Mock 4

Question 1

What is the second line choice of drug for ADHD?

Answer 1

Lisdexamfetamine

Question 2

What are the DSM-V 6 criteria for ADHD?

Answer 2

Answers questions prematurely
Always on the go, spontaneously moving around
Losing important things, forgetful
Cannot play quietly

Question 3

Is William’s syndrome associated with cyanotic heart disease?

Answer 3

No - generally associated with Supravalvular aortic stenosis (not a cause of cyanotic heart disease).

Question 4

What can be given in an asthma attack if unresponsive to initial management?

Answer 4

IV salbutamol, IV aminophylline or IV magnesium

Question 5

What are the three descriptive terms for different levels of cryptorchidism (undescended testes)?

Answer 5

Retractile
Palpable
Impalpable

Question 6

What does: paroxysmal episodes of colicky abdominal pain, where the child is inconsolable and draws their legs up to their abdomen, alongside features of intestinal obstruction suggest?

Answer 6

Intussuception

Question 7

When does volvulus commonly present?

Answer 7

In the first few days of life
With bilious vomiting and pain that is less classical in description than intussusception

Question 8

What is the management of choice in most patients with intussusception?

Answer 8

Rectal air insufflation

Question 9

How does disulfiram work in preventing alcohol consumption?

Answer 9

Deterrent

Question 10

Why is it recommended to check FBC and iron studies in ruling out organic causes of generalised anxiety disorder?

Answer 10

Anaemia can present with fatigue and palpitations

Question 11

What is the staging of perineal tears?

Answer 11

First degree tear - perineal skin only
Second degree tear - fascia and muscles of perineum
Third degree (A) tear - fascia and muscles of perineum and <50% of external anal sphincter involved
Third degree (B) tear - fascia and muscles of perineum, and >50% of external anal sphincter involved
Third degree (C) tear- fascia and muscles of perineum, and both external and internal anal sphincters involved
Fourth degree tear - both external and internal anal sphincters completely torn, and anal epithelium involved.

Question 12

What are the nerve roots for Erb’s palsy (seen in shoulder dystocia)?

Answer 12

C5-6

Question 13

What is used in a medical abortion?

Answer 13

Mifepristone is used first, followed by misoprostol 36-48 hours later.

Question 14

What are some symptoms of ovarian neoplasms?

Answer 14

Hirsutism due to testosterone secretion
Acute abdomen due to ovarian torsion
Rupture or haemorrhage
Thyrotoxicosis as in struma ovaria
Amenorrhea

Question 15

What is haematocolpos?

Answer 15

Accumulation of the blood in the vagina, usually due to an imperforate hymen

Question 16

What is ovarian hyperthecosis?

Answer 16

The presence of luteineised theca cell nests in ovarian stroma
Closely related to PCOS but with more severe hyperandrogegism and virilisation
V high testosterone concentrations - may exceed 7 mol/L
Accounts for most of the cases of hyperandrogenaemia in postmenopausal women

Question 17

In what psychiatric condition is suppressed gonadotrophins with low estradiol seen?

Answer 17

anorexia nervosa

Question 18

What do bat wing opacities on chest x ray represent?

Answer 18

Alveolar oedema

Question 19

Sudden onset retro-orbital pain with excessive lacrimation and redness with nothing on CT head and other investigations suggests what?

Answer 19

Cluster headache.
Often associated with autonomic symptoms such as ptosis, mitosis conjunctival injection and excessive lacrimation
Affect patients in clusters of 6-12 weeks followed by a period of remission

Question 20

What is the first line treatment for cluster headaches?

Answer 20

Sumatriptan
High flow oxygen

Question 21

What is a contraindication of sumatriptan?

Answer 21

Coronary artery disease

Question 22

What is the name of the connecting structure between the two lateral ventricles and the third ventricle?

Answer 22

Foramina of Monro

Question 23

What is the name of the connecting structure between the third ventricle and the fourth ventricle?

Answer 23

Cerebral aqueduct

Question 24

What is the name of the connecting structure between the fourth ventricle and the subarachnoid space?

Answer 24

Foramina of Luschka and Magendie

Question 25

What is the Motor responses on GCS?

Answer 25

Obeys commands - 6
Localising to pain - 5
Withdrawal from pain - 4
Flexion to pain - 3
Extension to pain - 2
No motor response - 1

Question 26

Wha tis Uhthoff’s phenomenon?

Answer 26

Small increases in the body temperature can temporarily worsen current or pre-existing signs and symptoms.

Question 27

What is Charcot’s neurologic triad?

Answer 27

Combination of nystagmus, intention tremor, scanning or staccato speech
Triad is associated with multiple sclerosis

Question 28

What are Kernig’s and Brudzinskiu’s signs associated with?

Answer 28

Meningitis

Question 29

What antibodies are detected in 98% of primary biliary cholangitis?

Answer 29

Antimitochondrial antibodies

Question 30

What are some complications of nephrotic syndrome?

Answer 30

Hypercoagulable state - risk of DVT.PE
Hyperlipidaemia
pleural effusions
Immunocompromised due to loss of immunoglobulins
NOT RISK OF AKI

Question 31

What is the organism which causes syphilis?

Answer 31

Treponema Pallidum - a spirochaete bacterium

Question 32

What is the first line treatment in an acute severe flare-up of UC?

Answer 32

IV steroids

Question 33

What does gram positive diplococci in CSF with a clinical picture of meningitis suggest?

Answer 33

Streptococcus pneumoniae

Question 34

What are hormone levels like in PCOS?

Answer 34

Raised LH,
Low or normal FSH
TSH may be raised

Question 35

What is the diagnostic test for acromegaly?

Answer 35

Oral glucose tolerance test
- a glucose load should cause suppression of growth hormone normally, but in acromegaly there is failure of growth hormone suppression. If the lowest value of growth hormone during the oral glucose tolerance test is >1ug/L, acromegaly is confirmed.

Question 36

Where does the pain radiate in cholecystitis

Answer 36

To between the scapulae