A1&2

1. Calcium channel blockers

a. All cause bradycardia and are negatively inotropic F(Dyhdropyridines-reflex tachycardia)
b. All are sensitive to vascular smooth muscle T (Non-dyhdropyridines – cardioselective)**
c. Cause moderate ankle oedema T
d. All are used with beta blockers to control hypertension F
e. All reduce the risk of stroke in those with hypertension ??(Didn’t find evidence)
2. Prescribing in CVS
a. Thiazides lower blood cholesterol F
b. High dose aspirin is recommended for those at risk of cerebral infarction F(low dose)
c. Methyldopa can be used in pregnancy T
d. Glycerine trinitrate causes headaches T
3. These are true of atrial fibrillation
a. Very regular heart rate F
b. Very regular pulse F
c. Common complication of mitral stenosis T
d. Common cause of haemorrhagic stroke F (Infarctive)
e. Complication of thyrotoxicosis T
4. Recognized effects of chronic alcohol use include
a. Macrocytosis T
b. Atrial fibrillation T
c. Pancreatic carcinoma T(In directly a complication of Chronic pancreatitis; OHCM8)
d. Hypertriglyceridaemia T
e. Nephrotic syndrome F
5. A diagnosis of severe mitral stenosis is made in a patient with Rheumatic Heart Disease. The ff.
are expected findings on clinical examination
a. Pre systolic murmur T
b. Opening snap T (as stenosis becomes more severe Davidson21e615)
c. Left parasternal heave T(RV heave Davidson21e615; see table)
d. Ejection click F
e. Loud S1 F
6. In an echocardiogram study in a patient with shortness of breath
a. Obstructive hypertrophic cardiomyopathy T
b. Aortic stenosis T
c. Pulmonary hypertension T(by modified Bernoulli equation;Davidson21e533)
d. Systemic hypertension T (also by modified Bernoulli equation;Davidson21e533)
e. Mitral regurgitation T
7. An unkempt middle aged man was found unconscious by the roadside gutter and was brought
to the SME by well-wishers. He reeks of alcohol but no obvious external injuries. The probable
underlying cause of him being unconscious includes
a. Hit and run motor vehicle accident T
b. NSAID overdose F
c. Massive cerebrovascular hemorrhage T
d. Hypoglcaemia T
e. Acute subdural haemorrhage T(OHCM 486 risk factors)

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8. The ECG changes indicate the possibility of the the following
a. Tall T waves – Hypokalaemia F(HyperK)
b. Prominent P waves and right axis deviation – pulmonary embolism T(Chr PE)
c. PR interval more than 0.2 secs - type 1 second degree heart block F
d. Prolonged QT interval – Hypokalaemia T
e. ST segment elevation – acute myocardial infarction. T
9. The following statements about drug reactions are correct
a. Patient is more likely to have ADRs when taking several drugs together T
b. Newer drugs are unlikely to cause ADRs F
c. It is the doctor’s responsibility to report any ADRs in his patient to the national ADR
centre T
d. Paracetamol causes angioedema T
e. Because of teratogenicity, all newer drugs are avoided in pregnancy T
10. In infective endocarditis:
a. Flame shaped haemorrhages are seen in the retina F(Roth’s Spots- round white retina
spot surrounded by haemorrhage)
b. Staph aureus is the commonest infection T (OHCM8, Davidson21e)
c. Painless erythematous lesions are seen in the palms and soles T (Janeway Lesions-
irregular, erythematous, flat, painless macules on the palms, soles)
d. Oslers nodes are painless F (circumscribed, painful erythematous swellings, ranging in
size variable, in the skin and subcutaneous tissues of the hands and feet)
e. Red blood cells are seen on urine examination. T
20. Hyperprolactinaemia
a. associated with mastalgia in females F
b. causes impotence in males T
c. occurs in Sheehan’s syndrome F
d. phenothiazine is a cause T
e. can be treated with dopamine agonists T
21. A patient is referred to clinic with hypercalcaemia (Ca – 3.2mmol/L). causes include
a. sarcoidosis T
b. regular treatment with amlodipine F
c. parathyroid adenoma T
d. diabetes mellitus F
e. multiple myeloma T
22. The following are GI manifestations of CKD
a. haematemesis T
b. stomatitis T
c. malaena T
d. hepatomegaly F
e. diarrhoea T
25. Amoebic liver abscess
a. is usually located in the left lobe of the liver F
b. right intercostal tenderness is often present T
c. rupture of abscess leads to clinical improvement T??(into brochus POS:But depend of
site of rupture/also Davdsn21e363 also says serious if rupture to peritonm/pericardm)
d. chest X-ray shows increased right hemidiaphragm T
e. needle aspiration reveals frank pus F

