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Question 1
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A 15-year-old boy presented to a urologist with a complaint of blood in the urine and pain in his abdomen. On examination, abdominal swelling is present and blood pressure is elevated. Which of the following is the most appropriate investigation in this case?
Your Answer: Ultrasound
Explanation:Haematuria and abdominal swelling may indicate either polycystic kidney disease or a tumour. Because of the patient’s age, the likelihood of a tumorous growth is small, thus an ultrasound is the best choice for this case.
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This question is part of the following fields:
- Renal
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Question 2
Correct
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A screening test is found to have a sensitivity of 90% and a specificity of 95%.Which of the following is the best answer?
Your Answer: An individual without disease is more likely to be correctly diagnosed via the test than someone with the disease
Explanation:The sensitivity of a screening test can be described in a variety of ways, typically such as sensitivity being the ability of a screening test to detect a true positive, being based on the true positive rate, reflecting a test’s ability to correctly identify all people who have a condition, or, if 100%, identifying all people with a condition of interest by those people testing positive on the test.The specificity of a test is defined in a variety of ways, typically such as specificity is the ability of a screening test to detect a true negative, being based on the true negative rate, correctly identifying people who do not have a condition, or, if 100%, identifying all patients who do not have the condition of interest by those people testing negative on the test.
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This question is part of the following fields:
- Epidemiology And Statistics
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Question 3
Correct
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A 5 year old girl presented with short stature, primary amenorrhea, puffy arms and a webbed neck. The most likely diagnosis will be?
Your Answer: Turner's syndrome
Explanation:Turner’s syndrome is characterised by a webbed neck, short stature, primary amenorrhea and cardiac, renal and muscular defects. Gene analysis shows a single X chromosome in the patients. Downs syndrome has certain cognitive and physical abnormalities, whereas in Klinefelter syndrome there are widely spaced nipples, long arms and infertility and it only occurs in men.
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This question is part of the following fields:
- Genetics And Dysmorphology
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Question 4
Correct
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Which of the following skills would a 1-year-old girl be able to demonstrate, assuming that her developmental growth is normal?
Your Answer: Understanding of object permanence
Explanation:Among the options provided, a 1-year-old child will be able to understand object permanence e.g. understands that objects continue to exist even when they can’t be seen, e.g. looking for a fallen toy.At the age of 1 year, children should have developed an accurate pincer grip and be able to see and co-ordinate and manipulate fairly small objects such as a raisin.Gross motor development varies, but the average 1-year-old should be able to stand and cruise around furniture or walk with their hands held but not necessarily walk unaided.Drinking from a cup will become established at around 15 months and scribbling at 18 months.
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This question is part of the following fields:
- Child Development
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Question 5
Incorrect
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A 15-year-old boy is identified as having a Meckel's diverticulum. Which of the following embryological structures gives rise to the Meckel's diverticulum?
Your Answer: Hindgut
Correct Answer: Vitello-intestinal duct
Explanation:Meckel’s diverticulum is a congenital diverticulum of the small intestine. It is a remnant of the omphalomesenteric duct (also called the vitellointestinal duct) and contains ectopic ileal, gastric or pancreatic mucosa.Rule of 2’s- occurs in 2% of the population- it is located 2 feet proximal to the ileocaecal valve- it is 2 inches long- it is 2 times more common in men- there are 2 tissue types involvedIt is typically asymptomatic. Symptomatic presentation indicates inflammation of the diverticulum. The symptoms include:- Abdominal pain mimicking appendicitis- Rectal bleeding- Intestinal obstruction: secondary to an omphalomesenteric band (most commonly), volvulus and intussusceptionManagement:Surgical removal if the neck of the diverticulum is narrow or symptomatic. Surgical options are excision or formal small bowel resection and anastomosis.
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This question is part of the following fields:
- Gastroenterology And Hepatology
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Question 6
Incorrect
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A young girl is brought to the ED by her parents because of increased body temperature, rhinorrhoea and an unusual bark-like cough. The girl is also drooling because of excessive salivation. What would be the most appropriate management?
Your Answer: Adrenaline nebulizer
Correct Answer: Corticosteroids
Explanation:The symptoms and signs described are typical for epiglottitis which represents a paediatric emergency and the child should be put immediately on corticosteroids.
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This question is part of the following fields:
- Respiratory
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Question 7
Incorrect
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A 9-year-old girl complains of perioral blisters and a burning sensation of her face. Some of the blisters are crusted and some are weeping. What is the most likely diagnosis?
Your Answer: Shingles
Correct Answer: Impetigo
Explanation:Impetigo appears more commonly on the face than other exposed areas like the limbs. Its blisters are clustered and may have a fluid discharge.
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This question is part of the following fields:
- Dermatology
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Question 8
Correct
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A 15 month old boy has a history of repeated bacterial pneumonia, failure to thrive and a sputum culture positive for H.influenzea and S.pneumoniae. There is no history of congenital anomalies. He is most likely suffering from?
Your Answer: X-linked agammaglobulinemia
Explanation:Recurrent bacterial infections may be due to lack of B-cell function, consequently resulting in a lack of gamma globulins production. Once the maternal antibodies have depleted, the disease manifests with greater severity and is called x-linked agammaglobulinemia also known as ‘X-linked hypogammaglobulinemia’, ‘XLA’ or ‘Bruton-type agammaglobulinemia. it is a rare x linked genetic disorder that compromises the bodies ability to fight infections. Acute leukaemia causes immunodeficiency but not so specific. DiGeorge syndrome is due to lack of T cell function. Aplastic anaemia and EBV infection does not cause immunodeficiency.
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This question is part of the following fields:
- Respiratory
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Question 9
Incorrect
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A 17-year-old boy is brought to the endocrinologist by his parents who are worried that he might have delayed growth as all his friends are taller than him. On examination, he has a preadolescent body habitus and no evidence of development of secondary sexual characteristics. Serum LH, FSH, and testosterone all match prepubertal range. Following an injection of GnRH, the LH and FSH concentrations increase only slightly. However, when the GnRH is given daily for 7 days, a normal response is elicited. Which of the following is the most likely causing this boy's delayed puberty?
Your Answer: A pituitary disorder
Correct Answer: A hypothalamic disorder
Explanation:Hypogonadotropic hypogonadismIn Kallmann syndrome: impaired migration of GnRH cells and defective olfactory bulb → ↓ GnRH in hypothalamus → ↓ FSH and ↓ LH → ↓ testosterone and ↓ oestrogenIn hypothalamic and/or pituitary lesions: ↓ pituitary gonadotropins (↓ FSH and ↓ LH) → ↓ testosterone and ↓ oestrogen
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This question is part of the following fields:
- Endocrinology
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Question 10
Correct
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A 5 month old boy presents with a history of one episode of green vomiting. Upon clinical examination, doctors notice an acutely swollen mass located in the groin, extending to the scrotum. What is the most probable diagnosis and what's the most appropriate management?
Your Answer: Incarcerated indirect inguinal hernia, analgesia, sedation and attempt to reduce
Explanation:An incarcerated indirect inguinal hernia presents with abdominal pain, bloating, nausea, vomiting, and intestinal obstruction. It is characterized by the appearance of a tender mass in the inguinal area. Manual reduction in children requires analgesia and sedation.
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This question is part of the following fields:
- Paediatric Surgery
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SESSION STATS - PERFORMANCE PER SPECIALTY
