Question Bank Needs Answers - pichaya_n

[ArchivalUser]

Hi guys, below are some new question bank I have from oversea and they are great practice. Hopefully not too easy for you guys, I don't have answers for them so it would be great if we can work them out together. Some questions are missing, they are either incomplete or just missed.

Question 1:

A 56 year old male presents to hospital with confusion. He was recently discharged from hospital after an admission for acute pancreatitis, that was complicated by a pseudocyst, steatorrhea and glucose intolerance. He was discharged home on insulin, candesartan and pancreatic enzymes. On examination, he is confused and clammy. HR=97, BP=120/80 and temp=36.5

What is the most likely cause of his symptoms?

1. Dehydration
2. Malnutrition.
3. Sepsis
4. Pancreatitis
5. Hypoglycemia

Question 2:

A 65yo man from a homeless shelter is brought into ED with ataxia, confusion, and an opthalmoplegia with difficulty in lateral gaze. This has partially corrected with hospital management (no details on what management was instituted). Which of the following is likely to be present post resolution of the acute symptoms?

a) Amnesia
b) Speech disturbance
c) Chronic dementia
d) Visuospatial disturbance
e) Calculation problems

Question 3:

70 year old male with SCC is found to have hypercalcemia.

Bloods: Ca(corr): 3.42
Urea=8.1
Creatinine=135

What is the next step in management?

1. IV fluids
2. Dexamethsone
3. s/c denosumab
4. s/c calcitonin
5. IV bisphosphonate

Question 4:

56 year old male presents with chest pain. He has long standing angina that settles with aspirin. His last stress test was positive at high workload. His angiogram shows 50% stenosis of his mid RCA.

What intervention will be most beneficial in decreasing his coronary risk?

1. Diltiazem
2. Clopidogrel
3. HMG-CoA reductase inhibitor
4. ACE inhibitor
5. Angioplasty and stent

A 76 year old female is evaluated for osteoporosis. She is currently on vitamin D and calcium medications. She states that she drinks milk regularly and exercises 20 minutes a day. She completed menopause at the age of 46 and never had any HRT.

Her UEC, CMP and vitamin D are all normal. Her DEXA scan results are shown below:

T score
Lumbar spine -1.5
Hip -1.2

What is the management plan?
1. Continue calcium and vitamin D
2. Commence HRT
3. Commence strontium
4. Commence bisphosphonate
5. Commence raloxifene

Question 6:

A 70 year old woman presents with recurrent episodes of symptomatic cystitis. These recur soon after completing courses of antibiotics. She had a normal renal tract ultrasound three years ago during investigations for hypertension. Her fasting blood glucose level is 4.5 (within the normal range). What is the most likely cause of her recurrent cystitis?

a. Bladder diverticulum
b. Resistant organism
c. Non-compliance with oral antibiotics
d. Impaired glucose tolerance
e. Oestrogen deficiency

Question 7

A 43 year old woman presents with painful dysaesthesias of both hands, as well as weakness of

dorsiflexion of the left foot. She also reports sicca symptoms and arthralgia. Results of some of her blood tests are outlined below:

ANA positive 1:2560
Anti-SSA and SSB antibodies positive
Rheumatoid factor positive
ANCA negative
Normal C3 and C4

What is the most likely underlying pathology?

a. Rheumatoid arthritis
b. Primary Sjogren’s syndrome
c. Mixed connective tissue disease
d. SLE
e. Cryoglobulinaemic vasculitis

Question 8

A 55 year old woman presents complaining of recurrent dizziness while exercising. Her symptoms are relieved with rest, and completely resolve after drinking water. One of these episodes occurred while she visited her GP, at which time she was found to be pulseless for a period of 10 seconds. A further episode occurred while performing an exercise stress test, with the ECG shown below.

