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Question 1
Incorrect
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Which of the following conditions result in a rash involving the palms and soles of the extremities?
Your Answer: Erythema infectiosum
Correct Answer: Tinea corporis
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. It produces an itchy rash with a central area of clearance surrounded by raised scaly borders. Diagnosis can be made by skin examination. All other mentioned conditions do not affect the palms and soles.
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This question is part of the following fields:
- Dermatology
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Question 2
Incorrect
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All of the following drugs tend to worsen the symptoms of myasthenia gravis except?
Your Answer: Pyridostigmine
Correct Answer: Prednisolone
Explanation:Prednisone is used for the treatment of myasthenia gravis if there is no initial response to the anticholinesterase medications. Pyridostigmine can make the symptoms of myasthenia gravis worse if used in the initial stages of treatment.ÂÂ
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This question is part of the following fields:
- Pharmacology
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Question 3
Incorrect
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A 15-year-old girl has a 5-day history of fever, general malaise and headache and has developed diffuse raised oedematous papules. These lesions are typical of erythema multiforme. Which one of the following is true?
Your Answer: The lesions can be distinguished from urticaria as they are normal in the centre
Correct Answer: The lesions will heal without scarring
Explanation:Erythema multiforme lesions typically heal without scarring. Other options:- In erythema multiforme, lesions are typically symmetrical and acral, i.e. on the hands, feet and limbs. – HSV is a common cause of erythema multiforme in children, accounting for at least 50% of cases; the lesions typically have damaged skin in the centre and are dusky and bullous (in contrast to urticaria, where the centre of the lesion is normal).
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This question is part of the following fields:
- Dermatology
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Question 4
Incorrect
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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: Vitamin D supplementation
Correct 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.
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This question is part of the following fields:
- Endocrinology
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Question 5
Correct
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A 16 year old girl fractured a bone in her left foot. Upon examination the clinician discovered that the fracture affected the insertion of the peroneus brevis muscle. Which of the following bones was most likely affected?
Your Answer: Base of the fifth metatarsal
Explanation:The peroneus brevis muscle originates from the lower two-thirds of the lateral body of the fibula and has inserts at the base of the fifth metatarsal. Fractures to this bone are common and can be due to infection, trauma, overuse and repetitive use.
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This question is part of the following fields:
- Anatomy
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Question 6
Correct
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A 16 year old boy presented, complaining that an insect had lodged in his left ear. Which of the following can be considered as the most appropriate method to remove the insect?
Your Answer: Syringe the ear with warm water
Explanation:Removal of foreign bodies from the ear is indicated whenever a well-visualized foreign body is identified in the external auditory canal. Insects are better extracted with suction than with forceps or hooks. From the given answers, irrigation with warm water is the most suitable answer.
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This question is part of the following fields:
- ENT
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Question 7
Incorrect
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A 8 year old child presents with acute abdominal pain. Last time he used the restroom, he noticed fresh blood after wiping. Doctors suspect an intussusception. What is the most probable cause?
Your Answer: Coeliac disease
Correct Answer: Gastrointestinal polyp
Explanation:Gastrointestinal polyps are common in children and may result in intussusception due to polyp traction. Treatment is usually surgical with enterotomy and removal of the polyp or of a segment of the bowel.
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This question is part of the following fields:
- Gastroenterology And Hepatology
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Question 8
Incorrect
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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: We should study a larger number
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.
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This question is part of the following fields:
- Epidemiology And Statistics
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Question 9
Correct
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A child cannot wave goodbye or grasp objects with her fingers and thumb but can sit briefly supported by leaning forward on her hands. She can reach and grasp objects with the whole hand and then pass it from one hand to the other and is babbling. What is her expected age?
Your Answer: 7 months
Explanation:At 7 months, children are expected to sit briefly leaning forward on their hands, reach and grasp objects, transfer objects from hand to hand, and babble. Children are usually expected to wave goodbye or grasp objects with their fingers or thumb at around 10 months and older.
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This question is part of the following fields:
- Child Development
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Question 10
Incorrect
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As the junior doctor on duty you are called to see a 4 year old boy who is has been experiencing intermittent temperature spikes of 38.7C throughout the night. He underwent a laparoscopic appendicectomy for a perforated appendix four days ago, and has opened his bowels with diarrhoea. His chest is clear on examination.Which of the following is the most likely explanation for his condition?
Your Answer:
Correct Answer: Intra-abdominal collection
Explanation:Perforated appendices are common in children as it is more difficult to surgically assess an unwell child due to poor localisation of abdominal pain, and their inability to express discomfort. They are therefore prone to a greater risk of post operative complications including would infections, intra abdominal fluid collections, and chest infections. In the above scenario the spiking temperature points to an abscess, which characteristically presents with a swinging temperature. The fever is unlikely due to bacterial resistance as blood tests performed post surgery would have indicated any resistance, and a UTI is also unlikely since the child is already on antibiotics. As his chest is clinically clear, a severe chest infection may be ruled out, leaving intra-abdominal collection as the most likely explanation.
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This question is part of the following fields:
- Paediatric Surgery
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SESSION STATS - PERFORMANCE PER SPECIALTY
