1. Recognised causes of abnormal movements of the hands include:
a) respiratory failure
b) renal failure
c) chronic alcoholism
d) liver failure
e) depigmentation and sustantia nigra
2. Recognised complications of renal failure are:
a) pulmonary oedema
b) convulsions
c) paresthesia in hands in the absence of anaemia
d) acidosis
e) hypokalaemia
3. Diabetes mellitus may present with:
a) vulvititis
b) change in refraction
c) paresthesia in legs
d) impotence
e) acute abdominal pain
4. Acute cardiac tamponade may cause:
a) progressive bradycardia
b) cold cyanosed peripheries
c) elevated jugular venous pressure (JVP)
d) giant a waves in JVP
e) pulsus paradoxus
5. Causes of acute pulmonary oedema include:
a) aortic stenosis
b) pulmonary emboli
c) atrial myxoma
d) myocardial infarction
e) chlorine inhalation
6. Regarding hyponatraemia:
a) it should be corrected with hypertonic saline
b) it always implies a disturbance in total body water
c) there is abnormal aldosterone secretion
d) it cannot be interpreted without clinical data
e) it is associated with advanced carcinoma of the bronchus
7. DC cardioversion is indicated for:
a) digitalis toxicity
b) premature atrial contractions
c) ventricular tachycardia
d) supraventricular tachycardia
e) premature ventricular contractions
8. Surgical treatment is the treatment of choice for:
a) Hashimoto’s thyroiditis
b) retrosternal goitre
c) longstanding thyroid cyst
d) thyrotoxicosis
e) solitary thyroid nodule
9. Correct treatment for ventricular arrhythmias includes:
a) procainamide
b) digoxin
c) lidocaine
d) carotid sinus massage
e) disopyramide
10. There is an increased risk of development of intestinal malignancy in:
a) pernicious anaemia
b) Peutz-Jegher’s syndrome
c) familiar polyposis coli
d) ulcerative colitis
e) diverticular disease
11. Phaeochromocytoma is associated with:
a) elevated 3-hydroxy 4-methoxy mandelic acid in urine
b) bilateral tumours in 50% of cases
c) medullary carcinoma of thyroid
d) frequent metastases of liver
e) hyperglycaemia
12. In a patient on clonidine presenting for surgery:
a) clonidine should be given parenterally through to the postoperative period
b) the patient is at risk of pulmonary embolism during anaesthesia
c) the patient should have a noradrenaline infusion during operation
d) the clonidine should be stopped before surgery
e) clonidine should be stopped on the day before surgery
13. Recognised causes of glycosuria are:
a) pregnancy
b) partial gastrectomy
c) phaeochromocytoma
d) chronic renal failure
e) old age
f) head injury, acromegaly
14. Hiatus hernia is associated with:
a) vitamin B12 deficiency
b) iron deficiency anaemia
c) retrosternal pain
d) lower oesophageal fibrosis
e) hiccoughs
15. Features of lower motor neurone disease are:
a) fasciculation
b) spasticity
c) wasting
d) increased reflexes
e) upgoing plantar response
16. Immediately after complete transection of the spinal cord, the following features may be found below the lesion:
a) loss of motor power, but preservation of limb reflexes
b) urinary incontinence
c) loss of muscle power, but preservation of sensation
d) flaccid paralysis with loss of limb reflexes
e) loss of muscle power, but preservation of muscle joint position sense
17. Regarding acute pancreatitis:
a) abdominal rigidity and guarding are characteristic early features
b) the serum amylase is characteristically not raised for first 12 hours
c) it may cause adult respiratory distress syndrome
d) hypocalcaemia occurs within the first week of the illness
e) hyperglycaemia is common
18. In a case of a Rhesus negative mother with a Rhesus positive foetus, a high level of anti-D antibody in the mother is associated with:
a) foetal red cells entering maternal circulation
b) antigen only crossing placenta
c) neonatal anaemia
d) neonatal jaundice
e) sensitisation only occurs in first 3 months of pregnancy
19. Indications for an urgent craniotomy in a person with head injury include:
a) sudden appearance of one fixed dilated pupil
b) rapidly deteriorating conscious level
c) cerebrospinal fluid rhinorrhea
d) falling blood pressure and rising pulse
e) generalised convulsions
