MEDICAL
MAGNESIUM SULFATE IS COMMONLY ADMINISTERED TO WOMEN WITH PRE-ECLAMPSIA. WHAT IS THE PRIMARY GOAL OF THIS THERAPY
A. To lower the BP B. To prevent preterm labor C. For neuroprotection of the fetus D. To prevent seizures ✓ E. To dilate the cerebral vasculature and prevent headache Pre-eclampsia is a serious condition that can occur during pregnancy, characterized by high blood pressure…
A 46-YEAR-OLD, NON-PREGNANT, MORBIDLY OBESE WOMAN PRESENTS WITH IRREGULAR PERIODS OVER THE PAST 6 MONTHS. WHICH OF THE FOLLOWING REPRESENTS THE MOST APPROPRIATE INITIAL MANAGEMENT IN THIS SETTING
A. Oral contraceptives B. Endometrial ablation C. Office hysteroscopy D. Dilation and curettage (D&C) E. Endometrial biopsy ✓ In this case, the most appropriate initial management for a 46-year-old, non-pregnant, morbidly obese woman presenting with irregular periods over the past 6 months would be…
A PATIENT WHO IS A CHRONIC HEPATITIS B CARRIER DELIVERS VAGINALLY AT 39 WEEKS’ GESTATION. THE BABY SHOULD RECEIVE WHICH OF THE FOLLOWING THERAPIES ON THE FIRST DAY OF LIFE
A. Hepatitis B immune globulin (HBIG) B. Hepatitis B vaccination C. HBIG and hepatitis B vaccination ✓ D. None of the above In the scenario described, where a chronic hepatitis B carrier delivers vaginally at 39 weeks’ gestation, the baby should receive both…
WHICH STRUCTURE PROVIDES THE MAJOR SUPPORT TO THE UTERUS AND CERVIX
A. Round ligaments B. Broad ligaments C. Cardinal ligaments ✓ D. Uterosacral ligaments E. Scarpa fascia The cardinal ligaments provide the major support to the uterus and cervix. These ligaments are located at the base of the broad ligament of the uterus, extending from…
WHICH MEDICINE HAS TO BE DIRECTLY INJECTED INTO THE FETUS
A. Digoxin B. Propranolol C. Flecanide D. Amiodarone ✓ In the case of fetal supraventricular tachycardia (SVT) with hydrops fetalis, amiodarone is the medicine that has to be directly injected into the fetus. Amiodarone is an antiarrhythmic medication that can be…
THE TERM “ZONE OF ALTERED MORPHOLOGY” REFERS TO
A. The zone of amnion, chorion, and decidua in the edge of the placental mass B. The zone of amnion, chorion, and decidua at the midpoint between the placental mass at the site of rupture of membranes C. The zone…
THE MOST COMMON MICROORGANISM ISOLATED BY CULTURE OF AMNIOTIC FLUID IN PRETERM PROM IS
A. Ureaplasma urealyticum ✓ B. Fusobacterium nucleatum C. Mycoplasma hominis D. Escherichia coli E. Group B Streptococcus In cases of preterm premature rupture of membranes (PROM), the most common microorganism isolated by culture of amniotic fluid is Ureaplasma urealyticum. This…
INITIAL TREATMENT FOR MASTITIS INCLUDES A 10 TO 14-DAY COURSE OF A PENICILLINASE-RESISTANT ANTIBIOTIC WITH ADVICE TO THE MOTHER TO
A. Continue nursing with careful attention to thorough breast drainage ✓ B. Pump and discard milk with careful attention to through breast drainage C. Allow the breasts to “rest” removing only enough milk to relief discomfort D. Bind the breasts…
IN INFANTS WITH PERSISTENT PULMONARY HYPERTENSION, WHICH ONE OF THE FOLLOWING MEDICATIONS HAS BEEN DEMONSTRATED BY RANDOMIZED, CONTROLLED TRIALS TO REDUCE THE NEED FOR EXTRACORPOREAL MEMBRANE OXYGENATION
