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Questions Flashcards

1
Q

Rank calcium concentration from lowest to highest: osteoporosis, osteomalacia, primary hyperparathyroidism, parathyroid carcinoma, secondary hyperparathyroidism

A

1) Osteomalacia
2) Secondary hyperparathyroidism
3) Osteoporosis
4) Primary hyperparathyroidism
5) Parathyroid carcinoma

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2
Q

A patient with fever and longstanding diabetes presents with a pleural effusion and ascites. Rank the diagnoses from the most likely to least likely:

Lung cancer, septicaemia, congestive cardiac failure, nephrotic syndrome, liver failure.

A

1) Congestive heart failure
2) Liver failure
3) Nephrotic syndrome
4) Lung Cancer
5) Septicaemia

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3
Q

A 24 year old drug dealer is found dead, Post mortem is carried out. What is the most to least likely:

Brain haemorrhage, acute liver failure, heroin overdose, alcohol intoxication, crystal meth overdose.

A

1) Heroin Overdose
2) Alcohol Intoxication
3) Crystal Meth Overdose
4) Acute Liver Failure
5) Brain Haemorrhage

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4
Q

Rank the size of red blood cells from smallest to largest:

Folate deficiency, Iron Deficiency, Alcohol excess and liver disease, rheumatoid arthritis, Vitamin B12 deficiency

A

1) Iron deficiency anaemia
2) Rheumatoid arthritis
3) Alcohol excess and liver disease
4) Folate deficiency
5) Vitamin B12 deficiency

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5
Q

Rank these microscopic appearances of cardiac tissue in evolutionary stages following myocardial infarction with 1 being the first thing to be seen and 5 being the last thing:

Dense fibrosis, further granulation, oedema and inflammation, necrosis and granulation, dense fibrosis and normal appearance.

A

1) Normal appearance
2) Oedema and inflammation
3) Necrosis and granulation
4) Further granulation
5) Dense fibrosis

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6
Q

RANK the antibiotic use in a patient who presents with pseudomembranous colitis with 1 being the first line most appropriate treatment with 5 being the least appropriate:

Gentamicin PO, Cefalexin PO, Metronidazole PO, Vancomycin PO, Gentamicin IV

A

1) Metronidazole PO
2) Vancomycin PO
3) Gentamicin PO
4) Gentamicin IV
5) Cefalexin PO

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7
Q

Rank the plasma concentrations with 1 being the lowest and 5 being the highest:

Potassium
Chloride
Calcium
Sodium
Phosphate

A

1) Phosphate
2) Calcium
3) Potassium
4) Chloride
5) Sodium

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8
Q

Rank the expected calculated osmolality in the patients with the following conditions, with 1 being the highest and 5 being the lowest:

Diabetes insipidus, pneumonia, diabetic ketoacidosis (DKA), hyperosmolar non ketotic coma (HONKC), SIADH

A

1) HONK
2) DKA
3) Diabetes Insipidus
4) Pneumonia
5) SIADH

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9
Q

A 50 year old man has fever, SOB, hepatosplenomegaly and pallor. A blood count shows he has a white cell count of 65x10^9 and a blood film that shows 90% blast cells. The blast cells contain granules and occasional Auer Rode. Rank the differentials from 1 being the most likely to 5 being the least.

AML, CLL, CML, ALL, Chest Infection

A

1) AML
2) CML
3) ALL
4) CLL
5) Chest infection

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10
Q

24 year old female with rapid onset skin rash, breathlessness, and loss of consciousness shortly after eating shellfish. Rank the appropriateness of the treatments with 1 being the most appropriate and 5 being the least.

IV hydrocortisone, IM adrenaline, IV Fluids, Nebulised salbutamol, IV adrenaline.

A

1) IM Adrenaline
2) IV Fluids
3) Nebulised Salbutamol
4) IV hydrocortisone
5) IV Adrenaline

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11
Q

All conditions here are associated with a raised plasma gastrin level. Rank the following conditions with 1 being the highest gastrin levels and 5 being the lowest.

Achlorhydria, Zollinger Ellison Syndrome, Following a vagotomy, H.Pylori Infection, Renal Failure

A

1) Achlorhydria
2) Following a Vagotomy
3) H.Pylori
4) Zollinger Ellison Syndrome
5) Renal Failure

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12
Q

Thyroxine exists bound to several substances although some thyroxine is free, Rank the percentage of thyroxine that exists with 1 having the most and 5 having the least thyroxine that exists in it.

