CHHD Flashcards
1
Q
What is the difference between stroke and transient ischaemic attack (TIAs)?
A
stroke causes permanent damage to the brain due to block of blood supply for a prolonged period
TIA causes temporary loss of focal CNS functions due to a temporary block/reduction in blood supply to the brain
2
Q
Which part of the brain is primarily affected in Parkinson’s disease?
a) medulla oblongata
b) substantia nigra
c) globus pallidus
d) corpus callosum
e) amygdala
A
b) substantia nigra
3
Q
Why should LA with adrenaline be avoided for a patient suffering from Parkinson’s?
A
adrenaline can interact with L-DOPA and carbidopa and COMT inhibitors
4
Q
What may present orally for a patient with Parkinson’s who takes anticholenergics eg Benzotropine ?
A
present with dry mouth
5
Q
What is multiple sclerosis?
A
MS is the demyelination and scarring of white matter of the brain resulting in reduced conduction velocity and loss of information conveyed
6
Q
Which statement regarding herpes Zoster is incorrect?
a) lies dormant in dorsal root ganglia cells
b) reactivation of VZV leads to shingles
c) bilateral vesicular rash affecting a single dermatome
d) localised pain and itching
e) treated with acyclovir
A
c) bilateral vesicular rash affecting a single dermatome
causes UNILATERAL rash affecting a single dermatome
7
Q
What is Ramsays Hunt Syndrome?
A
VZV infection of facial nerve causing lower motor neurone facial palsy
8
Q
Which agents are used in the treatment of trigeminal neuralgia?
a) carbamazepine, bromide, phenytoin
b) phenytoin, gabapentin, benzotropine
c) carbamazepine, gabapentin, lamotrigine
d) carbodipa, adrenaline, benzotropine
e) entacapone, gabapentin, carbidopa
A
c) carbamazepine, gabapentin, lamotrigine
9
Q
A patient complains of regular nose bleeds, dizziness, fatigue and eye changes. The patients blood pressure reading is 150/95mmHg.
What is the possible condition leading to these symptoms?
a) hypothyroidism
b) hypertension
c) arteriosclerosis
d) pericarditis
A
b) hypertension
10
Q
What is NOT a complication of hypertension?
a) arteriosclerosis of small arteries eg in eye and kidneys
b) left ventricular hypertrophy
c) thoracic aortic dissection
d) decreased total peripheral resistance
e) abdominal aortic aneurysms
A
d) decreased total peripheral resistance
the peripheral resistance is INCREASED due to narrowing of arteriolar lumen in kidneys
11
Q
What category pf drugs are used to prevent/reduce future cardiac ischaemic attacks ?
A
calcium channel blockers
and
long acting nitrates
12
Q
What is infective endocarditis?
A
microbial infection of the endocardium surface of heart, in particular the heart valves
13
Q
Which statement is incorrect regarding acute bacterial endocarditis?
a) common in elderly
b) common in IV drug users
c) staphylococcus most common offending organism
d) within 7 days of bacteraemia
e) streptococcus most common offending organism
A
e) streptococcus most common offending organism
14
Q
Why is there no prophylaxis for infective endocarditis patients?
A
no strong evidence for improvement in IE episodes and intervention procedures
adverse reactions (eg anaphylaxis) from antimicrobials possible
death from anaphylaxis 5-6 times greater than by IE
increased risk of bacterial resistance in society
15
Q
What is the pathogenesis of left ventricular heart failure?
A
left ventricular dysfunction
↓
decreased cardiac output
↓
increased sympathetic tone and RAS system
↓
increased afterload
↓
further myocardial deterioration
↓
cardiac failure
16
Q
What are the clinical features of left ventricular heart failure?
A
reduced pulmonary compliance = increased work of breathing
increased pulmonary venous pressure
pulmonary oedema
difficulty breathing whilst lying flat and during exertion
decreased systemic arterial oxygenation
cyanosis
17
Q
What are the clinical features of right ventricular heart failure?
