Day 13 Flashcards
Q1-A child presents with blue marks on the sclera, short stature and heart murmur. What is the diagnosis?
A-Osteogenesis imperfect B-Hypopituitarism C-VSD (Ventricular septal defect) D-Achondrogenesis E-Dwarfism
Ans: A. Osteogenesis imperfecta(OI) is a group ofgenetic disordersthat mainly affect thebones. It results in bones thatbreakeasily. The severity may be mild to severe.Other symptoms may include a blue tinge to thewhites of the eye, short height,loose joints,hearing loss, breathing problems, and problems with the teeth.
Q2-A homeless alcoholic presents to your emergency department complaining of cough, rigors, pleuritic chest pain, and difficulty breathing. Chest radiograph shows right upper-lobe pneumonia. What organism must be considered?
A-Klebsiella pneumoniae
B-Escherichia coli
C-Haemophilus influenzae
D-Pneumococcus
Ans: A
Q3-To prevent tetanus in neonate?
A-Give anti-tetanus serum to neonate B-Give immunoglobulin to mother C-Give tetanus toxoid to mother D-Give antibiotics to mother E-Give penicillin to child to kill tetanus bacilli
Ans: C. Antitetanus vaccination in multiple doses (2–3) is up to 98% effective in preventing neonatal tetanus and neonatal tetanus deaths in under-resourced settings. Single doses of the tetanus vaccine are not enough to prevent neonatal tetanus deaths. In addition to administration of antitetanus vaccines, efforts should be made to ensure that women receive obstetric care to ensure clean deliveries.
http://apps.who.int/rhl/newborn/cd002959_Ogunlesit_com/en/
Q4- The most sensitive physical finding for the diagnosis of testicular torsion is?
A-The alleviation of pain when the testis is elevated
B-Pain lasting for hours or days
C-Abnormal results of urine culture
D-Absence of the cremasteric reflex
Ans: D
Q5- A 50-year man has had anterior resection of the rectum for carcinoma. He expressed concerns about control of post-operative pain in discussions with the anaesthetist before surgery. What is the best management strategy?
A-Oral diclofenac B-Oral codeine C-IM morphine D-IM dihydrocodeine E-Ondansetron oral
Ans: C. IM morphine. Post operative pain is severe pain which needs strong
opioid analgesic.
Q6-A premature infant is born with a patent ductus arteriosus. In closure can be stimulated by administration of?
A-Prostaglandin analogue
B-Estrogen
C-Anti-estrogen compounds
D-Prostaglandin inhibitors
Ans: D-Prostaglandin inhibitors
Normally ductus arteriosus closes soon after birth. Vasodilatory effect of prostaglandin is what maintains the patency of ductus arteriosus in intrauterine life. Hence in cases of delayed closure of ductus arteriosus, we can use prostaglandin inhibitors to induce its closure.
Q7-A child with a small head, minor anomalies of the face including a thin upper lip, growth delay, and developmental disability can have all of the following, except?
A-Chromosomal syndrome
B-Teratogenic syndrome
C-A Mendelian syndrome
D-A polygenic syndrome
Ans: D. polygenic syndrome
The features given can occur as a part of a chromosomal / teratogenic / mendelian syndrome. Polygenic inheritance is the answer of exclusion. In a polygenic inheritance, multiple genes are involved in the phenotypic expression. Some examples of polygenic inheritance are hypertension and diabetes
Q8- A previously healthy 60 year old man is reffered for urological evaluation of macroscopic hematuria, urinary cytology is positive for malignant cells,and cystoscopic examination reveals an exophytic multifocal tumor.A biopsy of the tumor demonstrates pappilary fronds lined by cells similar to transitional epithelium but showing nuclear atypia, mitoses and necrosis.which of the following is most appropriate risk factor in the US for the development of this type of tumor?
A-Aniline dyes B-Cyclophospjamide C-Phenacetin D-Radiation E-Recurrent cystitis F-Schistosomiasis G-Smoking
Ans: C. Aqueductal stenosis
Aqueductal stenosis is a narrowing of the aqueduct of Sylvius which blocks the flow of cerebrospinal fluid (CSF) in the ventricular system. Blockage of the aqueduct can lead tohydrocephalus, specifically as a common cause of congenital and/or obstructive hydrocephalus.
Q9-A 32-year-old man is brought to the emergency department because of multiple nonlethal stab wounds. He is incarcerated and serving a life sentence for murder and armed robbery. After his condition is stabilized, he insists that it is his “right” to remain in the hospital until he is fully “cured.” He threatens to harm the attending physician if she endorses his return to prison. Which of the following is the most likely diagnosis?