Unbound or free, Bound to thyroxine binding globulin (TBG), bound to testosterone, bound to albumin, bound to thyroxine binding prealbumin (TBPA)

A

1) TBG
2) TBPA
3) Bound to albumin
4) Unbound or free
5) Bound to testosterone

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13
Q

Rank the causes of PUO in a returning traveller in decreasing frequency with 1 being the most common and 5 being the least common.

Bacterial diarrhoea, Viral hemorrhagic fever, Malaria, Dengue, UTI

A

1) Malaria
2) Dengue
3) Bacterial diarrhoea
4) UTIs
5) Viral Hemorrhagic Fever

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14
Q

A 33-year-old woman develops a DVT. She is given treatment, returns to the clinic and asks you how likely this is to happen again. Assume that there are 5 identical women, each of whom ask the same question. Rank the following factors in order of likelihood of being high risk of recurrence, with 1 indicating a high risk of recurrence and 5 being low. In other words, which woman is most likely to come back next year with recurrence (1) and who is least likely (5)

D-dimer measurement (after completing her period of anticoagulation) is elevated

The DVT occurred after a 4 hour plane flight

The DVT was idiopathic

She was taking the COCP at the time of the DVT

The DVT occurred shortly after the operation

A

1) DVT was idiopathic
2) D-dimer measurement (after completing her period of anticoagulation) is elevated
3) The DVT occurred after a 4 hour plane flight
4) She was taking the COCP at the time of the DVT
5) The DVT occurred shortly after the operation

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15
Q

Anaphylaxis is the most likely to occur following exposure to which of the following? Rank with 1 being the most likely and 5 being the least

Gliadin, Peanut, Penicillin, Eggs, Banana

A

1) Peanut
2) Penicillin
3) Eggs
4) Gliadin
5) Banana

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16
Q

A 35 year old IVDU with a one week history of lower back pain and 24 hours of leg weakness. A MRI scan reveals a collection around the T12 vertebrae. Rank the following organisms which may have caused this presentation with 1 being the most likely and 5 being the least.

Mycobacterium TB
Staph aureus
E.Coli
Pseudomonas aeruginosa
Strep pneumoniae

A

1) Staph aeureus
2) Mycobacterium TB
3) Strep pneumoniae
4) E.Coli
5) Pseudomonas aeruginosa

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17
Q

A 19 year old uni student with no PMHx has a headache and neck stiffness. Lumbar puncture microscopy reveals 3800 white cells, 90% which are neutrophils. Rank the following with 1 being the most likely and 5 being the least.

Neisseria Meningitidis, Cryptococcus neoformans, streptococcus pneumoniae, mycobacterium tuberculosis, listeria monocytogenes.

A

1) Neisseria Meningitidis
2) Streptococcus pneumoniae
3) Listeria monocytogenes
4) Mycobacterium tuberculosis
5) Cryptococcus neoformans

18
Q

A 23 year old woman presents to clinic with one year history of bloody diarrhoea associated with large amounts of mucus. This most likely diagnosis with 1 being the most likely and 5 being the least

Nemaline rod deficiency
Large bowel cancer
Infection
Endometrial adenocarcinoma
Inflammatory Bowel Disease

A

1) Inflammatory bowel disease
2) Infection
3) Large Bowel Cancer
4) Endometrial Adenocarcinoma
5) Nermaline rod deficiency

19
Q

A 80 year old woman presents with tense fluid filled bullae. Rank the following in order of most likely to least.

Pemphigoid gestationis
Pemphigus vulgaris
Traumatic blisters
Pemphigus foliaceus
Bullous pemphigoid

A

1) Bullous Pemphigoid
2) Pemphigus vulgaris
3) Pemphigus foliaceus
4) Traumatic blisters
5) Pemphigoid gestationis

20
Q

A 76 year old man presents with symptomatic anaemia, undergoes bone marrow examination and a diagnosis of myelodysplastic syndrome is made. With respect to the revised international prognostic scoring system, rank the following findings in order of poor prognostic significance (1 being the worst and 5 being the least worse)