A
- hepatomegaly
- splenomegaly
- abdominal distension ( fluid build up in peritoneal cavities)
- oedema
- swelling of hands and fingers
18
Q
What is the difference between Osler’s nodes and Janeway’s lesions?
A
Osler’s nodes:
- tender, red-purple lumps
- often found on fingers/toes
- last for hours/days
- usually due to subacute IE
Janeway’s Lesions:
- non-tender
- often on palms/soles
- last for days/weeks
- usually due to acute IE
19
Q
What are the clinical presentations of IE?
A
- splinter haemorrhages
- Osler’s nodes
- Janeway’s lesions
- Conjuctival petechiae
- Flu-like symptoms
20
Q
Define dysphagia
A
difficulty swallowing
21
Q
Define cachexia
A
the wasting of muscle due to severe chronic illness
22
Q
The degeneration of the myenteric plexus leading to failure of the lower oesophageal sphincter relaxing is called:
a) Paterson-Kelly syndrome
b) Alachasia
c) Retrosternal goitre
d) Globus Hystericus
e) Myesthesia Gravis
A
b) Alachasia
23
Q
A female patient finds it difficult to swallow, complains of fatigue and has glossitis, what could the possible disease be?
a) Paterson-Kelly syndrome
b) Alachasia
c) Retrosternal goitre
d) Globus Hystericus
e) Myesthesia Gravis
A
a) Paterson-Kelly syndrome
24
Q
A 28 year old male patient complains of frequent heart burn ( 2-3 times week), a chronic cough, acid reflux and occasionally suffers from asthma-like symptoms at night and fatigue. What could the patient possibly be suffering from?
a) Asthma
b) Gastro-oesophageal reflux disease
c) Diabetes
d) Paterson-Kelly Syndrome
e) Peptic ulcers
A
b) Gastro-oesophageal reflux disease
25
What medication can be given to someone suffering from Gastro-oesophageal reflux disease?
a) Anticholinergics
b) tricyclics
c) NSAIDs
d) nitrates
e) proton pump inhibitors
e) proton pump inhibitors
26
What's the difference between sliding hiatus hernia and rolling hiatus hernia?
SLIDING:
- gastro-oesophageal junction slides into chest
- acid reflux
- lower oesophageal sphincter less competent
ROLLING;
- gastro-oesophageal junction remains in abdomen
- bulge of stomach herniates into chest
- no acid reflux
27
Which statement is false regarding rolling hiatus hernias?
a) 20% of cases
b) gastro-oesophageal junction remains in abdomen
c) acid reflux
d) bulge of stomach herniates into chest
e) may strangulate
c) acid reflux
28
Which statement is false regarding Barret's oesophagus?
a) squamous epithelium is replaced by columnar epithelium
b) associated with Helicobactor pylori
c) risk of adenocarcinoma
d) a risk factor of GORD
e) may be continuous or patchy
b) associated with Helicobactor pylor
it is NOT associated with it
29
Define dyspepsia
nonspecific group of symptoms related to upper GI tract
30
A patient complains of difficulty swallowing, pain behind the sternum (heartburn), and hoarseness and upon inspection, palpable lymph nodes. What is the likely diagnosis ?
a) Barret's oesophagus
b) Oesophagitis
c) Oesophageal carcinoma
d) Hiatus hernia
e) Achalasia
c) Oesophageal carcinoma
31
A 78 year old patient complains of pain in the stomach shortly after eating a meal and has noticed weight loss. What could be a possible diagnosis?
a) Gastric cancer
b) GORD
c) Gastric ulceration
d) Duodenal ulceration
e) Hernia
c) Gastric ulceration
32
A 67 year old male patient with a yellowish complexion complains of painful swallowing and difficulty in swallowing which is getting worse. Dark stool and persistent vomiting.
Upon inspection of lymph nodes, the left supraclavicular lymph node is palpable.
What could be possible diagnosis?
a) Gastric cancer
b) GORD
c) Gastric ulceration
d) Duodenal ulceration
e) Hernia
a) Gastric cancer
33
Define dysphonia
hoarseness of voice
34
Define haemoptysis
blood upon coughing
35
Define dyspneoa
difficulty breathing
36
Define stridor
high-pitched sound caused by disrupted airflow - heard most upon inspiration
37
What is the difference between intrinsic and extrinsic asthma?
