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STATE > Rheuma, Derma, Opthalmo, ENT > Flashcards

Rheuma, Derma, Opthalmo, ENT Flashcards

1
Q 
Which symptom is NOT typical to lower leg nerve root compression?
A)  	Positive Lasegue-sign
B)  	Tenderness at the Valleix points
C)  	Positive femoral sign
D)  	Loss of the Achilles tendon reflex
E)  	Patellar ballottement
A

E) Patellar ballottement

EXPLANATION
Patellar ballottement is typical to knee joint fluid, the four other symptoms could be the sign of nerve route compression

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2
Q

Which clinical symptom is NOT characteristic of rheumatoid arthritis?

A) Early morning stiffness in the hands
B) Symmetrical small joint inflammation of the hands
C) Small joint erosions on X-ray
D) Anti-CCP positivity
E) Early low back pain with sacroiliitis

A

E) Early low back pain with sacroiliitis

EXPLANATION
The first four symptoms are specific to RA, early low back pain with sacroiliitis is a typical symptom of seronegative spondyloarthritis.

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3
Q

Which symptom is NOT characteristic of Felty syndrome?

A)  	Inflammatory arthritis
B)  	High titer rheumatoid factor positivity
C)  	Splenomegaly
D)  	Pneumoconiosis
E)  	Granulocytopenia
A

D) Pneumoconiosis

EXPLANATION
Pneumoconiosis is part of Caplan’s syndrome, the other four symptoms are characteristic of Felty’s syndrome.

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4
Q

It does NOT belong to the characteristics of adult-onset Still’s disease:
A) Pigmented villonodular synovitis
B) High fever
C) Maculopapular rash on the upper arms
D) Arthralgia
E) Visceral symptoms

A

A) Pigmented villonodular synovitis

EXPLANATION
Pigmented villonodular synovitis is a benign synovial proliferation and an independent disease, the other four symptoms are characteristic of the adult-onset Still’s disease.

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5
Q 
It does NOT belong to the diagnostic criteria for systemic lupus erythematosus:
A)  	Anti-DNA positivity
B)  	Nervous system manifestation
C)  	Erosive arthritis
D)  	Renal involvement
E)  	Butterfly (malar) rash
A

C) Erosive arthritis

EXPLANATIONThe disease could be characterized by non-erosive arthritis.

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6
Q

What is the most important immunological marker of mixed connective tissue disease (MCTD)?

A)  	Anti-CCP
B)  	Antinuclear factor
C)  	Anti-SSA
D)  	Anti-U1RNP
E)  	Anti-SSB
A

D) Anti-U1RNP

EXPLANATION
For MCTD, the anti-U1RNP antibody is the most specific, for RA, the anti-CCP, for SLE, the antinuclear factor, and for Sjögren’s syndrome anti-SSA and -SSB are the most specific.

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7
Q

What joints are NOT affected in rheumatoid arthritis?
A) Metacarpophalangeal (MCP) joints
B) Proximal interphalangeal (PIP) joints
C) Distal interphalangeal (DIP) joints
D) Knee joints
E) Radiocarpal joints

A

C) Distal interphalangeal (DIP) joints

EXPLANATION
The involvement of DIP joints is not typical for RA at all, opposed to the other typical lesions.

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8
Q 
What subgroup of juvenile idiopathic arthritis is characterized primarily by rheumatoid factor positivity?
A)  	Polyarthritis
B)  	Systemic form
C)  	Oligoarthritis
D)  	Enthesopathic arthritis
E)  	Psoriatic arthritis
A

A) Polyarthritis

EXPLANATION
The polyarthritis subgroup may show seropositivity, the rest mostly doesn’t

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9
Q 
It does NOT belong to seronegative spondyloarthritis:
A)  	Ankylosing spondylitis
B)  	Reactive arthritis
C)  	Enteropathic arthritis
D)  	Polymyalgia rheumatica
E)  	Psoriatic arthritis
A

D) Polymyalgia rheumatica

EXPLANATION
Polymyalgia rheumatica does not belong to this group due to having different characteristics.

