Test 1 MCQs

41. Which of the following statements are true concerning tennis elbows? May be caused sprain of the radial collateral ligaments 42. Student/ miners elbow is characterised by: Effusion into a bursa over the subcutaneous posterior surface of the olecranon process. 43. Injury of the circumflex nerve caused paralysis of the deltoid muscle, may lead to which of the following? Loss of sensation over the lower half of the deltoid muscles. 44. The most commonly used vein for blood sampling and intravenous injection is: medial cubical vein 45. Which of the following nerve injury is responsible for Ape thumb? Median nerve 46. Carpal tunnel syndrome presents with the following except: Coolness in the area of sensory loss. 47. In a patient presenting with a history of swelling, the following is a possible differential diagnosis: Allergic reaction. 48. A 5-year-old male presented with a history of trauma and CT head was done. The image below was taken, what is the diagnosis? (Banana) Subdural hematoma 49. The following are causes of shock: all of the above. 50. A 15-year-old male presented with a history of trauma and CT head was done. The image below was taken, what is the diagnosis? Epidural hematoma (lemon)

Answers There

81. Oligohydramnios is associated which of the following? Potter sequence 82. Causes of polyhydramnios include: Duodenal atresia 83. The hand of benediction is caused by injury to the: median nerve 84. How many bursa are in the body? 150 85. In posterior shoulder dislocation which of the following is correct? Arm is abducted 86. Trigger finger is associated with the following conditions except: Hyperthyroidism. 87. Concerning the synovial sheath, which of the following statement are true? It is reinforced by a system of fibrous pulleys which includes five annular pulleys and 3 cruciform pulleys. 88. Cause of chronic burslishneederolowing except: infection 89. The following are examples of Right to left shunts: Ventricular septal defects 90. Which of the following is a true tetralogy of Fallot? Pulmonary stenosis, right ventricular hypertrophy. overriding aorta, ventricular septal defect

Answers There

1. Accessory Nerve may be assessed by asking the patient to do which of the following a) Smile b) Shrug their shoulder * c) Stick out their tongue d) Say aah e) All of the above 2. Pancytopenia can by caused by the following except a) Tumours b) Sepsis c) Drugs d) Trauma* e) Inflammatory causes 3. Regarding JVP, cannons A waves are caused by the following a) Premature ventricular contraction* b) Tricuspid regurgitation c) Aorta regurgitation d) Atrial fibrillation e) All of the above 4. 45-year-old woman comes to the physician because of a 5-month history of recurrent retrosternal chest pain that often wakes her up at night. Physical examination shows no abnormalities. Upper endoscopy shows hyperaemia in the distal third of the oesophagus. A biopsy specimen from this area shows non-keratinized stratified squamous epithelium with hyperplasia of the basal cell layer and neutrophilic inflammatory infiltrates. Which of the following is the most likely underlying cause of this patient's findings? a) Increased lower oesophageal sphincter tone b) Increased collagen production and fibrosis c) Dysfunction of the gastroesophageal junction* d) Spread of neoplastic cells e) Metaplastic transformation of the oesophageal epithelium 5. A 21-year-old woman comes to the physician for the evaluation of dry cough and some chest tightness for the past 2 months. The cough is worse at night and while playing volleyball. She frequently has a runny nose and nasal congestion. Her mother has systemic lupus erythematosus. The patient has smoked one pack of cigarettes daily for the past 5 years. She does not drink alcohol. Her only medication is cetirizine. Her vital signs are within normal limits. Pulse oximetry on room air shows an oxygen saturation of 98%. The remainder of the examination shows no abnormalities. Which of the following is the most appropriate next step in management? a) Spirometry* b) X-ray of the chest c) Methacholine challenge test d) CT scan of the chest e) Laboratory studies 6. A 52-year-old man is brought to the emergency department 30 minutes after his farmhand found him on the ground sweating profusely. On arrival, he is lethargic and unable to provide any history. His temperature is 37.5°C (99.5°F), pulse is 42/min, and blood pressure is 95/60 mm Hg. Physical examination shows diaphoresis and excessive salivation. The pupils are constricted. There is scattered expiratory wheezing throughout both lung fields. His clothes are soaked with vomit, urine, and faeces. A drug with which of the following mechanisms of action is most appropriate for this patient? a) Non-selective α adrenergic receptor antagonism b) β2 adrenergic receptor agonism c) Muscarinic acetylcholine receptor antagonism* d) Acetylcholinesterase enzyme inhibition e) Nicotinic acetylcholine receptor agonism 7. A 19-year-old man is rushed to the emergency department 30 minutes after diving head-first into a shallow pool of water from a cliff. He was placed on a spinal board and a rigid cervical collar was applied by the emergency medical technicians. On arrival, he is unconscious and withdraws all extremities to pain. His temperature is 36.7°C (98.1°F), pulse is 70/min, respirations are 8/min, and blood pressure is 102/70 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 96%. The pupils are equal and react sluggishly to light. There is a 3-cm (1.2-in) laceration over the forehead. The lungs are clear to auscultation. Cardiac examination shows no abnormalities. The abdomen is soft and non-tender. There is a step-off palpated over the cervical spine. This young man has likely sustained an injury to the cervical spine, which is compromising his respiratory function. Which of the following is the most appropriate next step investigation? a) CT scan of the spine b) X-ray of the cervical spine c) CT of the brain and spine* d) MRI e) All of the above 8. What is the most likely diagnosis? a) Raised Intracranial pressure* b) Confusion c) Subarachnoid haemorrhage d) Pontine myelinosis e) None of the above 9. An 18-month-old boy is brought to the emergency department 25 minutes after an episode of loss of consciousness. The child began crying after his 4-year-old brother snatched a toy from him. The brief shrill cry was followed by a period of expiration; he then turned blue, became unconscious, and briefly lost his muscle tone, before he stiffened and had jerky movements of his arms and legs for 15 seconds. After this episode, he immediately regained consciousness. He had a similar episode 2 weeks ago when his father refused to give him a juice box. He has been healthy and has met all his developmental milestones. Vital signs are within normal limits. He is alert and active. Cardiopulmonary examination shows no abnormalities. Neurologic examination shows no focal findings. Which of the following is the most appropriate next step in management? a) CT scan of the head b) Echocardiography c) Reassurance* d) Electroencephalography e) Lumbar puncture 10. A 58-year-old woman is brought to the emergency department for shortness of breath and chest pain. Pulmonary angiography shows a large saddle embolus in the pulmonary arteries. Emergency drug therapy is administered and she is admitted to the hospital for observation. A follow-up CT scan of the chest shortly after admission shows that the thrombus has disappeared. Five hours later, the patient is found to be lethargic with slurred speech. Physical examination shows decreased consciousness, dysarthria, and optic disc swelling bilaterally. Which of the following is the most likely cause of her neurological symptoms? a) Internal carotid artery dissection b) Idiopathic intracranial hypertension c) Drug-induced hypotension d) Embolic cerebrovascular accident e) Intracerebral haemorrhage*