A-Adjustment disorder with mixed features B-Antisocial personality disorder C-Bipolar disorder, manic D-Borderline personality disorder E-Narcissistic personality disorder
Ans: B
Q10-Most common nerve injured in supracondylar fracture humerus is?
A-Median
B-Radial
C-Ulnar
D-Anterior interosseous nerve
Ans: D. Anterior interosseous nerve
In order studies, the radial nerve was found to be the one most commonly injured. But recent studies have shown that the median nerve, particularly the anterior interosseous branch is the most commonly damaged in supracondylar fracture of humerus.
Q11-45 years old woman with rheumatoid arthritis develops pain,erythema and swelling of the cartilaginous portion of both of her external ears.this is accompanied by pain localized to the costochondral joints.which of the following is the most likely diagnosis?
A-Ankylosing spondiolitis B-Bechet syndrome C-Gout D-Reiters syndrome E-Relapsing polychondritis
Ans: E. Relapsing polychondritis, also known as atrophic polychondritis, systemic chondromalacia chronic atrophic polychondritis, Meyenburg-Altherr-Uehlinger syndrome, generalized chondromalacia, and systemic chondromalacia, is a multi-systemic condition characterized by inflammation and deterioration of cartilage. The often painful disease can cause joint deformity and be life-threatening if the respiratory tract, heart valves or blood vessels are affected. The exact mechanism is poorly understood, but it is thought to be related to an immune-mediated attack on particular proteins that are abundant in cartilage.
Q12-Known case of SLE pregnant lady should be screened for ?
A-Anti DS DNA
B-Anti Histone
C-Anti RO antibodies
D-None of above
Ans: C. There is also a risk that the baby born to a mother with these antibodies will develop a condition known as neonatal lupus syndrome. This typically presents with a rash, often a few weeks after birth. The baby’s rash may be triggered by sunlight as in women with SLE, so babies born to mothers with lupus and these antibodies should not be placed in sunlight after birth. An affected baby may have mildly abnormal liver function tests and occasionally low platelets as well but this rarely causes bleeding. Neonatal lupus rash and syndrome occurs in the babies of about 1 in 30 women with anti-Ro and/or anti-La antibodies. The condition usually settles by itself without any special treatment except avoiding sunlight over a few weeks, as the baby gradually destroys the antibodies transferred during pregnancy from the mother to the baby. It is rare for these antibodies to cause any problems more than 6 months after the birth of the baby, unless the baby is born with congenital heart block or partial heart block.
Q13-Which ligament is commonly torn in inversion sprain of ankle?
A-Anterior talofibular ligament
B-Deltoid ligament
C-Posterior ligament
D-Calcaneo-fibular ligament
Ans: A. Ligamentous injuries of the ankle are common among athletes. Inversion injuries of the ankle account for 40% of all athletic injuries. The anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL) are sequentially the most commonly injured ligaments when a plantar-flexed foot is forcefully inverted. The posterior talofibular ligament (PTFL) is rarely injured, except in association with a complete dislocation of the talus.
The anterior talofibular ligament is injured first, and the calcaneofibular ligament is injured second if there is a greater force of injury. The posterior talofibular ligament, the strongest of the lateral ligaments, inhibits eversion and runs from the posterior aspect of the lateral malleolus to the lateral calcaneus.
Q14- A pregnant female develops lesions on the vulva and vagina and she was diagnosed as genital herpes. What should be included in her future health care?
A-Cesrianshould be done if the lesions did not disappear before 2 weeks of delivery date.
B-Oral acyclovir to treat herpes
C-Termination of pregnancy because of the risk of fetal malformations
D-Avoidance of intercourse for 1 month after the healing of the lesions
Ans: A
Q15-Most common bengin cause of vaginal bleeding on postmenopausal women?
A-Atrophic Vaginitits
B-Endometrial cancer
C-Liomyoma
D-Fibriod
Ans: A. Postmenopausal bleeding (PMB) refers to any uterine bleeding in a menopausal woman (other than the expected cyclic bleeding that occurs in women taking sequential postmenopausal hormone therapy). It accounts for about 5 percent of office gynecology visits.
All postmenopausal women with unexpected uterine bleeding patients should be evaluated for endometrial carcinoma since this potentially lethal disease will be the cause of bleeding in approximately 10 percent (range 1 to 25 percent, depending upon risk factors). However, the most common cause of bleeding in these women is atrophy of the vaginal mucosa or endometrium. In the early menopausal years, endometrial hyperplasia, polyps, and submucosal fibroids are also common etiologies
http://www.uptodate.com/contents/postmenopausal-uterine-bleeding