A Hb concentration of 112g/L
A blood platelet count of 80x10^9
An intermediate karyotype (e.g. deletion of long arm of ch7)
A known history of diabetes
A bone marrow blast count of 17%

A

1) A bone marrow blast count of 17%
2) An intermediate karyotype (e.g. deletion of long arm of ch7)
3) A blood platelet count of 80x10^9
4) A Hb concentration of 112g/L
5) A known history of diabetes

21
Q

Rank the following beta-lactam antibiotics in order of spectrum from narrow (1) to broad (5)

piperacillin/tazobactam
meropenam
amoxicillin
benzylpenicillin
co-amoxiclav

A

1) Benzylpenicillin
2) Amoxicillin
3) Co-Amoxiclav
4) Piperacillin/tazobactam
5) Meropenem

22
Q

A 40 year old with heavy periods complains of breathlessness. Examination bibasal crep. Rank in order of likelihood that the investigation will be useful.

ECG
FBC
Echo
CXR
U&Es

A

1) FBC
2) CXR
3) Echo
4) ECG
5) U&Es

23
Q

A 14 year old boy presents complaining of pain and swelling around the knee. The X-Ray should a single lesion that is worrying for malignancy. Rank the following in order of likelihood, with 1 being most likely.

Ewings Sarcoma
Osteosarcoma
Metastatic lung cancer
Metastatic Neuroblastoma
Osteomyelitis

A

1) Osteosarcoma
2) Ewings Sarcoma
3) Metastatic neuroblastoma
4) Osteomyelitis
5) Metastatic Lung Cancer

24
Q

Rank the following in order of likelihood of being followed by recurrent thromboses.

Thrombosis whilst taking the COCP (and then discontinuing)
Thrombosis following 4 hour flight
Female with idiopathic thrombosis with no clear precipitant
Thrombosis following surgery
Male with idiopathic thrombosis with no clear precipitant

A

1) Male with idiopathic thrombosis with no clear precipitant
2) Female with idiopathic thrombosis with no clear precipitant
3) Thrombosis following 4 hour flight
4) Thrombosis whilst taking the COCP (and then discontinuing)
5) Thrombosis following surgery

25
Q

A 49-year-old man presents with haemoptysis. On imagine he has a mediastinal lymphadenopathy and is referred for an endobronchial ultrasound guided transbronchial fine needle aspirate. EBUS-TBNA , of the lymph nodes. List the sequence of events that would occur.

EGFR mutation detected
Rapid on-site evaluation by cytopathologist of endoscopic sample
Adenocarcinoma diagnosed
Target chemotherapy commenced
Sample processed and cell block made

A

1) Rapid on-site evaluation by cytopathologist of endoscopic sample
2) Adenocarcinoma diagnosed
3) Sample processed and cell block made
4) EGFR mutation detected
5) Target chemotherapy commenced

26
Q

A 56 year old woman presents with hepatomegaly and generalised lymphadenopathy. Rank the following in order of likelihood of being the final diagnosis.

Hodgkins Lymphoma
CML
CLL
Primary myelofibrosis
ALL

A

1) CLL
2) CML
3) Hodgkin’s Lymphoma
4) ALL
5) Primary Myelofibrosis

27
Q

A previously healthy 65 year old patient develops a painful vesicular rash with a T8 dermatomal distribution. Rank in order of appropriateness ( in terms of cost and efficacy according to NICE) which antiviral treatments are indicated?

Aciclovir IV , 10mg/kg three times a day
Valaciclovir PO, 1g three times a day
Foscarnet IV infusion, 60mg/kg every 8 hours
Oseltamivir PO, 75mg twice daily
Aciclovir PO, 800mg five times daily

A

1) Aciclovir PO, 800mg five times daily
2) Valaciclovir PO, 1g three times a day
3) Aciclovir IV , 10mg/kg three times a day
4) Foscarnet IV infusion, 60mg/kg every 8 hours
5) Oseltamivir PO, 75mg twice daily

28
Q

Causes of HAI from most to least likely:

Secondary bacterial infection
Ventilator being blocked
Health care worker spreading seasonal influenza
Antiviral resistance to oseltamivir
Virus mutates increasing lung tropism.

