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Question 1
Incorrect
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Which of the following vaccines do not contain live organisms?
Your Answer: Yellow fever
Correct Answer: Polio (Salk)
Explanation:Live virus vaccines include: Vaccinia (smallpox), Measles, Mumps, Rubella (MMR combined vaccine), Varicella (chickenpox), Influenza (nasal spray), Rotavirus, Zoster (shingles) and Yellow fever. Inactivated vaccines are Polio (IPV), Hepatitis A and Rabies.
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This question is part of the following fields:
- Infectious Diseases
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Question 2
Incorrect
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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: Mycobacterium tuberculosis
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.
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This question is part of the following fields:
- HIV
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Question 3
Correct
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A 15-year-old boy diagnosed with pulmonary tuberculosis was initiated on treatment. A month later, he presents with anorexia, malaise, reduced urine output and fever. Laboratory investigations reveal: Hb - 12.6 g/dL WBC Count - 13,000/µL Urea - 30 mmol/L Creatinine - 400 µmol/L; andUrinalysis shows numerous pus cells. What is the probable cause of the presenting symptoms of the patient?
Your Answer: Acute interstitial nephritis
Explanation:Among the given options, the most likely cause for the patient’s presenting symptoms is acute interstitial nephritis secondary to anti-tubercular therapy (ATT)Drug-induced acute interstitial nephritis can occur following treatment with beta-lactams, sulphonamides, rifampicin, ethambutol, and erythromycin. They can cause an acute allergic reaction with the infiltration of immune cells.Acute interstitial nephritis is said to be the most common renal complication in patients undergoing anti-TB treatment. Rifampicin is the most implicated drug, although ethambutol can also be a cause. The pathogenesis involves an immune-complex mediated acute allergic response, which leads to their deposition on renal vessels, the glomerular endothelium, and the interstitial area. Other options:Isoniazid does not affect the kidneys. Pulmonary-renal syndrome is a feature of Goodpasture’s syndrome. It is characterized by renal failure and lung haemorrhage. Severe cardiac or renal failure ensues and is complicated by pulmonary oedema, systemic lupus erythematosus, Henoch-Schonlein purpura, and cryoglobulinemia.
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This question is part of the following fields:
- Nephro-urology
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Question 4
Correct
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A 10 year old child presents with enlarged tonsils that meet in the midline. Oropharyngeal examination confirms this finding and you also notice petechial haemorrhages affecting the oropharynx. On systemic examination he is noted to have splenomegaly. What is the most likely cause?
Your Answer: Acute Epstein Barr virus infection
Explanation:Answer: Acute Epstein Barr virus infectionThe Epstein-Barr virus is one of eight known human herpesvirus types in the herpes family, and is one of the most common viruses in humans. Infection with Epstein-Barr virus (EBV) is common and usually occurs in childhood or early adulthood.EBV is the cause of infectious mononucleosis, an illness associated with symptoms and signs like:fever,fatigue,swollen tonsils,headache, andsweats,sore throat,swollen lymph nodes in the neck, andsometimes an enlarged spleen.Although EBV can cause mononucleosis, not everyone infected with the virus will get mononucleosis. White blood cells called B cells are the primary targets of EBV infection.
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This question is part of the following fields:
- Paediatric Surgery
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Question 5
Incorrect
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Which of the following does not cause a scaly scalp?
Your Answer: Cutaneous lupus erythematous
Correct Answer: Pityriasis amiantacea
Explanation:Pityriasis amiantacea is a reaction pattern rather than a specific diagnosis. Common conditions that may present with pityriasis amiantacea include:Scalp psoriasisSeborrhoeic dermatitisAtopic dermatitisTinea capitis.Head lice and lichen simplex should also be considered.When no underlying cause is found, the condition is often called idiopathic pityriasis amiantacea.
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This question is part of the following fields:
- Dermatology
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Question 6
Correct
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A 10-year-old boy is brought to the hospital by his mother following complaints of fatigue. Considering a possible diagnosis of iron deficiency anaemia, blood investigations, including a peripheral smear, were ordered. The reports confirmed iron deficiency anaemia. Which of the following abnormal red cell types is likely to be seen in the peripheral smear of this patient?
