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Question 1
Incorrect
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A 16-year-old boy suffers recurrent episodes of haematuria following a flu-like illness. He is otherwise well. Physical examination is normal. Urinalysis reveals no proteinuria, blood ++, and 2-3 white blood cells/mm3.What is the most probable diagnosis?
Your Answer: Post-streptococcal glomerulonephritis
Correct Answer: IgA nephropathy
Explanation:IgA nephropathy’s characteristic presentation is haematuria following a non-specific upper respiratory infection as was evident in this case. IgA nephropathy also usually occurs in children and young males, like this patient.
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This question is part of the following fields:
- Renal
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Question 2
Incorrect
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A new-born has several strawberry naevi. You're concerned about internal haemangiomas. How many naevi should warrant further investigation?
Your Answer: More than 4
Correct Answer: More than 5
Explanation:Eight percentage of infantile haemangiomas are focal and solitary. Sixty percent of cutaneous haemangiomas occur on the head and neck, 25% on the trunk, and 15% on the extremities. Haemangiomas also can occur in extracutaneous sites, including the liver, gastrointestinal tract, larynx, CNS, pancreas, gall bladder, thymus, spleen, lymph nodes, lung, urinary bladder, and adrenal glands.Guidelines on the management of infantile haemangioma were released in December 2018 by the American Academy of Paediatrics stating that:Imaging is not necessary unless the diagnosis is uncertain, there are five or more cutaneous infantile haemangiomas present, or there is suspicion of anatomic abnormalities.
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This question is part of the following fields:
- Neonatology
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Question 3
Correct
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An infant born at 34 weeks was kept in the incubator for almost a month. Physical examination revealed a heart murmur, which however was not present at discharge. What is the most probable cause of this murmur?
Your Answer: PDA
Explanation:PDA is particularly common in premature babies and it is managed by indomethacin administration. However, if PDA is not the only defect, prostaglandin E1 can be administered in order to keep the ductus open until the surgery takes place.
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This question is part of the following fields:
- Cardiovascular
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Question 4
Incorrect
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All of the following are features of tinea corporis EXCEPT?
Your Answer: Flat, red scaly lesions progressing to annular lesions with central clearing
Correct Answer: It is less common on glabrous skin
Explanation:Tinea corporis is a type of dermatophytosis, caused by Trichophyton or Microsporum. The disease is highly contagious and rapidly spreads to all the areas of the body, including the glabrous skin. It produces an erythematous itchy skin rash with a central area of clearance surrounded by raised scaly borders. Lesions can appear as concentric circles that overlap, referred to as tinea imbricate.
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This question is part of the following fields:
- Dermatology
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Question 5
Incorrect
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Children can be offered cow's milk starting from what age?
Your Answer:
Correct Answer: 12 months
Explanation:Cow’s milk differs in composition to human breast milk. The sodium content of cows milk is too high, which can easily overwhelm a baby’s developing kidneys and lead to hypernatremia and dehydration. In addition to its iron content being too low, cows milk can cause further increase iron deficiency anaemia by irritating the baby’s intestinal lumen and causing blood loss per rectum. After 12 months a baby’s gastrointestinal tract and organs are able to tolerate cows milk.
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This question is part of the following fields:
- Neonatology
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Question 6
Incorrect
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A 17 year old female presented with irregular menstrual cycles for 4 months. On examination her weight was 85 kg and height was 145 cm. She was not on any medications. Which of the following is the most appropriate investigation to arrive at a diagnosis?
Your Answer:
Correct Answer: Pelvic ultrasound
Explanation:Oligomenorrhoea and BMI of 40.4 is suggestive of Polycystic ovary syndrome (PCOS). To diagnose PCOS 2 out of following 3 criteria should be present : oligo/anovulation, hyperandrogenism, clinical (hirsutism or less commonly male pattern alopecia) or biochemical (raised FAI or free testosterone) and polycystic ovaries on ultrasound.
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This question is part of the following fields:
- Genitourinary
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Question 7
Incorrect
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Which of the following is true regarding precocious puberty?
Your Answer:
Correct Answer: It is treated with LHRH agonists
Explanation:Precocious puberty refers to the appearance of physical and hormonal signs of pubertal development at an earlier age than is considered normal.Most patients, particularly girls suspected of having central precocious puberty, are otherwise healthy children whose pubertal maturation begins at the early end of the normal distribution curveIn a series of more than 200 patients evaluated at a single medical centre, central precocious puberty occurred 5 times more often in girls than boys.GnRH-dependent precocious puberty is treated with GnRH agonists or Luteinizing Hormone Releasing Hormone (LHRH). Follow up every 4-6 months to ensure that progression of puberty has been arrestedFavourable signs include normalization of accelerated growth, reduction (or at least no increase) in size of breasts, and suppression of gonadotropin levels after a challenge of GnRHThe ideal testing frequency has not been established. Monitor bone age yearly to confirm that the rapid advancement seen in the untreated state has slowed, typically to a half year of bone age per year or less
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This question is part of the following fields:
- Endocrinology
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Question 8
Incorrect
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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.
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This question is part of the following fields:
- Embryology
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Question 9
Incorrect
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A 7-year-old girl was brought to the OPD with a history of a large swelling on the side of her neck with associated lymph node swellings in her neck and axilla. Which if the following investigations will you order next?
Your Answer:
Correct Answer: Lymph node biopsy
Explanation:As there is lymphadenopathy already present in this patient, doing a biopsy of the lymph nodes will rule out metastasis of any underlying tumour.
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This question is part of the following fields:
- ENT
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Question 10
Incorrect
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A 2-year-old child, who is not very active, presented with bruises on the back as well as on the chest. X-ray showed a radiolucent area around the ribs indicating callus formation. Which of the following is the most important investigation in this case?
Your Answer:
Correct Answer: Skeletal survey
Explanation:Because the initial chest X-ray returned an anomaly, a skeletal survey is the best option. Also known as a bone survey, the skeletal survey is a series of X-rays that will help analyse the structure of all the bones in the body. Because the child is not very active yet presents with bruising, the child protection register should also be checked but only after a skeletal survey has been conducted.
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This question is part of the following fields:
- Musculoskeletal
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SESSION STATS - PERFORMANCE PER SPECIALTY
