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  • Question 1 - A 14-year-old girl presents with primary amenorrhoea. She is an athlete who is...

    Correct

    • A 14-year-old girl presents with primary amenorrhoea. She is an athlete who is currently training for a national athletics championship.What is the best treatment option for her?

      Your Answer: Adequate diet and observation

      Explanation:

      Intensive physical training and participation in competitive sports during childhood and early adolescence may affect athletes’ pubertal development.Female athletes who do not begin secondary sexual development by the age of 14 or menstruation by the age of 16 warrant a comprehensive evaluation and treatment.Since she is still 14, adequate diet and observation are enough.

    • This question is part of the following fields:

      • Endocrinology
      31.8
      Seconds
  • Question 2 - A 17-year-old girl presents to the clinic complaining of dry skin and amenorrhoea...

    Correct

    • A 17-year-old girl presents to the clinic complaining of dry skin and amenorrhoea for the past 9 months. She goes to college and is performs well academically. Physical examination shows an underweight girl (weight 38 kg), height 1.78 m (5 ft 10 inches). Excessive small hair can be seen growing on the body. Labs are significant for an elevated cortisol level, normal T4 level, and anaemia associated with reduced WBCs and platelets. Based on this clinical picture, what is the most likely cause of her symptoms?

      Your Answer: Anorexia nervosa

      Explanation:

      Anorexia nervosa is an eating disorder defined by restriction of energy intake relative to requirements, leading to a significantly low body weight. Patients will have an intense fear of gaining weight and distorted body image with the inability to recognize the seriousness of their significantly low body weight. Athletes in sports such as ballet, long-distance running, and martial arts are pressured to maintain lean body weights to outperform the competition.

    • This question is part of the following fields:

      • Endocrinology
      191.1
      Seconds
  • Question 3 - A pathologist is examining a histological section and identifies Hassall's corpuscles.With what are...

    Incorrect

    • A pathologist is examining a histological section and identifies Hassall's corpuscles.With what are they most commonly associated?

      Your Answer: Medulla of the kidney

      Correct Answer: Medulla of the thymus

      Explanation:

      Hassall’s corpuscles are groups of epithelial cells within the thymic medulla. The physical nature of these structures differs between mammalian species. Although Hassall’s corpuscles have been proposed to act in both the removal of apoptotic thymocytes and the maturation of developing thymocytes within the thymus, the function of Hassall’s corpuscles has remained an enigma.

    • This question is part of the following fields:

      • Haematology And Oncology
      21.3
      Seconds
  • Question 4 - A 20-year-old female was brought to the emergency department. Her presentation was highly...

    Incorrect

    • A 20-year-old female was brought to the emergency department. Her presentation was highly suggestive of meningitis. Direct ophthalmoscopy revealed no signs of papilledema. Thus, she was planned for a lumbar puncture. What is the structure first encountered while inserting the needle?

      Your Answer: Dural sheath

      Correct Answer: Supraspinous ligament

      Explanation:

      During lumbar puncture, the first structures encountered by the needle are skin and subcutaneous tissue. But, since they are not provided in the options, the most superficial structure after them is the supraspinous ligament.Lumbar puncture is a procedure performed to obtain cerebrospinal fluid. The procedure is best performed at the level of L3/L4 or L4/5 interspace. During the procedure, the needle pierces the following structures in order from superficial to deep: Skin, subcutaneous tissue, supraspinous ligament, interspinous ligament, ligamentum flavum, the epidural space containing the internal vertebral venous plexus, dura, and arachnoid, finally entering the subarachnoid space. The supraspinous ligament connects the tips of spinous processes and the interspinous ligaments between adjacent borders of spinous processes.As the needle penetrates the ligamentum flavum, it causes a give. A second give is felt when the needle penetrates the dura mater and enters the subarachnoid space. At this point, clear CSF flows through the needle and can be collected for diagnostic purposes.

    • This question is part of the following fields:

      • Emergency Medicine
      56.1
      Seconds
  • Question 5 - A woman gives birth to a baby at 36 weeks of gestation through...

    Incorrect

    • A woman gives birth to a baby at 36 weeks of gestation through spontaneous, vaginal delivery. She had rupture of membranes 30 hours before birth, however looked healthy and did not receive antibiotics. On admission, doctors obtained a vaginal swab. Which of the following is the most appropriate management for the baby?