Answers there

1. An 8-year-old boy is brought to the emergency department by his parents 30 minutes after losing consciousness. He was at a water park with his family when he fell to the ground and started to have jerking movements of the arms and legs. On arrival, he continues to have generalized, violent muscle contractions and is unresponsive to verbal and painful stimuli. The emergency department physician administers lorazepam. The expected beneficial effect of this drug is most likely caused by which of the following mechanisms? a) Increased affinity of GABA receptors to GABAB b) Allosteric activation of GABAA receptors* c) Increased duration of chloride channel opening d) Inhibition of GABA transaminase e) Noncompetitive NMDA receptor antagonism 2. A 56-year-old man comes to the emergency department because of chest pain. The pain occurs intermittently in 5-minute episodes. It is not conclusively brought on by exertion and sometimes occurs at rest. He has a history of hyperlipidemia and takes a high-dose statin daily. His father died of lung cancer at the age of 67 years and his mother has type 2 diabetes. He smokes a pack of cigarettes daily and does not drink alcohol. His temperature is 37°C (98.8°F), pulse is 88/min, and blood pressure is 124/72 mm Hg. Cardiac examination shows no abnormalities. He has no chest wall tenderness and pain is not reproduced with palpation. While waiting for laboratory results, he has another episode of chest pain. During this event, an ECG shows ST elevations in leads II, III, and aVF that are > 1 mm. Thirty minutes later, a new ECG shows no abnormalities. Troponin I level is 0.008 ng/mL. Cardiac angiography is performed and shows a 30% blockage of the proximal right circumflex artery and 10% blockage in the distal left circumflex artery. This patient's condition is most closely associated with which of the following? a) Peripheral artery disease b) Stroke c) Type 2 diabetes mellitus d) Hypertension e) Raynaud phenomenon* 3. A 34-year-old woman comes to the office because of decreased appetite, nausea, vomiting, and episodic abdominal pain for the past two months. The pain is sharp, colicky, and lasts about an hour after meals. Her stools are light in appearance and difficult to flush. Physical examination shows tenderness in the right upper quadrant. Without treatment, this patient is at greatest risk for developing which of the following? a) Glossitis b) Megaloblastic anaemia c) Low bone mineral density* d) Delayed wound healing e) Steatohepatitis 4. A 75-year-old with hypertension and atrial fibrillation comes to the emergency department because of a 2-hour history of severe abdominal pain and nausea. He has smoked 1 pack of cigarettes daily for the past 45 years. The patient undergoes emergency laparotomy and is found to have dusky discoloration of the bowel and subsequently has his terminal ileum removed. He will in future most likely suffer from which deficiency? a) Iron b) Folate c) Bile salts d) Vitamin B12 e) C & D* 5. A 3-year-old who has liver failure is likely to have which of the following deficiencies? a) Vitamin b12 b) Vitamin C c) Vitamin K* d) Vitamin B e) None of the above 6. In a patient with hypothyroidism, which of the following results reflect the true clinical picture? a) Low TSH, low T3, low T4 b) Low TSH, high T3, high T4 c) High TSH, low T3, high T4 d) High TSH, low T3, lowT4 e) A & D* 7. Which of the following intravenous fluid has the closest composition to the body's plasma? a) Normal saline * b) Ringers Lactate c) Sodium bicarbonate d) Darrow's e) None of the above 8. What is the pressure gradient produced by the left ventricle equal to? a) The mean arterial pressure. b) The difference between mean arterial pressure and pressure at the start of the capillaries c) The difference between mean arterial pressure and pressure at the start of the capillaries, divided by the distance between the start of the aorta and capillaries* d) The mean arterial pressure divided by the distance between the start of the aorta and capillaries e) None of the above 9. What is one of the determinants of the resistance to blood flow? a) Blood viscosity. * b) Cardiac output. c) Heart rate. d) The blood osmolality. e) All of the above 10. Which one of the following will make blood pressure fall? a) Increased cardiac output b) Increased heart rate c) Increased vasodilation* d) Increased peripheral resistance All of the above