A

1) Antiviral resistance to oseltamivir
2) Virus mutates increasing lung tropism.
3) Secondary bacterial infection
4) Health care worker spreading seasonal influenza
5) Ventilator being blocked

29
Q

A 40 year old presents to A&E with severe hypotension and shock. He appears dehydrated and tests reveal the following:

Sodium 123 mmol/L (135–146)
Potassium 6.8 mmol/L (3.5–5.3)
Glucose 2.9mM
Rank the following diagnoses in order of likelihood:

  1. Gastroenteritis
  2. Addison’s
  3. Conn’s syndrome
  4. Primary hyperparathyroidism
  5. Hypothyroidism
A
  1. Addison’s disease
  2. Gastroenteritis
  3. Hypothyroidism
  4. Primary hyperparathyroidism
  5. Conn’s syndrome
30
Q

Thyroid Cancer: Rank from 1-5, starting with the most common

1) Papillary
2) Anaplastic
3) Thyroid lymphoma
4) Follicular
5) Medullary

A

1) Papillary
2) Follicular
3) Medullary
4) Anaplastic
5) Thyroid lymphoma

31
Q

Renal Stone Composition Likelihood

1) Cystine
2) Xanthine
3) Uric
4) Oxalate stones
5) Struvite

A

1) Oxalate stones
2) Struvite
3) Uric
4) Cystine
5) Xanthine

32
Q

Normal Cortisol and Amenhorrea Causes:

1) Addison’s
2) Depression
2) Pituitary apoplexy
4) Prolactinoma
5) Sheehan’s syndrome

A

1) Prolactinoma
2) Sheehan’s syndrome
2) Pituitary apoplexy
4) Addison’s
5) Depression

33
Q

Causes of painless jaundice and pruritis

1) Antibiotic-induced cholestasis
2) Wilson’s
3) Gallstones
3) Pancreatic cancer
5) Viral Hepatitis

A

1) Antibiotic-induced cholestasis
2) Viral hepatitis (she had tattoos)
3) Pancreatic cancer
4) Gallstones (painful)
5) Wilson’s (because it is so rare).

34
Q

Highest to lowest for a runner in Ramadan who is fasting

1) Insulin
2) Creatinine
3) Insulin
4) Urea
5) Glucose

A

1) Urea increases the most
2) potassium would increase (as it would be released by cells)
3) creatinine would go from say 70 to 72
4) glucose wouldn’t change
5) insulin level falls the most.

35
Q

Tx for Thrombosis

1) IV unfractionated heparin infusion
2) Warfarin
3) Prophylactic heparin
4) IVIG
5) aspirin

A

1) IV unfractionated heparin infusion
2) prophylactic heparin
3) warfarin
4) aspirin (no benefit - platelets)
5) IVIG (would make it worse).

36
Q

Rank cancers as cause of death in UK men according to frequency with (1) being the most common

a) Lung

b) Colon

c) Head and Neck

d) Breast

e) Prostate

A

1) Lung
2) Prostate
3) Colon
4) Head and Neck
5) Breast

37
Q

4) Rank the following stages of oesophageal adenocarcinoma progression in chronological order

a) Metaplasia

b) Reactive

c) Adenocarcinoma

d) High grade dysplasia

e) Low grade dysplasia

A

1) Reactive
2) Metaplasia
3) Low grade dysplasia
4) High grade dysplasia
5) Adenocarcinoma

38
Q

Rank in order of potency at reducing LDL with (1) being the most potent

a) Evolocumab

b) Simvastatin

c) Prednisolone

d) Bezafibrate

e) Atorvastatin

A

1) Evolocumab

2) Atorvastatin

3) Simvastatin

4) Bezafibrate

5) Prednisolone

39
Q

Young woman with dysuria, urinary frequency and suprapubic pain. Rank organisms with (1) being most likely

a) Escherichia coli

b) Acinetobacter baumanii

c) Candida albicans

d) Proteus mirabilis

e) Staph saprophyticus

A

1) Escherichia coli

2) Staph saprophyticus

3) Proteus mirabilis

4) Candida albicans

5) Acinetobacter baumanii

40
Q

A neonate presents at 36 hours of life with meningitis signs. Rank the organisms with (1) being most likely

a) E. coli

b) GBS

c) Listeria

d) Cryptococcus

e) Pseudomonas

A

1) GBS

2) E. coli

3) Listeria

4) Pseudomonas

5) Cryptococcus

CPQ Past Questions (1 decks)

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