      Your Answer: Perform an infection screen and treat with intravenous antibiotics if results suggestive of sepsis

      Correct Answer: Perform an infection screen and treat with intravenous antibiotics for at least 48 hours pending results

      Explanation:

      Doctors must perform an infection screen and treat with intravenous antibiotics for at least 48 hours pending results to prevent neonatal sepsis. Risk factors for neonatal sepsis include rupture of the membranes. Risk factors for neonatal sepsis include rupture of membranes greater than 12-24 hours, intrapartum maternal pyrexia (> 38°C), fetal tachycardia, chorioamnionitis, pre-term birth and maternal colonisation with group B Streptococcus. In this case there are two risk factors: prolonged rupture of membranes, and pre-term birth.

    • This question is part of the following fields:

      • Neonatology
      104.2
      Seconds
  • Question 6 - According to NICE guidelines, which of the following factors pose an increased risk...

    Incorrect

    • According to NICE guidelines, which of the following factors pose an increased risk of severe hyperbilirubinemia?

      Your Answer: Gestation < 34 weeks

      Correct Answer: History of a previous sibling requiring phototherapy for jaundice

      Explanation:

      Identify babies as being more likely to develop significant hyperbilirubinemia if they have any of the following factors:- gestational age under 38 weeks- a previous sibling with neonatal jaundice requiring phototherapy- mother’s intention to breastfeed exclusively- visible jaundice in the first 24 hours of life.

    • This question is part of the following fields:

      • Neonatology
      27.1
      Seconds
  • Question 7 - A 6 month old baby can squeeze an object against his palm, can...

    Incorrect

    • A 6 month old baby can squeeze an object against his palm, can vocalize and can sit with support. But he cannot hold objects between his index finger and the thumb. He cannot sit without support and he doesn't have stranger fear. Which of the following is correct regarding his development?

      Your Answer: Delayed motor milestones

      Correct Answer: Normal development

      Explanation:

      Children are able to use a palmar grasp by the age of 6 months and use a pincer grasp by the age of 9 to 10 months. They can sit with support by 6 months and sit without support by 7 to 9 months. They can vocalize by 3 months. Stranger fear appears from 7 to 10 months. So this baby’s development is normal.

    • This question is part of the following fields:

      • Child Development
      38.5
      Seconds
  • Question 8 - A 17-year-old female presents to the dermatologist with erythematous plaques on her chest...

    Incorrect

    • A 17-year-old female presents to the dermatologist with erythematous plaques on her chest and forearm during autumn. Presence of which of the following will point towards a diagnosis?

      Your Answer: Antinuclear antibody

      Correct Answer: None of the above

      Explanation:

      Pityriasis rosea is a common, acute exanthem of uncertain aetiology. Viral and bacterial causes have been sought, but convincing answers have not yet been found. Pityriasis rosea typically affects children and young adults. It is characterized by an initial herald patch, followed by the development of a diffuse papulosquamous rash. The herald patch often is misdiagnosed as eczema. Pityriasis rosea is difficult to identify until the appearance of characteristic smaller secondary lesions that follow Langer’s lines (cleavage lines). Several medications can cause a rash similar to pityriasis rosea, and several diseases, including secondary syphilis, are included in the differential diagnosis. Typically, only symptomatic treatment of pruritus with lotions, oral antihistamines, and/or a short course of topical steroids is necessary.

    • This question is part of the following fields:

      • Dermatology
      29.1
      Seconds
  • Question 9 - What is the most common cardiac abnormality found in Noonan syndrome? ...

    Incorrect

    • What is the most common cardiac abnormality found in Noonan syndrome?

      Your Answer: Coarctation of the aorta

      Correct Answer: Pulmonary stenosis

      Explanation:

      Noonan syndrome is one of the most common genetic diseases associated with congenital heart defects, being second in frequency only to Down syndrome.Pulmonary stenosis and hypertrophic cardiomyopathy are generally the most common congenital heart defects found in Noonan syndrome.Pulmonary stenosis is often associated with a thickened and dysplastic valve. It is usually difficult to obtain a satisfactory result using the transcatheter balloon dilatation of such dysplastic valves, so surgical intervention is more likely to be needed.Hypertrophic cardiomyopathy involves predominantly the ventricular septum as asymmetric septal hypertrophy, but may also affect the ventricular free walls. Left ventricular outflow tract obstruction may occasionally be produced.

