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  • Question 1 - Which among the following is most likely to be beneficial to a patient...

    Incorrect

    • Which among the following is most likely to be beneficial to a patient with schizophrenia?

      Your Answer: Adherence therapy

      Correct Answer: Cognitive behavioural therapy

      Explanation:

      Among the given options, cognitive-behavioural therapy is the most likely to benefit a patient with schizophrenia.

      Schizophrenia is a functional psychotic disorder characterized by the presence of delusional beliefs, hallucinations, and disturbances in thought, perception, and behaviour.

      Clinical features:
      Schneider’s first-rank symptoms may be divided into auditory hallucinations, thought disorders, passivity phenomena, and delusional perceptions:

      Auditory hallucinations of a specific type:
      Two or more voices discussing the patient in the third person
      Thought echo
      Voices commenting on the patient’s behaviour

      Thought disorder:
      Thought insertion
      Thought withdrawal
      Thought broadcasting

      Passivity phenomena:
      Bodily sensations being controlled by external influence
      Actions/impulses/feelings – experiences which are imposed on the Individual or influenced by others

      Other features of schizophrenia include
      Impaired insight (a feature of all psychoses)
      Incongruity/blunting of affect (inappropriate emotion for circumstances)
      Decreased speech
      Neologisms: made-up words
      Catatonia
      Negative symptoms: incongruity/blunting of affect, anhedonia (inability to derive pleasure), alogia (poverty of speech), avolition (poor motivation).

      Treatment:
      For the initial treatment of acute psychosis, it is recommended to commence an oral second-generation antipsychotics such as aripiprazole, olanzapine, risperidone, quetiapine, etc.
      Once the acute phase is controlled, switching to a depot preparation like aripiprazole, paliperidone, zuclopenthixol, fluphenazine, haloperidol, pipotiazine, or risperidone is recommended.
      Cognitive-behavioural therapy (CBT) and the use of art and drama therapies help counteract the negative symptoms of the disease, improve insight, and assist relapse prevention.
      Clozapine is used in case of treatment resistance.

    • This question is part of the following fields:

      • Psychiatry
      20.3
      Seconds
  • Question 2 - Which of the following is most consistent with small cell lung cancer? ...

    Incorrect

    • Which of the following is most consistent with small cell lung cancer?

      Your Answer: hypercalcemia is commonly seen

      Correct Answer: hypertrophic pulmonary osteoarthropathy is rarely seen

      Explanation:

      The clinical manifestations of Small cell lung cancer (SCLC) can result from local tumour growth, intrathoracic spread, distant spread, and/or paraneoplastic syndromes.
      Hypertrophic pulmonary osteoarthropathy (HPO) is a rare paraneoplastic syndrome that is frequently associated with lung cancer; however, the incidence of clinically apparent HPO is not well known.
      SIADH is present in 15% of cases and most commonly seen.
      Although hypercalcaemia is frequently associated with malignancy, it is very rare in small cell lung cancer despite the high incidence of lytic bone metastases.
      Ectopic Cushing’s syndrome in SCLC does not usually exhibit the classic signs of Cushing’s syndrome and Cushing’s syndrome could also appear during effective chemotherapy.
      Chemotherapy is the treatment of choice in SCLC.

    • This question is part of the following fields:

      • Endocrinology
      8.4
      Seconds
  • Question 3 - A 65 yr. old male patient presented with acute severe central chest pain...

    Correct

    • A 65 yr. old male patient presented with acute severe central chest pain for one hour. His ECG confirmed the diagnosis of acute ST elevation myocardial infarction and he was treated with thrombolysis. Two days later he developed sudden onset breathlessness and became unwell. On examination he had bibasal crepitation and a systolic murmur at the apex which radiated to the axilla. Which of the following is the most likely cause for this presentation?

      Your Answer: Ruptured papillary muscle

      Explanation:

      The most likely cause for acute breathlessness is due to papillary muscle rupture which causes mitral regurgitation.

    • This question is part of the following fields:

      • Cardiology
      13.6
      Seconds
  • Question 4 - Which of the following statements regarding restless leg syndrome is not true? ...

    Incorrect

    • Which of the following statements regarding restless leg syndrome is not true?

      Your Answer: Movements may be seen during sleep

      Correct Answer: It is three times as common in females

      Explanation:

      In restless leg syndrome (RLS), males and females are thought to be equally affected. RLS is a syndrome of spontaneous, continuous lower limb movements that may be associated with paraesthesia. It is extremely common, affecting between 2-10% of the general population and a family history may be present.

    • This question is part of the following fields:

      • Neurology
      6.7
      Seconds
  • Question 5 - An 83-year-old gentleman presents to his GP with increasing oedema and ascites. He...

    Incorrect

    • An 83-year-old gentleman presents to his GP with increasing oedema and ascites. He is hypertensive, for which he takes amlodipine. There is shortness of breath on exercise. His alcohol history is two cans of stout per day.   ECG is normal, and CXR reveals normal heart size and no signs of cardiac failure. Serum albumin is 23 g/dl; urinary albumin excretion is 7 g/24 h, with no haematuria. He has mild anaemia with a normal MCV. Total cholesterol is elevated.   What diagnosis fits best with this clinical picture?

