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  • Question 1 - A 13-year-old girl was recently diagnosed with type 1 diabetes mellitus about two...

    Incorrect

    • A 13-year-old girl was recently diagnosed with type 1 diabetes mellitus about two weeks ago and started on an insulin pump. Which of the following complications is least likely to occur due to the treatment modality adopted?

      Your Answer: Allergy

      Correct Answer: Lipoatrophy

      Explanation:

      Among the given options, lipoatrophy takes time to develop as it is a long-term complication of insulin therapy. Since it has only been two weeks since the initiation of insulin therapy, it is unlikely to occur so early.The risk of lipoatrophy is reduced with newer insulins and also can be avoided by site rotation.However, anaphylaxis, allergic reactions, infection and abscesses at the site of an insulin pump can occur in this patient as a complication of insulin therapy.

    • This question is part of the following fields:

      • Endocrinology
      45.4
      Seconds
  • Question 2 - Out of 30 children who are exposed to a chemical, 15 develop a...

    Incorrect

    • Out of 30 children who are exposed to a chemical, 15 develop a disorder, compared to only 1 child out of 10 developing the same disorder who were not exposed.The following can be deduced from this information:

      Your Answer: The disorder can be avoided

      Correct Answer: The relative risk of exposure to the chemical is 5

      Explanation:

      Relative risk is the probability of an outcome occurring in an exposed group as compared to the probability of that outcome in an unexposed group. In the scenario given, 50% of the children exposed developed the disease while only 10% of the children who were unexposed developed the disease. The relative risk was therefore 50/10=5. There is no further information about whether the study was controlled, the confidence interval, or the type of study. It therefore cannot be confirmed whether the chemical is causative and if it should be avoided.

    • This question is part of the following fields:

      • Epidemiology And Statistics
      5.3
      Seconds
  • Question 3 - Which of the following is NOT a gonadal or sexual differentiation disorder? ...

    Correct

    • Which of the following is NOT a gonadal or sexual differentiation disorder?

      Your Answer: XXX (Triple X Syndrome)

      Explanation:

      The correct answer is triple X syndrome with a genotype of XXX and an almost normal female phenotype. The extra X chromosome is inactive. The final phenotype of an individual is determined after normal sexual and gonadal differentiation, a process that involves several genes located on chromosomes X and Y. Disorders of sexual differentiation result in cases of ambiguous genitalia and are caused by a number of genetic abnormalities. Among these disorders is the turner syndrome with a genotype of 45X0, characterized by gonadal dysgenesis and ovarian failure. DAX-1 gene mutation leads to congenital adrenal hypoplasia and hypogonadotropic hypogonadism, which results in virilization of female external genitalia. Campomelic dysplasia results from mutation of the SOX-9 gene, leading to 46XY sex reversal. Danys-Drash syndrome is characterized by disordered sexual development in affected males due to the mutated WT-1 gene, which also causes Wilm’s tumour.

    • This question is part of the following fields:

      • Genetics And Dysmorphology
      13.7
      Seconds
  • Question 4 - 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: Give paracetamol with future doses of the same vaccine

      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
      19.1
      Seconds
  • Question 5 - Two healthy parents have two children, one with cystic fibrosis and the other...

    Incorrect

    • Two healthy parents have two children, one with cystic fibrosis and the other one healthy. What are the chances of the third child being a carrier?

      Your Answer: 1 in 4

      Correct Answer: 1 in 2

      Explanation:

      Cystic fibrosis has an autosomal recessive pattern of inheritance, meaning that a person might be a carrier of the disease without developing it. If the unaffected partner is a carrier, then there is a 50% chance of inheritance and a 50% chance of having a child who is a carrier. However, if the partner is not a carrier, the offspring will not develop the disease but the possibility of being a carrier raises up to 100%.

    • This question is part of the following fields:

      • Genetics And Dysmorphology
      45.1
      Seconds
  • Question 6 - A 10-year-old boy presents with bilaterally enlarged parotid glands for more than 9...

    Incorrect

    • A 10-year-old boy presents with bilaterally enlarged parotid glands for more than 9 months. On examination, both parotid glands are firm and non-tender and are not warm to touch.What is the most probable infectious cause for chronic parotitis in the given scenario?

