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Question 1
Incorrect
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Which of the following inhibit Glucagon?
Your Answer: Arginine
Correct Answer: Uraemia
Explanation:Glucagon release is inhibited by increased blood glucose, ketones, free fatty
acids, insulin, raised urea levels and somatostatin. Glucagon is produced by alpha cells of the pancreas and increases the plasma glucose level by stimulating glycogenolysis and gluconeogenesis. -
This question is part of the following fields:
- Endocrinology
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Question 2
Incorrect
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A 26-year-old pregnant woman in her third trimester, was admitted with headache, abdominal pain and visual disturbances. Shortly after, she had a fit. What is the most appropriate management?
Your Answer:
Correct Answer: 4g MgSO4 in 100ml 0.9% Normal saline in 5 min.
Explanation:The woman is most probably suffering from eclampsia.
Magnesium sulphate (MgSO4) is the agent most commonly used for treatment of eclampsia and prophylaxis of eclampsia in patients with severe pre-eclampsia. It is usually given by either intramuscular or intravenous routes. The intramuscular regimen is most commonly a 4 g intravenous loading dose, immediately followed by 10 g intramuscularly and then by 5 g intramuscularly every 4 hours. The intravenous regimen is given as a 4 g dose, followed by a maintenance infusion of 1 to 2 g/h by controlled infusion pump. -
This question is part of the following fields:
- Obstetrics
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Question 3
Incorrect
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Hypoplasia & yellow discoloration of the primary teeth has occurred in infants whose pregnant mothers were treated with which drug:
Your Answer:
Correct Answer: Tetracycline
Explanation:Tetracycline is a broad-spectrum antibiotic that crosses placental barrier. Tetracycline was the first line of therapy in treating infections caused by Mycoplasma pneumoniae, chlamydia, rickettsia, and some spirochaetes. It has a wide range of adverse effects and is known for a unique property of being incorporated into skeletal and dental tissues at sites of active mineralization and staining of these tissues.
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This question is part of the following fields:
- Pharmacology
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Question 4
Incorrect
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A 21-year-old woman has been stable on medicating with lamotrigine after developing epilepsy 2 years ago. She is planning to conceive but is concerned about what her medications may do to her baby.
Which of the following is considered to reduce the incidence of neural tube defects?Your Answer:
Correct Answer: High dose folic acid for one month before conception and during first trimester
Explanation:CDC urges all women of reproductive age to take 400 micrograms (mcg) of folic acid each day, in addition to consuming food with folate from a varied diet, to help prevent some major birth defects of the baby’s brain (anencephaly) and spine (spina bifida).
The use of lamotrigine during pregnancy has not been associated with an increased risk of neural tube defects; however, the recommendation regarding higher doses of folic acid supplementation is often, but not always, broadened to include women taking any anticonvulsant, including lamotrigine.
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This question is part of the following fields:
- Obstetrics
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Question 5
Incorrect
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A 32 year old women who is 25 weeks pregnant presents with vaginal bleeding and cramping lower abdominal pain. On examination the cervix is closed. Fetal cardiac activity is noted on ultrasound. What is the likely diagnosis?
Your Answer:
Correct Answer: Antepartum Haemorrhage
Explanation:Antepartum haemorrhage is any bleeding that occurs from the female genital tract during the antenatal period after the 24+0 week of pregnancy and prior to the birth of the baby. The most common causes are placenta previa and placental abruption.
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This question is part of the following fields:
- Clinical Management
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Question 6
Incorrect
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Menstrual irregularities and hirsutism affect a 15-year-old girl. All of the syndromes listed below have been linked to obesity in children.
Select the syndrome with which the other clinical symptoms in this patient are most likely to be linked.Your Answer:
Correct Answer: Polycystic ovary syndrome
Explanation:Polycystic ovary syndrome (PCOS) is a condition in which the ovaries produce an abnormal amount of androgens, male sex hormones that are usually present in women in small amounts. The name polycystic ovary syndrome describes the numerous small cysts (fluid-filled sacs) that form in the ovaries. However, some women with this disorder do not have cysts, while some women without the disorder do develop cysts.
The symptoms of PCOS may include:
– Missed periods, irregular periods, or very light periods
– Ovaries that are large or have many cysts
– Excess body hair, including the chest, stomach, and back (hirsutism)
– Weight gain, especially around the belly (abdomen)
– Acne or oily skin
– Male-pattern baldness or thinning hair
– Infertility
– Small pieces of excess skin on the neck or armpits (skin tags)
– Dark or thick skin patches on the back of the neck, in the armpits, and under the breastsThe so-called Laurence-Moon-Biedl syndrome is a fairly rare condition characterized by six cardinal signs, namely obesity, atypical retinitis pigmentosa, mental deficiency, genital dystrophy, polydactylism and familial occurrence.
Froehlich syndrome is characterized by increased or excessive eating that leads to obesity, small testes, and a delay in the onset of puberty. It is also common for children with Froehlich syndrome to experience the delay in physical growth and the development of secondary sexual characteristics.
Cushing’s syndrome is a disorder that occurs when your body makes too much of the hormone cortisol over a long period of time. Cortisol is sometimes called the “stress hormone” because it helps your body respond to stress. Cortisol also helps. maintain blood pressure. regulate blood glucose, also called blood sugar.
