March 2022 Block Three

What is the recommended treatment for a male presenting with clinical signs of testis torsion after a Doppler ultrasound?

Observation and conservative management
Medical management with pain control
Immediate surgical exploration with detorsion and orchiopexy or orchiectomy
Referral to a specialist

What are the consequences of Vernal Keratoconjunctivitis (VKC) if left untreated?

Mild irritation of the eyes
Temporary blurred vision
Corneal scarring and vision loss
No long-term effects

What are the criteria for diagnosing Systemic Inflammatory Response Syndrome (SIRS)?

Temperature <38.3°C
Respiratory rate of <20 breaths/minute
Heart rate of <90 beats/minute and PaCO2 of <32 mmHg
Temperature >38.3°C or 90 beats/minute, Respiratory rate of >20 breaths/minute and WBC count of >12,000 cells/mm3 or 10% immature (band) forms

Which muscles and ligaments form the borders of the femoral triangle?

Inguinal ligament, sartorius muscle, and adductor magnus muscle
Inguinal ligament, sartorius muscle, and adductor longus muscle
Inguinal ligament, rectus femoris muscle, and adductor longus muscle
Sartorius muscle, gracilis muscle, and adductor longus muscle

As a medical doctor, what should be the recommended course of action for a diabetic patient prior to undergoing surgery?

Increase their insulin dose
Skip the morning dose of their medication
Stop taking their medication altogether
Take their usual dose of medication

What is the composition of coconut oil’s fatty acids?

High in polyunsaturated fatty acids
Mostly composed of long-chain fatty acids
Mostly composed of medium-chain fatty acids
High in monounsaturated fatty acids

What is the alternative drug for Metronidazole-sensitive pseudomembrane colitis?

Amoxicillin
Erythromycin
Vancomycin
Penicillin

What is the effect of using pindolol alone for hypertension treatment?

It has no effect on blood pressure and heart rate.
It slightly lowers blood pressure and heart rate
It significantly lowers blood pressure and heart rate
It significantly increases blood pressure and heart rate.

What is the preferred management for a labyrinthine fistula found after performing a mastoidectomy?

Urgent tympanotomy
Conservative management
Exploratory tympanotomy
Complete removal of cholesteatoma matrix and closure of the fistula

Which type of hernia is more likely to become strangulated?

Inguinal hernia
Femoral hernia

What are the three main parts of the uveal tract?

Choroid, ciliary body, and iris
Choroid, lens, and cornea
Cornea, iris, and ciliary body
Iris, lens, and choroid

What are the clinical presentations of Budd-Chiari syndrome caused by blood clots blocking the blood flow from the liver?

Sudden onset of ascites, abdominal pain, jaundice, and hepatic encephalopathy
Progressive ascites and absence of jaundice
Only renal impairment

What is the purpose of performing tarsorrhaphy?

To treat corneal injury
To correct strabismus
To address corneal exposure resulting from lagophthalmos caused by facial nerve palsies
To treat ptosis

What are the characteristics of a normal antenatal CTG trace?

Baseline FHR is between 90-100 bpm, variability is between 0-5 bpm, and decelerations are absent.
Baseline FHR is between 110-160 bpm, variability is between 5-25 bpm, and decelerations are present.
Baseline FHR is between 110-160 bpm, variability is between 5-25 bpm, and decelerations are absent or early.
Baseline FHR is between 140-180 bpm, variability is between 20-30 bpm, and accelerations x2 within 5 minutes

What is the most common cause of elevated Antimitochondrial antibody (AMA)?

PBC
Autoimmune hepatitis
Lupus
Rheumatoid Arthritis
Graft-versus-host disease

In Michaelis-Menten kinetics, the reaction rate is described by the Michaelis-Menten equation. Which of the following best describes the parameters in the equation?

The substrate concentration and the maximum reaction rate
The substrate concentration and the rate of the reaction
The maximum reaction rate and the rate of the reaction
The substrate concentration, the rate of the reaction, and the maximum reaction rate (Vmax) and the substrate concentration that results in half of the maximum reaction rate (Km)

Which antiepileptic drugs have a known association with hepatotoxicity?

Lamotrigine and Topiramate
Valproic acid and Phenytoin
Carbamazepine and Oxcarbazepine
Gabapentin and Pregabalin

What is the likely diagnosis of a patient presenting with aspiration pneumonia, dysphagia, and foul breath odor?

Esophagitis
Zenker's Diverticulum
Gastroesophageal Reflux Disease (GERD)
Barrett's Esophagus

What is the primary manifestation of tenosynovitis?

Pain
Swelling
Contractures
All of the above

A patient presents with a liver lesion that was diagnosed as a hepatic cyst. The patient has a history of colorectal cancer but there are no signs of metastasis to the liver. Which of the following is the most likely origin of the hepatic cyst?

Biliary cell epithelium
Mesenchymal tissue
Metastases from the colorectal cancer
Hepatocytes

What is the potential outcome of a nasal septal hematoma resulting from nasal trauma, if left untreated?

Mild pain and discomfort
Minor nasal deformities
Irreversible damage or destruction of the nasal cartilage leading to major nasal deformities
No significant consequences

What is a characteristic feature of tuberculosis in caseous necrosis?

Inflammation of the fluid-filled synovium within the tendon sheath
Multinucleated Langhans giant cells
Pain and swelling in the tendon sheath
Contractures in the tendon sheath

What is the most likely genetic syndrome associated with progressive bilateral sensorineural hearing loss and goitre?

Alport syndrome
Pendred syndrome
Turner syndrome
Down syndrome

Intralesional Candida antigen in the treatment of basal cell carcinoma (BCC)?