[answering question depends largely on the exact nature of the ECG, in addition to the clinical scenario - wide complex tachycardia, HR 220]

Where is this arrhythmia most likely to arise from?

a. Right ventricular outflow tract
b. Left ventricle
c. AV node
d. Right atrium
e. Pulmonary vein

Question 9

An 80 year old woman with known chronic heart failure presents with acute decompensated heart failure. She has a background of osteoporosis, chronic pain, hypertension and depression. Which of the following medications is most likely to be responsible?

a. Calcium supplement
b. Ibuprofen
c. Fentanyl patch
d. Amlodipine
e. Sertraline

Question 11

A 25 year old female undergoes workplace screening for haemochromatosis. She is found to be homonymous for the HFE gene. She is currently asymptomatic with a normal clinical examination.

Laboratory findings:
Hb 120 (N 120-150)
Ferritin 145 (N 25-400)
Transferin 49% (N

[ArchivalUser]

Question 11
A 25 year old female undergoes workplace screening for haemochromatosis. She is found to be homonymous for the HFE gene. She is currently asymptomatic with a normal clinical examination.
Laboratory findings:
Hb 120 (N 120-150)
Ferritin 145 (N 25-400)
Transferin 49% (N

[ArchivalUser]

Question 13
An 87 y.o male presents with syncope. His past medical history consists of Ischaemic heart disease, depression and benign prostatic hypertrophy. He currently takes, lisinopril, metoprolol, dutasteride, tamsulosin and citalopram. He is found to have a postural drop from 160/90 to 110/70 on examination.
Which medication would you first trial discontinuing in this gentleman?
A. Lisinopril
B. Metoprolol
C. Dutasteride
D. Tamsulosin
E. Citalopram
Question 14
A 76 y.o female presents with difficulty forming a fist bilaterally. She has been having progressive difficulty with using a key over the last 12 months. She was wasting of the distal forearms and hands with associated weakness of the hands. She is ANA and ANCA –ve and has a normal FBC, LFT and CK.
What is the likely diagnosis?
A. Hypothyroidism
B. Inclusion body myosotis
C. Polymyositis
D. SLE
E. Viral myopathy


Question 15
80 year old woman admitted to hospital and is delirious due to ?UTI. She has a background of moderate dementia. Which of the following will assist the most in differentiating delirium from dementia?
a. inattention (e.g. inability to count backwards from 20 to 1)
b. orientation (e.g. unable to identify the date)
c. language (e.g. ?)
d. visuospatial (e.g. inability to draw intersecting pentagons)
e. ?

Question 16
In a patient with moderate to severe COPD and no other symptomatic comorbidities, what is the most likely cause of death?
a. acute exacerbation of COPD
b. cardiovascular disease
c. primary lung malignancy
d. respiratory failure
e. pneumonia

[ArchivalUser]

Question 23
Which of the following is associated with a better prognosis in oropharyngeal cancer?
a. EBV positive
b. squamous cell carcinoma?
c. HPV negative
d. p16 mutation positive
e. non smoker

Question 24
Which of these changes is associated with normal aging?
a. reduced resting stroke volume
b. reduced resting ejection fraction
c. increased resting heart rate
d. reduced early diastolic filling
e. increased telomere length

Question 25
Which of these is a feature of subcortical dementia rather than cortical dementia?
a. agnosia
b. alexia
c. aphasia
d. apraxia
e. apathy

Question 26
A middle aged female has returned from a holiday in India with urinary symptoms. A urine culture reveals a gram-negative bacteria resistant to ampicillin, vancomycin and meropenem.
What is the most appropriate choice of intravenous antibiotic?
a) Colistin
b) Linezolid
c) Tigecycline
d) Moxifloxacin
e) Irtapenem

Question 27
Which of the following parameters increases with normal ageing?
a) increased mitochondrial phosphorylation
b) telomere length
c) protein synthesis
d) oxidative stress
e) rhubarb

Question 28

Question 29

Question 30

Question 31

Question 32
The odds ratio of Indigenous people having T2DM is 4.5. The prevalence of T2DM in Caucasians is 10%. What is the prevalence of T2DM in Indigenous people?
a. 10%
b. 33%
c. 45%
d. 60%


