MCQ's

Which one of the following would be consistent with a Glasgow Coma Score of 9?

1. The patient opens their eyes spontaneously, but has no verbal or motor response 2. The patient has no eye opening, no verbal response and no motor response. 3. The patient opens their eyes only to pain, mutters "I'm home" and withdraws to pain bilaterally. 4. The patient opens their eyes to voice, is confused but obeys motor commands. 5. The patient opens their eyes to pain, groans and has an extensor motor response.

Boris Zucker, a 50 year old man, is found to have a 3 cm cancer in the body of his stomach. After staging, a single hepatic metastasis is identified. Which one of the following statements regarding Mr Zucker is MOST correct?

1. Without gastric surgery he is likely to develop gastric outlet obstruction. 2. Helicobacter pylori should be eradicated if present. 3. Gastrectomy is reserved for local symptom control. 4. Both his primary and secondary tumours should be resected. 5. Gastrectomy should be offered if chemotherapy is not effective.

A 72 year old male smoker with a past history of multiple myocardial infarcts, presents with severe dyspnoea, orthopnoea, peripheral oedema and general malaise. Which one of the following is the MOST likely diagnosis?

1. acute myocardial infarct 2. unstable angina 3. congestive cardiac failure 4. ventricular tachycardia 5. pericarditis

In the management of anaphylaxis, after oxygen which one of the following is the first treatment?

1. adrenaline 2. fluid replacement 3. antihistamines 4. steroids 5. skin prick testing

Answer

1. adrenaline - All other options are appropriate, but the first line treatment of anaphylaxis is adrenaline

Which one of the following is MOST important in slowing down the progression of chronic renal failure due to IgA nephropathy?

1. aggressive blood pressure control 2. ACE inhibitors 3. salt-reduced diet 4. low protein diet 5. high fluid intake

An elderly woman in hospital with a recent myocardial infarction suddenly becomes distressed. On examination she is very short of breath. She has a sinus tachycardia, a normal JVP, crepitations at her lung bases and a long systolic murmur (not previously noted) at her cardiac apex that radiates to the axilla. Which one of the following is the MOST likely cause of her deterioration?

1. cardiac tamponade due to pericarditis 2. pulmonary embolus 3. bacterial endocarditis 4. rupture of a mitral valve cusp 5. rupture of the interventricular septum

Which one of the following drugs is NOT of proven benefit in the treatment of chronic heart failure?

1. carvedilol 2. aspirin 3. enalapril 4. spironolactone 5. captopril

A 13-year old girl presents with severe hypertension and renal failure. She is found to have small, irregular-shaped kidneys on ultrasound examination. Which one of the following is the MOST likely diagnosis?

1. familial glomerulonephritis 2. post-streptococcal glomerulonephritis. 3. SLE 4. IgA nephropathy 5. reflux nephropathy

A 74 year old man falls astride a low fence receiving a blow to his perineum. Subsequently his temperature is elevated and he has gradual increased swelling of the perineum and genitalia. Which one of the following is the MOST likely diagnosis?

1. fractured pelvis 2. haematoma of the scrotum 3. rupture of the bladder 4. rupture of the urethra 5. contusion and haemorrhage of the perineal muscles

Which one of the following combinations best describes the clinical features of hypercapnia?

1. hypotension, pallor, sweating 2. tremor, bounding pulse, sweating 3. central cyanosis, agitation, tremor 4. drowsiness, tachycardia, sweet-smelling breath 5. confusion, agitation, tachypnoea

Which one of the following investigations is NOT useful in the management of a patient with gastric cancer?

1. laparoscopy 2. gastroscopy 3. MRI abdomen 4. Histology of a biopsy specimen 5. CT Scan abdomen

`Twelve hours after a total thyroidectomy for thyrotoxicosis, a 32 year old woman becomes restless, cyanosed and develops stridor. Which one of the following is the MOST appropriate initial course of action?

1. measurement of blood gases 2. lung scan 3. exploration of the wound 4. indirect laryngoscopy 5. endotracheal intubation

A 7 year old Aboriginal boy presents with dark urine and puffy eyes, 3 weeks after a middle ear infection. Which one of the following is the MOST likely diagnosis?

1. minimal change disease 2. IgA nephropathy 3. pyelonephritis 4. post-streptococcal glomerulonephritis 5. chronic renal failure

Management of an epidural infusion of local anaesthetic and opioid for post-operative pain relief includes which one of the following:

1. monitoring of respiratory rate 2. removal of the epidural if motor blockade is evident 3. avoidance of subcutaneous heparin 4. daily changes of dressing 5. adjuvant intramuscular opioid if analgesia is unsatisfactory

In a patient presenting with acute renal failure which one of the following tests is the MOST appropriate initial imaging modality?

