CARDIOVASCULAR SYSTEM
1. Following ECG changes occur with hyperkalaemia:
a)
b)
c)
d)
e)
Peaked P waves
Tall tented T waves
Broadening of QRS complex
Absent P waves
Sine wave
2. Effects of left ventricular failure:
a)
b)
c)
d)
e)
Basal rales
Gallop rhythms
Pulsus alternans
Peripheral oedema
Elevated JVP
3. ECG in pulmonary embolism characteristically shows
a)
b)
c)
d)
e)
Sinus bradycardia
ST and T wave changes in V5 and V6
Left axis shift
Changes which may disappear in a few days
Right bundle branch block
4. Characteristic effects of severe aortic stenosis:
a)
b)
c)
d)
e)
Exertional syncope
Loud AS2 sound
BP of 105/50 mmHg
Early closure of aortic valve
Catheter gradient of 60 mmHg across the valve
5. Characteristic effect of Eisenmenger’s syndrome complicating VSD:
a) Development before 20 years old
b) Giant A waves
c) Pulmonary incompetence
d) Differential cyanosis
e) Necessity of surgical correction
f)
6. Prominence of main pulmonary artery on CXR may be seen in
a) VSD
b) Valvular pulmonary stenosis
c) Tertralogy of Fallot
d) Severe mitral stenosis
e) Multiple PE
7. In pure mitral stenosis:
a) S3 heard
b) Apex beat displaced
c) Infective endocarditis is a characteristic complication
d) Females affected more than males
e) Recurrent RTI is an early feature
8. In pure mitral stenosis:
a)
b)
c)
d)
e)
Loud S1
Prominently displaced apex
Opening snap soon after the S2 suggests severe disease
Graham-Steell murmur
Giant V waves
9. The following statements on heart sounds are correct:
a)
b)
c)
d)
e)
Loud S1 in MS suggests a rigid mitral valve
Splitting of S2 occurs normally during inspiration
LBBB results in P2 preceding A2
A2 is normally louder than P2
S3 occurs at the termination of atrial contraction
10. 45 y.o female, non-smoker presented to A&E with chest pain for 2 hrs, no history of
hypertension:
a) IV analgesics are indicated
b) PO aspirin is advised
c) IV thrombolytic treatment is not contraindicated
d) Monitoring of BP and ECG is necessary
e) Patient is allowed home to return in 2 hrs for ECG
11. Characteristic features of subacute bacterial endocarditis:
a)
b)
c)
d)
e)
Heberden’s nodes
Proteinuria
Osler’s nodes
Thrombocytopenia
Conjunctival haemorrhages
12. During CPR,
a)
b)
c)
d)
External cardiac massage must be discontinued during inflation of the lungs
Intubation should be attempted immediately
PE should be treated with IV adrenaline
50 mls of 8.4% sodium bicarbonate should be given as son as central line is
established
e) Ventricular fibrillation associated with hypotension is best treated with IV
lignocaine
13. Following true about hypertension:
a) Thiazide treatment is the choice in elderly
b) Headache and dizziness is the side effects of mild to moderate hypertension
c) There’s more of a chance finding a cause for more severe malignant than in more
benign form
d) Systemic hypertension often requires to treatment
e) Cannot get postural hypotension in patient with previous hypertension
14. Characteristic features of aortic incompetence:
a)
b)
c)
d)
e)
Atrial fibrillation
Heaving apex impulse
Right ventricular failure
BP 145/110 mmHg
Diastolic murmur heard in carotid arteries
15. High risk of thromboembolism in atrial fibrillation:
a) Young patient
b) Cardioversion
16. Mitral stenosis and atrial fibrillation
a)
b)
c)
d)
e)
Past history of chorea
Opening snap on auscultation