    • This question is part of the following fields:

      • Neonatology
      9.6
      Seconds
  • Question 10 - A 6 year old with a recent history of ear infection, now represents...

    Incorrect

    • A 6 year old with a recent history of ear infection, now represents with bilateral, erythematous and bulging tympanic membranes. His parents claim the boy also has hearing difficulty. Otoscopy reveals an effusion on the left side. Doctors suggest to perform Weber and Rinne tests. Which of the following is consistent with a left-sided middle ear effusion?

      Your Answer: Weber's localising to right, Rinne positive on left, Rinne negative on right

      Correct Answer: Weber's localising to left, Rinne negative on left, Rinne positive on right

      Explanation:

      When a child does not hear the sound in the middle during Weber test, it means they either they have a conductive hearing loss on the side they hear the sound, or a sensorineural hearing loss on the opposite side. Rinne’s test helps distinguish between the two. In this particular case, the hearing loss is most probably conductive due to the middle ear effusion. Therefore, Weber’s test should be localised to the left and Rinne’s should be positive on the right.

    • This question is part of the following fields:

      • ENT
      9.5
      Seconds
  • Question 11 - A 15 year old girl is taken to the A&E after complaining of...

    Incorrect

    • A 15 year old girl is taken to the A&E after complaining of right iliac fossa pain which started suddenly. She is well other than having some right iliac fossa tenderness but no guarding. She has no fever and the urinary dipstick result is normal. Her last menstrual cycle was 14 days ago which was also normal and the pregnancy test done is negative. What is the most likely underlying condition?

      Your Answer: Appendicitis

      Correct Answer: Mittelschmerz

      Explanation:

      Mittelschmerz is midcycle abdominal pain due to leakage of prostaglandin-containing follicular fluid at the time of ovulation. It is self-limited, and a theoretical concern is treatment of pain with prostaglandin synthetase inhibitors, which could prevent ovulation. The pain of mittelschmerz usually occurs in the lower abdomen and pelvis, either in the middle or to one side. The pain can range from a mild twinge to severe discomfort and usually lasts from minutes to hours. In some cases, a small amount of vaginal bleeding or discharge might occur. Some women have nausea, especially if the pain is very strong.Diagnosis of pelvic pain in women can be challenging because many symptoms and signs are insensitive and nonspecific. As the first priority, urgent life-threatening conditions (e.g., ectopic pregnancy, appendicitis, ruptured ovarian cyst) and fertility-threatening conditions (e.g., pelvic inflammatory disease, ovarian torsion) must be considered. Many women never have pain at ovulation. Some women, however, have mid-cycle pain every month, and can tell by the pain that they are ovulating.As an egg develops in the ovary, it is surrounded by follicular fluid. During ovulation, the egg and the fluid, as well as some blood, are released from the ovary. While the exact cause of mittelschmerz is not known, it is believed to be caused by the normal enlargement of the egg in the ovary just before ovulation. Also, the pain could be caused by the normal bleeding that comes with ovulation.Pelvic inflammatory disease can be ruled out if the patient is not sexually active.

    • This question is part of the following fields:

      • Paediatric Surgery
      15.3
      Seconds
  • Question 12 - A case-control study is developed to assess passive smoking as a risk factor...

    Incorrect

    • A case-control study is developed to assess passive smoking as a risk factor for the development of asthma in children. The total number of patients recruited for this study is 200. 40 out of the 200 patients report at least one parent smoking in the house when they were younger. 200 more people without asthma are recruited and 20 out of them report that at least one parent smoked in the house when they were younger. What is the odds ratio of patients with asthma having been exposed to passive smoking during their childhood?

      Your Answer:

      Correct Answer: 2.25

      Explanation:

      An odds ratio (OR) is a measure of association between an exposure and an outcome. The OR represents the odds that an outcome will occur given a particular exposure, compared to the odds of the outcome occurring in the absence of that exposure. Odds ratios are most commonly used in case-control studies, however they can also be used in cross-sectional and cohort study designs as well (with some modifications and/or assumptions). Wherea = Number of exposed casesb = Number of exposed non-casesc = Number of unexposed casesd = Number of unexposed non-casesOR=(a/c) / (b/d) = ad/bc

    • This question is part of the following fields:

      • Epidemiology And Statistics
      0
      Seconds
  • Question 13 - Which organs amongst these are the derivatives of the endoderm? ...