A. Sodium bicarbonate B. Fentanyl (narcotic) C. Pancuronium (paralytic) D. Inhaled nitric oxide ✓ E. Albuterol In infants with persistent pulmonary hypertension, the medication that has been demonstrated by randomized, controlled trials to reduce the need for extracorporeal membrane…
IN A TERM, GROWTH-RETARDED 10-HOUR-OLD NEONATE WITH SOME HYPOTONIA, JITTERINESS, MODERATE TACHYPNEA, AND A BLOOD GLUCOSE OF 10 MG/DL ASSESSED BY A RAPID REAGENT TEST, THE FOLLOWING IS THE MOST APPROPRIATE IMMEDIATE COURSE OF ACTION
A. Send a confirmatory blood glucose sample and start enteral feedings B. Start enteral feedings and send a blood sample for insulin determination C. Send a confirmatory blood glucose sample and start an intravenous glucose infusion ✓ D. Give a…
THE MOST COMMON CAUSE OF POSTPARTUM HEMORRHAGE IS
A. Uterine atony ✓ B. Coagulopathy C. Obstetric trauma D. Retained placenta The most common cause of postpartum hemorrhage is A) Uterine atony. Postpartum hemorrhage is defined as excessive bleeding following childbirth, and uterine atony refers to the inability…
THE FUNDUS COMPRESSION SUTURE USED IN THE MANAGEMENT OF UTERINE BLEEDING WAS DESCRIBED BY
A. O’Leary B. B-Lynch ✓ C. Haultain D. Huntington The B-Lynch suture, also known as the B-Lynch compression suture, is a surgical technique used in the management of postpartum hemorrhage (PPH) or uterine bleeding. It was developed by Dr.…
A PATIENT WITH MARFAN SYNDROME IS CONTEMPLATING PREGNANCY. WHICH OF THE FOLLOWING CLINICAL FINDINGS PLACES HER AT HIGHEST RISK FOR MORTALITY DURING PREGNANCY
A. A grade 2/6 apical diastolic murmur with radiation to the axilla B. An aortic root diameter of 47 mm ✓ C. Marked tricuspid regurgitation D. Unifocal premature ventricular contractions In a patient with Marfan syndrome contemplating pregnancy, an…
IN DIABETIC PATIENTS WHO ARE IN PREMATURE LABOR, THE DRUG OF CHOICE IS
A. A beta-sympathomimetic B. Magnesium sulfate ✓ C. Prostaglandin synthetase inhibitors D. Salbutamol In diabetic patients who are in premature labor, the drug of choice is magnesium sulfate. Magnesium sulfate is commonly used as a tocolytic agent to delay…
THE CONDITION MOST FREQUENTLY MISDIAGNOSED AS APPENDICITIS IS
A. Renal colic B. Round ligament syndrome C. Preterm labor D. Pyelonephritis ✓ E. Cystitis Pyelonephritis is the condition most frequently misdiagnosed as appendicitis. Pyelonephritis is an infection of the kidney and upper urinary tract, usually caused by bacteria…
A PATIENT PRESENTS IN LABOR WITH APPENDICITIS. THE CORRECT MANAGEMENT IS
A. Cesarean section with removal of the appendix B. Vaginal delivery with appendectomy postpartum ✓ C. Appendectomy followed by vaginal delivery D. Appendectomy followed by Cesarean section E. Tocolysis with appendectomy followed by vaginal delivery F. Appendectomy followed by tocolysis…
THE ANTIPHOSPHOLIPID ANTIBODY SYNDROME IS TYPICALLY ASSOCIATED WITH WHICH RENAL DISEASE
A. Thrombotic microangiopathy ✓ B. Minimal change disease C. Focal segmental glomerulosclerosis D. Membranous glomerulopathy Antiphospholipid antibody syndrome (APS) is typically associated with renal disease, particularly thrombotic microangiopathy. Thrombotic microangiopathy is a condition characterized by the formation of blood…