20. The following are characteristic features of myasthenia gravis:
a) over 90% suffer from diplopia or ptosis at some stage of their illness
b) symptoms are usually symmetrical
c) muscular weakness is made worse by exercise
d) symptoms characteristically remit during pregnancy
e) steroids and azathioprine may be effective therapy
21. Carcinoma of the lung:
a) can cause Cushing's syndrome
b) may present with a peripheral neuropathy
c) can cause cerebellar degeneration without posterior fossa secondaries
d) can produce Horner’s syndrome
e) occurs three times more frequently in men than in women
22. Acute pancreatitis:
a) may present with flank staining
b) may be complicated by abscess formation
c) may be precipitated by steroids
d) is treated with steroids
e) can precipitate tetany
23. The following are features of hyperparathyroidism:
a) polydipsia and polyuria
b) bone pain
c) raised urinary calcium
d) tetany
e) peptic ulceration
24. Digitalis toxicity:
a) may be indicated by bradycardia and a prolonged P-R internal
b) may be indicated by a supraventricular tachycardia or ventricular extrasystoles
c) may be reduced by giving calcium salts
d) is usefully treated by a slow infusion of phenytoin
e) is an absolute contraindication to beta-blockade
25. Clubbing may be seen in:
a) Fallot’s tetralogy
b) acromegaly
c) ulcerative colitis
d) cirrhosis
e) myxoedema
26. In haemophilia A:
a) factor VII levels are markedly decreased
b) prothrombin and partial thromboplastin times are usually normal
c) adult sufferers are usually Australian Antibody (HB3Ab) positive
d) drug abuse is a frequent problem
e) the dose of cryoprecipitate to be given prior to surgery is calculated from the patient's factor VIII level and estimated plasma volume
27. The treatment of adult respiratory distress syndrome should include:
a) steroids
b) prophylactic antibiotics
c) high concentrations of oxygen
d) heparin
e) positive end-expiratory pressure
28. Which of the following are true of hepatitis B (serum hepatitis):
a) it is spread only by blood and blood products
b) most cardiac surgeons acquire the infection
c) it is common in prostitutes, homosexuals and the tattooed
d) it may be prevented by vaccination
e) it remains the commonest cause of post-transfusion hepatitis
29. Acute viral bronchitis and pneumonitis:
a) characteristically affects middle-aged individuals
b) are typically secondary to another infection
c) may be associated with the formation of epithelial giant cells in the alveoli
d) often show hyaline membranes in the respiratory passages
e) may be complicated by the development of lung abscesses
30. Finger clubbing is a recognised feature of:
a) asbestosis
b) chronic alveolitis
c) fibrosing alveolitis
d) fibrocaseous tuberculosis
e) empyema
31. The following features are characteristic of pure mitral stenosis with atrial fibrillation:
a) a loud first heart sound
b) an apical pre-systolic murmur
c) left ventricular hypertrophy on ECG
d) an elevated left atrial pressure on cardiac catherisation
e) pulsus paradoxus
32. A collapsing pulse is a recognised feature of patients with:
a) malignant hypertension
b) Paget’s disease
c) patent ductus arteriosus
d) alcoholic cardiomyopathy
e) atrial septal defect
33. Methaemoglobinaemia may be precipitated by:
a) nitrites
b) methylene blue overdosage
c) aniline dyes
d) ascorbic acid
e) sulphonamides
34. The normal ventricular myocardium:
a) has the ability to contract regularly after complete interruption of the conducting system
b) has an exceptionally high mitochondrial content
c) responds to an increased workload by hypertrophy
d) responds to an increased workload by hyperplasia
e) is of greater thickness in the right ventricle than in the left ventricle
35. The oxygen content of arterial blood is reduced:
a) by the presence of a left to right shunt in the heart
b) in patients with fibrosing alveolitis when the PaCO2 is low
c) in carbon monoxide poisoning
d) in methaemoglobinaemia
e) in Fallot’s tetralogy
36. The following are recognised features of deep vein thrombosis:
a) venography is the single most useful diagnostic test
