Monday, January 14, 2008

48 - medicine mcqs - 53 to 63

53 - A 27 year old, otherwise fit man gives a history suggestive of recurrent tachyarrhythmias. During a previous anaesthetic he apparently arrested and required DC cardioversion. He now presents for an arthroscopy. His ECG is shown below.
The most likely diagnosis is:
A. Lown Ganong Levine syndrome.
B. Prolonged QT syndrome.
C. Wolff Parkinson White syndrome.
D. Sick Sinus syndrome.
E. Atrio-Ventricular (AV) nodal re-entrant tachycardia.


ANSWER IS C - WPW syndrome
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54 - Which of the following is a risk factor for increased susceptibility to drug-induced 'Torsades de pointes'?
A. Male Gender.
B. Hypokalaemia.
C. Hypermagnesaemia.
D. Sinus tachycardia.
E. None of the above.
THE ANSWER IS B . HYPOKALEMIA
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55 - A fifty year old man suffers an acute myocardial infarction (MI). In which of the following conditions is temporary transvenous pacing most clearly indicated?
A. First-degree heart block.
B. Mobitz type I second-degree AV block with normal haemodynamics.
C. Mobitz type II second-degree AV block.
D. Accelerated idioventricular rhythm.
E. Bundle branch block known to exist before the acute MI.
ANSWER IS C .
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56 - With regard to the Dandy-Walker syndrome:
1. The cerebellar vermis is hypoplastic.
2. Obstructive hydrocephalus is the commonest mode of presentation.
3. Presentation usually occurs within the 1st two years of life.
4. A cyst is always present in the posterior fossa
all are correct .
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57 - In transfusion practice:
1. Fever is usually due to anti-leucocyte antibodies
2. Desmopressin (DDAVP) will raise levels of factor VIII in patients with mild haemophilia A
3. Haemolytic reactions may be delayed for up to 1 week
4. Severe anaphylaxis may be seen in IgA deficient individuals
all are true .
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58 - Recognised causes of macrocytosis in the peripheral blood with normoblastic erythropoiesis in the bone marrow include:
1. Hypothyroidism
2. Chronic alcohol abuse
3. Cryptogenic cirrhosis
4. The administration of phenytoin
1 , 2 , 3 are correct .
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59 - Which are true of Hepatitis E virus?
1, It is a 34nm single stranded RNA virus.
2. It is more common in IV drug abusers
3. Can produce epidemic waterborne infections
4. Will cause 10% of patients to develop chronic hepatitis
1 and 3 are correct .
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60 - Which of the following are correctly paired?
1. Conn's syndrome and metabolic alkalosis
2. Uretero-colic anastomosis and hyperchloraemic acidosis
3. Shock and metabolic acidosis
4. Pancreatic fistula and metabolic acidosis
all are correctly paired .
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61 - The following are recognised causes of pulmonary fibrosis:
1. External raditaion for carcinoma of the breast
2. Bleomycin
3. Sarcoidosis
4. Myelofibrosis
1 , 2 , 3 are correct .
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62 - Recognised causes of finger clubbing include:
1. Carcinoid tumour
2. Bronchial carcinoma
3. Iron deficiency anaemia
4. Coeliac disease
2 and 4 are the answers .
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63 - Dupuytren's contracture has a recognised association with:
1. Diabetes Mellitus
2. Peyronie's disease
3. Epilepsy
4. Alcoholic liver cirrhosis
all are correct .
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