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10
Q

NOT characteristic of ankylosing spondylitis:
A) Elevated erythrocyte sedimentation rate
B) Low back pain worsens after activity, improves after rest
C) Low back pain worsens during early morning rest, improves with activity
D) Early bilateral sacroiliitis
E) Syndesmophytes on spinal X-ray

A

B) Low back pain worsens after activity, improves after rest
EXPLANATION
Inflammatory spinal pain typical to Bechterew’s disease increases in rest, relieves with motion, oppositely to degenerative back pain which increased after motion.

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11
Q

Characteristics of joint processes associated with inflammatory bowel diseases (IBD), EXCEPT
A) Especially lower extremities oligoarthritis
B) Spondarthritis of the spine
C) Effectiveness of infliximab therapy
D) Effectiveness of sulfasalazine therapy
E) Effectiveness of methotrexate therapy

A

E) Effectiveness of methotrexate therapy

EXPLANATION
Infliximab and sulfasalazine are effective in IBD however methotrexate isn’t.

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12
Q

What is the absolute classification criteria for gout diagnosis?
A) Detection of synovial monosodium monohydrate crystals
B) Uric acid nephrolithiasis
C) Occurrence of acute flares of gouty arthritis
D) The presence of tophuses
E) Hyperuricemia

A

A) Detection of synovial monosodium monohydrate crystals

EXPLANATION
During the diagnosis of gout, the detection of urinary crystals is an absolute marker, the other symptoms are characteristic, but not absolute criterions.

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13
Q

What is the most important laboratory symptom of primary osteoporosis?
A) Elevated alkaline phosphatase
B) Elevated erythrocyte sedimentation rate
C) Elevated parathyroid hormone levels
D) Decreased serum calcium levels
E) None of the above

A

E) None of the above

EXPLANATION
In case of primary osteoporosis the routine laboratory parameters are negative.

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14
Q 
What condition does NOT lead to increased formation of osteoarthritis?
A)  	Hip joint dysplasia
B)  	Significant weight gain
C)  	Varus / valgus deformity
D)  	Excessive arthritis
E)  	HLA B-27 positivity
A

E) HLA B-27 positivity

EXPLANATION
HLA B-27 positivity does not predispose to osteoarthritis, but the other factors listed are risk factors.

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15
Q

In which joints does Heberden’s osteoarthritis develop?

A)  	In distal interphalangeal joints
B)  	In proximal interphalangeal joints
C)  	In knee joints
D)  	In the small joints of the leg
E)  	Anywhere
A

A) In distal interphalangeal joints

EXPLANATION
Heberden’s osteoarthritis is a degenerative lesion of the DIP joints.

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16
Q

NOT a characteristic hand change of rheumatoid arthritis:
A) Erosions of the small joints
B) Subluxations of the small joints
C) “Pencil in cup” lesion
D) Bone ankylosis
E) Swan-neck and boutonniere finger deformity on the hands

A

C) “Pencil in cup” lesion

EXPLANATIONThe “pencil in cup” lesion is a feature of psoriatic arthritis, the other X-ray findings are characteristic of RA.

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17
Q

Genetic subtypes predominant to rheumatoid arthritis:
1) HLA DRB101
2) HLA DRB104
3) HLA DRB1*10
4) HLA B27
5) HLA B35
A) the 1st, 2nd and 4th answers are correct
B) the 1st, 3rd and 5th answers are correct
C) the 1st, 2nd and 3rd answers are correct
D) the 3rd, 4th and 5th answers are correct
E) the 2nd, 3rd and 5th answers are correct

A

C) the 1st, 2nd and 3rd answers are correct

EXPLANATION
The mentioned subtypes of HLA DRB1are predisposing factors for RA while HLA B27 and B35 are associated with seronegative spondyloarthritis.