      Your Answer: Bacille Calmette-Guerin (BCG)

      Correct Answer: Human immunodeficiency virus (HIV)

      Explanation:

      The most probable cause for chronic parotitis in this patient would be HIV infection.Rationale:Chronic infectious parotitis is relatively uncommon in children. While mycobacterial infection can result in chronic parotitis, HIV is a relatively more common cause. The presentation should always prompt an HIV test. Other options:- While mumps is the most common cause of acute viral parotitis, the chronic nature of the boy’s presentation rules it out. – Acute bacterial parotitis is usually unilateral and is warm and tender to touch.

    • This question is part of the following fields:

      • HIV
      26.2
      Seconds
  • Question 7 - An 8 month old baby boy presents with a fine, white and scaly...

    Incorrect

    • An 8 month old baby boy presents with a fine, white and scaly rash that is more profound on the extensor surfaces of his arms and legs. It is also found on his trunk. However, the flexor surfaces, face and neck are spared. It has been present for 4 months. Which of the following is the most probable diagnosis?

      Your Answer: Psoriasis

      Correct Answer: Ichthyosis vulgaris

      Explanation:

      Ichthyosis vulgaris presents clinically with xerosis, hyperkeratosis, excess scaling, keratosis pilaris, and palmar and plantar hyperlinearity. It most commonly affects the extensor surfaces of the limbs and spares flexor surfaces, the face, and the neck.

    • This question is part of the following fields:

      • Dermatology
      59.6
      Seconds
  • Question 8 - A 15-year-old boy presents with a history of abdominal pain. He has no...

    Incorrect

    • A 15-year-old boy presents with a history of abdominal pain. He has no features of puberty. A lower gastrointestinal (GI) endoscopy shows patches of ulceration in the terminal ileum. What is the first-line treatment for this boy?

      Your Answer: Surgery

      Correct Answer: Exclusive enteral nutrition (EEN)

      Explanation:

      Based on the presentation, the patient is probably a case of Crohn’s disease. The first-line treatment of Crohn’s disease is exclusive enteral nutrition.Exclusive enteral nutrition (EEN)This involves drinking a protein-based formula exclusively for 6-8 weeks. It has been shown to have superior mucosal healing when compared with steroids. Furthermore, it is nutritionally advantageous when compared to steroids and does not have the side-effect profile of steroids.Other options:- Intravenous steroids: This is the first-line treatment for ulcerative colitis (UC) or Crohn’s disease if there is rectal disease (which is not the case here). Side-effects include adrenal suppression, behavioural effects, osteopenia and changes in adipose tissue distribution.- Oral steroids: This can be used if EEN is not possible. However, the side-effect profile is less favourable and is not as effective concerning mucosal healing.- Parental nutrition and surgery: They may be occasionally required in severe cases that have failed first-line therapy.

    • This question is part of the following fields:

      • Gastroenterology And Hepatology
      25
      Seconds
  • Question 9 - A 9 year old girl who has recently undergone a laparoscopic appendicectomy for...

    Incorrect

    • A 9 year old girl who has recently undergone a laparoscopic appendicectomy for a perforated appendix develops a swinging temperature of 38.8 C while on admission. What is next step in her management?

      Your Answer: Arrange for a chest x-ray and physiotherapy to manage likely chest infection

      Correct Answer: Arrange for an ultrasound scan to look for intra-abdominal collection

      Explanation:

      Children who present with ruptured appendices are at increased risk of intra abdominal collections or abscesses. A swinging temperature is the first clue in indicating an intra abdominal abscess in a patient who had recently undergone surgery for a perforated appendix. The best course of action is therefore to get an ultrasound of the fluid collection before proceeding to rule out any other complication.

    • This question is part of the following fields:

      • Paediatric Surgery
      21.1
      Seconds
  • Question 10 - A 17-year-old boy is brought to the emergency after being stabbed in the...

    Incorrect

    • A 17-year-old boy is brought to the emergency after being stabbed in the upper arm and the median nerve is transected. Impaired function can be demonstrated in which of the following muscle/s?