1. plain abdominal radiograph 2. isotope renography will inform us of the function of the kidney (perfusion and drainage). 3. intravenous pyelogram 4. CT abdominal scan without intravenous contrast enhancement 5. abdominal ultrasound

Which one of the following treatments is NOT useful in reverting a patient from atrial fibrillation to sinus rhythm?

1. sotalol 2. digoxin 3. quinidine 4. amiodarone 5. defibrillator

A 68 year old woman presents to the Emergency Department with chest pain followed by sudden collapse with loss of consciousness. She has a rapid weak pulse. Her ECG shows a regular wide complex tachycardia. Which one of the following is the MOST likely diagnosis?

1. ventricular tachycardia 2. supraventricular tachycardia 3. ventricular fibrillation 4. atrial fibrillation 5. atrial flutter

Features of an acute exacerbation of COPD that increase mortality risk include:

a. Hypercapnoea secondary to the acute exacerbation b. Chronic hypercapnoea prior to the acute exacerbation c. All of the above d. Presence of heart failure and cor pulmonale e. Acute respiratory failure due to the acute exacerbation

With respect to measurement of end-tidal carbon dioxide in an intubated patient which one of the following is NOT correct?

a. Hyperventilation causes a lowering of the end-tidal carbon dioxide measurement. b. The capnogram waveform may be normal in an endobronchial intubation. c. Venous gas embolism is associated with a sudden fall in end-tidal carbon dioxide. d. In a healthy individual the normal difference between arterial and end-tidal carbon dioxide is about 8 mmHg. e. It can be used to detect a leaking endotracheal cuff.

The diagnosis of bronchiectasis is usually based on:

a. Increased retrosternal airspace on chest x-ray b. A history of chronic cough and occasional haemoptysis and no sputum production c. Regular need for bronchodilators d. Large bullae seen on CT e. A history of chronic daily cough and sputum production

Which of the following is least likely to cause dyspneoa?

a. Ischaemic heart disease b. Carbon monoxide poisoning c. Anaemia d. Chronic obstructive pulmonary disease e. Anxiety

Which of the following is NOT a sign of infective endocarditis?

a. Janeway lesions b. Osler's node c. Xanthelasma d. fever e. a new cardiac murmur

Which Korotkoff sound is used for detecting the diastolic blood pressure?

a. Korotkoff III b. Korotkoff V c. Korotkoff II d. Korotkoff IV e. Korotkoff I

Answer

a. Mitral regurgitation

Patients with Chronic Obstructive Pulmonary Disease usually present with:

a. Pneumonia and a significant smoking history b. Worsening shortness of breath on exertion c. Productive cough for several months, worse in the morning d. Lung cancer e. Wheeze

Which of the following should be done before checking a patient's blood pressure?

a. allow the patient time to rest b. use palpation to estimate the systolic blood pressure c. check whether the patient has any pain or recent surgery in the arm d. explain what you are going to do e. all of the above

Which of the following may affect Blood pressure readings?

a. blood pressure cuff size b. physical exertion prior to the blood pressure measurement c. smoking 2 hours before d. caffeine 2 hours before e. all of the above

Answer

a. clubbing Although this bronchiectasis is a cause of clubbing - bullshit question

Which of the following are causes of an elevated central venous pressure?

a. fluid overload b. superior venal caval obstruction c. right heart failure d. pericardial effusion e. all of the above

The jugular venous pressure can be differentiated from the arterial pulse because it is:

a. light pressure at the base of the neck will cause it to fill b. visible, but not palpable c. it moves on respiration d. it has a complex wave form e. all of the above

In which clinical situation might you hear hyperresonant percussion note?

a. pneumonia b. pleural effusion c. all of the above d. haemothorax e. pneumothorax

Which of the following are accessory muscles of respiration?

a. sternomastoid b. sternomastoid, platysma & strap muscle of neck c. platysma d. strap muscle of neck e. diaphragm

Which of the following is true about a spacer?

a. they were invented in New Zealand b. it is not as effective as a nebuliser in administering bronchodilator c. it should be washed in detergent and left to dry in the kitchen sink d. it is no more effective than a metered dose inhaler on its own e. they are expensive