INTRINSIC:
- adult onset
- non allergic
- no family history
- associated with chronic bronchitis
- due to mast cell instability and airway hyper-responsiveness
- worsens over time
EXTRINSIC:
- childhood onset
- allergic
- family history
- allergens causing IgE mediated mast cell degranulation
- improves over time
38
A parent is worried that her child still has no teeth erupted. The child suffers from cystic fibrosis. What is the possible reason?
cystic fibrosis delays development and eruption of dentition
39
In which part of the lower GIT is iron and folate absorbed?
a) duodenum
b) jejenum
c) ileum
d) ascending colon
e) stomach
a) duodenum
40
In which part of the GIT is vitamin B12 absorbed?
a) duodenum
b) jejenum
c) ileum
d) ascending colon
e) stomach
c) ileum
41
In which part of the GIT are fat soluble vitamins absorbed?
a) duodenum
b) jejenum
c) ileum
d) ascending colon
e) stomach
c) ileum
42
What is the role of Gastric intrinsic factor?
produced by parietal cells in the stomach, it is necessary for the absorption of vitamin B12
43
Define steatorrhoea
fatty stools
44
Which one is NOT a feature of malabsorption?
a) steatorrhoea
b) failure to thrive
c) lassitude
d) weight gain
e) anaemia
d) weight gain
theyll LOSE WEIGHT
45
Which component of gluten are coeliacs intolerant to?
a) Glutenin
b) alpha gliadin
c) beta gliadin
b) alpha gliadin
46
Which statement in regards to coeliac disease is FLASE?
a) strong genetic background
b) leads to abdominal pain
c) reduced number of antigliadin antibodies
d) villous atrophy
e) can lead to glossitis
c) reduced number of antigliadin antibodies
these are RAISED - normally not present
gliadin is the component of gluten that causes the immune response to attack the villi
47
A patient comes in complaining of a burning sensation of the mouth, sores on the corner of the lips and severe cramps. they constantly feel lethargic and suffer from non bloody diarrhoea. What could a possible diagnosis be?
a) IBS
b) ulcerative colitis
c) coeliacs disease
d) duodenal ulcers
e) Crohn's disease
c) coeliacs disease
48
A patient complains of abdominal pain, diarrhoea lasting for 2 months, and red patches on the skin over the shins. They also complain of painful ulcers in the mouth. What could be the cause?
a) IBS
b) ulcerative colitis
c) coeliacs disease
d) duodenal ulcers
e) Crohn's disease
e) Crohn's disease
49
A patient complains of slime-like diarrhoea containing blood, fever abdominal pain and red patches on the skin on the legs. What could be the cause?
a) IBS
b) ulcerative colitis
c) coeliacs disease
d) duodenal ulcers
e) Crohn's disease
b) ulcerative colitis
50
Which form is not blood bourne ?
a) hep A
b) hep B
c) hep C
d) Hep D
e) Hep E
a) hep A
51
What treatment is available for hepatitis b?
Lamivudine
interferon
52
Which type is not RNA?
a) hep A
b) hep B
c) hep C
d) Hep D
e) Hep E
b) hep B
53
Which two are non -enveloped forms of viruses?
a) hep A and B
b) hep B and C
c) hep C and D
d) Hep D and A
e) Hep E and A
e) Hep E and A
54
A patient who works in childcare facilities comes into clinic complaining of abdominal pain, dark urine and discolouration of the eyes. What could be a possible cause?
a) Chronic liver disease
b) malabsorptions
c) Hep A
D) Hep C
e) gastritis
c) Hep A
55
What is the difference clinically between a dentoalveolar abscess and a periodontal abscess and the differences in treatment?
dentoalveolar:
- infection at the apices of the root
- treatment: RCT or extraction
periodontontal:
- infection at the opening of the periodontal pocket
- treatment: extraction or periodontal treatment
56
What are the clinical features of acute necrotising ulcerative gingivitis?