      Your Answer: Abductor pollicis longus

      Correct Answer: Abductor pollicis brevis

      Explanation:

      The median nerve is a peripheral nerve originating in the cervical roots C5-T1 of the brachial plexus. It supplies motor innervation to the anterior forearm flexors, the thenar muscles, and the two lateral lumbricals as well as sensory innervation to the lateral palm and anterior, lateral three and a half fingers. Motor and sensory deficits depend on whether the lesion is proximal (above the elbow) or distal (below the elbow). While proximal lesions present with the hand of benediction,ť distal lesions present with either the pinch signť (anterior interosseous nerve syndrome) or, in the case of carpal tunnel syndrome, with mildly impaired thumb and index finger motion. Both proximal lesions and carpal tunnel syndrome result in reduced sensation in the area of the thumb, index and middle finger. Anterior interosseus nerve syndrome does not cause any sensory deficits. Chronic injuries to the nerve result in atrophy of median nerve innervated muscles while acute injuries do not have this feature. Treatment is mostly conservative and focuses on rest and immobilization.

    • This question is part of the following fields:

      • Musculoskeletal
      23
      Seconds
  • Question 11 - Which of the following conditions is most commonly seen in PANDAS (Paediatric Autoimmune...

    Incorrect

    • Which of the following conditions is most commonly seen in PANDAS (Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections)?

      Your Answer: Panic attacks

      Correct Answer: Obsessive compulsive disorder

      Explanation:

      A child may be diagnosed with PANDAS when:- Obsessive-compulsive disorder (OCD), tic disorder, or both suddenly appear following a streptococcal (strep) infection, such as strep throat or scarlet fever.- The symptoms of OCD or tic symptoms suddenly become worse following a strep infection.The symptoms are usually dramatic, happen overnight and out of the blue,Å¥ and can include motor or vocal tics or both and obsessions, compulsions, or both. In addition to these symptoms, children may become moody or irritable, experience anxiety attacks, or show concerns about separating from parents or loved ones.

    • This question is part of the following fields:

      • Neurology And Neurodisability
      15.8
      Seconds
  • Question 12 - 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
      10.4
      Seconds
  • Question 13 - Which of the following dermatological conditions is not recognised to be associated with...

    Correct

    • Which of the following dermatological conditions is not recognised to be associated with Crohn's disease?

      Your Answer: Xanthomas

      Explanation:

      CUTANEOUS DISORDERS OR DERMATOSIS ASSOCIATED WITH IBD- Psoriasis- Secondary amyloidosis- Vitiligo- Acquired epidermolysis bullosaIn some cases, non-granulomatous skin disorders occur as a reaction to the intestinal disease. These include:- Pyoderma gangrenosum- Neutrophilic dermatosis / Sweet syndrome, typically with pustules- Pyodermatitis-pyostomatitis vegetans, a purulent erosive dermatosis characterised by snail-track ulcers- Erythema multiforme- Erythema nodosum- Acneiform eruptions including nodulocystic acne, hidradenitis suppurativa and folliculitis- Palisaded neutrophilic and granulomatous dermatitis- Necrotizing and granulomatous small vessel vasculitis.

    • This question is part of the following fields:

      • Gastroenterology And Hepatology
      61.6
      Seconds
  • Question 14 - A 15-month-old boy was brought to the hospital following a high-velocity road traffic...

    Incorrect

    • A 15-month-old boy was brought to the hospital following a high-velocity road traffic accident. His car seat was thrown forward into the front passenger seat. He has sustained multiple injuries, including a fractured pelvis and suspected skull fracture.On initial assessment in the emergency department, the child was lying supine with c-spine immobilized. His eyes were closed, and he was motionless. He did not respond to voice commands. He cried and produced weak vocal sounds to pain but did not open his eyes. He tries to move away from the examining hand.What is the Paediatric Glasgow Coma Scale score of this child?

      Your Answer: 6

      Correct Answer: 8

      Explanation:

      The Glasgow Coma Scale, being inappropriate for use in children (especially below the age of 5) as they are unable to elicit the verbal response as per the adult GCS. Therefore, GCS for the paediatric age group was modified to Adelaide coma scale (ACS), which is stated as follows:Best Eye Response (as in adult scale):Spontaneous – 4To speech – 3To pain – 2No response – 1Best Verbal Response:Oriented – 5Words – 4Vocal sounds – 3Cries – 2No response – 1Best Motor Response (as in adult scale):Obeys commands – 5Localises pain – 4Flexion to pain – 3 Extension to pain – 2No response – 1 The described child scores:Eye response – 1; Verbal response – 3; Motor response – 4Thus, bringing the total ACS score to 8.