Answers there

1. Which of the following is the most common palsy seen in raised intracranial pressure? a) Abducens nerve* b) Optic nerve c) Facial Nerve d) Auditory Nerve e) Ophthalmic Nerve 2. Anisocoria may be seen in patients with raised ICP. This maybe caused due to compression of which of the following nerves? a) Abducens nerve b) Optic nerve * c) Facial Nerve d) Auditory Nerve e) Ophthalmic Nerve 3. Which of the following are types of shoulder dislocation a) Anterior dislocation b) Lateral dislocation c) Full dislocation d) Posterior dislocation e) A & D* 4. Diaphragmatic hernias may occur through any opening of the diaphragm. Which of the following may occur? a) Oesophageal Hiatus Hernia b) Aortic Hiatus hernia c) Caval hernia d) D& A e) All of the above* 5. Causes of absent unilateral radial pulse include a) Cardiac arrest b) Myocardial infarction c) Thyrotoxicosis d) Anastomosis surgery between subclavian artery and pulmonary artery* e) A & D 6. Concerning epilepsy, a person who describes seizures as abnormal jerking movements is most likely to have epilepsy involving the a) Frontal lobe* b) Parietal lobe c) Temporal lobe d) Occipital lobe e) All of the above 7. A distended abdomen may be caused by the following a) Fat b) Foetus c) Fluid d) Faeces e) All of the above * 8. A patient presented with weak palpable pulses on the left upper limb and both lower limbs with normal neurological function. The lesion is most likely a) Between the brachiocephalic and left Common Carotid Artery b) After the descending aorta c) Before the arch of the aorta d) Between the left common carotid artery and left subclavian* e) Between the left subclavian and descending Aorta 9. Empyema thoracis is accumulation of a) Air in the thorax b) Blood in the thorax c) Pus in the thorax * d) Blood and air in the thorax e) All of the above 10. Chylothorax is accumulation of a) Air in the thorax b) Blood in the thorax c) Pus in the thorax d) Lymph in the thorax* e) All of the above

Internals March 21

Concerning resuscitation, during the airway management, which of the following is true a) Oxygen delivery is essential for patients with low oxygen levels* b) Patients with unstable respiration must be intubated immediately c) In a neonate, the best position to keep the airway patent is the neutral position d) Raising the foot end of the bed is important to improve venous return to the heart.

a) Oxygen delivery is essential for patients with low oxygen levels*

Which of the following group of lymph nodes directly drain the breast a) Pectoral nodes* b) Parasternal nodes c) Lateral axilliary nodes d) Infraclavicular nodes e) Subscapular nodes

a) Pectoral nodes*

1. Rheumatoid arthritis deformities include a) Bird beak appearance deformity b) Clubbing c) Carpel tunnel syndrome* d) Radial deviation of metacarpophalangeal joints e) All of the above* 2. Scoliosis is best visualized with which of the following imaging a) X-ray b) Ultrasound c) MRI d) CT scan * e) Examination 3. Claw hand is caused by injury to a) Medial Nerve b) Ulnar Nerve c) Lower trunk of the Branchial plexus d) Radial Nerve e) B & C* 4. Waiters tip is caused by palsy of which of the following nerve? a) Ulnar Nerve b) Median Nerve c) Upper trunk of the Branchial Plexus* d) Radial Nerve e) Lower Trunk of the Branchial Plexus 5. Cushing triad of raised intracranial pressure include which of the following a) Hypertension* b) Regular respirations c) Confusion d) Headache e) Tachycardia 6. Carpal tunnel syndrome presents with the following except: a) Ape hand b) Coolness in the area of sensory loss * c) Absence of sweating d) Median nerve compression e) Usually presents in females between the age of 40 -70 7. Regarding lymphatic drainage of the arm a) Superficial lymphatics follow volar aspect b) Superficial travel with arteries c) Deep travel with veins* d) Hand drains into apical lymph nodes in axilla e) They are 7 groups 8. In a patient presenting with a history of swelling, the following is a possible differential a) Pain b) Pallor c) Allergic reaction* d) Redness e) All of the above 9. Fever maybe seen in the following conditions except: a) Infections b) Malignancy c) Auto immune disorders d) Heart failure* e) All of the above 10. Which of the following is a complication of liver failure? a) Clotting b) Weight loss c) Infections * d) Diarrhoea e) All of the above

answers there

51. The following sign (s) are present in the patient with hydrocephalus: Sun setting eye signs 52. The following are seen in hyperthyroidism except: edema 53. The following are seen in a patient with hypothyroidism: low mood. 54. Damage to the median nerve may be suggested clinically by: pointing index finger 55. Structures in the anatomical, snuff box include all the following EXCEPT: The radial tubercle 56. The following are types of shoulder dislocation: anterior dislocation. 57. Diaphragmatic hernias may occur through any opening of the diaphragm. Which of the following may occur? All of above 58. Causes of absent unilateral radial pulse include: Anastomosis surgery between subclavian artery and pulmonary artery 59. Concerning epilepsy, a person who describes seizures as abnormal jerking movements is most likely to have epilepsy involving the: frontal lobe. 60. A distended abdomen may be caused by the following: all of the above

answers there

Compression of the median nerve in the carpal tunnel produces a) Anesthesia over the thenar eminence b) Loss of power of opposition of the thumb*

b) Loss of power of opposition of the thumb*

In the assessment of the hand function which of the following is true? a) Abduction of the thumb is supplied by spinal root T2 b) Opposition of the thumb by opponens policis is supplied by spinal root T1* c) Finger adduction is supplied by the median nerve d) Finger abduction is mediated by the palmar interossei

b) Opposition of the thumb by opponens policis is supplied by spinal root T1*

In the assessment of the hand function, which of the following is true a) Abduction of thumb is supplied by spinal root T2 b) Opposition of thumb by opponens pollicis is supplied by spinal root T1* c) Finger abduction is mediated by the palmar interossei d) Finger adduction is supplied by median nerve

b) Opposition of thumb by opponens pollicis is supplied by spinal root T1*

Gartland fracture classification is used in which of the following fractures a) Fracture dislocations b) Supracondylar fractures* c) Radial fractures d) Humeral shaft fractures e) Ulna fractures