    Incorrect

    • Which organs amongst these are the derivatives of the endoderm?

      Your Answer:

      Correct Answer: Epithelial part of the tympanic cavity

      Explanation:

      Endoderm derivatives include the epithelium of the following: gastrointestinal tract and its glands, glandular cells of the liver and pancreases, urachus and urinary bladder, pharynx, trachea and alveoli, part of the tonsils, thyroid and parathyroid, tympanic cavity and thymus and part of the anterior pituitary gland.

    • This question is part of the following fields:

      • Embryology
      0
      Seconds
  • Question 14 - A 12 year old boy is shot in the abdomen with a pellet...

    Incorrect

    • A 12 year old boy is shot in the abdomen with a pellet gun. He hides the injury for over a week before he is taken to his doctor. CT scan shows that the pellet is lodged in his liver's left lobe. His abdomen is soft and non-tender on examination and he seems well. What is the most appropriate course of action?

      Your Answer:

      Correct Answer: Do not operate and review the patient several weeks later

      Explanation:

      Answer: Do not operate and review the patient several weeks laterAir weapon injuries in children should be managed in the same way as any low velocity gun shot injury. Subcutaneous pellets are best removed. Urgent specialist referral is indicated for cranial, ocular, chest, abdominal, or vascular injuries as they may require emergency surgery. Cardiac injuries may be rapidly fatal. Penetrating abdominal injuries involving hollow viscera or major blood vessels need prompt exploration and repair. Intracranial air weapon pellets should be removed if possible. A pellet in lung parenchyma or muscle may be safely left in situ but there is a risk of infection. A pellet that has penetrated a joint or is associated with a fracture requires skilled orthopaedic management. A pellet lodged near a major blood vessel or nerve should ideally be removed. The possibility of intravascular embolism must be considered if the pellet is absent from a suspected entry site and there is no exit wound; numerous examples of arterial and venous embolism of an air weapon pellet in children have been described.In this case, the child seems well so there is no need to operate. He should be reviewed several weeks later.

    • This question is part of the following fields:

      • Paediatric Surgery
      0
      Seconds
  • Question 15 - A 16-year-old male is learning about HIV as part of sex and relationships...

    Incorrect

    • A 16-year-old male is learning about HIV as part of sex and relationships education in school. What is the most common mode of transmission of HIV?

      Your Answer:

      Correct Answer: Unprotected anal or vaginal sexual intercourse with an infected individual

      Explanation:

      Unprotected anal or vaginal sexual intercourse with an infected individual is by far the most common (95%) route by which HIV is transmitted. Other options:- Blood transfusion is an extremely rare cause of HIV transmission in the UK. – While HIV can be transmitted from mother to baby either during birth or via breastfeeding, the transmission rate is only 5 -20%.- Sharing contaminated needles does put individuals at risk of getting HIV, although public health measures are in place to reduce this risk. – Although HIV can be transmitted via this route, it is around ten times less likely to result in transmission than unprotected anal or vaginal intercourse with an infected individual.

    • This question is part of the following fields:

      • HIV
      0
      Seconds
  • Question 16 - Which of the following conditions is associated with hypogonadism in boys? ...

    Incorrect

    • Which of the following conditions is associated with hypogonadism in boys?

      Your Answer:

      Correct Answer: Gigantism

      Explanation:

      Hypogonadism is found to be a feature in gigantism also known as acromegaly, a condition caused by growth hormone abnormalities. The most common cause of gigantism is a pituitary adenoma. Hypogonadism exists among other endocrinopathies found in gigantism. Other causes of hypogonadism include Kleinfelter’s syndrome, which is characterized by premature testicular failure. The other options listed, primary hypothyroidism, teratoma, tuberous sclerosis and hepatoblastoma are all associated with precocious puberty.

    • This question is part of the following fields:

      • Endocrinology
      0
      Seconds
  • Question 17 - Which of the given features does NOT occur in association with aniridia? ...

    Incorrect

    • Which of the given features does NOT occur in association with aniridia?