    • This question is part of the following fields:

      • Emergency Medicine
      20.3
      Seconds
  • Question 15 - 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: Await result of vaginal swab and treat the baby according to this

      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
      19.1
      Seconds
  • Question 16 - A 15-year-old child with learning difficulties is referred to the endocrine clinic for...

    Correct

    • A 15-year-old child with learning difficulties is referred to the endocrine clinic for review. His lab results show hypocalcaemia and increased serum concentration of parathyroid hormone. On examination, there is subcutaneous calcification and a short fifth metacarpal in each hand.What is the treatment of choice in this case?

      Your Answer: Calcium and vitamin D supplementation

      Explanation:

      This child has pseudo hypoparathyroidism. It is a heterogeneous group of rare endocrine disorders characterized by normal renal function and resistance to the action of parathyroid hormone (PTH), manifesting with hypocalcaemia, hyperphosphatemia, and increased serum concentration of PTH.Patients with pseudo hypoparathyroidism type 1a present with a characteristic phenotype collectively called Albright hereditary osteodystrophy (AHO). The constellation of findings includes the following:Short statureStocky habitusObesityDevelopmental delayRound faceDental hypoplasiaBrachymetacarpalsBrachymetatarsalsSoft tissue calcification/ossificationThe goals of therapy are to maintain serum total and ionized calcium levels within the reference range to avoid hypercalcaemia and to suppress PTH levels to normal. This is important because elevated PTH levels in patients with PHP can cause increased bone remodelling and lead to hyper-parathyroid bone disease.The goals of pharmacotherapy are to correct calcium deficiency, to prevent complications, and to reduce morbidity. Intravenous calcium is the initial treatment for all patients with severe symptomatic hypocalcaemia. Administration of oral calcium and 1alpha-hydroxylated vitamin D metabolites, such as calcitriol, remains the mainstay of treatment and should be initiated in every patient with a diagnosis of pseudo hypoparathyroidism.

    • This question is part of the following fields:

      • Endocrinology
      20.7
      Seconds
  • Question 17 - A 15-year-old Afro-Caribbean boy presents with a temperature of 38.5C and acute abdominal...

    Incorrect

    • A 15-year-old Afro-Caribbean boy presents with a temperature of 38.5C and acute abdominal pain. He has previously undergone a splenectomy secondary to sickle cell disease. On examination, he's found to be tachycardic. Abdominal examination reveals guarding. An ultrasound scan shows gall stones in the gall bladder, free fluid in the pelvis and an appendix with a diameter of 8 mm.What is the most probable diagnosis?

      Your Answer: Sickle Cell Crisis

      Correct Answer: Acute Appendicitis

      Explanation:

      Based on the clinical scenario, the most probable diagnosis is acute appendicitis.Acute appendicitis presents typically with central abdominal pain migrating to the right iliac fossa, anorexia, nausea and fever. The temperature usually does not go beyond 40C. Although appendicitis is a clinical diagnosis, an ultrasound scan showing an appendix width of greater than 6mm is diagnostic.Pyrexia, guarding, and pain are all in keeping with appendicitis.Other options:- Cholecystitis is very rare in children, and although gall stones are present, there is no jaundice or biliary tree dilatation suggested by the scan.- Impacted Gall Stone: There is no mention of common bile duct dilatation in the clinical scenario.- Sickle Cell Crisis: A sickle cell crisis should not cause guarding, or an ultrasound scan finding of a dilated appendix base.- Gastroenteritis: Gastroenteritis would not produce the ultrasound scan findings described above with a thickened appendix.

    • This question is part of the following fields:

      • Paediatric Surgery
      32.6
      Seconds
  • Question 18 - A new-born infant deteriorates on the postnatal ward. The child is breathless with...

    Incorrect

    • A new-born infant deteriorates on the postnatal ward. The child is breathless with no murmurs, 3 cm liver edge, and poor femoral pulses. She is acidotic with elevated lactate. Mum did not attend the antenatal screening. What is the most likely diagnosis?