Your Answer: Pencil cells
Explanation:A peripheral blood film in iron deficiency anaemia can reveal the following morphologically variant RBCs:- Microcytic cells- Hypochromic cells- Pencil cells- Target cellsOther options:- Schistocytes can be caused by mechanical heart valves. – Rouleaux can be seen in chronic liver disease and malignant lymphoma. – Tear-drop poikilocytes can be seen in myelofibrosis. – Acanthocytes can be seen in liver disease and McLeod blood group phenotype.Pathological red cell forms include:- Target cells: Sickle-cell/thalassaemia, iron-deficiency anaemia, hyposplenism, and liver disease.- Tear-drop poikilocytes: Myelofibrosis- Spherocytes: Hereditary spherocytosis and autoimmune haemolytic anaemia- Basophilic stippling: Lead poisoning, thalassaemia, sideroblastic anaemia, and myelodysplasia- Howell-Jolly bodies: Hyposplenism- Heinz bodies: G6PD deficiency and alpha-thalassaemiaSchistocytes (‘helmet cells’): Intravascular haemolysis, mechanical heart valve, and disseminated intravascular coagulation- Pencil poikilocytes: Iron deficiency anaemia- Burr cells (echinocytes): Uraemia and pyruvate kinase deficiency – Acanthocytes: Abetalipoproteinemia
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This question is part of the following fields:
- Haematology And Oncology
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Question 7
Correct
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A 1 year old child presents with barking cough, coryza and shortness of breath. What will be the most likely outcome associated with this condition?
Your Answer: Natural resolution
Explanation:Croup is the most common aetiology for hoarseness, cough, and onset of acute stridor in febrile children. Symptoms of coryza may be absent, mild, or marked. The vast majority of children with croup recover without consequences or sequelae.
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This question is part of the following fields:
- Respiratory
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Question 8
Correct
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A 15-year-old male presents complaining of gradually increasing fatigue. He says that he turned vegan a year ago. He explains that he takes vitamin B12 supplements every day. Considering iron deficiency anaemia as a possible cause, you order some blood tests to confirm. Which of the following would increase the ability of the body to absorb dietary iron?
Your Answer: Consuming iron in its ferrous (Fe2+) form
Explanation:Consuming iron in its Fe2+ (ferrous form) form can improve the ability to absorb dietary iron in patients with iron deficiency anaemia (IDA). Clinical features of IDA include:- Koilonychia- Atrophic glossitis- Post-cricoid webs- Angular stomatitisThe peripheral blood smear shows the following abnormal RBC morphologies:- Target cells- Pencil poikilocytes- Microcytic-hypochromic cells
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This question is part of the following fields:
- Haematology And Oncology
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Question 9
Incorrect
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A 16 year-old boy was stabbed in the right supraclavicular fossa. The sharp object punctured the portion of the parietal pleura that extends above the first rib. What is the name of this portion of the parietal pleura?
Your Answer: Costocervical recess
Correct Answer: Cupola
Explanation:Endothoracic fascia: the connective tissue (fascia) that is between the costal parietal pleura and the inner wall of the chest wall. Costomediastinal recess: the point where the costal pleura becomes mediastinal pleura. Costodiaphragmatic recess: is the lowest point of the pleural sac where the costal pleura becomes diaphragmatic pleura. Cupola: the part of the parietal pleura that extends above the first rib level into the root of the neck. Costocervical recess: this is a made-up term. Peritracheal fascia: a layer of connective tissue that invests the trachea.
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This question is part of the following fields:
- Anatomy
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Question 10
Correct
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A neonate is diagnosed with cryptorchidism of the right side (undescended testis). Which is the LEAST likely place to find the testis?
Your Answer: Perineum
Explanation:Embryologically the testes are retroperitoneal structures in the posterior abdominal wall, attached to the anterolateral abdominal wall by the gubernaculum. The gubernaculum ‘pulls’ the testes through the deep inguinal ring, inguinal canal and superficial inguinal ring and over the pelvic brim. The gubernaculum is preceded by the processus vaginalis that is derived from the peritoneum anterior to the testes. The processus vaginalis pushes the muscle and fascial layers. These eventually make up the canal and the spermatic cord, into the scrotum. The gubernaculum persists as the scrotal ligament while part of the processus vaginalis remains as a bursa-like sac i.e. the tunica vaginalis testes. The testes therefore could be caught in any one of these places along its path of descending. The testes are never in the perineum.
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This question is part of the following fields:
- Genitourinary
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