Highly effective and will alter current treatment of BCC
Effective in clearing superficial and nodular BCCs
Ineffective and unlikely to be used in treatment

Which of the following is a potential risk of vacuum-assisted vaginal deliveries?

Hyperbilirubinemia
Retinal Hemorrhage
Cephalohematomas
All of the Above

Which sympathetic ganglion is the largest?

Superior cervical ganglion
Middle cervical ganglion
Cervicothoracic ganglion

What is the most effective treatment for heart failure associated with diabetes?

Sulfonylurea
DDP-4 inhibitor
GLP-1 agonist
TZD
Sodium glucose cotransporter 2 (SGLT2) inhibitor

What is the cause of loss of sensation on the medial side of the sole of the foot?

Damage to the tibial nerve
Damage to the peroneal nerve
Damage to the radial nerve
Damage to the ulnar nerve

Which of the following is NOT a part of the development of the fallopian tubes?

Derived from paramesonephric or Müllerian ducts
Formed from the ectoderm
Undergo elongation and coiling
Developed from the middle layer of one of the three primary germ layers in the embryo

What is the most commonly used drug for the treatment of pulmonary edema?

ACE inhibitors
Calcium channel blockers
Diuretics
Nitrates

Which of the following treatments was the girl given in the emergency department for her symptoms of diarrhoea and drowsy state after taking medication from Hakim?

Ibuprofen
Atropine
Antibiotics
Insulin

Which of the following is true about the effect of estrogen and progesterone on uterine peristalsis?

Estrogen stimulates directed cervico-fundal peristalsis and progesterone inhibits peristalsis.
Progesterone stimulates directed cervico-fundal peristalsis and estrogen inhibits peristalsis.
Estrogen and progesterone both stimulate directed uterine peristalsis
Estrogen and progesterone both inhibit directed uterine peristalsis

What is the most common site of ectopic pregnancy?

Ampullary
Isthmic
Fimbrial
Cornual/Interstitial

Which of the following is a side effect of antipsychotic drugs?

Insomnia
Neuroleptic Malignant Syndrome (NMS)
Nausea
Headache

Which of the following is the most likely diagnosis for a patient who has been experiencing green-yellow mucus discharge from their nose for the past month?

Common Cold
Allergic Rhinitis
Sinusitis
Influenza

What is the most common cause of Cushing’s syndrome?

Tumor producing excessive cortisol by the adrenal glands
Pituitary adenoma
Medication such as prednisone
Inherited disorders such as multiple endocrine neoplasia type 1

Which of the following is the most common primary malignant bone tumor?

Osteosarcoma
Chondrosarcoma
Ewing's sarcoma
Chordoma

Which of the following disorders is marked by a combination of schizophrenia symptoms and mood disorder symptoms?

Depression
Mania
Schizophrenia
Schizoaffective disorder

What is the House-Brackman grade assigned to Bell’s Palsy in the case of obvious synkinesis but not disfiguring?

Normal facial function in all areas (Grade I)
Mild dysfunction (Grade II)
Moderate dysfunction (Grade III)
Moderately severe dysfunction (Grade IV)

Which of the following hormones is associated with the high levels in Polycystic Ovary Syndrome (PCOS)?

Follicle-stimulating hormone (FSH)
Luteinizing hormone (LH)
Progesterone
Estrogen

What is the most commonly used drug to treat rheumatoid arthritis?

Nonsteroidal anti-inflammatory drugs (NSAIDs)
Benzathine penicillin G
Corticosteroids
Disease-modifying antirheumatic drugs (DMARDs)

What is the most likely diagnosis for an immunocompromised person who presents with an abdominal dark red lesion and blisters?

Cellulitis
Meleney's Ulcer
Erysipelas
Lymphangitis

Which of the following is a genetic syndrome that can cause short stature?

Prader-Willi syndrome
Turner syndrome
Noonan syndrome
All of the above

What is the recommended treatment for individuals diagnosed with acute rheumatic fever?

Nonsteroidal anti-inflammatory drugs (NSAIDs)
Benzathine penicillin G
Corticosteroids
Disease-modifying antirheumatic drugs (DMARDs)

What does it mean if two drugs cause relaxation of the smooth muscle in the intestinal mucosa but have different EC50 values?

They have the same level of efficacy
They have different levels of potency
They have the same level of potency
They have different levels of toxicity
They have different levels of efficacy

What are the common cardiac anomalies associated with Noonan syndrome?

ASD, VSD, AVCD, TOF
CoA, BAV, AS, HLHS
IAA type B, aortic arch anomalies, truncus arteriosus, TOF
Supravalvar AS, PPS
PS, HCMP, ASD

Duchenne muscular dystrophy is caused by?

Mutation in the alpha-sarcoglycan gene
Mutation in the beta-sarcoglycan gene
Mutation in the dystrophin gene
Mutation in the gamma-sarcoglycan gene

What is the effect of salbutamol on Potassium?

Increases potassium levels
Decreases potassium levels
No effect on potassium levels

What are the potential complications of cholelithiasis?

Inflammation of the gallbladder
Jaundice
Infection of the bile ducts
All of the above

What is the recommended vaccine schedule for individuals undergoing surgery?

S. pneumoniae and N. meningitidis vaccination 2 weeks before surgery and live attenuated vaccines against measles-mumps-rubella and varicella 2 weeks after surgery
Influenza virus and H. influenzae type b vaccination 2 weeks before surgery and tetanus, diphtheria and pertussis vaccine 4-8 weeks after surgery
Measles-mumps-rubella and varicella vaccination 2 weeks after surgery and tetanus, diphtheria and pertussis vaccine 4-8 weeks before surgery
Influenza virus and H. influenzae type b vaccination 2 weeks after surgery and live attenuated vaccines against measles-mumps-rubella and varicella 2 weeks before surgery

March 2022 Block Three

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