      Your Answer: Mid-aortic syndrome

      Correct Answer: Coarctation of the aorta

      Explanation:

      Coarctation of the aorta may be defined as a constricted aortic segment that comprises localized medial thickening, with some infolding of the medial and superimposed neointimal tissue.The presence of associated defects and aortic arch anomalies, the extent of patency of the ductus arteriosus, the rapidity of the process of closure of the ductus arteriosus, and the level of pulmonary vascular resistance determine the timing of clinical presentation and the severity of symptoms. Young patients may present in the first few weeks of life with poor feeding, tachypnoea, and lethargy and progress to overt CHF and shock. These patients may have appeared well before hospital discharge, and deterioration coincides with closure of the patent ductus arteriosus. Presentation may be abrupt and acute with ductal closure.Neonates may be found to have tachypnoea, tachycardia, and increased work of breathing and may even be moribund with shock. Keys to the diagnosis include blood pressure (BP) discrepancies between the upper and lower extremities and reduced or absent lower extremity pulses to palpation. However, when the infant is in severe heart failure, all pulses are diminished.The murmur associated with coarctation of the aorta may be nonspecific yet is usually a systolic murmur in the left infraclavicular area and under the left scapula.

    • This question is part of the following fields:

      • Cardiovascular
      24.6
      Seconds
  • Question 19 - A 6 year old female child with a history of controlled type 1...

    Incorrect

    • A 6 year old female child with a history of controlled type 1 diabetes, presents with recurrent nightmares due to hypoglycaemia and early morning glycosuria. Her parents are well informed about the child's condition and adjust her insulin requirements according to carbohydrate counting. What is the cause of the hypoglycaemia during the night in association with early morning glycosuria?

      Your Answer: Inadequate insulin administration

      Correct Answer: Somogyi effect

      Explanation:

      Somogyi effect presents with night-time hypoglycaemia followed by early-morning hyperglycaemia, hence the glycosuria.

    • This question is part of the following fields:

      • Endocrinology
      33.6
      Seconds
  • Question 20 - A 13-year-old girl takes a deliberate, unknown number of paracetamol tablets in one...

    Incorrect

    • A 13-year-old girl takes a deliberate, unknown number of paracetamol tablets in one go. She immediately regrets her actions and calls for help. She was brought to the hospital 2 hours after consuming the tablets. She has a history of HIV and is on antiretroviral therapy, though she cannot recall the name of the medication. Which of the following management options is most appropriate for this patient?

      Your Answer: Give full treatment dose N-acetylcysteine iv now

      Correct Answer: Check paracetamol level in further 2 hours' time

      Explanation:

      According to the Rumack-Matthew Normogram, accurate levels of paracetamol can be measured only between 4-15 hours. The levels measured before 4 hours post-ingestion would highly underestimate the level of paracetamol ingested.The patient in question presents 2 hours after ingestion. Hence the most appropriate time to measure the levels of acetaminophen would be a further 2 hours later. Other options:- Note that the treatment with NAC can be delayed until the 4-hour level is obtained and compared to the nomogram.- Furthermore, haemodialysis is only indicated if she develops hepato-renal syndrome that is likely to occur 72-96 hours post-ingestion.- Indications for acute liver transplantation include persistent acidosis, hepatorenal syndrome and worsening coagulopathy.

    • This question is part of the following fields:

      • HIV
      33.3
      Seconds
  • Question 21 - A 7 day old male infant, born at term, presents with umbilical bruising...

    Incorrect

    • A 7 day old male infant, born at term, presents with umbilical bruising and bleeding. History reveals he wasn't given vitamin K after birth. Blood exam is normal but with a high prothrombin time and activated partial thromboplastin time. What is the most appropriate treatment?

      Your Answer: Intramuscular vitamin K only

      Correct Answer: Intravenous vitamin K plus fresh frozen plasma

      Explanation:

      The clinical picture suggests a vitamin K deficiency haemorrhagic disease of the new-born and requires IV vitamin K and fresh frozen plasma. This usually presents with gastrointestinal bleeding, bleeding from the umbilical stump and bruising after 2-7 days.

    • This question is part of the following fields:

      • Neonatology
      9.8
      Seconds
  • Question 22 - A 7-year-old girl is given cephalexin to treat an infection and develops hives,...