b) Supracondylar fractures*

Whispering pectoriloquy is commonly seen in which of the following conditions a) Parapneumonic effusions b) Pneumonia c) Pleural effusion d) Pneumonitis e) All of these*

e) All of these*

A 45 year old man is unable to initiate abduction of the arm following reduction of a dislocated shoulder. Damage to which nerve is most likely responsible for this condition a) Radial nerve b) Axillary nerve c) Long thoracic nerve d) Infrascapular nerve e) Suprascapular nerve*

e) Suprascapular nerve*

In the carpal tunnel: a) The synovial sheath of flexor digitorium superficialis arises from the ulna bursa but the sheath of profundus does not b) Flexor carpi radialis and flexor pollicis longus tendons share a synovial sheath c) The individual tendons arising from flexor digitorium profundus are all fused and do not separate until they reach the palm d) The tendon of flexor digitorium profundus to the middle finger lies deep to the tendons of the little finger e) The tendon for the index finger from flexor digitorium superficialis lies medial to the median nerve.*

e) The tendon for the index finger from flexor digitorium superficialis lies medial to the median nerve.*

1. Concerning a heart failure, which of the following signs on chest x-ray is suggestive? a) Pleural effusion b) Kerley B lines c) Cardiomegaly d) Bat wings e) All of the above* 2. The following are causes of oedema a) Renal failure b) Malnutrition c) Liver failure d) Hypothyroidism e) All of the above* 3. The following are causes of aortic auresyms a) Infections b) Marfans syndrome c) Connective tissues disorders d) Takayasu's Arteritis e) All of the above* 4. The following are causes of tall stature a) Downs syndrome b) Marfans syndrome * c) Hunter syndrome d) Diabetes Mellitus e) All of the above 5. The following are causes of hypertension a) Hypothyroidism b) Diabetes Insipidus c) Renal artery dilatation d) Glomerulonephritis* e) Stroke 6. The following are complications of nephrotic syndrome except a) Infections b) Hypocalcaemia c) Stroke d) Hypertension * e) None of the above 7. A child is diagnosed to have restrictive pericardial effusion. The important clinical signs are the following: a) Tachycardia, hypotension, and decreased oxygen saturation* b) Bradycardia, hypotension, and decreased perfusion c) Tachycardia, hypertension, and swelling of face d) Arrhythmia, normal BP, and venous engorgement of neck e) Fever, tachycardia, and hypertension 8. In a developing embryo, the vascular system appears in the a) First week b) Second week c) Third week* d) Fourth week e) Fifth week 9. Rapid depolarization of the action potential of the ventricular muscle (phase 0) results from opening of a) Voltage-gated Ca2+ channels b) Voltage-gated Na+ channels* c) Acetylcholine-activated K+ channels d) Inward rectifying K+ channels e) ATP- sensitive K+ channels 10. Atrial repolarisation normally occurs during the a) P wave b) QRS complex* c) ST segment d) T wave e) Isoelectric period

Answers there

1. During the cardiac cycle a) The aortic and mitral valves are never open at the same time* b) The first heart is caused by the rapid ejection of blood from the ventricles c) The mitral valve is open throughout diastole d) Left ventricular pressure is always less than aortic pressure e) Ventricular filling occurs primarily during systole 2. Which of the following sequences is a possible anatomic path for a red blood cell passing through a fetus and back to the placenta? (Some intervening structures are not included.) a) Umbilical vein, right ventricle, ductus arteriosus, pulmonary artery b) Ductus venosus, foramen ovale, right ventricle, ascending aorta c) Spiral artery, umbilical vein, left ventricle, umbilical artery d) Right ventricle, ductus arteriosus, descending aorta, umbilical artery* e) Left ventricle, ductus arteriosus, pulmonary artery, left atrium 3. After a newborn is delivered a) Pulmonary vascular resistance decreases and pulmonary arterial pressure increases b) Increased oxygen tension in aortic blood causes closure of the ductus arteriosus* c) The ductus venosus closes after immediately after birth d) Increased right atrial pressure pushes the tissue flap closing the foramen ovale e) Greater pulmonary resistance and higher blood flow to the left ventricle increases its mechanical load and overtime causes hypertrophy 4. Medical treatment for congestive cardiac failure may include a) Diuretics to increase the venous fluid overload b) Cardiac glycosides (e.g., digitalis) to reduce myocardial contractility c) Afterload reducing agents (e.g., arterial vasodilators) to reduce the load against which the ventricle must contract* d) Angiotensin converting enzyme inhibitors to increase preload e) Beta blockers in increase systemic pressure 5. Which one is correct about respiratory embryology? a) At approximately 6 weeks of gestation, the respiratory diverticulum develops from the ventral wall of the foregut. b) The cartilaginous, muscular, and connective tissue components are derived from splanchnic endoderm c) The cartilages and muscles originate of the larynx from mesenchyme of the fourth and sixth pharyngeal arches. * d) Mesenchyme of the first and second arches transforms into the thyroid, cricoid, and arytenoid cartilages. e) Recurrent laryngeal nerve innervates the derivatives of the fourth pharyngeal arch. 6. Respiratory failure may be due to dysfunction of one or more of the essential components of the respiratory system including the following except a) pulmonary circulation b) alveolar- capillary units c) airways d) CNS forebrain* e) Nerves 7. The following substances act as mediators in asthma except a) Histamine b) Adenosine c) Platelet activating factor d) Nitric dioxide* e) Prostanoids 8. A patient with a lesion involving the posterior column of the spinal tract will most likely present with loss of a) Pain sensation b) Motor strength c) Balance d) Consciousness e) None of the above * 9. One of the following is true about cardiac development a) The heart begins to contract exhibiting phases of the cardiac cycle at about 20-22 weeks b) The sinus venosus forms smooth walled part of the right atrium, valves of the inferior vena cava and the coronary sinus and the SA node * c) Exogenous retinoic acid is extremely useful to direct the ultimate fate of mesodermal cells during early embryogenesis d) Septation of the truncus arteriosus and conus cordis occurs in the 8th week e) Septum secondum remnant forms valve of the foramen ovale 10. Which of the following is not indicative of right ventricular hypertrophy? a) Tall pure R wave > 15 mm in right chest leads b) Upright T wave > 3-5 days of age c) qR pattern in V1 d) Deep S wave V6 S in V1/V2 above normal *

