word file questions

7/23/2019 word file questions

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1-Theme:Substance abuse.

A Amnestic disorder

B Anxiety disorder

CHallucinogen persisting perception

disorder

D Intoxication

E Intoxication delirium

F Psychotic disorder

G Mood disorder

H Withdrawl

I Withdrawl delirium

For each scenario choose the most likely diagnosis

A !"#year#old boy presents with deteriorating school per$ormance. He seems withdrawn%unenthusiastic and irritable.

&orrect

'his !"#year#old boy has $eatures o$ depression # mood disorder # with a withdrawna$$ect being typical.

A !(#year#old girl presents acutely with )isual disturbance. She describes distressing imageso$ colour$ul ob*ects with mo)ing trails.

&orrect

'he !(#year#old girl has )isual hallucinations% most likely due to +$lashbacks+ topre)ious substance abuse. 'his may be associated with drug abuse. Psychoticdisorder is unlikely as )isual hallucinations would not be expected.


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A !,#year#old boy is brought to casualty% ha)ing been $ound at the side o$ the road. Heresponds to )oice but appears ataxic.

&orrect

'he !,#year#old boy is intoxicated. In children o$ any age with unexplainedneurological symptoms or signs% drugs or alcohol should be suspected.

Substance abuse is an increasing problem in schools% and may present toeducational% social% medical or law en$orcement agencies. 'hey may triggersymptoms o$ mood or psychosis% and may be con$used with these conditions.

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2#A !-#year#old $emale presents a$ter taking an o)erdose o$ hergrandmothers medication.

In)estigations re)ealed a serum potassium o$ mmol/0 1,.(#".23.

Which one o$ the $ollowing drugs is the most likely cause o$ this abnormality4

1Please select ! option3

Aspirin

5igoxin Incorrect answer selected

Fluoxetine

6mepra7ole

Propranolol 'his is the correct answer

8etablockers% particularly propranolol% in o)erdose can cause hyperkalaemia

by transmembrane shi$ts. It is use$ul to think o$ the opposite # beta#agonistssuch as salbutamol are $ar more widely known to cause hypokalaemia.

6)erdose o$ digoxin therapy most commonly mani$ests as rhythmdisturbance% and may be exacerbated by hyper# or hypokalaemia. Salicylateo)erdose causes metabolic acidosis and respiratory alkalosis.

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3-Theme:In)estigation o$ Short stature.

A 8one age

B &hromosomal studies

C &oeliac screen

D &ortisol pro$ile

E9rowth hormone stimulation

tests

F I9F#!

G :enal biochemistry

H 'hyroid $unction tests

I ;rinalysis

For each scenario choose the most important

A ,#year#old girl presents with short stature. She is otherwise in good health. She is on the


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A #year#old boy presents with short stature. He is on the $or height and below the


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'he "#year#old boy has a midline mass. 'he di$$erential lies between thryoglossalcyst% goitre% dermoid cyst% teratoma or laryngocoele. 'he clinical presentationsuggests an in$ected thyroglossal cyst.

A < day old in$ant presents with large transilluminating mass in the right posterior triangle o$the neck.

&orrect

'he < day old in$ant has mass in the posterior triangle which transilluminates. Acystic hygroma is likely.

A < week old in$ant is noted to keep her head to the le$t. 6n examination she has a palpablelump in the le$t side o$ the neck.

&orrect

'he < week old in$ant has a $irm mass in the body o$ sternocleidomastoid associatedwith decreased head mo)ement to the contralateral side% a sternomastoid tumour.'his responds to stretching exercises.

?eck masses may be congenital or ac@uired. &ongenital masses may be in themidline% in the anterior triangle% posterior triangle% body or sternocleidomastoid oranywhere. Masses in the anterior triangle represent branchial cle$t cysts.Haemangiomas can occur anywhere% but are easily identi$ied by their so$t% spongyred characteristics.

6n examination o$ neck swellings...

5-Theme:Abdominal pain.

A Abdominal migraine

B Familial Mediterranean $e)er
http://www.gpnotebook.com/simplepage.cfm?ID=758448132&linkID=23528&cook=yeshttp://www.gpnotebook.com/simplepage.cfm?ID=758448132&linkID=23528&cook=yes


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C 9astro#oesophageal re$lux

D 9iardiasis

E In$lammatory bowel disease

F Meckels di)erticulum

G Pancreatitis

H Peptic ulcer disease

I:ecurrent abdominal pain o$

childhood

For each scenario choose the most likely diagnosis

A 2 month old boy presents with abdominal pain and black o$$ensi)e stools. 6n examination heappears pale.

&orrect

In the 2 month old boy the ma*or symptom is melaena. 'he pallor suggestssigni$icant bleeding. At this age the most likely diagnosis is Meckels di)erticulum.

