Parathyroid hyperplasia
166. Most common cause of superior venacaval obstruction is –
Treatoma
Lymphoma
Squamous cell Ca of lung
Adenocarcinoma lung
167. A 52-year-old woman on HRT presents with swollen left calf, chest pain and shortness of breath
Pneumothorax
Pulmonary embolism
Pneumonia
Cryprogenic fibrosing alveolitis
168. A 48-year-old man presents with a dull aching pain in the right hypochondrium, which has had for 3 weeks. Other complaints include impotence, arthritis, lethargy and weight loss.
Wilson’s disease
Sclerosing cholangitis
Primary billiary cirrhosis
Hepatocellular carcinoma
169. A 53-year-old unemployed alcoholic presents with haematemesis. A history of alcoholic liver disease and ascites
Duodenal ulcer
Variceal bleeding
Mallory-weiss tear
Gastric ulcer
170. Which of the following is true of iron deficiency anemia –
Iron binding capacity is decreased
Increased number of sideroblasts
Serum iron concentration is decreased
All of the above
171. Bone marrow transplantation is not indicated in –
Aplastic anaemia
Congenital spherocytosis
Thalassemia
Acute myeloid leukaemia in first remission
172. A 59-year-old man presents with obstructive jaundice. Ultrasound scan shows no gallstones. The liver appears normal and the common bile duct measure 12 mm in diameter. His past medical history includes partial gastrectomy 15 years ago for peptic ulcer.What is next best investigation
Endoscopic retrograde cholanfiiopancreatography and sphincterotomy
Percutancous transhepatic cholangiography
HIDA scan
Oral cholecystogram
173. A 37- year-old man presents with dyspnoea, non-productive cough, weight loss and night sweats and arthralgia. His chest radiograph shows diffuse bilateral infiltration.
Legionella pneumophila
Mycoplasma pneumonia
Chlamydia psittaci
Mycobacterium tuberculosis
174. A-29-year-old student was admitted to A&E with pyrexia and sweating. Her pulse was 120 and blood pressure was 100/60. She also complained of deafness and tinnitus.
Lithium overdose
Aspirin overdose
Tricyclic antidepressant overdose
LSD overdose
175. A 14-year-old adolescent with normal sexual development complains of amenorrhoea for 5 months. Her first menses were 10 months ago, after which she has had 3 menses.
Physiological amenorrhoea
Hypogonadotrophic amenorrhoea
Eugonadotrophic amenorrhoea
Hypergonadotrophic amenorrhoea
176. A 24-year-old engineer presents with worsening shortness of breath and chest tightness. His father had collapsed and died suddenly when he was 33. On examination, the cardiac apex is double and both fourth heart sound and late systolic murmur are audible at the apex.
Dissecting aortic aneurysm
Hypertrophic obstructive cardiomyopathy
Pneumothorax
Right ventricular infraction
177. A 73-year-old man presents with hemianopia, hemisensory loss, hemiparesis and aphasia of 16 hours duration.
Transient ischaemic attack involving the carotid system
Sagital sinus thrombosis
Lateral medullary syndrome
TIA involving the vertebrobasilar system
178. A 65-year-old man presents with intermittent claudication of the left calf. The claudication distance is 100m. Angiography demonstrates 1.5 cm stenosis of the left superficial femoral artery.What is next step in management
Femoro popliteal bypass
Percutaneous balloon angioplasty
Aortofemoral bypass
Femorofemoral crossover graft
179. A –50-year-old woman presents with a thyroid goitre. A core biopsy reveals evidence of lymphoma.What is treatment of choice
Total thyroid lobectomy
Abletive dose of radioactive lodine
Chemotherapy
Reassure and repeat fine needle aspiration cytology in 12 months
180. Mental retardation and epilepsy. Urine analysis shows phenyl pyruvate.
Homocystinuria
Phenylketonuria
Tyrosinosis
Cystinosis
181. A 35-year-old clerk presets with diplopia and fatigue. Her symptoms are worse towards the evening.
Multiple sclerosis
Lateral medullary syndrome
Eaton lambert Syndrome
Myasthenia gravis
182. A 27-year-old woman presented with renal colic. She was previously fit and ha no family history of renal problems. Blood tests were all normal but urinary calcium was elevated.
Medullary sponge kidney
Renal tubular acidosis
Idiopathic hypercalciuria
Cystinuria
183.Which investigation Is useful to assess renal size, identify parencnymal pattern and detect renal stones.