Answer

b. Chronic hypercapnoea prior to the acute exacerbation

Answer

b. Worsening shortness of breath on exertion

Answer

b. sternomastoid, platysma & strap muscle of neck The diaphragm is the main muscle of respiration. The other muscles are called accessory muscles. Source: Talley and O'Connor, page 106

Answer

c. 30%

Answer

c. Atrial fibrillation From Talley and O'Connor, a fourth heart sound is a late diastolic sound which is more high pitched than a third heart sound, although it also sounds like a gallop rhythm. It occurs when a high pressure atrial wave is reflected back from a poorly compliant left ventricle. As such, it does not occur in atrial fibrillation because you do not get a proper atrial contraction when someone is in atrial fibrillation.

Answer

c. The patient has other lung pathology and the extent of each must be defined d. The patient may be suitable for surgical resection of the lung e. The chest x-ray is clear/shows suspicious findings and more information is needed

Answer

c. it should be washed in detergent and left to dry in the kitchen sink

Answer

d. 12-16 breaths/minute

Answer

d. Airway dilatation +/- tapering and bronchial wall thickening

Answer

e. 5th Intercostal space, mid clavicular line

Answer

e. A history of chronic daily cough and sputum production

Answer

e. All of the above

Answer

e. It can be used to detect a leaking endotracheal cuff.

Answer

e. Permanent abnormal dilatation and destruction of the major bronchi and bronchiole walls

Answer

e. all of the above

Answer

2. ACE inhibitors Most correct answer.

Answer

2. tremor, bounding pulse, sweating - A bounding pulse is a characteristic feature of hypercapnia, with peripheral vasodilatation, sweating and tremor and therefore best describes this disorder. Confusion, central cyanosis, tachycardia, agitation, drowsiness and tachypnoea are all variably described in varying degrees of hypercarbia, but are less specific.

Answer

3. E2, M4, V3 = 9. One may dispute that "I'm home" represents confused speech rather than inappropriate words, but it is still the only one that even comes close.

Answer

3. MRI abdomen

Answer

3. Pancreatic transections most often occur in the midline. This is the right answer. It typically splits over the vertebral bodies.

Answer

3. congestive cardiac failure I think this question is a little ambiguous given that options 1, 2 and 3 are arguably reasonable choices for this presentation. I assume that the question was pointing to the symptoms of heart failure as the most likely choice however, this may be confused with the likely precipitants of heart failure - that being ischaemic heart disease (which are also diagnoses in their own right). If clinical perspective is what is intended to be tested here, then the question could be left as it stands. However to phrase it so that there can be only one answer, perhaps the history of multiple myocardial infarcts could be taken out and replaced with a valve problem such as aortic stenosis etc, Correct answer is congestive heart failure -- James Wong

Answer

3. exploration of the wound - this is also correct, may be necessary first if intubation (option 5) is unsuccessful.

Answer

4, or possibly 3. The aim of these manoeuvres is to bring the base of the tongue forwards and away from the posterior pharyngeal wall in order to restore the patency of the airway, which will facilitate both spontaneous and artificial respiration (note posterior wall rather than vocal cords. Also, recent MRI and cadaver studies suggest the manoeuvres work by bringing the epiglottis off the laryngeal inlet). Head tilt moves the head backwards, not forwards (depending upon your orientation), and jaw thrust aims for as forward a displacement as can reasonably be obtained - hence prognathism - rather than occlusion (but is this almost occlusion, and is occlusion more commonly achievable than prognathism?). In suspected cervical spine injury, it is not recommended to perform head tilt or chin lift (risk vs benefit), but to provide isolated jaw thrust before employing more invasive manoeuvres such as insertion of an oropharyngeal airway. A poll of senior colleagues has been inconclusive, with an even split over 3 and 4. One might ask, what fact is it that the question seeks to elucidate, bearing in mind that 50% of people who (supposedly) know the fact will still get it wrong.

Answer

4. Both his primary and secondary tumours should be resected.

Answer

4. Radiotherapy can cause a skin reaction due to a mechanism similar to that of sunburn. - Correct

Answer

4. post-streptococcal glomerulonephritis The clues given in the question leads to post infectious GN as the most correct answer. 3 weeks post an infection; puffy eyes imply there is a degree of nephrotic syndrome (or at least some degree of proteinuria) and dark urine may implicate glomerular haematuria. Post infectious GN is a disease commonly occurs after an infectious episode. Presenting with renal impairment, glomerular haematuria and can have significant amount of proteinuria.