A !


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Incorrect # 'he correct answer is Familial Mediterranean $e)er

'he ,#year#old boy has recurrent episodes o$ abdominal pain% $e)er and arthritis.'here is hepatomegaly. All these point to Familial Mediterranean Fe)er.

6-Theme:&onnecti)e tissue disorders.

A &amurati#Bngelmann syndrome

B Bhler#5anlos syndrome

C 8eals syndrome

DFibrodysplasia ossi$icans

congenita

E Homocystinuria

F Mar$an syndrome

G 6steogenesis imper$ecta type !

H 6steogenesis imper$ecta type and

se)ere !> . Haemarthrosis causes chronic de$ormities. 8leeding $rom themuscles and *oints results % rather than $rom the skin and umbilicus. Multipletrans$usions o$ blood products ha)e lead to the de)elopment o$ trans$usionrelated hepatitis and HID in many a$$ected patients. 'he patients may bemanaged at home with sel$ administration o$ recombinant $actor DIII therapyand aggressi)e haemostasis.

What exactly is Haemophilia A4...

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14#A !


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What are peptic ulcers and how are they treated4...

15#'reatment o$ salicylate poisoning may include

True / False

Bncouraging a high $luid intake &orrect

Forced acid diuresis &orrect

Ditamin G administration &orrect

9astric la)age 'his is the correct answer

Sodium bicarbonate &orrect

'reatment o$ children with Salicylate poisoningincludes A8& as re@uired. 9astricla)age is re@uired. 8lood le)els are o$ten misleading especially i$ enteric coatedtablets ha)e been taken. It is important to monitor the urine )olume and ph at alltimes. A $orced alkaline diuresis is induced with a bicarbonate in$usion. &orrection o$dehydration and maintenance is calculated with haemodialysis in se)ere cases.In thee)ent o$ a coagulopathy Ditamin G administration may be necessary.

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16#Sodium Dalproate

True / False

Is e$$ecti)e in treating petit mal &orrect

6$ten causes hyperacti)ity in children &orrect

May prolong the bleeding time &orrect

0e)els abo)e the therapeutic range may be tolerated without side e$$ects

Incorrect answer selected

Is the drug o$ choice in controlling epilepsy in pregnancy Incorrect answer

selected

Sodium )alproateis used $or the treatment o$ all $orms o$ epilepsy includingabsences. Hyperacti)ity and beha)ioural problems are listed in recognised sidee$$ects howe)er are )ery rarely seen. Plasma )alproate le)els are unhelp$ul.'heremay be dose related side e$$ects and le)els abo)e the therapeutic index may betolerated without symptoms. 'here is a potential $or prolonged bleeding as )alproatecan cause thrombocytopaenia as well as inhibition o$ platelet aggregation.0i)erdys$unction may also occur.'here is a risk o$ teratogenic side e$$ects with anti
http://hcd2.bupa.co.uk/fact_sheets/html/Peptic_ulcer.htmlhttp://www.emedicine.com/med/topic2057.htmhttp://en.wikipedia.org/wiki/Valproic_acidhttp://hcd2.bupa.co.uk/fact_sheets/html/Peptic_ulcer.htmlhttp://www.emedicine.com/med/topic2057.htmhttp://en.wikipedia.org/wiki/Valproic_acid


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con)ulsant therapy and there is a particular association o$ neural tube de$ects withthe use o$ sodium )alproate.Patients should be counselled and in$ormed and thetreatment changed 10amotrigine is an alternati)e3.

17#&alcitonin

True / False

is a polypeptide hormone &orrect

is secreted by the thyroid epithelial cells Incorrect answer selected

secretion is increased by a $all in serum calcium concentration &orrect

inhibits bone resorption &orrect

is secreted in excess in patients with medullary carcinoma o$ the thyroid.

Incorrect answer selected

&acitoninis a peptide hormone released $rom the & cels o$ the thyroid in response tohypercalcaemia. Its hypocalcaemic e$$ects are mediated by pre)enting boneresorption by osteoclasts.

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18-Theme:Paediatric accident and emergency

A ,

B "

C (

D

E -

F

G 2

H!

=
http://en.wikipedia.org/wiki/Calcitoninhttp://en.wikipedia.org/wiki/Calcitonin


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I!

!

$!

.

6n examination she is apyrexial% well and well per$used. Her respiratorydistress and grunting resol)e o)er the next !< hours% and she is out o$oxygen by the next morning.

What is the most likely diagnosis4

1Please select ! option3

&ongenital diaphragmatic hernia

&ongenital pneumonia

Meconium aspiration

Sur$actant#de$icient lung disease

'ransient tachypnoea o$ the newborn &orrect

'he history is o$ &S deli)ery and transient respiratory distress with low 6

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