Answers there

1. Hypertension in adults may be defined as: a) Excessive decrease in blood pressure. b) Mean arterial pressure greater than 110 mm Hg. c) Systolic blood pressure less than 100 mm Hg when resting d) Systolic blood pressure persistently greater than 140 mm Hg when resting* e) All of the above 2. Which of the following statements about the cardiovascular control centre of the brain is FALSE? a) Increased impulses along parasympathetic fibres causes vasoconstriction* b) Increased output along the sympathetic fibres increase heart rate. c) Output along of the parasympathetic fibres decreases heart rate. d) Decreased output along the sympathetic fibres causes dilation of arterioles. e) All of the above 3. Which of the following does Angiotensin II cause to happen? a) Atrial natriuretic peptide to be released. b) The collecting ducts in the kidney to become permeable to water. c) The release of antidiuretic hormone to be supressed. d) Aldosterone to be released* e) All of the above 4. The definition of mean arterial pressure (MAP) may be written as: a) MAP = stroke volume × heart rate b) MAP = (diastolic pressure + systolic pressure) ÷ 2 c) MAP = cardiac output × peripheral resistance* d) MAP = diastolic pressure + pulse pressure e) None of the above 5. Which one of the following statements is correct? a) the diaphragm separates the brain and spinal cord b) the ventral cavity contains the male and female reproductive system c) the abdomino-pelvic cavity contains the spinal cord. d) the dorsal cavity contains the brain and spinal cord* e) None of the above 6. Complete the sentence correctly: "Cervical vertebrae are...... a) superior to the rib cage. * b) inferior to the thoracic vertebrae. c) Located between the thoracic and sacral vertebrae. d) fused into a single bone called the sacrum. e) All of the above 7. What structure separates the thoracic cavity from the abdominal cavity? a) The mediastinum b) The diaphragm * c) The peritoneum d) The pylorus e) The thoracic duct 8. What is the nerve that that carries most of the parasympathetic signals? a) Phrenic b) Vagus* c) Sciatic d) Trigeminal e) Optic 9. Which is an example of a cholinergic receptor? a) Nicotinic receptor * b) Adrenergic receptor c) Alpha receptor d) Beta receptor e) GABA receptor 10. Exposing a foetus or young baby to x-rays should be avoided. What is the cause of the danger most likely to be due to? a) Denaturing of cells due to the increase in temperature in cells absorbing radiation. b) Damage to a cell's DNA. * c) The baby becoming radioactive. d) The formation of a blood clot. e) Development of a mutant X- baby

Answers there

1. The following are causes of unilateral lower limb swelling except a) Liver failure * b) Trauma c) Cellulitis d) Malignancy e) DVT 2. The following are causes of differential clubbing a) Liver failure b) Congenital heart disease * c) Bronchiectasis d) Hypothyroidism e) All of the above 3. The following are causes of clubbing a) Liver failure* b) Renal failure c) Oedema d) Hyperthyroidism e) Diabetes mellitus 4. The following are causes of cyanosis except a) Eisenmeger syndrome b) Pulmonary hypotension * c) Tetralogy of fallot d) Truncus arteriosus e) None of the above 5. The following are causes of right to left shunt a) Patent ductus arteriosus b) Ventricular septal defect c) Ebstein Anomaly * d) Mitral Valve prolapse e) Patent foramen ovale 6. Concerning a pneumothorax, a patient presenting with one will have which of the following signs on examination? a) Dull to percussion b) Increased air entry c) Hyper- resonant to percussion* d) Equal air entry e) None of the above 7. Concerning a pneumothorax, which of the following signs on chest x-ray is suggestive? a) Increased vascular marking b) Underinflated lung c) Cardiomegaly d) Black lung * e) All of the above 8. Which of the following are causes of pneumothorax? a) Rib fractures b) Infections c) Idiopathic d) Spontaneous e) All the above* 9. The following are types of pneumothorax except a) Closed b) Open c) Anterior * d) Tension e) None of the above 10. Concerning a heart failure, a patient presenting with one will have which of the following symptoms? a) Orthopnoea* b) Low blood pressure c) Pleural effusion d) Cardiomegaly e) Irregularly irregular pulses

Answers there

1. Which of the following is a sign of heart failure? a) Orthopnoea b) Easy fatigability c) Palpitations d) Low blood pressure* e) All of the above 2. Which of the following are symptoms of anaemia? a) Weakness* b) Pallor c) Jaundice d) Tachycardia e) All of the above 3. Which of the following is a cause of obesity? a) Heart failure b) Liver failure c) Hypothyroidism * d) Malnutrition e) None of the above 4. Regarding Dupuytren's contractures, which of the following is true? a) It is seen in renal failure b) There is thickening and relaxation of the aponeurosis c) It affects the radial aspect of the palmar aponeurosis d) The proximal and middle phalanx are flexed* e) None of the above 5. Pleurisy refers to: a) Pain in the pleural space b) Can be caused by pleural effusion c) Inflammation of the pleural d) All of the above e) B& C* 6. Klumpke's paralysis is caused by injury to which of the following segments a) C5 b) C6 c) C8 d) T 1 e) C&D* 7. Nerve injury can be assessed by which of the following methods? a) History b) Examination c) MRI d) Nerve conduction studies e) All of the above* 8. Which of the following is the best test to assess nerve function? a) Nerve conduction * b) MRI c) Electromyogram d) Nerve biopsy e) X-ray 9. Facial nerve may be assessed by asking the patient to do which of the following a) Smile * b) Shrug their shoulder c) Tick out their tongue d) Say aah e) All of the above 10. Glossopharyngeal Nerve may be assessed by asking the patient to do which of the following a) Smile b) Shrug their shoulder c) Stick out their tongue d) Say aah * e) All of the above