Question 33
A 78 year old gentleman presents with delirium secondary to UTI. He has no family members or carers. He needs IV antibiotics urgently however he is aggressive and is refusing all treatment. You believe antibiotics would be life-saving in this situation. Which law allows the administration of antibiotics against the patients wishes?
a. Hippocrates - duty of care?
b. Hospital legal
c. emergency medical treatment
d. common law
e. Mental health act

Question 34
A 70 year old gentleman presents with an abdominal bleed. He is on warfarin with an INR of 7. Supportive management and vitamin K is given. What else should be given?
a. Recombinant factor VII
b. Prothrombin X
c. Activated prothrombin X
d. Fresh frozen plasma
e. Platelets

Question 35
A 25 year old man presents with the following: (picture of bells palsy)
What is the next management?
a. aspirin
b. steroids
c. IVIG
d. acyclovir
e. no management

Question 36
A 28 year old man with cystic fibrosis is having difficulties conceiving. What is the likely cause?
a) Ciliary dysfunction
b) Obstructive azospermia
c) Gonadal dysgenesis
d) ?
e) ?

Question37
A 35 year old overweight woman (BMI 28) presents with 12 month history of bilateral shoulder pain, dry eyes, face flushing after alcohol and urinary frequency.
Investigations showed ANA 1:160, ENA, RF negative. Full blood count, creatinine, liver function tests and inflammatory markers were unremarkable.
What is the most likely diagnosis?
a) Polymyalgia rheumatica
b) Fibromyalgia
c) Sjogren’s syndrome
d) Systemic lupus erythematosus
e) ?

Question38
A 68 year old man is admitted with exacerbation of COPD. He has been commenced on antibiotics, bronchodilators, corticosteroids and intravenous fluids.
Which would indicate urgent intubation?
a) pH 7.12
b) pCO2 90
c) p O2 63
d) Bicarb 30?
e) ?

Question 39
A 32 year old lady presents with the following blood tests. She does not have any other significant medical history and her only medication is the oral contraceptive pill. Her father died of a myocardial infarction at 47 years old.
LDL High
Triglycerides Very high
TSH High
T4 Normal

What is the likely diagnosis?
a) Familial hypercholesterolaemia
b) Familial combined hyperlipidaemia
c) Lipoprotein lipase deficiency
d) Oral contraceptive pill
e) Hypothyroidism

Question 40
Thyroid storm can be treated with a number of medications. Which medication acts on the release of preformed thyroxine?
a) Propylthiouracil
b) Carbimazole
c) Propranolol
d) Potassium iodide
e) Prednisone

41
67 year old man presents with right sided shoulder pain. It is present on both active and passive movement. CRP, ESR are in normal range, and rheumatoid factor, and anti-CCP antibodies are negative. What is the most likely cause of his pain.
A - Adhesive capsulitis
B - Rheumatoid arthritis
C - Osteoarthritis
D - Gout
E - ?

42
A 65 year old male with a history of AF, normally managed on a combination of warfarin, digoxin, and an ACE inhibitor presents with creatinine 299, and INR 7.4. His echo is normal, he has no history of hypertension or stroke. In addition to correcting his coagulopathy, what is the best management:
A - re-examine the need for warfarin
B - restart warfarin at the previous dose
C - start an antithrombotic
D -

43
A 65 year old pilot presents for a routine medical examination in order to renew his pilots license. A 70% Internal Carotid Artery Stenosis was found on the right side. He complains of no symptoms and has no history of TIA or stroke. What is the most appropriate management?
A - aspirin and clopidogrel
B - Aspirin alone
C - Anticoagulate
D - Endarterectomy
E - Stent

44
? Sorry I could not remember

45
A 23 year old male presents to fertility clinic. He is 185cm tall, has a history of a quiet, awkward personality and on examination has small testes. What is the most likely underlying condition?
A - Klinefelters (XXY)
B - XX La Chapelle
C - Fragile X
D - XXX
E - ?