- hialitosis
- painful ulcerations
- Intense/excruciating pain
- gingival bleeding
- widespread (can be localised to lower anteriors)
- Ulcerated and necrotic papillary and marginal gingiva and cratering (punched out) of papillae
57
A patient complains of oral discomfort, and red patches forming in the mouth mucosa along with crusting and bleeding. They also suffer from Crohns disease. What could be the possible cause?
a) actinomycosis
b) NOMA
c) staphylococcal mucositis
d) acute necrotising ulcerative gingivitis
e) bacterial sialadentitis
c) staphylococcal mucositis
58
A patient complains of a hardened lump on the side of their neck just below the jaw that was previously painful. They've also noticed pus draining from the swelling and find it difficult to chew. What could the possible cause be?
a) actinomycosis
b) NOMA
c) staphylococcal mucositis
d) acute necrotising ulcerative gingivitis
e) bacterial sialadentitis
a) actinomycosis
59
A patient complains of pain and swelling when eating on the right side of the face. What could the possible cause be?
a) actinomycosis
b) NOMA
c) staphylococcal mucositis
d) acute necrotising ulcerative gingivitis
e) bacterial sialadentitis
e) bacterial sialadentitis - blocked duct
60
Which disease presents with 'punched out' ulcerated papillae, gingival bleeding and interdental necrosis?
a) periodontitis
b) gingivitis
c) acute necrotising ulcerative gingivitis
d) staphylococcus mucositis
e) Tuberculosis
c) acute necrotising ulcerative gingivitis
61
A patient complains of a non healing ulcer on the tongue that is getting worse. She has had a consistent cough for more than 10 months and complains of tiredness.
Upon inspection, her cervical lymph node is palpable.
What could the possible cause be?
a) syphilis
b) actinomycosis
c) acute necrotising ulcerative gingivitis
d) staphylococcus mucositis
e) Tuberculosis
e) Tuberculosis
62
What is the treatment for tuberculosis?
rifampicin,
isoniazide
ethambutol
pyrazinamide
63
A patient presents with painless ulcers in the mouth and white patches on the dorsal tongue. They also feel tiredness and have a fever. What could the possible cause be?
a) syphilis
b) actinomycosis
c) Primary herpetic gingivostomatitis
d) staphylococcus mucositis
e) Tuberculosis
a) syphilis
64
A patient presents with increased body temperature, swollen gingiva, painful oral ulcers and crusted lips. They occasionally suffer from these episodes, in particularly after increased sun exposure.
What could be the possible cause?
a) syphilis
b) Shingles
c) Primary herpetic gingivostomatitis
d) staphylococcus mucositis
e) Tuberculosis
c) Primary herpetic gingivostomatitis
caused by HSV1 and HSV2
65
A 75 year old patient presents with a painful unilateral rash in addition with a tingling/burning sensation appearing in a strip of skin across the back. What could be a possible cause?
a) syphilis
b) Shingles
c) Primary herpetic gingivostomatitis
d) Ramsay's Hunt Syndrome
e) Tuberculosis
b) Shingles
66
A patient complains of an ear rash, loss of taste on the anterior parts of the tongue and dropping of the face on the left side. What could be a possible cause?
a) syphilis
b) Shingles
c) Primary herpetic gingivostomatitis
d) Ramsay's Hunt Syndrome
e) Tuberculosis
d) Ramsay's Hunt Syndrome
67
Which statement regarding glandular fever is incorrect?
a) Caused by EBV virus
b) Virus enters B lymphocytes
c) Can cause pharyngeal enlargement and petechia of palate
d) Formation of Downey cells
e) Patients prescribed amoxicillin
e) Patients prescribed amoxicillin
amoxicillin can cause erythematous rash
68
Which disease is not caused by EBV ?
a) oral hairy leukoplakia
b) ramsay's hunt syndrome
c) glandular fever
d) burkitt's lymphoa
e) nasopharyngeal carcinoma
b) ramsay's hunt syndrome
69
Which bacterium causes syphilis?