b) it occurs very commonly in patients who have a fractured neck of femur
c) the initial treatment of choice is warfarin
d) surgical intervention using an umbrella filter is almost always indicated if symptoms fail to resolve
e) it is often found in association with carcinoma of the pancreas
37. The following features are commonly found in peripheral vascular disease:
a) angina pectoris
b) a normal cholesterol level
c) occlusion at the femoral-popliteal junction
d) it is more common in people from Europe and North America
e) surgery using synthetic prosthesis offers a low occlusion rate
38. Superior vena cava obstruction is commonly characterised by:
a) cyanosis and swelling of the head and arm
b) dyspnoea
c) clubbing
d) Horner’s disease
e) nausea and vomiting
39. Radiological findings of a large pulmonary artery on a chest X-ray are suggestive of:
a) infundibular pulmonary stenosis
b) atrial septal defect
c) Fallot’s tetralogy
d) pulmonary valve stenosis
e) Eisenmenger syndrome
40. The following statements are true or false:
a) starvation is characterised by loss of lean muscle mass
b) low zinc levels cause insulin resistance
c) L-amino acids alone are required for protein replacement
d) a normal adult requires 40-50 g of protein/24 hours
e) glucagon secretion is the prime response to trauma
41. Recognised unwanted effects of propranolol include:
a) bronchospasm
b) congestive cardiac failure
c) retinal detachment
d) tachycardia
e) hyperglycaemia
42. In hypothermia:
a) bradycardia is not marked
b) total oxygen consumption is closely related to shivering
c) a zone of dysrhythmia occurs between 26 degrees C and 28 degrees C
d) the dissolved oxygen in plasma is reduced
e) insulin excretion is reduced below 23 degrees C
43. Bleeding from oesophageal varices due to portal hypertension can be managed medically by:
a) an infusion of 20 units of Pitressin
b) propranolol
c) ice-cold saline infusions into the oesophagus
d) intraperitoneal aspiration
e) a Sengstaken tube
44. A patient with a parathyroid tumour has a calcium level of 4 mmol/L and is admitted to hospital. Preoperative investigations and management should include:
a) an intravenous pyelogram
b) an infusion of normal saline
c) administration of magnesium sulphate 10%
d) a skull X-ray and Towne view
e) vitamin D
45. A 40-year-old man is admitted after haemorrhage, dyspnoea and collapse. He is vigorously resuscitated but somewhat oliguric, and on passage of a pulmonary catheter the following results were found. RV – 85/15; PA 80/30 mmHg; Wedge pressure 39 mmHg, pulse 110 bpm, systolic pressure 100 mmHg. As part of his management, this patient requires the following:
a) doxapram
b) dobutamine
c) propranolol
d) spironolactone
e) nitroglycerine
46. Acute tubular necrosis is diagnosed by finding:
a) casts in the urine
b) a urine osmolality exceeding 500 mosm/L
c) a urine specific gravity of 1020
d) a urinary sodium of 10 mmol/L
e) a urinary volume of 700 mol/day
47. You are asked to see a patient on the ward. He has a swinging temperature, and his sputum and chest X-ray show a right-sided collapse of part of the lung. Treatment should include:
a) pleural aspiration
b) bronchial lavage
c) surgical biopsy of the appropriate part of the lung
d) bronchography
e) postural drainage
48. In severe airways obstruction:
a) pulsus paradoxus is a useful prognostic guide
b) helium is of benefit
c) the FEV1/FVC ratio is increased
d) alveolar hypoventilation is common
e) the drug of choice is aminophylline
49. A 50-year-old man is admitted with features of obstructive jaundice. The following investigations are indicated to establish the diagnosis:
a) barium meal
b) IgM levels
c) mitochondrial antibody
d) fibreoptic endoscopy
e) serum alkaline phosphatase
50. An elderly lady who has been on prolonged diuretic therapy presents with weakness, thirst and painful joints. The following investigations are required:
a) urinary electrolytes
b) serum phosphate
c) an ECG
d) a glucose tolerance test
e) blood gases
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ArticleDate:20050215
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