      Your Answer:

      Correct Answer: Macular hypoplasia

      Explanation:

      Aniridia is a genetic condition characterized by defects in the formation of a normal iris. The iris may be completely absent or only partially. One of the types of aniridia may be associated with other abnormalities like cataracts, glaucoma, corneal clouding, and nystagmus. The third type of aniridia is associated with intellectual disability, while a fourth type occurs in association with Wilm’s tumour. Aniridia may also be associated with amblyopia and buphthalmos, but macular hypoplasia is not a feature.

    • This question is part of the following fields:

      • Ophthalmology
      0
      Seconds
  • Question 18 - A 16-month-old girl with eczema is on the following treatment regimen: Oilatum in...

    Incorrect

    • A 16-month-old girl with eczema is on the following treatment regimen: Oilatum in baths; Baby' shampoo and soap and E45 cream to affected areas four times daily. Additionally, the mother uses 'non-biological' washing powder.The child often scratches the affected areas, sometimes even in her sleep. On examination, her skin is erythematous, excoriated, and lichenified over the knees, thighs, and flexor surfaces of the elbows.Which of the following would be the most appropriate next step in the management of this child?

      Your Answer:

      Correct Answer: Use E45 cream instead of soap; advise using a greasier emollient and try an antihistamine at night

      Explanation:

      The most appropriate next step in the management of this patient would be to use E45 cream instead of soap. Using a greasier emollient and an antihistamine at night can also be trialled..Management of eczema:Treatment of eczema can be problematic, and thus, parents should be advised regarding simple, everyday measures that can relieve the symptoms. These include:- Using non-biological washing powder- Wearing cotton clothes as opposed to artificial fibres- Avoiding the use of soaps or shampoos and using E45 Cream as an alternative.- Additional use of bath oil (e.g. Oilatum) is found to be beneficial.- Regular emollient use is recommended and essential. The aim is to keep the skin from feeling dry at any time of day. Sedating with older types of antihistamines at night does not help to reduce itching, but when used in large doses, they occasionally provide a sedative effect which may improve sleep. If all these measures are in use, but the eczema is still not controlled, the escalation of treatment would be appropriate. Note: There is no evidence for the benefit of topical antibiotics.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 19 - A 7-year old child from a rural setting complains of recurrent abdominal pain....

    Incorrect

    • A 7-year old child from a rural setting complains of recurrent abdominal pain. The child is found to have a heavy parasitic infestation and anaemia. Which type of anaemia is most likely seen in this patient?

      Your Answer:

      Correct Answer: Iron deficiency anaemia

      Explanation:

      The most common cause of iron deficiency anaemia in children in developing countries is parasitic infection (hookworm, amoebiasis, schistosomiasis and whipworm).

    • This question is part of the following fields:

      • Microbiology
      0
      Seconds
  • Question 20 - A 15-year-old girl presented with generalised excessive hair growth, especially on her limbs....

    Incorrect

    • A 15-year-old girl presented with generalised excessive hair growth, especially on her limbs. Which one of the following is the most likely cause for her symptoms?

      Your Answer:

      Correct Answer: She is on phenytoin to control seizures

      Explanation:

      The patient’s symptoms are most likely due to phenytoin intake.Note:Hypertrichosis occurs in 5-12% of patients on phenytoin and is most prominent on the extremities. Other options:- Hypertrichosis is the excess hair growth, whereas hirsutism is the development of male-pattern-dependent hair growth, as seen in polycystic ovarian syndrome. – A Becker’s naevus is associated with localised hypertrichosis in the naevus. – Cyclosporine intake can typically lead to diffuse hair growth that begins within 2-4 weeks of starting the drug. – Hereditary gingival fibromatosis is associated with variable hypertrichosis occurring on the eyebrows, face, limbs and mid-back.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 21 - A 12-month-old baby with HIV is scheduled for his MMR vaccine. What is...

    Incorrect

    • A 12-month-old baby with HIV is scheduled for his MMR vaccine. What is the most appropriate action?

      Your Answer:

      Correct Answer: Don't give the vaccine

      Explanation:

      Live attenuated vaccines such as the MMR, should be avoided in HIV+ patients.

    • This question is part of the following fields:

      • HIV
      0
      Seconds
  • Question 22 - What is the prevalence of atopic eczema in children? ...