a) Staphylococcus aureus
b) Mycobacterium tuberculosis
c) Treponema pallidum
d) Fusobacterium necrophatum
e) Spirochetes
c) Treponema pallidum
70
Patient presents with vesicular eruptions on the soft palate, fauces and tonsils. They find it difficult to swallow and have had a fever for 3 days along with a sore throat. What could the possible cause be?
a) Glandular fever
b) hand foot and mouth disease
c) Herpangina
d) Mumps
e) Papillomavirus
c) Herpangina
71
Which cells does the HIV virus infect?
CD4+ t helper cells
macrophages
some brain cells eg oligodendroglial cells
72
Which disease causes finger clubbing?
a) lung cancer
b) lichen planus
c) incontinentia pigmenti
d) alopecia areata
e) haemochromatosis
a) lung cancer
73
Which disease causes koilonychia ( spooned nails) ?
a) lung cancer
b) lichen planus
c) incontinentia pigmenti
d) alopecia areata
e) haemochromatosis
e) haemochromatosis
74
Which disease causes nail pitting?
a) lung cancer
b) psoriasis
c) congential heart disease
d) lupus
e) haemochromatosis
b) psoriasis
75
What is koilonychia ?
spooned nails
76
What are beau's lines?
deep horizontal grooves running from side-to-side on nail
77
Which disease presents with koilynchia and beau's lines?
a) lung cancer
b) lichen planus
c) raynaud's phenomenon
d) alopecia areata
e) haemochromatosis
c) raynaud's phenomenon
78
Which statement is false?
a) cystic fibrosis can lead to diabetes
b) Type 1 diabetes is as a result of destruction of beta pancreatic cells
c) tumors of alpha pancreatic cells can lead to diabetes
d) fasting blood glucose over 5.0mmol/l is considered diabetic
e) random blood glucose over 11.mmol/l is considered diabetic
d) fasting blood glucose over 5.0mmol/l is considered diabetic
over 7.ommol/l is diabetic
79
A patient complains of increased hunger and thirst and frequent need to visit the toilet. They sometimes suffer from blurred vision and have had multiple mouth ulcers that heal slowly. What could be the possible underlying cause?
a) Hyperthyroidism
b) Diabetes Mellitus
c) Acromegaly
d) Addison's disease
e) Cushing's disease
b) Diabetes Mellitus
80
Which disease results from an increased production of cortisol?
a) Hyperthyroidism
b) Diabetes Mellitus
c) Acromegaly
d) Addison's disease
e) Cushing's disease
e) Cushing's disease
81
Which disease results in increased amounts of growth hormone?
a) Hyperthyroidism
b) Diabetes Mellitus
c) Acromegaly
d) Addison's disease
e) Cushing's disease
c) Acromegaly
82
A patient complains of excessive sweating, feeling anxious, increased appetite, diarrhoea and infrequent menstrual periods. You also notice protruding eyes.
What could an underlying cause be?
a) Hyperparathyroidism
b) Hyperthyroidism
c) Cushing's disease
d) Diabetes Mellitus
e) corticosteroid use
b) Hyperthyroidism
83
The drugs, propylthiouracil, carbamizole and amiodarone are used for which disease?
a) Hyperparathyroidism
b) Hyperthyroidism
c) Cushing's disease
d) Diabetes Mellitus
e) Acromegaly
b) Hyperthyroidism
84
What is the difference between Grave's disease and Hashimoto's disease?