[ArchivalUser]

A 20 year old male presents with a 3 day history of cough, fever, cold and conjunctivitis. He has a maculopapular rash.



Which diagnosis would require urgent isolation?

A. Influenza A
B. EBV
C. Measles
D. Rubella
E. Syphilis

Question 48
A 28 year old male was diagnosed with Crohn’s disease several years ago. He had been anaemic at the time of diagnosis. Capsule endoscopy at the time showed extensive small bowel disease. He had a good clinical response to infliximab and blood tests normalised.

He now complains of severe abdominal pain, distension and vomiting.

Table of blood results given (normal, incl. CRP).

Small bowel study shows jejunal stricture with proximal dilatation.



What would be the next best management option?

A. Add mesalazine
B. Change AZA to 6MP
C. Change infliximab to adalimumab
D. Surgery
E. Restart prednisolone

Question 49
Two RCTs about closure of patent foramen ovale for prevention of stroke were published in the same issue of a medical journal. The authors came to different conclusions. A summary of the results follows:

Study Duration Events intervention (%) Events control (%) HR / 95% CI
1 4 years 7/204 (3.4%) 11/210 (5.2%) 0.63 (0.24–1.62, p=0.34)
2 2.5 years 9/499 (1.8%) 16/481 (3.3%) 0.49 (0.22–1.11, p=0.08)

Which of the following conclusions would you draw?

A. Both studies are underpowered
B. Study 1 is more persuasive due to higher event rate
C. Study 1 is more persuasive due to longer follow-up
D. Study 2 is more persuasive due to larger study population
E. Study 2 is more persuasive due to smaller hazard ratio

Q65.
Middled aged woman, overweight (BMI 32 or 36). Routine blood tests show abnormal LFTs.
Alcohol infrequent. Nil family history of liver disease. Only medications, perindopril for HTN and pantoprazole for GORD.
Raised BR, GGT, ALP, AST and ALT. Ferritin 638. Transferrin saturation

[ArchivalUser]

Q66.
Lady BMI 32 or 36, presents with headaches (worse in the morning). Also notices visual dimming when standing from squatting position. She is 5 weeks post partum.

Diagnosis?
1. Venous thrombosis
2. Migraine
3. CVA

Q67.
Elderly gentleman with dizziness and found to be bradycardic. Current drugs: oxybutynin, donepezil, PPI, ACE-I
Causative drug for bradycardia?
A. Oxybutynin
B. Donepezil
C. PPI
D. ACE-I

[ArchivalUser]

Q75.
Patient with sporadic colorectal cancer treated with resection 1 yr ago, is being monitored with CEA and CT chest/abdo/pelvis. By what curative intent does this monitoring offer?
A. Resection of solitary metastatic lung or liver lesion
B. Resection of pancreatic lesion
C. Low grade metastases for commencing chemotherapy
D. Detect Anastomotic site disease
E. Detect another primary tumour

Q76.
Sacral pressure ulcer 3cm x 0.5cm. No signs of sepsis or exudate. Wound swab grows Staphylococcus sensitive to flucloxacillin. What is the best way to promote healing of this ulcer?
A. Pressure mattress
B. Oral flucloxacillin
C. Moisturiser cream topically
D. Topical antibiotics
E. Improve nutritional support

Q77.
What is responsible for periodic fever syndrome?
A. Neutrophil
B. Inflammasome
C. NK cell
D. T cell
E. B cell

Q78.
Young male was hit on the head by a golf ball while at the driving range. Continued to play. Now brought into hospital by golf course staff after being found drowsy, ataxic, with R sided weakness, and a boggy bruise above the L ear. What is the cause?
A. SDH
B. EDH
C. ICH
D. Dissection of carotid artery
E. Dissection of vertebral artery

Q79.
Pleural effusion results as follows:
pH 7.15
LDH 800s
Protein 200s

Serum:
LDH 200s
Protein 12
 
Paper 2 – Medical Sciences

Question 1:
A 30 year old female with MS presents to hospital with pneumonia. Her temperature on admission is noted to be 39C. The next day, the vision in her left eye that has previously been affected by her MS is worse.
What is the reason for the change in her vision?