Mid-diastolic murmur
Presystolic accentation of murmur
S4 loud
17. In myocardial infarction,
a)
b)
c)
d)
Pericardial effusion rub may occur
ST segment is usually evident on ECG
Prolonged bed rest is essential
Use of digitalis may be dangerous
18. Characters of pure mitral stenosis with atrial fibrillation:
a)
b)
c)
d)
e)
A loud 1st heart sound
Apical pre-systolic murmur
Left ventricular hypertrophy shown by ECG
Increased left atrial pressure on cardiac catheterization
Pulsus paradoxu
19. Subacute bacterial endocarditis can manifest itself as
a)
b)
c)
d)
e)
Cerebrovascular accident
Anaemia
Haematuria
Hypertension
Vasculitis
20. Clubbing can be caused by:
a)
b)
c)
d)
e)
COPD
Cirrhosis
Congenital cyanotic heart disease
Bronchial carcinoma
Bronchiectasis
RESPIRATORY SYSTEM
1. ARDS
a)
b)
c)
d)
e)
May complicate incompatible blood transfusion
May feature combined hypoxia and hypocapnia
Simulates lobar pneumonia on CXR
Is accompanied by increased PCWP
Benefits from application of PEEP
2. Following investigations are indicated in a patient with BHL:
a)
b)
c)
d)
e)
Mantoux test
Kveim test
Serum Ca2+
CT scan
Lung biopsy
3. Cystic fibrosis
a) Results from mutation in CFTR
b) Characterized by decrease in transepithelial electrical potential difference
c) Shows significant clinical response to N-acetyl-cysteine
d) Causes death principally from GI complications
e) Is managed with aerosolized tobramycin to delay pulmonary exacerbations
f)
4. With bronchiectasis,
a) Haemoptysis common
b) Clubbing common
c) CXR commonly confirms diagnosis
d) Coarse crepitations overwhelmed
e) Sympathetic eventually recessing
5. Sister (24 y.o) of a boy diagnosed with CF
a)
b)
c)
d)
Does not have CF because she is asymptomatic
Has 50% chance of being a carrier
Her children have ¼ chance of getting CF
A genetic test exists for diagnosis of CF
6. Hereditary conditions:
a)
b)
c)
d)
e)
Cystic fibrosis
Bronchial carcinoma
Tuberculosis
Kartagener’s syndrome
Atopic asthma
7. In pneumonia consolidation, following statements are correct:
a)
b)
c)
d)
e)
Percussion note is characteristically stony dull
Breath sounds are bronchial
Kerly’s lines are seen in CXR during resolution
Sputum contains Curshmann’s spirals
Cavitation suggests a staphylococcal aetiology
8. Surgery is indicated in bronchial carcinoma if:
a)
b)
c)
d)
e)
Oat cell carcinoma
Lymph node in left supraclavicular
Clubbing
Recurrent haemoptysis
Hoarseness for 3 wks
9. Asthma is favoured against bronchial carcinoma if:
a) Symptoms mainly at night
b) History of asbestos exposure
c) Tracheal deviation to the left
10. In TB:
a) 4 mths of rifampicin, isoniazid, pyrazinamide + 2 mths rifampicin, isoniazid
b) Some of these drugs affect levels of COCP
11. In relation to sarcoidosis, the following are true:
a)
b)
c)
d)
e)
It is a disease characterized by caseating granulomatous inflammation
It is the commonest cause of bilateral hilar lymphadenopathy in Ireland
Hypercalcaemia of sarcoidosis may be exacerbated by sun exposure
Steroids are indicated for athralgia in patients with sarcoidosis
Inhaled steroids may be useful in patients with pulmonary sarcoidosis
12. The following features are consistent with a diagnosis of Horner’s syndrome in a patient
with Pancoast tumour:
a) Ipsilateral ptosis
b) Increased sweating on the affected side
c) Exophthalmos