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18
Q

Which therapeutic option(s) is (are) appropriate for the treatment of alopecia areata?
A) Topical glucocorticoid treatment
B) PUVA (psoralen + UVA)
C) Provocation of a local contact dermatitis
D) Systemic treatment of acive bacterial foci
E) All of the above

A

E) All of the above

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19
Q 
Which therapeutic option is appropriate for the treatment of allergic contact dermatitis?
A)  	marigold ointment
B)  	salicylic acid
C)  	5-fluorouracyl
D)  	topical glucocorticoids
E)  	none of the above
A

D) topical glucocorticoids

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20
Q

Which examination is not suitable for making diagnosis of a cutaneous vasculitis?
A) dermatohistopathological examination of lesional skin
B) direct immunofluorescent microscopy of lesional skin
C) hepatitis C serology
D) measurement of serum levels of cryoglobulin and cryofibrinogen
E) angiography

A

E) angiography

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21
Q 
Verruca vulgaris occurs commonly in the following conditions, except:
A)  	pes valgus
B)  	immunodeficiency
C)  	psoriasis
D)  	HIV positivity
E)  	hyperhidrosis
A

C) psoriasis

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22
Q

The following clinical features are characteristic for herpes zoster except
A) grouped vesicles
B) usually mild symptoms
C) linear arrangement of vesicle groups
D) contagious through direct lesional skin contact
E) severe complications are rare but possible

A

B) usually mild symptoms

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23
Q 
In which disease is tick bite typical for the patients’ history?
1)  	Lymphadenosis cutis benigna
2)  	Erythema chronicum migrans
3)  	Acrodermatitis chronica atrophicans
4)  	Lyme disease
A)  	Answers 1, 2 and 3 are correct.
B)  	Answers 1 and 3 are correct.
C)  	Answers 2 and 4 are correct.
D)  	Only answer 4 is correct.
E)  	All answers are correct.
A

E) All answers are correct.

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24
Q 
Which therapeutic option(s) is (are) appropriate for the treatment of cutaneous T cell lymphomas?
1)  	PUVA
2)  	Bone marrow transplantation
3)  	α-interferon
4)  	X-ray irradiation
A)  	Answers 1, 2 and 3 are correct.
B)  	Answers 1 and 3 are correct.
C)  	Answers 2 and 4 are correct.
D)  	Only answer 4 is correct.
E)  	All answers are correct.
A

E) All answers are correct.

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25
Q 
Which substances do have a keratolytic effect in adequate concentrations?
1)  	Salicylic acid
2)  	Urea
3)  	Lactic acid
4)  	Boric acid
A)  	Answers 1, 2 and 3 are correct.
B)  	Answers 1 and 3 are correct.
C)  	Answers 2 and 4 are correct.
D)  	Only answer 4 is correct.
E)  	All answers are correct.
A

A) Answers 1, 2 and 3 are correct.

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26
Q

Which signs or symptoms are characteristic for a postthrombotic leg ulcer?
1) White atrophy
2) A varicose vein draining the region of the ulcer
3) Localization just above the ankle on the inside of the leg
4) Intermittent claudication
A) Answers 1, 2 and 3 are correct.
B) Answers 1 and 3 are correct.
C) Answers 2 and 4 are correct.
D) Only answer 4 is correct.
E) All answers are correct.

A

A) Answers 1, 2 and 3 are correct.

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27
Q 
Which cutaneous manifestation(s) is (are) typical for a vasculitis?
1)  	Purpura
2)  	Persisting urtica for over 24 hours
3)  	Hemorrhagic papule
4)  	Skin necrosis
A)  	Answers 1, 2 and 3 are correct.
B)  	Answers 1 and 3 are correct.
C)  	Answers 2 and 4 are correct.
D)  	Only answer 4 is correct.
E)  	All answers are correct.
A

E) All answers are correct

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28
Q 
Tuberculin test is anergic …
1)  	in patients who had not been immunized against M. tuberculosis
2)  	under immunosuppressive therapy
3)  	in elderly
4)  	after tuberculotic infections
A)  	Answers 1, 2 and 3 are correct.
B)  	Answers 1 and 3 are correct.
C)  	Answers 2 and 4 are correct.
D)  	Only answer 4 is correct.
E)  	All answers are correct.
A

A) Answers 1, 2 and 3 are correct.