1. Progression of MS
2. High temperature
3. Infection of the optic nerve
4. Ischaemic optic neuropathy
5. Post-infectious flare of optic neuritis

Question 2:
What supplement is most likely to cause hepatotoxicity?
1. Fish oil
2. Chondroitin
3. Glucosamine
4. Valerian
5. Co-enzyme Q10

Question 3:
What is the initial treatment of minimal change disease in adults?
1. Azathioprine
2. Corticosteroids
3. Rituximab
4. Cyclosporine
5. Mycophenolate

Question 4:
A female with recurrent attacks of facial and lip swelling without rash, presents to hospital after her fifth attack. She states that she awoke from sleep with her current symptoms. She has been unable to identify any triggers.
[insert photo of facial angioedema without urticaria]



What investigation would be most useful in identifying the cause of her symptoms?
1. Eosinophils
2. Tryptase level
3. IgE
4. IgE to peanut
5. C4

Question 5
Question involving interpretation of a graph presenting results from two different randomized controlled trials. No specific knowledge needed to answer this question.

Question 6
Omission of which of the following aspects of management of anaphylaxis is likely to have the most deleterious effect?
a. Adrenaline
b. Antihistamine
c. Corticosteroid
d. Fluid resuscitation
e. Bronchodilators

Question 7
A 32 year old woman presents with abdominal pain, bloody diarrhoea and fever. Two days earlier she ate takeaway chicken. Her husband shared this meal with her, and is similarly unwell. They have had no recent overseas travel.
What is the most likely causative organism?
a. Cytomegalovirus
b. Norovirus
c. Staphylococcus aureus
d. Campylobacter jejuni
e. Bacillus cereus

Q9.
Which hormone would lead to weight loss?
A. Leptin
B. Growth hormone
C. Cortisol
D. Prolactin
E. Testosterone
Q10
The diasylate for peritoneal dialysis often is composed of glucose. What process does the glucose facilitate?
A. Prevention f hypoglycaemia
B. Prevention of bacterial infection
C. Ultrafiltration via an osmotic gradient
D. Urea clearance
E. ?

Q11
During cardiac catheterisation several measurements of LV systolic function are made. These are often influenced by preload and afterload. Which one of the following measures is independent of loading?
A. Ejection fraction
B. Systolic pressure olume ratio
C. End systolic volume
D. End systolic pressure
E. Peak systolic pressure

Q12. A 24 y.o female presents with excessive sweating in warm weather and during exercise.
Which neurotransmitter is involved in the activation of sweat glands?
A. Acetylcholine
B. Dopamine
C. Adrenaline
D. Neuropeptide Y
E. Noradrenaline.


Question 13
What will shift the oxygen-haemoglobin dissociation curve to the left?
a. fetal haemoglobin
b. reduced pH
c. increased pCO2
d. increased 2,3-diphosphoglycerate
e. increase in temperature

Question 14
60 year old man has a mechanical mitral valve. He presents with anaemia and cardiac failure. You suspect intravascular haemolysis. Which of the following tests is most diagnostic of this?
a. LDH
b. haptoglobin
c. direct antiglobulin test
d. urine haemosiderin
e. reticulocyte count

Question 15
Sorry mental blank, can’t remember

Question 16
How does insulin exert its effect to reduce BSL?
a. transmembrane receptor tyrosine kinase activation
b. forms a complex with IGF-1
c. binds to intracytoplasmic receptor
d. binds to nuclear receptor
e.

