MC Flashcards
A 22-year-old man presented with recurrent abdominal pain and malaise. Physical exam revealed iron deficiency anaemia.
What is the most likely diagnosis?
A. Peutz-Jeghers syndrome
B. McCune-Albright syndrome
C. Addison’s disease
D. Familial adenomatous polyposis
E. Hereditary haemorrhagic telangiectasia
A
A 65-year-old lady has known history recurrent episodes of epistaxis. She was admitted this time for melaena. Physical exam revealed iron deficiency anaemia.
What is the most likely diagnosis?
A. Peutz-Jeghers syndrome
B. McCune-Albright syndrome
C. Addison’s disease
D. Familial adenomatous polyposis
E. Hereditary haemorrhagic telangiectasia
E
This 50-year-old man presents with sudden onset abdominal pain and distension after bloody diarrhea for 2 days.
(X ray shows toxic megacolon)
A. a history of fever
B. recent weight loss
C. recent antibiotic usage
D. family history of colonic cancer
E. presence of mucous in the stool
~Not intestinal obstruction as there is diarrhea~
C
A 40-year-old woman presented with 4-limb weakness for 10 years. History taking revealed a strong family history of a similar condition.
Which of the following is correct?
A. Nerve conduction study is likely normal in this patient.
B. Nerve biopsy is necessary for ascertaining the aetiology of the disease.
C. Cognitive decline is common in this condition.
D. Edrophonium test should be arranged.
E. Peripheral nerve demyelination is a key feature.
E
A 65-year-old woman presented with sudden onset left hemiparesis for 5 hours. Non-contrast computer tomography of brain was performed.
Which of the following immediate management is correct?
A. Intravenous thrombolysis
B. CT angiography of head and neck vessels
C. Lumbar puncture
D. Electroencephalography
E. Blood test for ammonia
B
This is the plain CT brain scan of a 60-year-old right-handed woman. (Left hypodense lesion)
Which of the following physical signs is most likely to be present?
A. lateral gaze palsy
B. expressive aphasia
C. Gertsmann’s syndrome
D. right-sided homonymous hemianopia
E. loss of pin-prick sensation of right arm
B
A 73-year-old woman was admitted for bilateral lower limbs weakness. On physical exam, there was rash over face and hands. She was also found to have proximal muscle weakness. Which of the following investigations is indicated as part of the workup of the underlying condition?
A. Nerve conduction study
B. Bone marrow examination
C. PET-CT with contrast
D. Lumbar puncture
E. Echocardiogram
C
dermatomyositis is strongly associated with malignancy
This 25YO man presents with sudden onset painful skin rash over his chest. Which of the following information is the most important in establishing the diagnosis?
A. Absence of fever
B. Presence of eschar
C. Past Hx of chickenpox
D. Rash does not cross midline
E. Presence of vesicles over angle of mouth
C
This 80-year-old elderly home resident presents with generalized skin itchiness. The skin rash affects his hands but does not involve his face.
What is the most likely diagnosis?
A. tinea
B. scabies
C. impetigo
D. acute drug eruption
E. disseminated varicella
B
A 35-year-old woman presents to the Emergency Department for facial swelling shortly after she was started on anti-hypertensive treatment.
What is the most likely causative agent of this problem?
A. ACE inhibitor
B. alpha blocker
C. beta blocker
D. calcium channel blocker (dihydropyridine type)
E. thiazide diuretics
A
A 30-year-old woman presents with headache. Blood test shows low TSH and high serum prolactin.
What is the most important physical sign to look for?
A. anosmia
B. hirsutism
C. hand tremor
D. delayed ankle jerk relaxation
E. visual field defect
E
Possibly prolactinoma –> mass effect leading to low TSH
A 60-year-old man is admitted for generalized malaise. He has good past health and is not on any long-term medication. Blood and urine tests on admission show the following results:
plasma Na 115 mmol/l (NR 135-145);
K 3.8 mmol/l (NR 3.5-5.0)
glucose 5.5 mmol/l (NR 4.5-5.7)
urea 4.5 mmol/l (NR 2.5 – 7.0);
osmolality 242 mmol/l (NR 275 – 295)
spot urine Na 56 mmol/l; osmolality 220 mmol/l
What is the most likely cause of his hyponatraemia?
A. primary polydipsia
B. alcohol intoxication
C. dehydration with salt depletion
D. syndrome of inappropriate anti-diuretic hormone secretion (SIADH)
E. pseudohyponatraemia due to hypertriglyceridaemia
D
A 65-year-old man was admitted for weight loss and malaise. He was a chronic smoker who smoked 1 pack of cigarettes daily for 40 years. Physical exam showed normal hydration status and there was no lower limb oedema. Blood tests showed the following results (normal ranges in brackets):
Na 108 (137 - 144 mmol/l);
K 4.8 (3.5 - 5.0 mmol/l)
Urea 4.8 (2.6 - 6.6 mmo/I);
Cr 89 (49 - 83 umol/l)
Serum osmolality 25& (275 - 295 mOsm/kg)
Urine Na 55 mmol/l; urine osmolality 105 mOsm/kg
What is the cause of hyponatraemia?
A. Hypothyroidism
B. Pseudohyponatraemia
C. Syndrome of inappropriate antidiuretic hormone secretion
D. Fluid overload
E. Addisonian crisis
C
A 60-year-old woman has atrial fibrillation and is receiving warfarin therapy.
Blood tests showed:
PT 25.6 sec (NR 11.0-12.5)
APTT 38 sec (NR 30-40)
INR 2.35
(PT, prothrombin time; APTT, activated partial thromboplastin time; INR, international normalised ratio)
What is the most appropriate interpretation of the result?
A. inadequate warfarin dosage
B. appropriate warfarin dosage
C. excessive warfarin dosage
D. presence of lupus anticoagulant
E. concomitant usage of new oral anticoagulants
B
(2.5 for AF)
An 85YO woman is admitted for jaundice for 2 days. Blood test showed:
Total protein 82 (60-85)
Albumin 30 (35-44)
Bilirubin 48 (3-15)
Alkaline phosphatase 440 (30-80)
Alanine transaminase 186 (20-60)
Which of the following information from the history would be most relevant for determining the cause of her problem?
A. Cigarette smoking
B. DM with obesity
C. Previous biliary surgery
D. Recent intake of raw seafood
E. History of autoimmune disease
C