HYPEREMESIS GRAVIDARUM CAN CAUSE A NEUROPATHY BY CAUSING A DEFICIENCY OF WHAT
A. Vitamin B12 B. Vitamin B1 (thiamine) ✓ C. Vitamin C D. Vitamin D E. Vitamin B2 (riboflavin) Hyperemesis gravidarum is a severe form of nausea and vomiting during pregnancy that can lead to various complications, including nutritional deficiencies.…
THE MOST EFFECTIVE TREATMENT FOR SCLERODERMA COMPLICATED WITH RENAL CRISIS DURING PREGNANCY IS
A. Angiotensin-converting enzyme (ACE) inhibitors ✓ B. Corticosteroids C. Nonsteroidal anti-inflammatory drugs (NSAIDs) D. Methotrexate Scleroderma complicated with renal crisis during pregnancy is a serious condition that requires careful management to ensure the health and safety of both the…
THE MALIGNANCY OCCURRING IN PREGNANCY MOST LIKELY TO BE ASSOCIATED WITH FETAL METASTASES IS
A. Thyroid B. Hodgkin’s disease C. Chronic lymphocytic leukemia D. Vulva E. Melanoma ✓ The malignancy occurring in pregnancy most likely to be associated with fetal metastases is melanoma. Melanoma is a type of skin cancer that can spread…
WHEN OXYTOCIN IS GIVEN TO TREAT AN ARREST OF DILATION
A. It should be continued for as long as there is perceptible progress in cervical dilation B. It should be discontinued if no fetal descent occurs in the first 3 h C. Most patients who respond will do so within…
A FETAL HEAD THAT IS FLOATING ABOVE THE INLET DURING EARLY LABOR
A. Is always associated with a deflexed attitude B. Is associated with an increased risk of Cesarean delivery ✓ C. Signifies a malposition D. Only occurs in cases of android pelvic architecture During early labor, a fetal head that…
IN INFANTS WITH POLYCYTHEMIA AND SYMPTOMS SECONDARY TO HYPERVISCOSITY, MOST CENTERS WOULD
A. Perform a double-volume exchange transfusion B. Initiate phototherapy C. Perform a partial exchange transfusion ✓ D. Administer intravenous immunoglobulin (IVIG) E. Perform a triple lindy In infants with polycythemia and symptoms secondary to hyperviscosity, most centers would perform…
A 24 YEAR OLD WOMAN IS SCHEDULED FOR AN URGENT APPENDECTOMY. SHE HAS SEVERE ABDOMINAL PAIN BUT IS OTHERWISE WELL. A RAPID SEQUENCE INDUCTION IS PERFORMED USING FENTANYL, PROPOFOL AND SUXAMETHONIUM. SOON AFTER INTUBATION HER PULSE RATE IS 140BPM, BP 60/40MMHG AND SHE HAS SIGNIFICANT BRONCHOSPASM. WHICH IS THE SINGLE MOST LIKELY CAUSE
A. Acute asthma B. Anaphylaxis ✓ C. Inadvertent intubation of right main bronchus D. Septic shock E. Tension pneumothorax The single most likely cause of the symptoms described in the scenario is Anaphylaxis. Anaphylaxis is a severe, potentially life-threatening…
THE SPINAL LEVEL THAT IS APPROPRIATE FOR CESAREAN SECTION IS
A. T1–T2 B. T4–T6 ✓ C. T6–T8 D. T10 E. T7–T10 A Cesarean section, commonly known as C-section, is a surgical procedure used to deliver a baby through an incision in the mother’s abdomen and uterus. Spinal anesthesia is…
DURING THE SECOND AND THIRD TRIMESTERS, OVER 90% OF THE HEMOGLOBIN OF THE FETUS IS
A. Hemoglobin A B. Hemoglobin F ✓ C. Hemoglobin G D. Hemoglobin H E. Hemoglobin Z During the second and third trimesters of pregnancy, the fetal circulatory system undergoes significant development to support the growing fetus. One crucial component…
AFTER PARTURITION, NONLACTATING WOMEN EXPERIENCE OVULATION ON AVERAGE AT