GRAVES:
- excess thyroid hormone
- autoantibodies to TSH receptor
HASHIMOTOS:
- insufficient thyroid hormone
- autoantibodies to thryoglobulin
85
A patient who takes Beta-blockers for hyperthyroidism will only show which of the following symptoms of hypoglycaemia
a) dizziness
b) nausea
c) excessive sweating
d) Fast heartbeat
e) increased hunger
c) excessive sweating
86
Which one is NOT clinical feature of Cushing's disease?
a) Moon face
b) Hirsutism
c) Hypoglycaemia
d) Hypertension
e) Skin thinning
c) Hypoglycaemia
you would see hyperglycaemia because cushing's = too much cortisol =
cortisol stimulates gluconeogenesis and lipolysis and proteolysis and glycogenolysis = increased glucose levels in blood
87
A patient diagnosed with HIV recently suffered from a fungal lung infection. They now are coming into clinical with complaints of nausea, vomiting, lethargy and skin hyperpigmentation. What could be the possible diagnosis?
a) Hyperparathyroidism
b) Hyperthyroidism
c) Cushing's disease
d) Addison's disease
e) Acromegaly
d) Addison's disease
88
A patient exhibits spacing in-between teeth, an enlarged tongue and complains of headaches and slight vision loss from the peripheries of both eyes. What could be a possible diagnosis?
a) Hyperparathyroidism
b) Hyperthyroidism
c) Cushing's disease
d) Addison's disease
e) Acromegaly
e) Acromegaly
89
True or false,
cleidocranial dysplasia is the defect in endochondral ossification
FALSE
it is defect in membranous ossification
90
In osteogenesis imperfecta, which collagen type is defected?
a) 1
b) 2
c) 3
d) 4
e) 5
a) 1
91
A 65 year old patient complains of joint stiffness and pain, particularly in the mornings lasting just under an hour. The pain is exacerbated by movement and relieved when resting. What could a possible diagnosis be?
a) Osteopetrosis
b) Osteoarthritis
c) Rheumatoid arthritis
d) Reiter's syndrome
e) Osteoporosis
b) Osteoarthritis
92
A male patient who recently had a chlamydia infection has come into clinic complaining of joint pain and frequent oral ulcers. They also complain of pain when urinating and itchy/burning eyes. They have nail pitting aswell. What could a possible diagnosis be?
a) Rickets
b) Reiter's syndrome
c) Glandular fever
d) Raynaud's phenomenon
e) Systemic lupus erythematous
b) Reiter's syndrome
93
Which disease causes increased bone density due to defective osteoclastic and osteoblastic activity?
a) Osteopetrosis
b) Osteomalacia
c) Paget's disease
d) Osteoporosis
e) Fibrous dysplasia
c) Paget's disease
osteopetrosis is defective OSTEOCLASTS only and results in increased bone density.
94
Select the correct statement
All malignant tumours metastasise except..
a) Brain tumours and osteomas
b) Squamous cell carcinomas and basal cell carcinomas
c) liposarcoma and adenocarcinoma
d) Brain tumours and basal cell carcinoma
e) Squamous cell carcinoma and lung tumours
d) Brain tumours and basal cell carcinoma
95
Which immunosuppressant drug works by inhibiting TNF-alpha ?
a) azathioprine
b) cyclosporin
c) mycophenolate mofetil
d) adalimumab
e) prednisolone
d) adalimumab
96
Which immunosuppressant requires a PPD test for latent TB before being administered?
a) azathioprine
b) cyclosporin
c) mycophenolate mofetil
d) adalimumab
e) prednisolone
d) adalimumab
all biological modifying drugs increase the risk of TB reactivation
(others include infliximab and etanercept)
97
Which antibiotic is used as an immunosuppressant prophylaxis for organ transplant rejection?
a) azathioprine
b) cyclosporin
c) mycophenolate mofetil
d) adalimumab
e) prednisolone
c) mycophenolate mofetil
98
Which immunosuppressant used for Rheumatoid arthritis has a side effect of decreased bone marrow activity (myelosuppression)
a) azathioprine
b) cyclosporin
c) mycophenolate mofetil
d) adalimumab
e) prednisolone
a) azathioprine
99
Which drug works as selectively inhibiting COX2 to reduce inflammation?
a) prednisolone
b) ibuprofen
c) naproxen
d) celecoxib
e) aspririn
d) celecoxib
| - selective NSAID
100
Which antibacterial can induce antibiotic colitis?
a) Erythromycin
b) Amoxicillin
c) Clarithromycin
d) Clindamycin
e) Metronidazole
d) Clindamycin
101
Which antibiotic works by inhibiting DNA synthesis in bacteria?
a) Erythromycin
b) Amoxicillin
c) Clarithromycin
d) Clindamycin
e) Metronidazole
e) Metronidazole
102
A female patient complains of tiredness, shortness of breath and difficulty swallowing. She also occasionally suffers from acid reflux. Upon inspection, you noticed koilonychia and pale conjunctiva.