    Incorrect

    • A 7-year-old girl is given cephalexin to treat an infection and develops hives, with localised facial oedema. Which of the following conditions will cause localised oedema?

      Your Answer: Cirrhosis

      Correct Answer: Angio-oedema

      Explanation:

      Angio-oedema, is the rapid swelling of the skin, mucosa and submucosal tissues. The underlying mechanism typically involves histamine or bradykinin. The version related to histamine is to due an allergic reaction to agents such as insect bites, food, or medications. The version related to bradykinin may occur due to an inherited C1 esterase inhibitor deficiency, medications e.g. angiotensin converting enzyme inhibitors, or a lymphoproliferative disorder.

    • This question is part of the following fields:

      • Renal
      18.7
      Seconds
  • Question 23 - A healthy 8 month old baby boy was brought in by his parents,...

    Incorrect

    • A healthy 8 month old baby boy was brought in by his parents, who claimed that the baby had come into close contact with another child with measles two days ago. Which of the following is the most appropriate management?

      Your Answer: She should have her measles serology checked now

      Correct Answer: She should receive the MMR vaccine now together with measles immunoglobulin

      Explanation:

      People who are at risk for severe illness and complications from measles, such as infants younger than 12 months of age, pregnant women without evidence of measles immunity, and people with severely compromised immune systems, should receive immunoglobulin. Intramuscular immunoglobulin should be given to all infants younger than 12 months of age who have been exposed to measles. For infants aged 6 through 11 months, MMR vaccine can be given in place of IG, if administered within 72 hours of exposure.

    • This question is part of the following fields:

      • Infectious Diseases
      4.8
      Seconds
  • Question 24 - What is the most common identified trigger of anaphylaxis in children? ...

    Incorrect

    • What is the most common identified trigger of anaphylaxis in children?

      Your Answer: Wasp venom

      Correct Answer: Food

      Explanation:

      In children, food-induced anaphylaxis is the most common trigger and accounts for 37 %-85 % of cases, whereas insect bites/stings account for 5 %-13 % and medications account for 5 %-12 % Despite differences between studies, food allergy is clearly the most common cause of anaphylaxis in children

    • This question is part of the following fields:

      • Emergency Medicine
      17.9
      Seconds
  • Question 25 - All of the given conditions are scaly dermatologic pathologies EXCEPT? ...

    Incorrect

    • All of the given conditions are scaly dermatologic pathologies EXCEPT?

      Your Answer: Icthyosis

      Correct Answer: Hand, foot, and mouth disease

      Explanation:

      Skin conditions resulting from excessive epidermal proliferation or inflammation, leading to a production of excessive scales, are referred to as papulosquamous disorders. These disorders can be generalized and localized. Localized causes of scaly lesions include tinea corporis, tinea cruris, tinea pedis, seborrheic dermatitis, psoriasis, pityriasis Versicolor, pityriasis alba, DLE, ichthyosis including Netherton syndrome (a severe form of ichthyosis which is autosomal recessive), and pellagra. Generalized causes include guttate psoriasis and pityriasis rosacea. Hand, foot, and mouth disease is a contagious viral illness that causes blisters in the mouth and on the extremities.

    • This question is part of the following fields:

      • Dermatology
      15
      Seconds
  • Question 26 - A 13-year-old girl is complaining of severe acne. She does not have her...

    Incorrect

    • A 13-year-old girl is complaining of severe acne. She does not have her period yet and her BMI is 37. She has high insulin levels on her lab results. What is the most likely diagnosis?

      Your Answer: Acquired hypothyroidism

      Correct Answer: Polycystic Ovarian Syndrome (PCOS)

      Explanation:

      The best answer is Polycystic Ovarian Syndrome (PCOS), supported by amenorrhea, obesity and acne. High insulin levels are indicative of PCOS and exclude Cushing syndrome (as this is associated with low insulin levels).

    • This question is part of the following fields:

      • Genitourinary
      33.3
      Seconds
  • Question 27 - A 13-year-old boy's mother notices he has a lump in his arm, near...