29
Q 
Which statements are true for basal cell carcinoma? Please find the correct combination.
1)  	It affects mainly elderly patients.
2)  	It occurs commonly as a plaque with telangiectasias and glistening edges.
3)  	It is commonly ulcerated.
4)  	It destroys neighboring tissues.
5)  	Metastatic spreading is common.
A)  	Answers 1, 2, 3 and 4 are correct
B)  	All answers are correct
C)  	Answers 1, 2 and 4 are correct
D)  	Answers 2, 3 and 5 are correct
E)  	Answers 1, 3 and 5 are correct
A

A) Answers 1, 2, 3 and 4 are correct

30
Q

Which chemotherapeutic agent is used most commonly for treatment of a malignant melanoma?
A 50-year-old male presents with a bleeding, pruritic, exophytic, ulcerated, brownish black, nodular tumor of 1 cm diameter over the left scapula which has grown quickly in the last half a year.
A) Azathioprine
B) Dacarbazine
C) Bleomycin
D) Cyclophosphamide

A

B) Dacarbazine

31
Q

The consequence of the use of pacifier soaked in candy :
A) caries at the upper and lower central incisors
B) gingivitis
C) periodontitis
D) circular caries on the four upper deciduous incisors
E) all of theme.

A

D) circular caries on the four upper deciduous incisors

EXPLANATIONThe pacifier soak in candy or the very sweet tea given from a bottle thru a nipple can cause very characteristic lesion- the so called circular caries. It is located on the upper deciduous incisors. A dark brown lesion develops around the cervical area of the crown, later a real decay is formed and can lead to crown fractur

32
Q 
What is the cause of the gingival enlargement in leukaemia ?
A)  	infiltration by malignant cells
B)  	reactive fibrosis
C)  	haemangioma
D)  	capillary rigidity
E)  	neither of them
A

A) infiltration by malignant cells

EXPLANATIONThe early sign of acute leukemia is the swelling of the interdental gingiva, the spontaneously bleeds ,and finally necrotized creating ulcers. (see also FOG-1) It is caused by the infiltrating malignant hematological cells.

33
Q 
Drugs decreasing salivary flow rate
1)  	homatropine
2)  	scopolamine
3)  	atropine
4)  	noscapine
A)  	if 1., 2. and 3. are correct
B)  	if 1. and 3. are correct
C)  	if 2. and 4. are correct
D)  	only the 4th answer is correct
E)  	if all the answers are correct
A

A) if 1., 2. and 3. are correct
EXPLANATION
The tropeins ( a structure made up by the condensation of a pyridine and pirolidine ring) even in therapeutic dose cause xerostomia, dray through, thirst and mydriasis. This sometimes can be used for the transitory inhibition of the salivation. This is very useful during impression taking or special oral exams.

34
Q 
The characteristic signs of Down-syndrome
1)  	hyper salivation
2)  	microglossia
3)  	small teeth
4)  	very wide upper dental arch
A)  	if 1., 2. and 3. are correct
B)  	if 1. and 3. are correct
C)  	if 2. and 4. are correct
D)  	only the 4th answer is correct
E)  	if all the answers are correct
A

B) if 1. and 3. are correct

EXPLANATIONDown’s syndrome is a chromosomal aberration. Its general syndromes associate with characteristic facial features. Macroglossia, hypopastic teeth, and at least in 90% orthodontic abnormalities -like open bite, cross bite occur

35
Q 
It is characteristic to the central midface bone fracture:
1)  	diplopia
2)  	swollen face
3)  	nasal bleeding
4)  	liquour discharge
A)  	1st, 2nd and 3rd answers are correct
B)  	1st and 3rd answers are correct
C)  	2nd and 4th answers are correct
D)  	only the 4th answer is correct
E)  	all of the answers are correct
A

