Questions Part 3

Question 1

A 24-year-old female with a history of anorexia nervosa presents with red crusted lesions around the corner of her mouth and below her lower lip. What is she most likely to be deficient in?

• Zinc
• Tocopherol
• Iron
• Pantothenic acid
• Thiamine
• Magnesium

Answer 1

1. Iron

2. Zinc

Question 2

A 72-year-old man who is known to have chronic kidney disease stage 4 is admitted to the Emergency Department. Since yesterday he has felt short-of-breath on exertion and has been coughing up blood. On examination he tachycardic at 110/min with a normal chest examination. What is the most suitable initial imaging investigation to exclude a pulmonary embolism?

• Ventilation-perfusion scan
• Computed tomographic pulmonary angiography
• Pulmonary angiography
• MRI thorax
• Echocardiogram

Answer 2

Ventilation-perfusion scan
(Computed tomographic pulmonary angiography is usually first line but since she is in renal failure, the contrast my worsen it)

Question 3

Which one of the following is not associated with non-alcoholic steatohepatitis?

• Hyperlipidaemia
• Obesity
• Sudden weight loss or starvation
• Jejunoileal bypass
• Type 1 diabetes mellitus

Answer 3

Type 1 diabetes mellitus (It is associated with T2DM)

Question 4

What percentage of patients with HCV become chronic carriers?

Answer 4

85%

Question 5

What do raised ALP and GGT suggest?

Answer 5

Cholestasis

Question 6

Elevated AST and ALT suggest what?

Answer 6

Hepatocyte damage

Question 7

What antibody is positive in 95% of patients with Primary Billiary Cirrhosis?

Answer 7

AMA

Question 8

What ceruloplasmin level is typical of Wilson’s Disease?

Answer 8

Low

Question 9

What happens to transferrin saturation in haemochromatosis?

Answer 9

It is high

Question 10

What are possible causes for an ALT>1000IU?

Answer 10

Acute viral hepatitis
Drug reaction
Ischaemic hepatitis

Question 11

What is Corrigan’s sign and what is it seen in?

Answer 11

Abrupt distension and collapse of carotid arteries

Seen in aortic regurgitation

Question 12

Are beta-blockers positively or negatively inotropic?

Answer 12

Negatively

Question 13

What opens in the left, posterior aortic sinus?

Answer 13

Left coronary artery

Question 14

What is most commonly associated with the AV groove?

Answer 14

Right coronary artery

Question 15

What supplies the AV node?

Answer 15

Posterior interventricular artery

Question 16

What supplies the apex of the heart?

Answer 16

Anterior interventricular artery

Question 17

What supplies the SA node?

Answer 17

Right coronary artery