    Incorrect

    • What is the prevalence of atopic eczema in children?

      Your Answer:

      Correct Answer: 15-20%

      Explanation:

      Atopic dermatitis (AD), also called atopic eczema, is a common chronic or recurrent inflammatory skin disease and affects 15-20% of children and 1-3% of adults worldwide. It is characterized by acute flare-ups of eczematous pruritic lesions over dry skin.The incidence has increased by 2- to 3-fold during the past decades in industrialized countries.Some of the most valuable AD prevalence and trend data have come from the International Study of Asthma and Allergies in Childhood (ISAAC). This is the biggest (close to 2 million children in 100 countries) and only allergy study that has taken a truly global approach. The strength of the study is the use of a uniformly validated methodology allowing a direct comparison of results between paediatric populations all over the world (http://isaac.auckland.ac.nz/index.html).

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 23 - A 15-year-old boy arrives at the clinic with a history of fainting. Physical...

    Incorrect

    • A 15-year-old boy arrives at the clinic with a history of fainting. Physical examination shows a male habitus, height above 75th percentile, weight and occipitofrontal circumference both below 50th percentile. Pectus excavatum and pectus carinatum can be seen. Hand joints are markedly flexible, and fingers show arachnodactyly. His palate is high arched. ophthalmoscopic examination reveals ectopia lentis. On auscultation, a 2/6 soft, systolic ejection murmur can be heard at the upper right 2nd intercostal space which radiates to the carotids. BP is normal, and so are the respiratory, abdominal and neurological examinations. investigations show a dilated aorta. HIs cerebral MRI scan, magnetic resonance angiography, ECG and blood tests are unremarkable. From the information provided, the boy most likely has which of the following?

      Your Answer:

      Correct Answer: Marfan syndrome

      Explanation:

      Individuals with Marfan syndrome are usually tall and slender, have elongated fingers and toes (arachnodactyly), loose joints, and have an arm span that exceeds their body height. Other common features include a long and narrow face, crowded teeth, an abnormal curvature of the spine (scoliosis or kyphosis), stretch marks (striae) not related to weight gain or loss, and either a sunken chest (pectus excavatum) or a protruding chest (pectus carinatum). Some individuals develop an abnormal accumulation of air in the chest cavity that can result in the collapse of a lung (spontaneous pneumothorax). A membrane called the dura, which surrounds the brain and spinal cord, can be abnormally enlarged (dural ectasia) in people with Marfan syndrome. Dural ectasia can cause pain in the back, abdomen, legs, or head. Most individuals with Marfan syndrome have some degree of near-sightedness (myopia). Clouding of the lens (cataract) may occur in mid-adulthood, and increased pressure within the eye (glaucoma) occurs more frequently in people with Marfan syndrome than in those without the condition.

    • This question is part of the following fields:

      • Endocrinology
      0
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  • Question 24 - A child is admitted due to potassium supplement overdose. What of the following...

    Incorrect

    • A child is admitted due to potassium supplement overdose. What of the following do you expect to see?

      Your Answer:

      Correct Answer: High voltage T waves in the electrocardiogram

      Explanation:

      Hyperkalaemia presents with high voltage (peaked) T waves on ECG. Other features on ECG include smaller p-waves and wider QRS complexes.

    • This question is part of the following fields:

      • Cardiovascular
      0
      Seconds
  • Question 25 - Which of the following statements is correct for distal renal tubular acidosis? ...

    Incorrect

    • Which of the following statements is correct for distal renal tubular acidosis?

      Your Answer:

      Correct Answer: Children can present with nephrocalcinosis

      Explanation:

      Distal renal tubular acidosis (dRTA) is characterised by a decreased hydrogen ion excretion from the alpha intercalated cells of the collecting duct of the distal nephron. The resultant acidosis causes Ca and phosphates to be released from bones to buffer the acidosis causing hypercalciuria, thus precipitating calcium compounds in the kidney. Other consequences of the dRTA in children include rickets, hypokalaemia, and polyuria. While dRTA can occur as a result of various pathologies including autoimmune disease, proximal renal tubular acidosis often presents as part of Fanconi’s syndrome. One way to differentiate between the two conditions is with an acid challenge test. In proximal RTA offering the child an acid load will decrease the urinary ph whereas in distal disease the pH will be unaffected due to impairment in hydrogen ion secretion.