A) 1st, 2nd and 3rd answers are correct

EXPLANATION
The Le Fore II mid-facial fracture usually involves the bones of the orbital basis , the bones move caudally and therefore diplopia develops. The soft tissue injury leads to sudden swelling of the face, because the mimic muscle have no fascia sheets. The nasal bleeding is also a common sing. This fracture does not involves the cranial bones. The liquour discharge is not common-

36
Q

Funduscopy of the right eye should be made in the following order, except:
A) the examiner sits or stands on the right side of the patient
B) the retinoscope is held in the right hand of the examiner and he/she examines with the right eye
C) possibly performs the examination in a dark room
D) the left hand is positioned on the forehead of the patient and with her/his thumb lifts the upper eyelid
E) asks the patient to look directly into the light

A

E) asks the patient to look directly into the light

EXPLANATION
During direct funduscopy the right eye should be examined by the right eye, the left eye with the left one, the approach is easier that way. The examination should be carried out in a dark room, eyelid might be lifted. Patients should not look directly into the light, because in that case the pupil narrows and the peripheral part of the fundus cannot be observed.

37
Q

The most important early characteristics of hypertensive retinopathy:
A) arteriovenous crossing
B) constriction of arterioles
C) widening of the light reflex of the arterioles
D) copper wire arterioles
E) silver wire arterioles

A

B) constriction of arterioles

EXPLANATION
Hypertension starts with the constriction of the smallest vessels, this sign is specific. The other signs can be found not exclusively in hypertension and occurs in the later phase of hypertension.

38
Q

The one-sided subconjunctival hemorrhage which is not associated with pain, nor visual disturbances refers to:
A) acute glaucomatous attack
B) usually thrombocytopenia is in the background
C) usually it is caused by arteriolosclerosis
D) urgent, severe ophthalmic disturbance which needs emergency care
E) usually harmless idiopathic disturbance

A

E) usually harmless idiopathic disturbance

EXPLANATIONThe cause is rupture of one (or more) conjunctival vessels, there is no visual consequence, painless.

39
Q 
Which is the most characteristic visual field defect from the followings in a hypophyseal tumor?
A)  	complete homonym hemianopsia
B)  	lower homonym hemianopsia
C)  	bitemporal hemianopsia
D)  	upper homonym hemianopsia
E)  	monocular blindness
A

C) bitemporal hemianopsia

EXPLANATIONThe hypohysis tumor presses the chiasm centrally. The crossing fibers arriving here from the nasal retina, they transmit visual stimuli from the temporal visual field. The damage of these nerve fibers causing bilateral temporal visual field defect.

40
Q 
If you observe in front of the retina a semicircle, in the upper part a horizontal shape hemorrhage during funduscopy, what do you think?
A)  	superficial intraretinal hemorrhage
B)  	preretinal hemorrhage
C)  	deep intraretinal hemorrhage
D)  	vitreous hemorrhage
E)  	chorioideal hemorrhage
A

B) preretinal hemorrhage

EXPLANATION
It is preretinal bleeding. The shape is horizontal in only that cases when the bleeding is between the retina and the detached posterior vitreous.

41
Q 
Normal intraocular pressure does not exceed:
A)  	7 mmHg
B)  	11 mmHg
C)  	14 mmHg
D)  	18 mmHg
E)  	22 mmHg
A

E) 22 mmHg

EXPLANATION
The normal intraocular pressure is below 22 mmHg.

42
Q 
Ectropium often presents together with:
A)  	pterygium
B)  	entropium
C)  	pinguecula
D)  	epiphora
E)  	ptosis
A

D) epiphora
EXPLANATION
If the lower eyelid is ectropic, usually the lower punctual point is everted outward also. Therefore tearing (epiphora) is the consequence, because the drainage of the tear is impaired, the lower punctual point is not reaching the tear level.

43
Q

A 25-year old male patient complains in the emergency room of having an inflamed red eye. Fluorescein staining shows branch like corneal ulcer. The most likely diagnosis:
A) corneal abrasion
B) foreign body in the cornea
C) heat induced corneal damage
D) bacterial origin of corneal inflammation (keratitis)
E) herpetic infection

A

E) herpetic infection

EXPLANATION
In younger age the one-sided corneal inflammation, which shows branch like ulceration means a herpetic infection.