d) Tongue deviation to the contralateral side
e) Ipsilateral miosis
13. In patient with pleural effusion:
a)
b)
c)
d)
e)
Bronchial breathing may be heard above the effusion
A protein content of 40g/L suggests heart failure may be the cause
Pleural effusion may occur in the patient with an ovarian tumour
Atypical pneumonia is a classical cause of a pleural effusion
Acute pancreatitis may cause a left-sided pleural effusion and ascites may cause a
right sided effusion
14. Bronchial carcinoma is a recognized occupational hazard in the following industries:
a)
b)
c)
d)
e)
Coal mining
Manufacture of coal gas
Asbestos industry
Welding
Manufacture of aniline dyes
15. Young male caretaker in a boarding school presents with prodromal illness followed by
cough and dyspnoea. CXR – shadows in the right lower lobe. The following is
appropriate:
a) FBC and ESR
b) Mycoplasma antibodies
c) Cold agglutinins
16. Features of Brucellosis includes:
a) Phylectenular conjunctivitis
b) Allergic alveolitis
c) Lymphadenopathy
17. An open ward demonstrated tubercle bacillus on several sputum samples. The following
should be done:
a) Transfer patient to a single room
b) Incinerate all his personal clothes
c) Tell his family that it is unlikely that they are infected
d) Arrange skin tests and CXR for family contacts
e) Commence drug therapy before TB culture results are available
GASTROENTEROLOGY
1. A 41 y.o female presenting with DM, pigmentation and hepatomegaly. The following
supports diagnosis of idiopathic HH:
a) History of heavy smoking
b) Serum K+ 6.2 mmol/L, serum Na+ 119 mmol/L
c) Arthropathy of spine
d) Cardiac enlargement
e) Thrombocytosis
f) Cardiac arrhythmias
g) Impotence
h) Hypertension
2. Following statements is about chronic alcoholism:
a) Commoner in males than females
b) Hallucinations during DT – characteristically of visual kind
c) After having abstinent for 1 year 50% able to resume social drinking under
supervision
d) It may be associated with other psychiatric illness e.g. depression
e) Prognosis is worse in males than in females
3. Alcoholic presenting with hepatosplenomegaly and haematemesis:
a)
b)
c)
d)
e)
Bleeding can be assumed to oesophageal varices
Vitamin K will reverse all clotting defects
Presence of blood in GIT may be harmful
Lactulose, magnesium sulfate and neomycin will all be helpful
Features of encephalopathy including fetor and altered consciousness
4. In patient with chronic liver disease,
a)
b)
c)
d)
e)
Increased serum Na+ is typical
Incidence of hepatoma is low
Treatment with a porto-caval shunt increases likelihood of encephalopathy
GI bleeding may precipitate encephalopathy
There is an increased clotting tendency
5. Portal systemic encephalopathy with advanced liver disease may be precipitated by
a)
b)
c)
d)
e)
Eating 200 gm lean chicken
IV glucose
High-dose loop diuretics
Standard dose morphine sulphate
Oral lactulose
6. The following are associated with hereditary haemachromatosis:
a)
b)
c)
d)
e)
Glycosuria
Infertility
Pulmonary emboli
High dietary intake of iron
Hepatocellular carcinoma
7. In hepatic disease:
a) Jaundice is usually present in patients with acute hepatitis
b) Splenic atrophy is associated with portal hypertension
c) Non-alcoholic steatohepatitis (NASH) responds to steroid therapy
8. Associations:
a)
b)
c)
d)
Ulcerative colitis --- dermatitis herpetiformis