Answers there

101. Bursitis is best seen using which of the following test a) CT scan b) MRI * c) X-ray d) Nuclear studies e) Blood tests 102. Myocardial infarction is best assessed with which of the following tests a) Electrocardiograph* b) Echocardiogram c) Chest Xray d) Full blood count e) MRI 103. Complications of scoliosis include which of the following except a) Pulmonary hypertension b) Type 2 respiratory failure c) Cor pulmonale d) Heart failure e) None of the above* 104. Concerning the radial nerve, which of the following are true a) During injuries the triceps doesn't usually escape paralysis b) Wrist drop is not common finding in radial nerve palsy c) The superficial branch may be damaged during an operation exposing the radial head d) Wrist drop occurs when the is injury to the radial nerve below the origin of the posterior interosseous nerve. e) None of the above * 105. Mill's test maybe used to diagnose which of the following injuries? a Rotator cuff injuries b) Tennis elbow* c) Golfers elbow d) Compartment syndrome e) Supracondylar fractures 106. Concerning pulseless disease which of the following is associated with worse prognosis a) HLA-B5 b) HLA-A2 c) HLA_B35 d) HLA- B52* e) HLA-DR4 107. All of the following are Later-stage or second-stage symptoms of Takayasu's arteritis except: a) Chest pain b) Shortness of breath c) Muscle and joint pain* d) Headaches e) Dizziness 108. The following aid in the diagnosis of rotator cuff injuries except: a) History: Patients usually present with anterior shoulder pain and weakness of the glenohumeral joint b) Signs: Inspection; looking for atrophy (common in infraspinatus tear) c) Symptoms: tenderness and reduced range of active and passive movement* d) Imaging: Ultrasound (dynamic motion weakness) e) X-ray (loss of space between acromion and humeral head) and MRI (partial /full thickness tear) 109. Which of the following are causes of pulmonary hypertension? a) Pulmonary Arterial Hypertension (PAH) b) Left heart disease c) Lung disease d) Chronic blood clots in lungs e) All of the above* 110. Which of the following is the least likely site for formation of myocardial infarction? a) Left ventricle b) Inferior infarcts* c) Anterior infarct d) Lateral infarct e) Posterior infarct

Answers there

11. Handlebar palsy is caused by injury at which level? C8, T1 12. Froments test is used to assess which of the following nerve palsy? Ulnar nerve 13. Which of the following is true concerning claw hand? None of the above. 14. Which of the following are true? Galeazzi facture may have dislocation of the ulna at the elbow 15. Cozen's test maybe used to diagnose which of the following injuries? Lateral epicondylitis 16. Mill's test maybe used to diagnose which of the following injuries? Tennis elbow 17. Concerning pulseless disease which of the following is associated with worse prognosis: HLA-B52 18. All of the following are Later-stage or second-stage symptoms of Takayasu's arteritis except: Muscle and joint pain 19. The following aid in the diagnosis of rotator cuff injuries except: Symptoms: tenderness and reduced range of active and passive movement 20. Which of the following are causes of pulmonary hypertension? All of the above

Answers there

111. All of the following are complications of myocardial infarction except: a) Cardiogenic shock b) Thrombocytopenia* c) Cardiac arrythmia d) Chronic heart failure e) Left ventricular failure 112. A butterfly fracture is also known as a a Spiral fracture b) Transverse fracture c) Undisplaced fracture d) Segmental fracture * e) Greenstick fracture 113. The following are causes of atrial fibrillation except: a) Hypothyroidism b) Hypertrophic cardiomyopathy c) Hypernatremia d) Polycythaemia e) All of the above* 114. Complications of bell palsy include: a) Dryness of the unaffected eye b) Cosmetic defect c) Ramsey hunt syndrome d) A& B e) B&C * 115. The trachea may be compressed by the following organs except a) Ascending aorta * b) Thymus c) Lymph nodes d) Thyroid e) Parathyroid 116. Which of the following is true concerning winging of the scapula? a) The medial border the bones becomes less prominent b) Is caused by paralysis of the serratus posterior C) Arm cannot flex d) Arm cannot abduct beyond 90 degrees * e) None of the above 117. Common sites of humerus fracture include: a) Head of humerus b) Epiphysis c) Supracondylar* d) Distal humerus e) All of the above 118. Which of the following nerves of directly related to the humerus? a) Axillary, median, ulnar b) Axillary, radial, ulnar* c) Ulnar, median, Radial d) Median, axillary, radial e) Radial, median 119. The head of the humerus commonly dislocates a) Superiorly b) Inferiorly* c) Posteriorly d) Anteriorly e) Medially 120. Concerning fractures: if a person falls on the point of the elbow, which of the following fractures would be most common. a) Olecranon* b) Coronoid process c) Head of radius d) Shaft of the ulna e) All of the above

