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Question 1
Correct
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An 18 year old girl presented with dysmenorrhea and irregular menstrual cycles. The most appropriate management in this case would be?
Your Answer: Combined pill
Explanation:Combined oral contraceptive pills have an anti ovulatory function and also reduce the pain of menstruation.
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This question is part of the following fields:
- Adolescent Health
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Question 2
Incorrect
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An 18-year-old male presents to the clinic with a solitary, painless penile ulcer 2 cm in diameter. It appeared as a small red lump, 3 weeks after an episode of unprotected sexual intercourse with a new male partner and quickly progressed to this form. On examination, the ulcer has slightly elevated edges. This infection is most likely caused by which of the following organism?
Your Answer: Neisseria gonorrhoeae
Correct Answer: Treponema pallidum
Explanation:Syphilis is an infectious venereal disease caused by the spirochete Treponema pallidum. Syphilis is transmissible by sexual contact with infectious lesions, from mother to foetus in utero, via blood product transfusion, and occasionally through breaks in the skin that come into contact with infectious lesions. If untreated, it progresses through 4 stages: primary, secondary, latent, and tertiary.
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This question is part of the following fields:
- Adolescent Health
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Question 3
Incorrect
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A 19-year-old boy presents to the emergency department at about 6 am with reduced responsiveness and muscle rigidity. His mother reports that he attended a rave and came home euphoric, ataxic, and experiencing multiple hallucinations.Which of the following illicit substances is the most likely to have been consumed?
Your Answer: MDMA (ecstasy)
Correct Answer: Ketamine
Explanation:The given presentation is highly suggestive of withdrawal effect of ketamine.Ketamine is known for its unique property of inducing dissociative anaesthesia. Emergence phenomenon (as seen in the child in question) is an adverse effect that occurs during recovery from dissociative anaesthesia. The components of emergence phenomenon include a euphoric state associated with hallucinations.
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This question is part of the following fields:
- Adolescent Health
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Question 4
Correct
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What is the main mechanism of action of the combined oral contraceptive pill?
Your Answer: Inhibition of ovulation
Explanation:The progesterone is primarily responsible for preventing pregnancy. The main mechanism of action is the prevention of ovulation; they inhibit follicular development and prevent ovulation. Progestogen negative feedback works at the hypothalamus to decreases the pulse frequency of gonadotropin-releasing hormone. This, in turn, will decrease the secretion of follicle-stimulating hormone (FSH) and decreases the secretion of luteinizing hormone (LH). If the follicle isn’t developing, then there is no increase in the oestradiol levels (the follicle makes oestradiol). The progestogen negative feedback and lack of oestrogen positive feedback on LH secretion stop the mid-cycle LH surge. With no follicle developed and no LH surge to release the follicle, there is the prevention of ovulation. Oestrogen has some effect with inhibiting follicular development because of its negative feedback on the anterior pituitary with slows FSH secretion; it’s just not as prominent as the progesterone’s effect. Another primary mechanism of action is progesterone’s ability to inhibit sperm from penetrating through the cervix and upper genital tract by making the cervical mucous unfriendly. Progesterone induced endometrial atrophy should deter implantation, but there is no proof that this occurs.
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This question is part of the following fields:
- Adolescent Health
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Question 5
Incorrect
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Anorexia nervosa is associated with which of the following skin and nail related changes?
Your Answer: Transverse white lines to the nails
Correct Answer: Acrocyanosis
Explanation:Anorexia nervosa is an eating disorder which is characterized by distorted self-image leading to abnormally decreased calorie intake. This disorder affects multiple bodily systems, including the skin, GI, and endocrine system. Due to extreme weight loss, patients with anorexia nervosa develop cold intolerance along with bluish discoloration of their fingers, nose, and ears, which is known as acrocyanosis. This phenomenon may be due to the shunting of the blood from the peripheries to the central body systems as a reaction to hypothermia. Other notable changes in the integumentary system include extreme dryness (xerosis), lanugo hairs, decubitus ulcers, and easy bruisibility.
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This question is part of the following fields:
- Adolescent Health
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Question 6
Incorrect
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An 18-year-old male presents to the clinic with a solitary, painless penile ulcer 2 cm in diameter. It appeared as a small red lump, 3 weeks after an episode of unprotected sexual intercourse with a new male partner and quickly progressed to this form. On examination, the ulcer has slightly elevated edges. Which of the following treatment strategies should be employed?