Pseudohypoparathyroidism is characterized by short stature, a round face, short neck, and shortened bones in the hands and feet. Intelligence usually ranges from low normal to mentally retarded. Headaches, weakness, tiring easily, lethargy, cataracts and blurred vision or hypersensitivity to light may also be present.
This patient’s condition can only be explained by PCOS. -
This question is part of the following fields:
- Gynaecology
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Question 7
Incorrect
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A patients MSU comes back showing heavy growth of E.coli that is resistant to trimethoprim, amoxicillin and nitrofurantoin. You decide to prescribe a course of Cephalexin. What is the mechanism of action of Cephalexin?
Your Answer:
Correct Answer: inhibit peptidoglycan cross-links in bacterial cell wall
Explanation:Cephalosporins are beta lactum drugs, like penicillin. They act by inhibiting the cross linkage of the peptidoglycan wall in bacteria.
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This question is part of the following fields:
- Clinical Management
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Question 8
Incorrect
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A 25 year-old lady presented with complaints of generalised pruritis during the 3rd trimester of her pregnancy. She was diagnosed as a case of intrahepatic cholestasis of pregnancy. Which one of the following factors carries the greatest risk to the foetus in this disease?
Your Answer:
Correct Answer: Perinatal mortality
Explanation:Intrahepatic cholestasis of pregnancy can affect both mother and foetus, however it is more harmful for the foetus. Amongst foetuses, there is an increased risk of perinatal mortality, meconium aspiration, premature delivery and post partum haemorrhage. Exact cause of fetal death cannot be predicted accurately but it is not related to intra uterine growth retardation or placental insufficiency. The liver can be affected in the mother leading to generalized pruritis but no evidence of fetal hepatic dysfunction has been found.
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This question is part of the following fields:
- Obstetrics
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Question 9
Incorrect
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The following are true for dizygotic twins EXCEPT:
Your Answer:
Correct Answer: Both twins are identical & of the same sex
Explanation:Dizygotic means two (di) fertilized eggs (zygotes). Dizygotic twins occur when two eggs are fertilized by two separate sperm. Dizygotic twins are also known as fraternal or non-identical twins. They are the most common type of twins.
Unlike monozygotic twins (also known as identical twins), dizygotic twins do not share the same genes. Monozygotic twins share 100 percent of each other genes. Dizygotic twins share only 50 percent. This is the same genetic similarity found between siblings conceived and born at different times.
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This question is part of the following fields:
- Genetics
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Question 10
Incorrect
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A 34-year-old woman, gravida 1 para 1, presented to the emergency department complaining of left breast pain six weeks after a spontaneous, uncomplicated term vaginal delivery. She reported having noticed the pain and redness on her left breast a week ago. From her unaffected breast, she continued to breastfeed her infant.
Upon history taking, it was noted that she has no chronic medical conditions and for medication, she only takes a daily multivitamin. Her temperature was taken and the result was 38.3 deg C (101 deg F).
Further observation was done and the presence of an erythematous area surrounding a well-circumscribed, 4-cm area of fluctuance extending from the areola to the lateral edge of the left breast was noted. There was also the presence of axillary lymphadenopathy.
Which of the following is the next step to best manage the condition of the patient?Your Answer:
Correct Answer: Needle aspiration and antibiotics
Explanation:Breast infections can be associated with superficial skin or an underlying lesion. Breast abscesses are more common in lactating women but do occur in nonlactating women as well.
The breast contains breast lobules, each of which drains to a lactiferous duct, which in turn empties to the surface of the nipple. There are lactiferous sinuses which are reservoirs for milk during lactation. The lactiferous ducts undergo epidermalization where keratin production may cause the duct to become obstructed, and in turn, can result in abscess formation. Abscesses associated with lactation usually begin with abrasion or tissue at the nipple, providing an entry point for bacteria. The infection often presents in the second postpartum week and is often precipitated in the presence of milk stasis. The most common organism known to cause a breast abscess is S. aureus, but in some cases, Streptococci, and Staphylococcus epidermidis may also be involved.
The patient will usually provide a history of breast pain, erythema, warmth, and possibly oedema. Patients may provide lactation history. It is important to ask about any history of prior breast infections and the previous treatment. Patients may also complain of fever, nausea, vomiting, purulent drainage from the nipple, or the site of erythema. It is also important to ask about the patient’s medical history, including diabetes. The majority of postpartum mastitis are seen within 6 weeks of while breast-feeding
The patient will have erythema, induration, warmth, and tenderness to palpation at the site in question on the exam. It may feel like there is a palpable mass or area of fluctuance. There may be purulent discharge at the nipple or site of fluctuance. The patient may also have reactive axillary adenopathy. The patient may have a fever or tachycardia on the exam, although these are less common.
Incision and drainage are the standard of care for breast abscesses. If the patient is seen in a primary care setting by a provider that is not comfortable in performing these procedures, the patient may be started on antibiotics and referred to a general surgeon for definitive treatment. Needle aspiration may be attempted for abscesses smaller than 3 cm or in lactational abscesses. A course of antibiotics may be given before or following drainage of breast abscesses.
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This question is part of the following fields:
- Obstetrics
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