Answers there

121. Concerning axillary lymph nodes, which of the following nodes are obstructed when the skin has peau d' orange appearance a) Deep b) Medial c) Anterior d) Superficial* e) Posterior 122. Concerning Klumpke's paralysis a) Site of injury: middle trunk of branchial plexus b) Muscles paralysed include: intrinsic muscles of the hand c) Muscles paralysed include: ulnar extensors of the wrist d) Disability: claw hand and Horner's syndrome e) B&D* 123.Concerning Erb's palsy, the site of injury is a) Upper trunk of branchial plexus * b) Lower trunk of the brachial plexus C) Anterior division of lower trunk d) Posterior cord of branchial plexus e) Anterior cord of branchial plexus 124. Which of the following nerves are affected by Saturday night palsy? a) Radial nerve* b) Median Nerve c) Long thoracic nerve d) Ulna nerve e) Axillary nerve 125. Which of the following nerve palsy is responsible for a wrist drop? a) Radial nerve * b) Median Nerve c) Long thoracic nerve d) Ulna nerve e) Axillary nerve 126. Which of the following nerve is referred to as the musician's nerve? a) Radial nerve b) Median nerve c) Long thoracic nerve d) Ulna nerve* e) Axillary nerve 127. The following are type of clavicle dislocations except; a) Superior b) Posterior c) Anteriorly d) Inferior * e) All of the above 128. Which of the following statements are true concerning tennis elbows? a) Abrupt supination may lead to resolution b) Abrupt pronation leads to pain over the medial epicondyle* c) May be caused sprain of the radial collateral ligaments d) Maybe caused by tearing of fibres of the extensor carpi radialis longus e) C&D 129. Student/ miners elbow is characterised by: a) Effusion into a bursa over the subcutaneous posterior surface of the olecranon process* b) Effusion into a bursa over the subcutaneous posterior surface of the coronoid process c) Effusion into a bursa over the subcutaneous posterior surface of the ulna shaft d) Effusion into a bursa over the subcutaneous posterior surface of the radial head e) None of the above 130. A split S2 is caused by which of the following a) Ventricular septal defect b) Atrial septal defect* (c) Tetralogy of Fallot d) Truncus arteriosus e) Pulmonary stenosis

Answers there

21. Which of the following is the least likely site for formation of myocardial infarction? Inferior infarcts 22. All of the following are complications of myocardial infarction except: Thrombocytopenia 23. A butterfly fracture is also known as a: Segmental fracture 24. The following are causes of atrial fibrillation except: All of the above 25. Complications of bell palsy include: (b&c) (Cosmetic defect & Ramsey hunt syndrome) 26. The trachea may be compressed by the following organs except: Ascending aorta 27. Which of the following is true concerning winging of the scapula? Arm cannot abduct beyond 90 degrees 28. Common sites of humerus fracture include: supracondylar 29. Which of the following nerves of directly related to the humerus? Axillary, radial, ulnars 30. The head of the humerus commonly dislocates: Inferiorly

Answers there

31. Concerning fractures: if a person falls on the point of the elbow, which of the following fractures would be most common: olecranon 32. Concerning axillary lymph nodes, which of the following nodes are obstructed when the skin has peau d' orange appearance: Superficial 33. Concerning Klumpke's paralysis: Muscles paralyzed include: intrinsic muscles of the hand. Muscles paralyzed include: ulnar extensors of the wrist. (B&C) 34. Concerning Erb's palsy, the site of injury is: Upper trunk of branchial plexus 35. Which of the following nerves are affected by Saturday night palsy? a) Radial nerve 36. Which of the following nerve palsy is responsible for a wrist drop? (a) Radial nerve 37. Which of the following used for feeling arterial pulse at the wrist? Radial artery 38. Concerning Duputryens contractures which of the following is true? The ring finger is most commonly involved. 39. Which of the following nerve is referred to as the musician's nerve? Ulna nerve 40. The following are type of clavicle dislocations except; inferior

Answers there

61. A patient presented with weak palpable pulses on the left upper limb and both lower limbs with normal neurological function. The lesion is most likely: Between the left common carotid artery and left subclavian. 62. Empyema thoracis is accumulation of: Pus in the thorax. 63. Chylothorax is accumulation of: lymph in the thorax. 64. Rheumatoid arthritis deformities include: carpel tunnel syndrome. 65. Claw hand is caused by injury to: (B & C) ulnar n. & lower trunk of brachial plexus 66. Waiters tip is caused by injury to: upper trunk of brachial plexus 67. Volkmann's Ischemic Contracture best identified using which of the following tests? MRI 68. Aortic Aneurysm is best identified using which of the following tests? Angiography 69. Rib fractures best identified using which of the following tests? CT scan 70. Bronchopulmonary segments best identified using which of the following tests? Bronchoscopy

Answers there

71. Rotator cuff injuries are best identified using which of the following? MRI 72. Bursitis is best seen using which of the following test? MRI 73. Myocardial infarction is best assessed with which of the following tests? Electrocardiograph 74. Complications of scoliosis include which of the following except: all of above 75. Concerning the radial nerve, which of the following are true? None of the above 76. Complete the sentence correctly: "Cervical vertebrae are... superior to rib cage" 77. Hospital acquired pneumonia is usually caused by which of the following organisms? Klebsiellas 78. The following are clinical manifestation of diaphragmatic hernias except: Abdomen that appears convex 79. Bochdaleck hernia is the most commonly found on: A&C (posterolateral & left side) 80. The following are congenital lung malformations except: pleural effusion

Answers there

91. Concerning golfers elbow, which of the following is true? None of the above 92. Which of the following is true concerning mallet finger? Caused by injury to the tendon at the DIP joint of the finger 93. Exudative pleural effusion occurs in the following conditions except of: Heart failure 94. Which of the following is complication of pleural effusions? All of the above 95.Treatment of nerve injury include which of the following: all of the above 96. Respiratory failure may be due to dysfunction of one or more of the essential components of the respiratory system including the following except: CNS forebrain 97. non-communicating hydrocephalus may be due to the following except: Obstruction of the foramen of Morgagni 98. Atrial depolarisation normally occurs during the: P wave 99. During the cardiac cycle: The aortic and mitral valves are never open at the same time 100. Which of the following sequences is a possible anatomic path for a red blood cell passing through a fetus and back to the placenta? (Some intervening structures are not included.) Right ventricle, ductus arteriosus, descending aorta, umbilical artery