44
Q 
The diagnosis of proliferative diabetic retinopathy can be established by the following signs:A)  	cotton-wool type degenerative spots
B)  	microaneurysms
C)  	neovascularization
D)  	point-like bleedings
E)  	retinal edema
A

C) neovascularization
EXPLANATION
In the proliferative stadium of diabetic retinopathy neovascularization is the most characteristic sign, other signs may occur in the non-proliferative stadium as well.

45
Q 
From the below mentioned symptoms which might be found both in keratitis, iritis, and in acute glaucomatous attack?
A)  	corneal precipitates
B)  	corneal blur
C)  	dilated pupil
D)  	circumcorneal or ciliary injection
E)  	subconjunctival bleeding
A

D) circumcorneal or ciliary injection

EXPLANATIONCircumcorneal or ciliary injection. This sign labels inflammations, congestion within the iris, ciliary body and this can occur in glaucoma as well.

46
Q

The most frequent complication of severe myopiaA) posterior uveitis
B) cataract
C) angioid streaks
D) atrophic chorioideal area in the posterior pole
E) iris rubeosis

A

D) atrophic chorioideal area in the posterior pole

EXPLANATION
In severe myopia in the posterior pole of the eye, staphylomata may occur, which causing a circulatory deficiency and leading to atrophic area in the choroid. The stretching of the sclera is not followed by the retina and choroid. With the rupture of the blood vessels bleeding might occur in the atrophic areas (Fuchs spots).

47
Q 
In case of malfunction of the rectus superior muscle in which direction of the looking is affected?
A)  	inward and downward
B)  	outward and downward
C)  	inward and upward
D)  	upward
E)  	outward and upward
A

C) inward and upward
EXPLANATIONThe examiner should ask the patient to look in- and upward in order to control the function of the superior rectus muscle, because this muscle pulls the eye upward and inward.

48
Q

From the below listed questions, choose the incorrect sentence
A) In the cornea and sclera collagen fibres can be founded
B) the physiologic function of the Schlemm’s channels to drain the aqueous from the anterior chamber
C) the anterior and posterior surface of the iris is covered by multilayer squamous epithelium
D) parts of the uvea: iris, ciliary body, chorioid

A

C) the anterior and posterior surface of the iris is covered by multilayer squamous epithelium

EXPLANATION
The statement about to cover the anterior and posterior surface of the iris by multilayer squamous epithelium is incorrect. Anterior surface is covered by endothelial cells, the posterior surface is covered by pigment epithelium.

49
Q

In case of damage of the visual pathway which of the below listed visual filed defect does not correlate with the anatomical localization?
A) crossing fibers of the chiasm – bitemporal heteronym hemianopia
B) left optical tract – right sided homonym hemianopsia
C) left lingular gyrus – right sided lower quadrant anopia
D) left temporal lobe – right sided upper quadrant anopia

A

C) left lingular gyrus – right sided lower quadrant anopia

EXPLANATION
The damage of the left lingular gyrus causing right sided temporal peripheral defect in the visual field.

50
Q

At the contraction of the ciliary muscle:

1) decreasing the pulling effect of the lens zonules
2) the crystalline lens thickens
3) the refractive power increased
4) the pupil dilates

A)  	1st, 2nd and 3rd answers are correct
B)  	1st and 3rd answers are correct
C)  	2nd and 4th answers are correct
D)  	only 4th answer is correct
E)  	all of the answers are correct
A

A) 1st, 2nd and 3rd answers are correct

EXPLANATION
During the constriction of the ciliary muscle the pupillary reaction does not change, but on the other hand the refraction increases, because the lens zonules relax and the crystalline lens thickens (becomes more convex).