Answer

4. rupture of a mitral valve cusp The heart new systolic heart murmur would exclude a pulmonary embolis. Pericarditis will cause a heart murmur but will be heard throughout the cardiac cycle (both systole and diastole) and tamponade will lessen the loudness of any pericardial sound. Bacterial endocarditis is a possibility but a rare cause post infarction and given that there is no mention of fever or other septic symptoms. A new systolic heart murmur could fit with the rupture of the interventricular septum but the murmur is not usually radiating to the axilla and the presentation is generally with hypotension with an elevated JVP. The acute rupture of the mitral valve papillary muscle is therefore the most likely choice. Correct answer is rupture of a mitral valve cusp.

Answer

4. rupture of the urethra classical straddle injury. Description of gradual swelling and fever fits. Scrotal hematoma will be associated as well. You'll find students picking that and it won't exactly be wrong

Answer

5. a ruptured spleen - most likely explanation of L shoulder tip pain, tachycardia, and hypotension after blunt trauma

Answer

5. abdominal ultrasound An ultrasound is the safest and most useful initial test to assess someone with acute renal failure. It will let us know whether there is an obstruction (hydronephrosis); the size of the kidneys will help us determine whether the renal impairment has an element of chronicity (small kidneys); and unequal size kidneys (with no evidence of hydronephrosis) will give us a clue of vascular insufficiency (eg chronic unilateral renal artery stenosis). It will also be the test with the least amount of radiation (safe).

Answer

All but digoxin have the ability to revert atrial fibrillation to sinus rhythm. Digoxin is used primarily to control heart rate not heart rhythm in atrial fibrillation. (Quinidine is now hardly used these days and may not feature heavily in current teaching of antiarrhythmic drugs.) Correct answer is digoxin.

Answer

All the rhythms listed are generally rapid in rate. The regularity of the rhythm rules out Atrial fibrillation. In general and without aberrant conduction, atrial fibrillation, flutter and supraventricular tachycardia all have narrow QRS complexes. Patients in ventricular fibrillation are generally unconscious and pulseless. Therefore the most likely diagnosis is ventricular tachycardia. Correct answer is ventricular tachycardia

Answer

Carbon monoxide poisoning (usually from fire or self poisoning) most commonly presents with headache, then other constitutional symptoms such as malaise, nausea, and dizziness. They may have confusion or in more severe cases, other neurological signs or coma. They do not usually present with respiratory symptoms.

Answer

I am assuming that 'aspirin' is the one that is likely to be the odd one out. However, all of the listed drugs including aspirin have some proven prognostic benefit in the treatment of ischaemic heart failure. It boils down to how the student interprets the word 'benefit' -symptomatic or prognostic or both?. Perhaps the question could be clarified by stating "Which one of the following drugs is NOT proven to have symptomatic benefit in the treatment of chronic heart failure." All these drugs bar aspirin have symptomatic benefit. Correct answer is Aspirin

Answer

Korotkoff phase V, disappearance of sound should be used as the measurement, phase IV can be used only if the sound continues until zero.

Answer

Reflux nephropathy fits the picture the best. Young girls (commonly affecting females) and usually the pathology of reflux nephropathy is said to occur in-utero. The irregular shaped kidneys imply that there are at least scarring affecting certain parts of the kidney (poles) rather than the whole kidney. The hypertension is just a sequelae of her CKD.

Following a motor car accident, a young woman lying in the Emergency Department begins to complain of left shoulder tip pain. On examination, she has a pulse of 110/min and a systolic blood pressure of 100 mmHg. Your biggest concern would be that this clinical picture most likely represents

Select one: 1. traumatic pancreatitis 2. gas under the diaphragm 3. fractured ribs 4. a subluxation of the acromio-clavicular joint 5. a ruptured spleen

Answer

The main reason for positioning the patient at 45 degrees is to enable a standard measurement of the Jugular Venous Pressure. When the patient is lying at 45 degrees the sternal angle is roughly in line with the base of the neck. An additional advantage is that it facilitates easy movement of the patient forwards for dynamic maneuvers, as well as auscultation of the posterior chest.