MS --- erythema nodosum
Primary biliary cirrhosis --- hyperlipidaemia
Celiac disease --- osteomalacia
9. Extra-intestinal manifestation of IBD include:
a)
b)
c)
d)
e)
Sacroilitis
Erythema nodosum
Syndenham’s chorea
Pyoderma gangrenosum
Neuropathy
10. In ulcerative colitis:
a)
b)
c)
d)
e)
Men and women are equally affected
Rectum is generally spared
Presence of pyoderma gangrenosum relates to disease activity
Increase incidence of both LB and biliary carcinoma
Elemental diets have significant therapeutic benefit in acute relapse
11. Recognized complication of ulcerative colitis:
a)
b)
c)
d)
e)
f)
g)
h)
i)
Aphthous ulceration
Erythema marginatum
Pyoderma gangrenosum
Large bowel lymphoma
Cirrhosis
Carcinoma of colon
Arthritis
Thyroiditis
Pleural effusion
12. Crohn’s disease, as compared to ulcerative colitis, is characterised by:
a)
b)
c)
d)
Perianal abscess
Fistula
Granulomata
Rectum affected
13. Abdominal pain may be caused by:
a)
b)
c)
d)
e)
MI
Mesenteric infarction
Porphyria
Pneumonia
Ureteric calculi
14. Jaundiced patient has urobilinogen but no bile in urine, may have:
a)
b)
c)
d)
e)
Congenital spherocytosis
Carcinoma of head of pancreas
Haemachromatosis
Massive pulmonary embolus
Ascending cholangitis
15. Clinical features of acute hepatitis:
a)
b)
c)
d)
e)
Dislike of cigarettes
Splenomegaly
Glycosuria
Anorexia
Bilirubinuria
16. In hereditary haemachromatosis:
a)
b)
c)
d)
e)
Inheritance is autosomal dominant
Chondrocalcinosis is a recognized feature
Bronze skin pigmentation due to iron deposition
Cardiac failure may be a presenting feature
Hepatoma is an important complication
RENAL MEDICINE
1. In patient with renal impairment and increased urea and creatinine:
a) IV urogram is the best method of visualizing
b) Urinary output is a reliable method of differentiating between acute and chronic
renal failure
c) Haematuria and proteinuria indicate glomerular disease
d) Polycystic kidneys are usually associated with liver disease
2. About renal transplantation:
a) CMV is treated with ganciclovir
b) ADPKD recurs in the graft
c) Azathioprine levels need to be monitored on regular basis
3. Polycystic kidney
a)
b)
c)
d)
Is transmitted as autosomal dominant
Often presents in childhood
Causes hypertension
Is associated with cystic liver disease
4. Renal artery stenosis
a) Is found in up to 50% of patients undergoing peripheral angiopraphy
b) Should be suspected if there is more than 0.5cm difference in kidney size on
ultrasound
c) Typically presents with ‘flash’ pulmonary oedema when unilateral
d) Is associated with hypokalaemia
e) Nearly always progress to complete occlusion
5. Haematuria:
a)
b)
c)
d)
e)
f)
g)
h)
i)
Acute pyelonephritis
Post-streptococcal glomerulonephritis
Obstructive nephropathy
Polycystic kidney disease
Goodpasture’s syndrome
Nephropathy associated with diabetes mellitus
Infective endocarditis
Acute papillary necrosis
Steroid sensitive
6. Advanced renal failure is associated with:
a)
b)
c)
d)
Repeated paracetamol abuse
Hypersplenism
Hyperkalaemia
Pleural effusions
7. Nephrotic syndrome is a well recognized feature of:
a)
b)
c)
d)
e)
Chronic pyelonephritis
Renal papillary necrosis
Thrombosis of renal vein
Proliferative glomerulonephritis
Disseminated lupus erythematosus
8. Excretion urography (IVP) can be diagnostic in:
a)
b)
c)
d)
e)