What could the possible diagnosis be?
a) Menorrhagia
b) Haemochromatosis
c) Patterson-Kelly Syndrome
d) Crohn's disease
e) Systemic Lupus Erythematosus
c) Patterson-Kelly Syndrome
- oesophageal webs = dysphagia
+
- iron deficiency anaemia = tiredness, koilonychia, pale conjunctiva
103
A 60 year old woman comes into clinic with complaint of a 'burning tongue'. She also has had persistent mucus-like diarrhoea for the past 2 months. What could a possible diagnosis be?
a) Menorrhagia
b) Haemochromatosis
c) Patterson-Kelly Syndrome
d) Crohn's disease
e) Systemic Lupus Erythematosus
d) Crohn's disease
Vit B12 deficiency = burning tongue
104
```
Examination of FBC and blood smear shows
the Mean corpuscle volume(MCV) of 75 ,
low serum iron,
high serum ferratin and
low total iron binding capacity.
What could the possible cause be?
(normal MCV=80-100)
```
a) Iron deficiency anaemia
b) Anaemia of chronic disease
c) Aplastic anaemia
d) Haemolytic anaemia
e) Pernicious anaemia
b) Anaemia of chronic disease
105
```
Examination of FBC and blood smear shows
the Mean corpuscle volume(MCV) of 60 ,
low serum iron,
low serum ferratin and
high total iron binding capacity.
What could the possible cause be?
(normal MCV=80-100)
```
a) Iron deficiency anaemia
b) Anaemia of chronic disease
c) Aplastic anaemia
d) Haemolytic anaemia
e) Pernicious anaemia
a) Iron deficiency anaemia
106
A patient complains of frequent episodes of heart burn -
especially after meals and when lying down, and painful swallowing. Theyve had a chronic cough for a while and can at times find it difficult to breath when lying down
what could a possible diagnosis be?
a) GORD
b) Achalasia
c) Hiatus hernia
d) Crohns disease
e) Oesophagitis
a) GORD
| hint: nocturnal asthma and frequent heart burn episodes
107
A 58 year old patient presents with central obesity, foot ulcer, hypertension and loss of light touch in the extremities. He has come into clinic with complaint of a white patch in his mouth that can be rubbed off to give a reddened mucosa.
What could the underlying cause be?
a) Shingles
b) Hypothyroidism
c) Diabetes Mellitus type 2
d) Acromegaly
e) Bulbar palsy
c) Diabetes Mellitus type 2
| - causes increased likelihood of infections like candidiasis.
108
Which statement is false concerning the bacterial infection NOMA
a) caused by fuusobacterium necrophatum
b) Spread through the sinuses of the head and neck
c) causes gangrene of the face
d) can occur in the immunosuppressed
e) caused by alpha haemolytic streptococcus
b) Spread through the sinuses of the head and neck
it is spread via the MUSCLES and BONE
109
A 68 year old male patient taking furosemide and methyldopa for their hypertension presents with typical target like lesions on back of hands. They recently went on holiday to spain are otherwise fit and healthy. What is the most likely reason?
a) Methyldopa
b) Uncontrolled hypertension
c) Furosemide
d) Environmental change
e) Common in old age
c) Furosemide
diuretics can cause erythema multiforme
110
Three early findings on radiograph of ankylosing spondylitis
symmetrical changes: of
- spotty ligamentous calcification
- subchondral erosions
- upper lumbar vertebral squaring wit sclerosis at corners
111
What four late findings are seen of ankylosing spondylitis?
- bamboo spine
- prominent syndesmophytes
- osteoporosis
- diffuse paraspinal ligamentous calcification