The normal position of the apex beat in adults is Select one:

a. 4th intercostal space, anterior axillary line b. between sternocleidomastoid and the deltoid muscles c. 4th intercostal space, mid clavicular line d. 5th intercostal space, mid axillary line e. 5th Intercostal space, mid clavicular line

You may hear a left ventricular fourth heart sound all of the following situations EXCEPT which one?

a. Advanced age b. Acute mitral regurgitation c. Atrial fibrillation d. Aortic stenosis e. Systemic hypertension

Bronchiectasis is defined by:

a. All of the above b. An infectious insult to the lungs c. Inappropriate immune response to noxious stimuli leading to airway dilatation d. The presence of chronic bronchitis and/or emphysema e. Permanent abnormal dilatation and destruction of the major bronchi and bronchiole walls

High resolution computed tomography is indicated under which circumstance in the patient suspected of having bronchiectasis? - all correct responses

a. All of the above b. It is a first line test c. The patient has other lung pathology and the extent of each must be defined d. The patient may be suitable for surgical resection of the lung e. The chest x-ray is clear/shows suspicious findings and more information is needed

Important differentials in an individual presenting with dyspnoea and wheeze include:

a. Cardiac Failure b. Asthma c. Bronchiolitis Obliterans with Organising Pneumonia d. Chronic Obstructive Pulmonary Disease e. All of the above

Common physical examination findings in the patient with bronchiectasis include all of the following except:

a. Clubbing b. Wheeze c. Lowered oxygen saturations d. Cough e. Crepitations

Major features of bronchiectasis on HRCT include :

a. Consolidation and lymph node enlargement b. Vascular disruption c. Evidence of pleural effusion d. Airway dilatation +/- tapering and bronchial wall thickening e. Bullae

Answer

e. all of the above - Smoking transiently raises the BP; thus, the office BP may underestimate the usual BP in a heavy smoker who has not smoked for more than 30 minutes before the measurement is made. - Caffeine intake can raise the BP acutely, primarily in nonhabitual coffee drinkers. - Taking the BP in a cool room (12ºC or 54ºF) or while the patient is talking can raise the measured value by as much as 8 to 15 mmHg - If too small a cuff is used, the pressure in the cuff may be considerably higher than the intraarterial pressure

Answer

- Aortic stenosis is not a cause of clubbing. - Clubbing is a nail sign which is due to a variety of underlying causes. The exact mechanism causing clubbing is not clear, but may be related to hypoxia. You should hold up the finger and look at it side on to check for loss of the angle between the nailbed and the finger. You can also press on the nailbed to check for sponginess. - The following are all potential causes of clubbing: Cardiovascular: - Cyanotic congenital heart disease - Infective Endocarditis Respiratory - Lung carcinoma - Bronchiectasis - Lung abscess - Empyema - Idiopathic pulmonary fibrosis - Cystic fibrosis - Asbestosis - Mesothelioma or pleural fibroma Gastrointestinal - Cirrhosis - Inflammatory bowel disease - Celiac Disease - Thyrotoxicosis Familial/idiopathic - Neurogenic diaphragmatic tumours - Pregnancy - Secondary hyperparathyroidism - Bronchial arteriovenous aneurysm - Axillary artery aneurysm

Answer

- Haemothorax and pleural effusion cause a dull percussion note. - An effusion tends to be stony dull. - Pneumonia can also be indicated by dull percussion note over the area of consolidation. - Pneumothorax caused hyperresonant percussion note and reduced breath sounds.

Answer

- Xanthelasma are yellow or orange deposits of lipid under the skin, usually around the eyes. Associated with dyslipidaemia - Infective endocarditis is an important clinical condition, which if missed can cause death. It is due to bacterial deposits, usually on an underlying abnormal valve. The most common bacterial causes are: - Infective endocarditis should be suspected in any patient with - Fever of unknown origin, Fever and new cardiac murmur - The peripheral stigmata of infective endocarditis include; 1. Janeway lesions which are macular, non blanching, red, non painful lesions on the palms of the hand, and soles of the feet 2. Osler's nodes, painful violaceous lesions on the pulps of the fingers. 3. Petechie. These are the most common skin sign, and are due to small emboli in the skin. They may also be seen in the mouth, and under the eyelids. 4. Splinter haemmorrhages-of the nails 5. Roth spots-on retinal examination. These are exudative lesionds on the retina. - Patients may have septic emboli (clumps of bacteria break off from the vegetative lesion and are carried through the circulation and lodge in various parts of the body), and you may find evidence of septic emboli affecting different organs, such as the brain, which would cause focal neurological signs. - With the advent of antibiotics, it is less common nowadays to see some of these peripheral signs.

Answer

1. Image guided core biopsy or fine needle aspirate should be used to confirm the diagnosis in this patient

Which one of the statements regarding a 47 year old woman with a clinical suspicion of breast cancer is MOST correct?