Answers there

A female newborn delivered at 32 weeks' gestation develops severe respiratory distress within hours of birth. Despite resuscitative efforts, the patient dies. Examination of the lungs at autopsy shows lung alveoli with radii of less than 50 μm (N=100). Which of the following is most likely decreased in the lungs of this newborn? a) Airway resistance b) Compliance * c) Elastic recoil d) Surface tension e) Vascular resistance 92. In hypersensitivity reactions: a) Type I hypersensitivity reactions are mediated by IL-1, IL-2 coma TNF-alpha b) Type I hypersensitivity reactions are associated withTh2 effector T-cells* c) Type Il reactions are mediated by antibody-antigen complexes d) Type IlI reactions are cellular mediated e) Type IV reactions lead to cell lysis 93. A patient will most likely die from which of the following first? a) Shock b) Airway obstruction* c) Ischemic d) Seizures e) Renal failure 94. The optic nerve can be assessed by which of the following test a) Visual field b) Colour discrimination c) Pupillary response d) Visual acuity e) All of the above * 95. Fundoscopy assesses which of the following nerves? a) Abducens nerve b) Optic nerve * c) Facial Nerve d) Auditory Nerve e) Ophthalmic Nerve 96. Spondylosis best identified using which of the following tests a) CT scan b) MRI* c) X-ray d) Nuclear studies e) Blood tests 97. Bronchopulmonary segments best identified using which of the following tests a) CT scan b) MRI c) Bronchoscopy* d) Spirometry e) X-ray 98. Rotator cuff injuries are best identified using which of the following a) CT scan b) MRI * c) X-ray d) Nuclear studies e) Blood tests 99. Proximal muscles weakness is caused by which of the following a Peripheral nerves b) Muscle weakness * c) Central causes d) None of the above e) A& C 100. Distal muscles weakness is caused by which of the following a) Peripheral nerves * b) Muscle weakness c) Central causes d) None of the above e) A& B

Answers there

1. following are true concerning supracondylar fractures except; Greenstick fracture of distal humerus 2.Concerning mechanism of supracondylar fractures: None of the above. 3.The following are true of epiphyseal growth plates: Responsible for linear growth in long bones 4.Volkmann ischemic contractures: Commonly caused by blood loss and hypoxia 5.Which of the following are innervated by the ulnar nerve? Medial two lumbricals 6.Which of the following is false concerning cubital tunnel syndrome? Cause numbness or tingling in the middle, ring and small finger 7. A cerebral vascular accident involving the left side of the face and right upper limb is caused by ischemia to the: Internal Carotid Artery 8. A cerebral vascular accident involving the right upper limb is caused by ischemia to the? Left Middle Cerebral Artery 9. A cerebral vascular accident involving the right side of the face is caused by ischemia to the: Left Middle Cerebral Artery. 10. A cerebral vascular accident involving the right lower limb is caused by ischemia to the: Left Anterior Cerebral Artery

Test 1 March 21

Platelet rich plasma is used in the management of which of the following a) Golfer's elbow* b) Ulnar nerve injury c) Frozen shoulder d) Shoulder dislocation e) None are correct

a) Golfer's elbow*

A child has gashed the palmar aspect of her wrist on some glass. Which of the following would be evidence of damage to her median nerve a) Inability to abduct index finger* b) Inability to flex the interphalangeal joint of the thumb c) Inability to flex the distal interphalngeal joint of the index finger d) Inability to oppose the thumb and little finger

a) Inability to abduct index finger*

Which of the following is true about the carpal tunnel syndrome? a) It can be caused by rheumatoid arthritis* b) It is caused by compression of the ulna nerve c) It causes pain and tingling in the medial three and half digits d) Paraesthesia is worse during the day

a) It can be caused by rheumatoid arthritis*

The following are causes of differential clubbing a) Liver failure b) Hypothyroidism c) Congenital heart disease* d) Bronchiectasis e) All of the above

c) Congenital heart disease*

Which of the following is true about an intention tremor? a) It is worse at rest b) It is caused by Parkinson's Disease c) It is indicative of a cerebellar lesion* d) Dyscalculia is a common association

c) It is indicative of a cerebellar lesion*

Which of the following is true in ulna nerve palsy? a) The ulna nerve can be affected by a fracture of the spiral groove of the humerus b) It gives rise to a positive phalen's sign c) It leads to loss of sensation over the medial half of the hand and medial one and a half digits on both palmar and dorsal aspects of the hand* d) It supplies the biceps muscles

c) It leads to loss of sensation over the medial half of the hand and medial one and a half digits on both palmar and dorsal aspects of the hand*

Which of the following is true about radial nerve palsy? a) The radial nerve arises from the lateral cord of the brachial plexus b) It is associated with sensory loss over the medial half of the hand c) It leads to wrist drop* d) It can occur due to a superficial laceration over the wrist

c) It leads to wrist drop*

Which of the following nursing positions is appropriate for a patient with a severe pneumonia a) Supine b) Prone c) Right lateral d) Decubitus* e) Left lateral

d) Decubitus*

VAPI (vaping associated pulmonary injury) is a form of which of the following a) Parapneumonic effusions b) Pneumonia c) Pleural effusion d) Pneumonitis*

d) Pneumonitis*

Regarding palmar spaces: a) The thenar space is open at the wrist b) Prevent spread of infection c) The mid palmer space is not continuous with the 3 ulnar lumbrical canals d) The mid palmar space is deep to the common synovial sheath and flexor tendons* e) The hypothenar space contains the long tendon of abductor digiti minimi

d) The mid palmar space is deep to the common synovial sheath and flexor tendons*