Chronic pyelonephritis
Acute glomerulonephritis
Renal artery stenosis
Polycystic kidney
Nephrotic syndrome
9. A young male presenting with rigors, dysuria and a 103° pyrexia. What will you do?
a)
b)
c)
d)
MSU, differential WBC, blood culture
IVP before starting treatment
Do not treat with antibiotic before getting culture back
Oral penicillin is the choice of treatment
10. A 75 y.o male with gross painless haematuria:
a)
b)
c)
d)
e)
Should have a rectal examination
May be TB
Should be reassured if IVP is normal
Should be given Vitamin B
Is likely to have renal stenosis
ENDOCRINOLOGY
1. In relation to patients with Type 2 NIDDM:
a) Control of body weight improves glycaemic control
b) Hypertension is more prevalent than in non-diabetic population
c) The earliest indicator of nephropathy is the presence of proteinuria on dipstick
urinalysis
d) Early introduction of ACE-inhibitor therapy may reverse renal disease in patient
with nephropathy
e) Insulin therapy may be required during an intercurrent illness
2. Regarding endocrine disorders:
a) Glucocorticoid therapy in Addison’s disease is a recognized cause of
osteoporosis
b) Galactorrhoea in hyperprolactinaemia
c) Hashimoto’s thyroiditis is usually associated with exophthalmos
d) Conn’s syndrome is associated with DM
3. A 41 y.o male with poorly controlled IDDM Type 1 for about 17 years recently treated
with hypertension complains of swollen feet and ankles. Possible causes are:
a) Diabetic nephropathy
b) Autonomic neuropathy
c) Recurrent hypoglycaemia
d) Insulin allergy
e) Treatment with CCB
4. The following may be of value in the treatment of hirsutism
a) Regular waxing
b) Spironolactone
c) Low-dose dexamethasone at night
5. Diagnosis of insulinoma is suggested by:
a)
b)
c)
d)
e)
Fasting hypoglycaemia
Hypoglycaemia relieved by meals
Hypoglycaemia coming on 1-2 hours after meals
Hepatic disease in an alcoholic
Hypoglycaemia with a very low plasma insulin
6. Complication of DM:
a)
b)
c)
d)
e)
Selective loss of pain and temperature sense in lower limb
Azoospermia in males
Postural hypotension
Fungal infections
Aseptic necrosis of femoral head
7. About insulin:
a)
b)
c)
d)
e)
Synthesized in the pancreas in delta cells
Promotes fat synthesis
Moves K+ into cells
Can cause temporary error of fraction
May cause fat infiltration of liver
8. Administration of the following hormones may induce hyperglycaemia:
a)
b)
c)
d)
Diazoxide
Noradrenaline
Thyroxine
Glucagon
9. Statements:
a)
b)
c)
d)
e)
Connective tissue disease is commonest in middle-aged women
Pretibial myxoedema is seen in thyrotoxicosis
Cushing’s syndrome in female usually give rise to amenorrhoea
Acromegaly may give rise to hypertension
Calcified ascending aorta on CXR suggests syphilis
10. Premature menopause is suggested by
a)
b)
c)
d)
Progesterone withdrawal bleeding
Increased serum prolactin
History of AIDs ???
Increased FSH levels
11. Consequences of irradiation to the neck:
a)
b)
c)
d)
e)
Hypothyroidism
Hyperthyroidism
Thyroid cancer
TSH deficiency
Jugular vein phlebitis
12. Acromegaly is associated with:
a)
b)
c)
d)
e)
Galactorrhoea
Connective tissue diseases
Insulin hypersensitivity
Homonymous hemianopia
Deep furrows of brows
NEUROLOGY
1. Motor neurone disease
a) Is a progressive, neurodegenerative disease involving mainly the spinothalamic
tracts
b) Is predominantly a disease affecting the females
c) Repiratory muscles involvement is unusual
d) Is typically associated with progressive cognitive impairment
e) Prognosis is usually in the order of 3-5 year survival
2. Dementia:
a)
b)
c)
d)
Most common cause is vascular
Short term memory usually remain intact
Cholinesterase inhibitors can/ should not be given in severe cases
Sudden deterioration of cognitive function
3. Parkinson’s:
a)
b)
c)
d)
Alt (alternating/alternative???) defects in dopaminergic transmission
Tardive dyskinesia is typical
Cogwheel rigidity is a feature
Pill-rolling tremor is characteristic
4. Immediately following an ischaemic stroke:
a)
b)
c)
d)
e)
Hypertension should always be aggressively treated
Patient may have a flaccid paralysis
ECG should always be performed
An absent gag reflex is an indication for PEG insertion
Patient with atrial fibrillation should always be on anticoagulant
5. The following associations are correct:
a)
b)
c)
d)
e)
Fracture of middle cranial fossa --- Battle’s sign
Fracture of anterior cranial fossa --- raccoon eyes
Extradural haematoma --- middle meningeal arterial haemorrhage
Subarachnoid haemorrhage --- meningism
Subdural haematoma --- hydrocephalus
6. On waking, a 34 y.o female complains of diplopia. She was found to have external