51
Q

Function of the vitreous:
1) to transmit the light
2) to support the crystalline lens and retina
3) to deliver metabolic products to the retina
4) tear production
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct

A

A) 1st, 2nd and 3rd answers are correct

EXPLANATION
The vitreous is a gel like material filling the inside of the eye, has nothing to do with tear production, but it transmits the light, give a support to the crystalline lens and transports metabolic products to the retina

52
Q 
About the function of the outher hair cells we can get objective information on
A)  	tympanometry
B)  	BERA
C)  	otoacoustic emission
D)  	investigation of stapedial reflex
A

C) otoacoustic emission

EXPLANATIONThe otoacoustic emission objectively registers the low intensity sounds at the external ear canal,that have been produced by the outer hair cells.

53
Q 
Rinne's test is informative in:
A)  	conductive hearing loss
B)  	sensorineural hearing loss
C)  	perforation of the tympanic membrane
D)  	sudden hearing loss
A

A) conductive hearing loss

EXPLANATIONIn Rinne test the patient hears the transmitted sound better on the bone due to bone conductivity, rather than in the air. This indicates a conductive hearing loss.

54
Q

The patient suffers from hearing loss on the right side. Weber test is lateralized to the right side. Probable cause of the hearing loss is
A) otosclerosis on the left side
B) cerumen on the right side
C) Ménière’s disease on the right side
D) sensorineural hearing loss on the right side

A

B) cerumen on the right side
EXPLANATION
Weber test is heard louder to the affected side due to conductive hearing loss in the defective ear. The reason of conductive hearing loss most of the times is the existence of earwax.

55
Q 
Which part of the tympanic membrane should be preferred when doing a paracentesis?
A)  	antero-inferior quadrant
B)  	antero-superior quadrant
C)  	postero-superior quadrant
D)  	postero-inferior quadrant
A

A) antero-inferior quadrant

EXPLANATIONIn paracentesis the preferred quadrant is the anterior inferior since there is no structure behind it that we can damage, and the fluid easily flows out from there.

56
Q 
In adult patients with unilateral, recurring catarrh of the Eustachian tube you should exclude...
A)  	peritonsillar abscess.
B)  	adenoid hypertrophy.
C)  	malignant tumor in the epipharynx.
D)  	deviated septum.
A

C) malignant tumor in the epipharynx.

EXPLANATION
Adult patients with unilateral, recurring catarrhal inflammation of the Eustachian tube should be examined for epipharyngeal tumors that obstruct the opening of the tube.

57
Q 
In acute upper airway infection of an infant, one-sided swelling of the upper and lower eyelid appears. Which condition would you think of?
A)  	acute rhinitis
B)  	acute maxillary sinusitis
C)  	acute ethmoiditis
D)  	allergic reaction
A

C) acute ethmoiditis

EXPLANATION
In acute upper respiratory infection of an infant, one sided swelling of the upper and lower eyelid is an indication of an acute ethmoiditis. In this age the rest of the sinuses are either not fully developed or cannot cause eyelid swelling. In case of allergy, there is a symmetric swelling.

58
Q

A middle-aged male patient has a painless, freely mobile mass of about 30 mm in one parotid gland for 5 years. Facial nerve funtion is intact. The probable diagnose is
A) osteoma in the external acoustic meatus
B) glomus caroticum tumor
C) pleomorph adenoma
D) salivary stone in the parotid gland
E) malignant tumor of the parotid gland

A

C) pleomorph adenoma

EXPLANATION
Pleiomorphic adenoma is the most frequent benign parotid tumor, accessible to remove surgically and does not give metastasis. The diagnosis is made by fine needle aspiration.

59
Q 
Necrotic, coated lesion of the tonsils suggests a(n)
A)  	scarlatina-associated tonsillitis
B)  	mononucleosis
C)  	agranulocytic angina
D)  	tonsillitis follicularis
E)  	herpangina
A

C) agranulocytic angina

EXPLANATION
Necrotic, coated lesion of the tonsils suggest agranulocytic angina. Treatment of the haematological status is recommended.

60
Q

Treatment of tonsillogenic sepsis requires
A) immediate tonsillectomy performed with antibiotic protection
B) application of broad-spectrum antibiotics
C) cryotherapy of the tonsils performed with antibiotic protection
D) therapeutic punction of cerebrospinal liquor
E) splenectomy

A

A) immediate tonsillectomy performed with antibiotic protection

EXPLANATIONTonsillogenic sepsis requires an immediate tonsillectomy and antibiotic treatment.