    Correct

    • A 13-year-old boy's mother notices he has a lump in his arm, near his right shoulder. An X-ray reveals a lateral projection in the metaphyseal region of his humerus. The lesion is removed and it is found to be composed of bony cortex, capped by cartilage. What's the most likely diagnosis in this case?

      Your Answer: Osteochondroma

      Explanation:

      Osteochondromas, or osteocartilaginous exostoses, are the most common benign bone tumours, and tend to appear near the ends of long bones. The overgrowth can occur in any bone where cartilage forms bone, and they are capped by cartilage. They are most common in people between the ages of 10-20 years old.

    • This question is part of the following fields:

      • Musculoskeletal
      29.5
      Seconds
  • Question 28 - A 4 year old girl is brought to the emergency due to fever...

    Incorrect

    • A 4 year old girl is brought to the emergency due to fever and urinary urgency. The temperature is recorded to be 39C. Which of the following is the best investigation in this case?

      Your Answer: US

      Correct Answer: Clean catch of urine

      Explanation:

      Urine culture and sensitivity is used to diagnose a urinary tract infection (UTI). A mid-stream clean catch urine sample is the most common type of sample collected. It is important to follow the clean catch process to have accurate results from an uncontaminated sample. Urine cultures can also check for infections of the bladder or kidney.

    • This question is part of the following fields:

      • Renal
      38.6
      Seconds
  • Question 29 - A 13-month-old boy presents to the hospital with a rash and breathing difficulties...

    Incorrect

    • A 13-month-old boy presents to the hospital with a rash and breathing difficulties following routine vaccination. On examination, it was noted that he was developing swelling around the mouth and neck.What is the most appropriate next step to manage this child?

      Your Answer: IM adrenaline 50 mcg (0.05ml of 1 in 1,000)

      Correct Answer: IM adrenaline 150 mcg (0.15ml of 1 in 1,000)

      Explanation:

      The IM dose of adrenaline for anaphylaxis in:< 6 months: 150 micrograms (0.15ml 1 in 1,000)6 months – 6 years: 150 micrograms (0.15ml 1 in 1,000)6 – 12 years: 300 micrograms (0.3ml 1 in 1,000)Adult and child > 12 years: 500 micrograms (0.5ml 1 in 1,000)Anaphylaxis:Anaphylaxis is an acute, rapidly progressing, potentially life-threatening IgE mediated Type I hypersensitivity reaction.It involves the release of mediators from mast cells, basophils and inflammatory cells. It is characterised by oedematous swelling of the airway mucosa giving rise to dyspnoea and respiratory distress. The most common cause of anaphylaxis in children is a food allergy.Risk factors for death in patients with anaphylaxis include asthma, age 11+, peanut allergy, and delay in adrenaline administration.Management of anaphylaxis includes:- ABCD- Remove the allergen- IM adrenaline or Nebulised adrenaline- IV Hydrocortisone – pro re nata IV fluid support. – Followed by observation.

    • This question is part of the following fields:

      • Emergency Medicine
      10.9
      Seconds
  • Question 30 - Which of the following conditions is rarely associated with hyposplenism? ...

    Incorrect

    • Which of the following conditions is rarely associated with hyposplenism?

      Your Answer:

      Correct Answer: Myxoedema

      Explanation:

      Hyposplenism usually occurs after the surgical removal of the spleen or in pathological processes where the splenic tissue is replaced with abnormal tissue. It is often associated with diseases such as sickle cell disease, Coeliac disease, SLE and Dermatitis Herpetiformis. Myxoedema however bears no known association with hyposplenism. Patients with hyposplenism are at risk of fulminant bacterial infection.

    • This question is part of the following fields:

      • Haematology And Oncology
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Endocrinology (2/4) 50%
Genetics And Dysmorphology (1/2) 50%
HIV (2/3) 67%
Dermatology (1/2) 50%
Gastroenterology And Hepatology (0/2) 0%
Paediatric Surgery (0/2) 0%
Musculoskeletal (0/2) 0%
Neurology And Neurodisability (0/1) 0%
Emergency Medicine (1/3) 33%
Neonatology (1/2) 50%
Cardiovascular (0/1) 0%
Renal (1/2) 50%
Infectious Diseases (0/1) 0%
Genitourinary (0/1) 0%
Haematology And Oncology (0/1) 0%
Passmed