1. Image guided core biopsy or fine needle aspirate should be used to confirm the diagnosis in this patient 2. A palpable axillary lymph gland indicates axillary lymph node involvement by tumour. 3. Skin dimpling indicates tumour spread to the skin. 4. Fixation of the tumour to the underlying pectoral muscle is a common finding in women with early breast cancer. 5. The patient can be reassured if careful mammographic and ultrasound examination of the area of clinical concern does not demonstrate any abnormality.

Which one of the following statements related to control of blood pressure and hypertension is NOT correct?

1. In established hypertension there is usually increased cardiac output. 2. Conn's syndrome is due to excessive adrenal section of aldosterone. 3. Most people with Mendelian inherited hypertension have defects in sodium metabolism. 4. Most people with Conn's syndrome have sodium and water retention. 5. Renal disease is the most common form of secondary hypertension.

Answer

1. Incorrect. In established hypertension, the pathophysiology is usually associated with increase vascular resistance rather than increased CO.

Which one of the following statements regarding head tilt, chin lift, jaw thrust method of opening the airway is MOST correct?

1. It requires firm backward pressure with the palm of the hand to tilt the head forwards. 2. It is safe to use in patients suspected of having cervical spine injuries. 3. It involves lifting the chin forward so that the teeth are almost in occlusion. 4. It is effective in lifting the base of the tongue away from the vocal cords. 5. It makes artificial respiration more difficult to perform.

Which one of the following statements about radiotherapy is MOST correct?

1. Radiotherapy can not be given together with chemotherapy. 2. Patients receiving radiotherapy should avoid close contact with others because they are radioactive. 3. Radiotherapy commonly involves the use of high energy protons. 4. Radiotherapy can cause a skin reaction due to a mechanism similar to that of sunburn. 5. After radiotherapy it is usually not possible to perform surgery in that area.

Answer

1. Respiratory suppression is an important clinical indicator of opioid toxicity. Tachypnoea can be seen with inadequate analgesia, which is also important in the ongoing assessment of epidural blockade. Motor block can indicate too dense a block or, very rarely, neurological damage as a result of direct injury or haematoma which is differentiated by reducing or stopping the infusion and awaiting resolution of motor block before restarting at a lower rate, rather than removing the epidural catheter altogether. Subcutaneous heparin is important in reducing the risk of post-operative DVT and PE - the insertion and removal of an epidural catheter should be timed around its administration, but heparin should still be used if clinically indicated. Daily dressing changes increase the likelihood of infection. Depot injections of opioid are inadvisable - they offer no improvement in analgesia over IV administration and are more prone to adverse effects such as respiratory suppression, particularly if given concomitantly with other routes.

Which one of the following statements relating to acute aortic dissection is NOT correct ?

1. The aneurysm may be associated with connective tissue disorders 2. Cardiac tamponade may be a consequence. 3. Chest X-ray may be helpful in the diagnosis 4. Renal failure may be a complication 5. Gangrene of the toes is commonly seen.

Select one:

1. The kidney is the most commonly injured abdominal organ 2. The majority of bladder ruptures are intraperitoneal 3. Pancreatic transections most often occur in the midline. 4. Ultrasound is more reliable than CT in diagnosing splenic laceration. 5. The main value of ultrasound is in demonstrating the presence of free intraperitoneal gas as it can be performed in the supine patient.

Answer

Unlikely to show up on plain xray

Which of the following is NOT a cause of clubbing?

Which of the following is NOT a cause of clubbing? Select one: a. Bronchiectasis b. Infective endocarditis c. Aortic stenosis d. Lung cancer e. Cyanotic Congenital heart disease

Which of the following is a systolic murmur?

Which of the following is a systolic murmur? Select one: a. Mitral regurgitation b. Aortic regurgitation c. Tricuspid stenosis d. Mitral stenosis e. Patent ductus arteriosus

When performing the cardiovascular examination, the patient should ideally be positioned at:

a. 0 degrees b. 90 degrees c. 45 degrees d. 60 degrees e. 180 degrees

A normal adult respiratory rate is:

a. 20-24 breaths per minute b. 6-10 breaths per minute c. 18 breaths per minute d. 12-16 breaths/minute e. 36-40 breaths per minute

What proportion of people, who have an elevated blood pressure detected in clinic, will have a normal blood pressure at home or outside the clinic?

a. 22.5% b. 15% c. 30% d. 75% e. 45%