61
Q 
Reinke-oedema is located on/in the
A)  	epiglottis
B)  	uvula
C)  	piriform sinus
D)  	vallecules
E)  	vocal chords
A

E) vocal chords

EXPLANATION
Reinke oedema is located at the vocal cords, and is prominent in heavy smokers.

62
Q

A patient living with tracheostomy cannula suddenly begins to suffocate. The first thing you do is to
A) suction the trachea through the cannula
B) refer the patient to a specialist
C) remove the cannula immediately and dilate the stoma with a nasal speculum
D) force the patient to cough

A

C) remove the cannula immediately and dilate the stoma with a nasal speculum

EXPLANATIONWhen a patient with tracheostomy cannula starts to suffocate, immediate removal of the cannula is recommended and dilation of the stoma with a nasal speculum

63
Q 
The condition in which the cause of dysphagia cannot be detected on swallow radiography is
A)  	esophageal diverticulum
B)  	cervical spondylarthrosis
C)  	esophageal carcinoma
D)  	globus hystericus
E)  	esophageal spasm
A

D) globus hystericus

EXPLANATION
If dysphagia is not detected by swallow radiography. Patients most of the times suffers out of globus hystericus.

64
Q

The best radiographic modality for the diagnosis of an esophageal foreign body is
A) chest X-ray
B) barium swallow test
C) swallow radiography without contrast media
D) swallow radiography with absorbable contrast media

A

D) swallow radiography with absorbable contrast media

EXPLANATIONThe esophageal foreign body is best detectable by swallow radiography with absorbable contrast media.

65
Q

Surgical solution of a median cervical cyst or fistule is
A) extirpation of the fistule together with the hyoid bone
B) extirpation of the fistule and the cyst together with the middle section of the hyoid bone
C) extirpation of the fistule up to the root of the tongue

A

B) extirpation of the fistule and the cyst together with the middle section of the hyoid bone

EXPLANATION
Surgical solution of the median cervical cyst or fistula is the extirpation of it together with the middle section of the hyoid bone, to prevent the recurrence of it.

66
Q

The term “unilateral radical neck dissection” means

A) removal of the metastatic-suspect lymph nodes on one side of the neck
B) removal of all cervical lymph nodes together with sternocleidomastoid muscle and internal jugular vein and nervus accessorius on one side
C) removal of jugular lymph nodes together with the larynx
D) removal of cervical fat tissues and cervical lymph nodes

A

B) removal of all cervical lymph nodes together with sternocleidomastoid muscle and internal jugular vein and nervus accessorius on one side

EXPLANATION
Unilateral radical neck dissection indicates removal of all cervical lymph nodes together with SCM muscle and internal jugular vein and nervus accessorius on the same side.

67
Q

Holzknecht–Jacobson sign indicates that
A) both sides of the lung functions equally
B) an unilateral bronchial foreign body causes the mediastinum move towards the affected side
C) a pulmonary emphysema is present
D) a pulmonary tumor giving radiography signs is detected
E) radiographic contour of the mediastinum is widened

A

B) an unilateral bronchial foreign body causes the mediastinum move towards the affected side

EXPLANATION
‘A unilateral bronchial foreign body causes the mediastinum move towards the affected side, whereas this sign is called Holzknecht-Jacobson.

68
Q

Sensorineural hearing loss may develop after the following viral infections
1) mumps
2) chickenpox
3) rubeola
4) measles
5) serous meningitis
A) the 1st, 2nd and 3rd answers are correct
B) the 1st and 3rd answers are correct
C) the 1st, 4th and 5th answers are correct
D) the 2nd, 3rd and 4th answers are correct
E) the 4th and 5th answers are correct

A

C) the 1st, 4th and 5th answers are correct

EXPLANATIONMumps, measles and serous meningitis can cause sensorineural hearing loss.

STATE (12 decks)

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