deviation of the left eye with dilated pupil on the same side. You would:
a) Be surprised to find ipsilateral ptosis of the eyelid
b) Be surprised if the left pupil constricted when the light shone on the left eye
c) Include DM in the differential diagnosis
d) Exclude infection from differential diagnosis
e) Be surprised to hear a bruit on listening with the stethoscope placed over the left
eye
RHEUMATOLOGY
1. A patient presents with a tender swollen knee:
a) An x-ray of the joint is likely to be abnormal if aseptic arthritis is present
b) The finding of bony swelling at the distal interphalangeal joints is suggestive of
osteoarthritis
c) A diagnosis of gout is made only if serum uric acid is elevated
d) A previous history of dysentery and the presence of conjunctivitis are suggestive
of Reiter’s syndrome
e) A diagnosis of SLE requires the presence of anti double-stranded DNA
antibodies
2. Ankylosing spondylitis:
a)
b)
c)
d)
e)
Occurs more commonly in females more than 40 y.o
Is significantly associated with the presence of HLA-B27 antigen
May present with sciatica
May be complicated with arthropathy affecting the hips
May be complicated by iritis
3. In rheumatoid arthritis:
a)
b)
c)
d)
ESR is a good index for disease activity
Renal lesions commonly occur
Nodules may occur over bony prominences
Osteoporosis is a common radiological finding adjacent to affected joint
4. Sacroiliac involvement is commonly found in the arthropathy of:
a)
b)
c)
d)
e)
Ankylosing spondylitis
Reiter’s syndrome
Gout
Rheumatoid arthritis
Ulcerative colitis
5. Rheumatoid arthritis:
a)
b)
c)
d)
Typically worst in the mornings
Hoarseness
Reduced breath sounds at the base
Nodules on the flexor aspect of arms
INFECTIOUS DISEASE
1. In a patient with a suspected diagnosis of HIV infection:
a) Antibody tests are diagnostic in the seroconversion phase
b) Absence of a history of IV drug abuse, blood transfusion, homosexuality and
haemophilia makes a diagnosis of HIV highly unlikely
c) HIV RNA levels are more predictive of prognosis than CD4 counts
d) Pneumocystis carinii pneumonia is more likely when a CD4 count is less than
200/mm3
e) Anti-retroviral therapy is reserved for late stage disease to avoid the development
of drug resistance
2. Infectious mononucleosis:
a)
b)
c)
d)
Spontaneous splenic rupture may occur
Severe exudative pharyngitis is a recognized feature
There is a 6 months incubation period
Rose spots on the abdomen are diagnostic
3. In patients who present with sore throat:
a)
b)
c)
d)
e)
70% caused by β-haemolytic strepcoccal infection
Penicillin V is effective in reducing non-suppurative complications
More severe clinical features are indicative of bacterial infection
Influenza vaccination appears to reduce incidence
Ibuprofen is of proven benefit
4. Measles:
a)
b)
c)
d)
e)
f)
No longer infected after the rash has faded
Can cause severe pneumonia in adults
Causes a rash which typically starts behing the ears and on the forehead
Causes minute patches of necrosis on the buccal mucosa
Can be followed by a subacute sclerosing panencephalitis after apparent recovery
Is characterized by suboccipital lymph nodes
5. Parasites are found in bucca (cheek) of patients suffering fr
a) Lyme disease
b) Schistosoma japonicum
c) Trypansomiasis cruzi (Chaga’s disease)
DERMATOLOGY
1. A female presented with a facial rash for 4 weeks:
a)
b)
c)
d)
e)
A history compatible with rosacea
Psoriasis could be a cause
Trial of oral steroids is advised
H2-antagonist could be a cause
Photosensitivity rash is a possible cause
2. Psoriasis:
a)
b)
c)
d)
e)
Scalp rarely affected
There is hereditary predisposition
Rash usually dry and scaly
Rash always aggravated by sunlight
Pitting nails can be seen
3. Statements:
a)
b)
c)
d)
e)
Warts are caused by virus
Plantar warts (verrucae) should be treated by radiotherapy
Impetigo is not contagious
Hodgkin’s disease can cause pruritus
Scabies is not contagious
4. Characteristic lesions of psoriasis include:
a)
b)
c)
d)
e)
Pitting of nails
Ulcerating lesions in skin flexures
Avoidance of direct sunlight may improve lesions
Arthropathy which spares the spine
Associated with HLA-B87
5. In adult, following are recognized cutaneous manifestations of internal malignant
neoplasia or reticulosis:
a) Dermatomyositis
b) Acquired ichthyosis
c) Acanthosis nigrans
d) Lichen planus
e) Herpes zoster
HAEMATOLOGY
1. A 25 y.o male presented with sore throat for 4-5 days. On examination, his temperature
was 38°C, his tonsils were enlarged and inflamed, and bilateral axillary, supraclavicular
and inguinal lymph nodes tenderness.