A. 45 days ✓ B. 60 days C. 90 days D. 120 days After parturition, nonlactating women typically experience ovulation at around 45 days postpartum. This period is known as the postpartum anovulatory phase, during which ovulation is suppressed…
FETOPLACENTAL CIRCULATION IS ESTABLISHED AT OR DURING THE
A. Tenth week of gestation B. Fifth week of gestation ✓ C. Third week of gestation D. Third month of gestation E. Fourth month of gestation Fetoplacental circulation is a crucial process in pregnancy where the circulatory system of…
A 64 YEAR OLD WOMAN WITH PREVIOUS EPISODES OF DEPRESSION HAS A SEVERE RELAPSE WITH PSYCHOMOTOR RETARDATION, INSOMNIA AND WEIGHT LOSS. AFTER TWO MONTHS SHE HAS FAILED TO RESPOND TO ANTIDEPRESSANTS AND SHE IS NOW CONVINCED THAT SHE IS BEYOND HELP. WHICH IS THE SINGLE MOST APPROPRIATE TREATMENT
A. Antipsychotic depot injection B. CBT C. ECT ✓ D. Hypnotherapy E. Supportive psychotherapy In the case of a 64-year-old woman experiencing a severe relapse of depression with symptoms such as psychomotor retardation, insomnia, and weight loss, who has…
A 72 YEAR OLD MAN IN ICU HAD AN ABDOMINAL AORTIC ANEURYSM REPAIR EIGHT HOURS AGO. IN THE LAST HOUR, HE HAS PASSED 10ML OF URINE VIA A CATHETER. HIS PULSE RATE IS 125 BPM AND BP 70/50MMHG. WHICH IS THE SINGLE MOST LIKELY DIAGNOSIS
A. Acute renal failure B. Blocked catheter C. Cardiogenic shock D. Hypovolaemia ✓ E. Sepsis Given the clinical scenario described, the most likely diagnosis for the 72-year-old man in the ICU who had an abdominal aortic aneurysm repair eight…
AN 18 YEAR OLD MAN WITH ASTHMA HAS GRADUALLY INCREASING BREATHLESSNESS AND WHEEZE DESPITE REGULAR USE OF HIS SALBUTAMOL AND CORTICOSTEROID INHALERS. WHICH IS THE MOST APPROPRIATE NEXT THERAPEUTIC STEP
A. Add leukotriene antagonist B. Add long acting inhaled beta 2 agonist ✓ C. Add oral theophylline D. Double the dose of inhaled corticosteroid E. Replace inhaled steroid with oral corticosteroid In this scenario, the most appropriate next therapeutic…
INFECTION WITH PNEUMOCYSTIS JIROVECI SUGGESTS A DEFECT IN WHICH ASPECT OF THE IMMUNE SYSTEM
A. B lymphocytes B. Phagocytic cells C. Complement system D. T lymphocytes ✓ When an individual becomes infected with Pneumocystis jiroveci, it typically suggests a defect in T lymphocytes within the immune system. Pneumocystis jiroveci is an opportunistic fungal pathogen that…
WHICH OF THE FOLLOWING TYPES OF MALARIA CAN CAUSE RELAPSING ILLNESS AT INTERVALS OVER MONTHS AND YEARS WITHOUT THE PATIENT BEING REINFECTED
A. Plasmodium vivax ✓ B. Plasmodium knowlesi C. Plasmodium malariae D. Plasmodium falciparum Plasmodium vivax is the type of malaria that can cause relapsing illness at intervals over months and years without the patient being reinfected. This characteristic is due…
A 78-YEAR-OLD MAN WITH KNOWN HYPERTENSION AND DIABETES PRESENTS WITH A HISTORY OF FIVE ATTACKS OF PALPITATIONS OCCURRING OVER THE PAST 6 MONTHS; THE PALPITATIONS OCCUR RANDOMLY, START SUDDENLY AND LAST 2–10 HOURS. DURING THE ATTACK HE FEELS FAST, IRREGULAR PALPITATIONS BUT NO OTHER SYMPTOMS. THE ATTACKS TERMINATE SUDDENLY. WHICH OF THE FOLLOWING STATEMENTS IS TRUE