      Your Answer: Polyarteritis nodosa

      Correct Answer: Nephrotic syndrome

      Explanation:

      Nephrotic syndrome usually presents with the symptoms in this patient: low albumin, abnormal cholesterol, increased urinary albumin excretion, oedema, and as a consequence, hypertension as well.

    • This question is part of the following fields:

      • Nephrology
      14.2
      Seconds
  • Question 6 - A 17-year-old girl presented with fever, headache and photophobia. Cerebrospinal fluid examination reveals:...

    Incorrect

    • A 17-year-old girl presented with fever, headache and photophobia. Cerebrospinal fluid examination reveals: Opening pressure 260 mm H20 (50-180) Total protein 0.8 g/l (0.15-0.45) Glucose 4.2 mmol/l (3.3-4.4) White cell count 60 per ml (<5) Lymphocytes 90% Plasma glucose 6.4 mmol/l (3.0-6.0) Which of the following is the most likely diagnosis?

      Your Answer: Tuberculosis meningitis

      Correct Answer: Viral meningitis

      Explanation:

      Normal cerebrospinal fluid (CSF) glucose together with lymphocytosis, an increased opening pressure and raised CSF protein are typical of a viral meningitis.

    • This question is part of the following fields:

      • Neurology
      153.2
      Seconds
  • Question 7 - A 45-year-old male patient presents with severe pharyngitis and dysphagia. He's found to...

    Correct

    • A 45-year-old male patient presents with severe pharyngitis and dysphagia. He's found to be HIV positive and with oesophageal candidiasis. Which of the following regarding HIV virus is correct?

      Your Answer: HIV is an RNA virus

      Explanation:

      The human immunodeficiency virus (HIV) is grouped to the genus Lentivirus within the family of Retroviridae, subfamily Orthoretrovirinae. The HIV genome consists of two identical single-stranded RNA molecules that are enclosed within the core of the virus particle. The genome of the HIV provirus, also known as proviral DNA, is generated by the reverse transcription of the viral RNA genome into DNA, degradation of the RNA and integration of the double-stranded HIV DNA into the human genome.

    • This question is part of the following fields:

      • Clinical Sciences
      9.9
      Seconds
  • Question 8 - A 34-year-old man was brought to the ER following a road-traffic-accident. An X-ray...

    Correct

    • A 34-year-old man was brought to the ER following a road-traffic-accident. An X-ray of his left thigh revealed a fractured shaft of the left femur. He has a known history of opioid abuse. You are called to the ward to assess him after he becomes unwell. Which of the following clinical features are NOT compatible with a diagnosis of opioid withdrawal?

      Your Answer: Hypothermia

      Explanation:

      Among the options provided, hypothermia is not a symptom of opioid withdrawal.

      Symptoms of opioid withdrawal include dysphoric mood, yawning, insomnia, muscle aches, lacrimation/rhinorrhoea, papillary dilatation, piloerection, fever, sweating, nausea/vomiting, diarrhoea.
      If the patient is having an opioid withdrawal reaction, then give 10 mg of methadone syrup and wait about 60 min to determine its effect.

      COWS (Clinical Opioid Withdrawal Scale) assessment for opioid withdrawal is commonly used to determine the severity of opioid withdrawal.

    • This question is part of the following fields:

      • Pharmacology
      6.4
      Seconds
  • Question 9 - Which of the following is not a risk factor for primary open-angle glaucoma?...

    Correct

    • Which of the following is not a risk factor for primary open-angle glaucoma?

      Your Answer: Hypermetropia

      Explanation:

      Acute angle closure glaucoma is associated with hypermetropia, whereas primary open-angle glaucoma is associated with myopia. Glaucoma is a group of eye disorders characterised by optic neuropathy due, in the majority of patients, to raised intraocular pressure (IOP). It is now recognised that a minority of patients with raised IOP do not have glaucoma and vice versa.

    • This question is part of the following fields:

      • Ophthalmology
      11.8
      Seconds
  • Question 10 - Which one of these features is typical of dermatomyositis? ...

    Correct

    • Which one of these features is typical of dermatomyositis?

      Your Answer: Gottron's papules over knuckles of fingers

      Explanation:

      The main symptom of dermatomyositis include skin rash and symmetric proximal muscle weakness (in over 90% of patients) which may be accompanied by pain and tenderness. It occurs more commonly in females. Skin findings include:
      Gottron’s sign – an erythematous, scaly eruption occurring in symmetric fashion over the MCP and interphalangeal joints
      Heliotrope or lilac rash – a violaceous eruption on the upper eyelids and in rare cases on the lower eyelids as well, often with itching and swelling
      Shawl (or V-) sign is a diffuse, flat, erythematous lesion over the back and shoulders or in a V over the posterior neck and back or neck and upper chest, which worsens with UV light.
      Erythroderma is a flat, erythematous lesion similar to the shawl sign but located in other areas, such as the malar region and the forehead.
      Periungual telangiectasias and erythema occur.

    • This question is part of the following fields:

      • Dermatology
      42.7
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Psychiatry (0/1) 0%
Endocrinology (0/1) 0%
Cardiology (1/1) 100%
Neurology (0/2) 0%
Nephrology (0/1) 0%
Clinical Sciences (1/1) 100%
Pharmacology (1/1) 100%
Ophthalmology (1/1) 100%
Dermatology (1/1) 100%
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