20. Patients with atrial fibrillation are at increased risk of stroke. Of the following, which feature carries the highest risk?
a) Hypertension
b) Congestive Cardiac Failure
c) Previous stroke
d) Age > 75
e) Left atrial enlargement





21. Which of the following malignancies occurs more frequently in patients with CVID?
a) Gastric adenocarcinoma
b) Multiple Myeloma
c) Lymphoma
d) Kaposi’s sarcoma
e) Squamous cell carcinoma

22. A 34 year old female has been admitted following a motor vehicle accident. She has sustained multiple rib fractures. She has been prescribed amitriptyline at night, pregabalin twice daily, Tramadol twice daily, Phenytoin, and Maxolon PRN. 3 days later, she develops muscular rigidity associated with a fever of 38 degrees. What is the most likely diagnosis?
a) Serotonin syndrome
b) Malignant hyperthermia
c) Neuroleptic malignant syndrome
d) Sepsis
e) Rhubarb toxicity

23. A 64 year old male has presented to the clinic for review. He has hypertension treated with frusemide 40mg daily, perindopril, hydralazine. He also has stage 3 chronic kidney disease with a creatinine of 200. He has gained 10Kg in weight recently. Though his Lasix dose has been increased to 160mg daily, he has not diuresed. Which of the following medications would overcome diuretic resistance?
a) Acetazolamide
b) Hydrochlorothiazide
c) Indapamide
d) Rhubarb
e) Grapefruit juice


Question 29
Genetic therapy involves insertion of normal genes into a patient’s cells. For which form of inheritance is this most useful for?
a) Autosomal dominance with complete penetrance
b) Autosomal dominance with incomplete penetrance
c) Autosomal recessive
d) Polygenetic
e) X-linked dominant

Question 30
Which condition leads to near absent B cells?
a) Common variable immunodeficiency
b) Chronic granulomatous disease
c) X-linked agammaglobulinaemia
d) ?
e) ?

Question 31
Type 1 diabetes is commonly associated with coeliac disease. In a 23 year old woman with Type 1 diabetes, which nutritional deficiency will prompt you to do coeliac screening?
a) B12
b) Folate
c) Iron
d) Calcium
e) Vitamin D

Question 28 (are these Q28-31 supposed to be in paper 1?)
79 year old lady presents to hospital with an acute sore, swollen R) shoulder. She has a background history of rheumatoid arthritis treated with ?adalimumab/steroids. She is febrile to 39.5C and has tenderness, swelling and limited range of movement with the right shoulder. Joint aspirate reveals a cell count of 120 000 (90% neutrophils) and negative gram stain. What is it most likely to be
a. RA
b. Gout
c. OA
d. Septic arthritis

Question 29
A lady with type one diabetes previously had well controlled disease. She has now had two children and gained weight (BMI 32). She has not had any DKA episodes for years but her HbA 1c has been increasing (now up to 7.8). What is the reason for this?
a. poor compliance
b. insulin antibodies
c. insulin resistance
d. poor diet?

Question 30
A man with difficult to control hypertension on an ACE inhibitor and calcium channel blocker (BP 150/90). He is asymptomatic. Incidental finding on abdo CT showed unilateral renal artery stenosis 50-70%. What is the best next course of management?
a. change ACE inhibitor to beta blocker
b. add on thiazide
c. renal artery dilation and stenting
d. renal denervation


Question 31
A 30 year old lady previously had an episode of spontaneous PE with no precipitating factors found. She is now pregnant. Best way to manage her anticoagulation is:
a. enoxaparin
b. heparin
c. warfarin
d. monitor
e. aspirin

Question 32
What is the afferent nerve of the cough reflex?
A - glossopharyngeal
B - Hypoglossal
C - Vagus nerve
D - Phrenic nerve
E - Recurrent laryngeal nerve

33
C - reactive protein is something we commonly measure. In which system does it play it’s role?
A - Innate immunity
B - Antigen presenting system
C - Adaptive immunity
D - Complement system
E - ?

34
The concentration of a drug at steady state is most related to which of the following?
A - clearance
B - Rate of elimination
C - Volume of distribution
D - Protein binding
E - Half life


Question 35
A 73 year old female presents with a Colles fracture. Her routine metabolic profile is as follows:

Calcium 2.9 mmol/L (2.2–2.6)
Albumin 34 g/L (38–48)
Creatinine 110 micromol/L (50–90)
ALP 250 units/L (50)
Urine Ca:Creat ratio 0.04 (0.04-0.7)
CTX 900 ng/L (100–700)
P1NP2 100 mcg/L (15–75)

(CTX = C-terminal telopeptide of type 1 collagen, a marker of bone resorption)
(P1NP2 = Procollagen type 1 N propeptide, a marker of bone formation)

What is the best explanation for these results?