Radioisotope bone scan
Ultrasound scan
Spiral CT scan
MRI abdomen
184. Following a spontaneous vaginal delivery, a 22-year-old woman continues to bleed in spite of the use of oxytocin. The uterus appears to contract well but then relaxes with increased bleeding.What is the cause
Retention of a succenturiate lobe
Placenta praevia
Ruptured vasa praevia
Placenta accrete
185. A 46-year-old woman presents having had a one-year history of menometrorrhagia. On examination she is slightly obese, her uterus is of normal size and her blood pressure is 145/100.
Endometrial biopsy
Dilatation and curettage
Progestin
Hysterectomy
186. A 70-year-old man presents with thigh claudication. Angiography demonstrates atherosclerotic narrowing of the distal aorta and proximal common illiac arteries.What is the treatment of choice
Aortofemoral bypass
Percutancous transluminal angioplasty
Axillofemoral bypass
Femorofemoral crossover graft
187. A 70-year-old man presents with backache. Plain radiographs show multiple sclerotic areas in the lumbosacral spine.
Osteosarcoma
Tuberculosis
Multiple myeloma
Primary hyperparathyroidism
188. A 50-year-old man presents with progressive burning pains in the sole of his left foot, bilateral cramps in both calves and left foot drop. He is a known asthmatic and suffers from recurrent sinusitis. Full blood count shows eosinophilia.
Extrinsic allergic alveolitis
Churg-Strauss syndrome
Allergic bronchopulmonary aspergillosis
Goodpasture’s syndrome
189. A 10-year-old boy presents with nocturnal enuresis, easy fatiguability and poor progress at school. On examination he looks short and is normotensive. Blood tests show hypokalaemic hypochloraemic alkalosis.
Liddle syndrome
Bartter’s syndrome
Gitleman.s syndrome
Renal tubular acidosis
190. Assessment of the quantity and quality of cervical mucus and sperm interaction is done by.
Vaginal-wall smear
Postcoital test
Hysterosalpingography
Cervical mucus studies
191. Only very rarely leads to congenital infection before 16 weeks gestation but is known to infect all infants born to women with recent infection.
Varicella zoster virus
Cytomegalovirus
Herpes simplex virus hominis type 2
Syphilis
192. A 27-year-old woman presents with fever, sore throat and dysphagia. On examination she has a fine tremor and a diffusely tender thyroid. Radioisotope scan shows no uptake.
De Quervain’s thyroiditis
Hashimoto’s thyroiditis
Grave’s disease
Papillary carcinoma
193. A 30-year-old HIV- positive man developed fits. On examination there were generalised lymphadenopathy, tender nodules on his legs, right homonymous hemianopia and mild right pyramidal weakness. CT showed a right frontoparietal space- occupying lesion.
Tuberculosis
Nerocysticercosis
Toxoplasmosis
Brain Abscess
194. A 70-year-old alcoholic and heavy smoker presents with a 3 – months history of progressive dysphagia and weight loss.What is next best investigation
Oesophageal manometry
Upper gastrointestinal endoscopy and biopsy
Barium swallow
Oesophageal pH testing
195. A 46-year-old man presented with progressive breathlessness, unproductive cough and difficulty in swallowing. He also noted that his hands become painful and pale in cold weather. Chest radio- graphs showed patchy shadows in both mid-zones and bases. Radiography of the hands showed calcification.
Scleroderma
CREST syndrome
Systemic lupus erythematosus
Sjogren’s syndrome
196. A 25-year-old sexually active woman presents with mucopurulent vaginal discharge, pelvic pain and fever. The symptoms begin towards the end of her menstrual period.
Gonorrhoea
Gardnerella vaginalis
Trichomonlasis
Candidiasis
197. Headache, postural hypotension and Raynaud’s phenomenon. High doses may cuse retroperitoneal fibrosis.
Danazol
Methotrexate
Gn RH analogues
Bromocriptine
198. A 28-year-old woman is in labour. The vertex is on the perineum and the infants head is visible at the perineum with each push. She has had no analgesia or anaesthesia up to this point.What is next best step for provideing analgesia
Spinal anaesthesia
Epidural anaesthesia
Pudendal block
Paracervical block
199. A 19-year-old student presents with abdominal pain and diarrhoea. She has had recurrent chest infections for most of her life
Cystic fibrosis
Intestinal lymphangiectasia
Whipple’s disease
Postinfectiosis malabsorption
200. A 27-year-old woman presented with headache. On examination, her blood pressure was 165/115, pulse was 90 and there was an ejection click in the aortic area and an ejection systolic murmur all over the precordium and back.Diagnosis is
Hypertrophic obstructive cardiomyopathy
Fallot’s tetralogy
Coarctation of the aorta and bicuspid aortic valve
Congenital aortic stenosis
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