a) Chronic myeloid leukaemia
b) Infectious mononucleosis
c) Acute toxoplasmosis
d) Chicken pox
e) HIV infection
2. Groin lymphadenopathy may occur with:
a)
b)
c)
d)
e)
Cancer of the anus
Uterine and cervical cancer
Testicular neoplasm
Cellulitis of the lower limb
Lymphoma
3. Anaemia of chronic disease is associated with:
a)
b)
c)
d)
e)
Low ESR
Decreased serum iron
Decreased utilization of iron
No response to oral iron
Decreased serum transferring
4. Haemolytic anaemia:
a)
b)
c)
d)
e)
Excess urobilinogen is present in urine
Itching is a feature
Coomb’s test may be positive
Red cell fragility may be increased
Faeces pale
5. Haemolytic anaemia is a feature of:
a)
b)
c)
d)
e)
Malaria
Tropical sprue
Hookworm disease
Thalassaemia
Brucellosis
BIOCHEMISTRY
1. Hypercalcaemia of malignancy:
a)
b)
c)
d)
e)
May present with confusion and impaired cognition
Often confused with opioid overdose
Indicator of poorer prognosis
Should be managed with fluid restriction
Associated with myeloma
2. Hypokalaemia may be associated with:
a)
b)
c)
d)
e)
Administration of insulin
Conn’s syndrome
Addison’s disease
Diarrhoea
Terminal stages of chronic renal failure
DRUGS
1. Side effects:
a)
b)
c)
d)
Fine crackles at lung bases --- methotrexate
Ataxia --- anticonvulsants
Myalgia --- statins
Tinnitus --- paracetamol
2. Verapamil:
a)
b)
c)
d)
e)
Inhibit Na/K ATP-ase
Causes hyperkalaemia
May be used to treat ventricular tachycardia at an arrest
Is a negative inotrope
Should be given IV quickly for maximum therapeutic effect
3. Drugs and common indications for their use:
a)
b)
c)
d)
e)
ACE-inhibitor and left ventricular failure
β-blockers and asthma
N-acetylcysteine and tricyclic antidepressant overdose
Verapamil and ventricular tachycardia
Bisphosphonates and hypercalcaemia of malignancy
4. Ototoxicity is an important adverse effect of
a)
b)
c)
d)
e)
Salicylates
Nitrofurantoin
Aminoglycoside
Furosemide
Atropine
Contraindication to β-blockers:
f) Raynaud’s phenomenon
g) Atrial fibrillation in thyrotoxicosis
h) Wolff-Parkinson-White syndrome
i) Asthma
j) Parkinson’s disease
5. Overdose:
a) Invariably involves alcohol as well
b) Opiates --- pin-point pupils
c) Naloxone --- reverse opiates
6. High dose steroid treatment causes
a)
b)
c)
d)
e)
PUO
Osteoporosis
Adrenal adenoma
Adrenal suppression
Peptic ulceration
7. Propanolol causes
a)
b)
c)
d)
e)
Increased cardiac output
Hypotension
Bronchodilation
Abolishes arrhythmia induced by digitalis
Tachycardia