Your Answer: Metronidazole
Correct Answer: Benzylpenicillin
Explanation:Syphilis is an infectious venereal disease caused by the spirochete Treponema pallidum. Syphilis is transmissible by sexual contact with infectious lesions, from mother to foetus in utero, via blood product transfusion, and occasionally through breaks in the skin that come into contact with infectious lesions. If untreated, it progresses through 4 stages: primary, secondary, latent, and tertiary. Primary and secondary syphilis are easy to treat with a penicillin injection. Penicillin is one of the most widely used antibiotics and is usually effective in treating syphilis. People who are allergic to penicillin will likely be treated with a different antibiotic, such as:doxycyclineazithromycinceftriaxone
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This question is part of the following fields:
- Adolescent Health
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Question 7
Correct
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A 17-year-old female presents with pelvic pain occurring during her periods, with 'deep' pain during intercourse and pain on defecation during this time. She states that her periods are regular with little bleeding.What is the most likely diagnosis?
Your Answer: Endometriosis
Explanation:Endometriosis is defined as the presence of normal endometrial mucosa (glands and stroma) abnormally implanted in locations other than the uterine cavityAbout one third of women with endometriosis remain asymptomatic. When they do occur, symptoms, such as the following, typically reflect the area of involvement:- Dysmenorrhea- Heavy or irregular bleeding- Pelvic pain- Lower abdominal or back pain – Dyspareunia- Dyschezia (pain on defecation) – Often with cycles of diarrhoea and constipation- Bloating, nausea, and vomiting- Inguinal pain- Pain on micturition and/or urinary frequency- Pain during exercise- Patients with endometriosis do not frequently have any physical examination findings beyond tenderness related to the site of involvement. – The most common finding is nonspecific pelvic tenderness.
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This question is part of the following fields:
- Adolescent Health
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Question 8
Incorrect
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A 26-year-old doctor who has recently been diagnosed with melanoma asks about survival rates associated with this condition. Which of the following statistical methods is employed to predict the survival rates?
Your Answer: Regression analysis
Correct Answer: Kaplan-Meier estimator
Explanation:The Kaplan-Meier estimator, also known as the product limit estimator, is a non-parametric statistic used to estimate the survival function from lifetime data. In medical research, it is often used to measure the fraction of patients living for a certain amount of time after treatment.
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This question is part of the following fields:
- Adolescent Health
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Question 9
Correct
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A 17-year-old boy is known to make irrational decisions which would normally be considered risky and subsequently gets in trouble with the police. An area in his brain controls judgement, impulse control and planning. Changes in this area of the brain mostly occur until what age?
Your Answer: 20 -29 years
Explanation:The rational part of a teen’s brain isn’t fully developed until the age of 25 or so.In fact, recent research has found that adult and teen brains work differently. Adults think with the prefrontal cortex, the brain’s rational part. This is the part of the brain that responds to situations with good judgment and an awareness of long-term consequences. Teens process information with the amygdala. This is the emotional part.
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This question is part of the following fields:
- Adolescent Health
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Question 10
Incorrect
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An 18-year-old pregnant female is brought to the emergency department with complaints of headache, blurred vision and abdominal pain. Her BP is recorded to be 160/110 mmHg and she is also found to have proteinuria. Which of the following findings will typically be found in this scenario?
Your Answer: Facial oedema, rash and stridor
Correct Answer: Haemolysis, elevated liver enzymes and low platelets
Explanation:HELLP syndrome is a complication of pregnancy characterized by haemolysis, elevated liver enzymes, and a low platelet count. It usually begins during the last three months of pregnancy or shortly after childbirth. HELLP syndrome is a life-threatening condition that can potentially complicate pregnancy. It is named for 3 features of the condition: Haemolysis, Elevated Liver enzyme levels, and Low Platelet levels. It typically occurs in the last 3 months of pregnancy (the third trimester) but can also start soon after delivery. A wide range of non-specific symptoms may be present in women with HELLP syndrome. Symptoms may include fatigue; malaise; fluid retention and excess weight gain; headache; nausea and vomiting; pain in the upper right or middle of the abdomen; blurry vision; and rarely, nosebleed or seizures. The cause of HELLP syndrome is not known, but certain risk factors have been associated with the condition. It is most common in women with preeclampsia or eclampsia. If not diagnosed and treated quickly, HELLP syndrome can lead to serious complications for the mother and baby. The main treatment is to deliver the baby as soon as possible, even if premature, if there is distress of the mother or the baby. Treatment may also include medications needed for the mother or baby, and blood transfusion for severe bleeding problems.
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This question is part of the following fields:
- Adolescent Health
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