A. The likely diagnosis is atrial fibrillation ✓ B. Supraventricular tachycardia is the most likely diagnosis. C. A 24-hour ECG will establish the diagnosis D. A cardiac ultrasound is unnecessary E. You can reassure the patient that he will not…
A PATIENT AGED 33 YEARS WITH AN UNEXPLAINED SWELLING OF ONE LEG FOR THE LAST 2 MONTHS PRESENTS WITH 14 DAYS OF EFFORT INTOLERANCE DUE TO BREATHLESSNESS AND HAEMOPTYSIS. EXAMINATION SHOWS BREATHLESSNESS, A HEART RATE OF 110 BPM, BP 125/65, OXYGEN SATURATIONS ON AIR OF 90%, AND AN ECG SHOWING SINUS TACHYCARDIA AND RIGHT AXIS DEVIATION. WHICH OF THE FOLLOWING IS TRUE
A. A D-dimer should be performed B. Immediate thrombolysis should be given C. A CT pulmonary angiogram should be undertaken immediately, and, if not possible, a cardiac ultrasound ✓ D. Warfarin should be given without any further investigation E. A…
THE PREGNANT WOMAN COMPLAINS OF NUMBNESS AND “PINS AND NEEDLES” IN HER FINGERS AND HANDS. THE CONDITION IS CALLED AS
A. Carpal tunnel syndrome ✓ B. Vericosites C. Pica D. Heart burn Carpal tunnel syndrome is a common condition that occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes compressed or…
A FIBROID TUMOUR IS ALSO KNOWN AS
A. Myalgia B. Myotic C. Myoma ✓ D. Myeloma Myoma is a benign tumor that originates from the smooth muscle layer of the uterus, also known as the myometrium. These tumors are commonly referred to as fibroids and are…
BLEEDING DUE TO THROMBOCYTOPENIA OFTEN OCCURS IN SMALL VESSELS, CAUSING
A. Infection B. Pruritus C. Scarring D. Petechiae and purpura ✓ Bleeding due to thrombocytopenia often occurs in small vessels, causing petechiae and purpura. Petechiae are small red or purple spots on the skin caused by minor bleeding from…
RITUXIMAB IS A MONOCLONAL ANTIBODY USED IN THE TREATMENT OF CERTAIN TYPES OF HAEMATOLOGICAL MALIGNANCIES. WHICH ANTIGEN DOES IT TARGET
A. CD56 B. CD20 ✓ C. CD4 D. CD8 Rituximab targets CD20, which is a specific B-cell surface antigen. In other words, Rituximab targets the CD20 antigen. CD20 is a cell surface protein that is primarily expressed on B cells,…
AN OVERWEIGHT 40-YEAR-OLD WOMAN PRESENTS WITH SEVERAL WEEKS’ HISTORY OF TIREDNESS, INCREASING JAUNDICE AND COLICKY RIGHT UPPER QUADRANT PAIN. ON THE DAY OF ADMISSION SHE HAS DEVELOPED ATTACKS OF PROFOUND SHIVERING WITH SHAKING, HIGH TEMPERATURES AND MALAISE. THE MOST LIKELY DIAGNOSIS IS WHICH OF THE FOLLOWING
A. Viral hepatitis B. Alcoholic hepatitis C. Biliary obstruction due to gallstones with superadded biliary sepsis ✓ D. Malaria E. Cirrhosis and urinary tract infection In the case presented, the symptoms of tiredness, increasing jaundice, colicky right upper quadrant…
IN AN OLIGURIC PATIENT, WHICH OF THE FOLLOWING SIGNS POINT TOWARDS FLUID DEPLETION
A. A depressed haematocrit B. An elevated jugular venous pressure C. Pulmonary oedema D. Postural hypotension ✓ E. Hypertension In an oliguric patient, postural hypotension is a sign that points towards fluid depletion. Postural hypotension refers to a drop…
A TALL THIN WOMAN AGED 26 PRESENTS WITH SUDDEN-ONSET LEFT-SIDED PLEURITIC CHEST PAIN AND BREATHLESSNESS. EXAMINATION SHOWS HER TO BE TALL AND THIN, WITH A STRAIGHT BACK, OXYGEN SATURATION 99% ON AIR, HEART RATE 70 BPM, BP 110/75 AND DECREASED BREATH SOUNDS TO THE LEFT HEMITHORAX. THE LIKELY DIAGNOSIS IS WHICH OF THE FOLLOWING