    • This question is part of the following fields:

      • Nephro-urology
      0
      Seconds
  • Question 26 - A 7-year-old boys undergoes a testicular biopsy after a tumour is found in...

    Incorrect

    • A 7-year-old boys undergoes a testicular biopsy after a tumour is found in his right testis. Elements similar to hair and teeth are found in it. What kind of tumour is this?

      Your Answer:

      Correct Answer: Teratoma

      Explanation:

      A teratoma is a tumour containing tissue elements that are similar to normal derivatives of more than one germ layer. They usually contain skin, hair, teeth and bone tissue and are more common in children, behaving as a benign tumour. After puberty, they are regarded as malignant and can metastasise.

    • This question is part of the following fields:

      • Genitourinary
      0
      Seconds
  • Question 27 - A child with a history of developmental delay presents with plaque-like lesions in...

    Incorrect

    • A child with a history of developmental delay presents with plaque-like lesions in the retina. The doctor suspects they are probably hamartomas. Which of the following is the most probable association?

      Your Answer:

      Correct Answer: Tuberous sclerosis

      Explanation:

      Tuberous sclerosis, an autosomal dominant disorder, may present with a variety of symptoms, including seizures, developmental delay, behavioural problems, skin abnormalities, and lung and kidney disease. Hamartomas are often associated.

    • This question is part of the following fields:

      • Genetics And Dysmorphology
      0
      Seconds
  • Question 28 - A 10-year-old boy presented to the ophthalmology clinic with a painless swelling on...

    Incorrect

    • A 10-year-old boy presented to the ophthalmology clinic with a painless swelling on the superotemporal aspect of his orbit. It was smooth on examination and produced no visual disturbances. Following excision, it was found to be lined by squamous epithelium and hair follicles.Which lesion is most probably associated with these findings?

      Your Answer:

      Correct Answer: Dermoid cyst

      Explanation:

      The most probable lesion in the patient is a dermoid cyst.Rationale:Dermoid cysts are embryological remnants and may be lined by hair and squamous epithelium (like teratomas). They are often located in the midline and may be linked to deeper structures resulting in a dumbbell shape to the lesion. Complete excision is required as they have a propensity to local recurrence if not excised.Note:Desmoid tumours are a different entity entirely. These lesions most commonly develop in ligaments and tendons. They are also referred to as aggressive fibromatosis and consist of dense fibroblastic lesions (resembling scar tissue). They should be managed in a similar manner to soft tissue sarcomas.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 29 - A 7 day old baby weighed 3.5kg when born. His weight is now...

    Incorrect

    • A 7 day old baby weighed 3.5kg when born. His weight is now 3kg. Choose the most appropriate next step for this child.

      Your Answer:

      Correct Answer: Continue regular child care

      Explanation:

      In the first week after birth, it is normal for the baby to lose weight and then gain it again. Therefore, regular child care should be maintained.

    • This question is part of the following fields:

      • Child Development
      0
      Seconds
  • Question 30 - A 10-year-old gentleman is referred with a six month history of daily headache,...

    Incorrect

    • A 10-year-old gentleman is referred with a six month history of daily headache, which is mostly frontal in location and occasionally associated with nausea.He has been taking paracetamol 3 g daily, aspirin 300 mg thrice daily, and codeine 40 mg thrice daily, all of which have had only a temporary effect. He has a two year history of depression treated with paroxetine. No abnormalities were found on examination.What is the most likely diagnosis?

      Your Answer:

      Correct Answer: Analgesic misuse headache

      Explanation:

      Because of the patient’s history of chronic analgesic use of daily paracetamol intake, the most likely diagnosis of this case is Analgesic misuse headache. In these cases, the headache is only temporarily relieved by analgesics. Treatment involves gradual withdrawal of analgesics.

    • This question is part of the following fields:

      • Neurology
      0
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SESSION STATS - PERFORMANCE PER SPECIALTY

Endocrinology (2/2) 100%
Haematology And Oncology (0/1) 0%
Emergency Medicine (0/1) 0%
Neonatology (0/3) 0%
Child Development (0/1) 0%
Dermatology (0/1) 0%
ENT (0/1) 0%
Paediatric Surgery (0/1) 0%
Passmed