A. Familial hypocalcuric hypocalcaemia
B. Primary hyperparathyroidism
C. Primary Vitamin D deficiency
D. Pseudohyperparathyroidism
E. Renal bone disease

Question 36
The product information for rivaroxaban contains the following statement:

“Of the administered rivaroxaban dose, approximately 2/3 undergoes metabolic degradation, with half then eliminated renally and the other half eliminated by the fecal route. The other 1/3 of the administered dose undergoes direct renal excretion as unchanged active substance in the urine, mainly via active secretion.”

In a patient with 1/3 of normal glomerular filtration rate, what is the approximate clearance of rivaroxaban relative to a normal person?

A. 1/3
B. 2/3
C. 2/9
D. 4/9
E. 7/9

Question 37
Urine dipstick nitrites is a useful tool in the ED for helping to diagnose urinary tract infections. Which of these organisms is likely to be negative for dipstick nitrites in the setting of culture-proven UTI?

A. Enterobacter cloacae
B. Enterococcus faecalis
C. Escherichia coli
D. Klebsiella oxytoca
E. Pseudomonas aeruginosa

Q47. Gentleman with Child Pugh C cirrhosis - which benzodiazepine is most appropriate for treatment of alcohol withdrawal?
A. Clonazepam
B.Diazepam
C. Oxazepam
D. Nitrazepam
E. Chlordiazepoxide

Q48. Which muscle is involved in forced expiration?
A. Diaphragm
B. External Intercostal muscle
C. Internal Intercostal muscle
D. Trasverse thoracalis muscle
E. Subcostalis muscle

Q49. Which component is involved in pathology of nephrotic syndrome?
A. Basement membrane
B. Mesangial cell
C. Endothelial cell
D. Podocyte
E. Proximal tubule





Question 50
Which of the following agents when used alone is most likely to cause hypoglycaemia?
A. Gliclazide
B. Pioglitazone
C. Metformin
D. Sitagliptin
E. Exenatide

Question 51.
Which of the following antihypertensives would benefit in the management of gout?
A. Atenolol
B. Frusemide
C. Hydrochlorothiazide
D. Lisinopril
E. Losartan

Question 52.
Which of the following would cause the highest risk of VTE?
A. Antithrombin deficiency
B. Moderate anticardiolipin antibodies
C. Factor V Leiden Heterozygous
D. Prothombin gene mutation
E. Fibrinogen (Not sure about this one)

Q85.
Which of the following opiates has the greatest risk of Serotonin Syndrome when combined with an SSRI?
A) Oxycodone
B) Methadone
C) Codeine
D) Morphine
E) Tramadol


Q53
Sorry forgot the question…

Q54.
Patient with 3 day h/o lower limb weakness, distal power 3/5, proximal 4/5, no reflexes, subjective loss of sensation in both feet.
Which nerve fibres are affected in this pathology?
A. C fibre
B. Large myelinated
C. Large unmyelinated
D. Small myelinated
E. Small unmyelinated

Q55.
The commonest defect in repaired tetralogy of fallot?
A. Pulmonary valve incompetence
B. VSD
C. ASD
D.


Q86.
Erythropoeitin is produced in response to which of the following:
A) Hypoxia
B) Hypercarbia
C) Renal sympathetic activation
D) Reduced glomerular filtration rate


Q87.
Which of the following are associated with corticosteroid induced osteoporosis as opposed to post-menopausal osteoporosis?
A) Asymptomatic vertebral fractures
B) Fractures at higher bone mineral density
C) Response to bisphosphonates
D) Response to calcium supplementation
E) Subtrochanteric fractures