A. Acute coronary syndrome B. Aortic dissection C. Pneumonia D. Pneumothorax ✓ E. Pulmonary embolus A pneumothorax is a condition characterized by the presence of air in the pleural space, leading to lung collapse. The classic presentation includes sudden-onset…
A PATIENT PRESENTS WITH A TESTICULAR MASS. YOU CARRY OUT A FULL CLINICAL EXAMINATION, CARRY OUT SOME BLOOD TESTS AND ARRANGE FOR FURTHER INVESTIGATIONS. WHICH BLOOD TESTS WOULD BE PARTICULARLY USEFUL IN HELPING YOU MAKE THE DIAGNOSIS
A. CA-125 B. Cytogenetics C. Lactate dehydrogenase, α-fetoprotein and β-human chorionic gonadotrophin ✓ D. Carcinoembryonic antigen To make an accurate diagnosis for a patient presenting with a testicular mass, several blood tests can be particularly useful. These tests help…
A 38-YEAR-OLD MAN PRESENTS WITH A BLOOD PRESSURE OF 170/100 IN THE RIGHT ARM, AND WEAK LEG PULSES, BUT NO RADIOFEMORAL DELAY. WHICH OF THE FOLLOWING IS TRUE
A. Aortic coarctation is excluded by the absence of radiofemoral delay. B. Aortic coarctation remains highly likely ✓ C. A cardiac ultrasound will diagnosis or exclude aortic coarctation reliably. D. A normal ECG excludes the diagnosis. E. Aortic angiography is…
BEFORE COMMENCING A PATIENT ON METFORMIN, WHICH OF THE FOLLOWING WOULD NOT BE A CRUCIAL CONSIDERATION
A. Hepatic impairment B. Alcohol intake C. Renal failure D. Cardiac failure E. Risk of hypoglycaemia ✓ The risk of hypoglycemia would NOT be a crucial consideration before commencing a patient on metformin. When starting a patient on metformin, crucial considerations…
POLYURIA MAY BE CAUSED BY WHICH OF THE FOLLOWING
A. Increased antidiuretic hormone secretion B. Lithium toxicity ✓ C. Reduced serum sodium concentration D. Hypocalcaemia E. Hypoglycaemia Polyuria, which refers to excessive urination and the production of abnormally large volumes of dilute urine, can be caused by various…
THE RETINOBLASTOMA GENE IS A TUMOUR SUPPRESSOR GENE. WHAT CELLULAR PATHWAY IS THE RETINOBLASTOMA PROTEIN INVOLVED IN
A. Apoptosis B. Controlling the cell cycle ✓ C. Angiogenesis D. Immunity The retinoblastoma gene, also known as the RB1 gene, is a tumor suppressor gene that plays a crucial role in controlling the cell cycle. The retinoblastoma protein…
IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS, THE IMMUNE SYSTEM IS
A. Underactive B. Overactive ✓ C. Inactive D. None of the above Systemic lupus erythematosus (SLE) is an autoimmune disease where the immune system mistakenly attacks healthy tissues in various parts of the body. This overactivity of the immune…
WHY IS THERE INCREASED EXCRETION OF CALCIUM IN THE CASE OF HYPERPARATHYROIDISM
Hyperparathyroidism is a condition characterized by overactivity of the parathyroid glands, leading to excessive production of parathyroid hormone (PTH). This hormone plays a crucial role in regulating calcium levels in the body. In cases of hyperparathyroidism, there is increased excretion…
THE MOST SERIOUS TYPE OF SKIN CANCER IS
A. Basal cell carcinoma B. Melanoma ✓ C. Sarcoma D. Squamous cell carcinoma Melanoma is a type of cancer that develops in the cells that produce melanin, which gives skin its color. It is considered the most serious type…