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26. Ulcerative colitis
a. often mimics dysentery T
b. is associated with pyoderma gangrenosum T
c. is an intestinal mucosal disease T
d. long term broad spectrum antibiotics is treatment of choice F
e. typically there are no perianal lesions T
31. Severe P. falciparum malaria can complicate into
a. CVA F
b. Cerebral malaria T
c. Malignant fever F (High fever from drugs; eg.suxameto ,tx with dantrolene)
d. Peripheral circulatory collapse T
e. Tropical splenomegaly T
33. Ascaris lumbricoides
a. is a round worm T
b. adult migrates to the lungs F(larvae)
c. the diagnosis is made by finding adult worms in the stool F(ovum)
d. severe infestation can cause intestinal obstruction T
e. treatment with Albendazole is effective T
34. Tetanus
a. striated muscle like the cardiac muscle cannot be tetanized T
b. risus sardonicus is characterized by spasms of the abdominal muscles F(facial muscles)
c. booster is needed 10 years after primary vaccination T(STG pp431)
d. features are drooling, urine and faecal incontinence F
e. is caused by rust F
35. In urine microscopy and biochemistry:
a. red cell cast indicate nephrotic syndrome F
b. red cell cast indicate glomerulonephritis T
c. glycosuria is only seen in diabetes mellitus F
d. bacteria is normally seen in healthy individuals F
e. ketones are seen in diabetic ketoacidosis and starvation T
36. Active SLE
a. occurs commonly in Afro-Caribbeans more than Caucasians T
b. associated with acute glomerulonephritis T
c. commoner in males F(9:1)
d. prognosis is better when treatment is initiated early T
37. False lateralizing signs in increased intracranial pressure affect what cranial nerve?
a. CN 1 F
b. CN 9 F
c. CN 6 T
d. CN 4 F
e. CN 3 F(may be affected; but not a false lateralising sign)
38. The following are characteristic clinical features of Parkinson’s disease except
a. nystagmus T
b. drooling of saliva F
c. cogwheel rigidity F
d. failure to swing arm while walking F
e. partial seizures T
[TRAP-N; Tremor, Rigidity, Akinesia, Postural disturbance & Non motor]

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39. Which of the following is considered a positive Romberg's test
a. The patient falls backwards when standing with eyes open when d examiner pushes
patient's sternum F
b. The patient falls wen attempting to stand with feet together and eyes open F
c. The patient falls without corrective movement when closing eyes while standing T
d. The patient starts to sway when closing eyes F
e. The patient falls without corrective movement with eyes open F
(Hutch pp227) also check Unterberger’s test

40. Stroke
a. is TIA if less than 24 hours F***(New definition; )
b. often infarctive if associated with polycystic kidney disease F
c. is associated with SCD T
d. is often managed by rapidly lowering the BP to less than 100mmHg if the patient is
hypertensive F
e. is haemorrhagic in diabetes F
41. Papilloedema
a. causes sudden loss of vision F(usually gradual)
b. mostly unilateral F
c. respiratory acidosis T
d. feature of diabetic retinopathy F (Macula edema)
e. seen with intracranial haemorrhage T
43. Good prognostic factors for Schizophrenia include
a. being single F
b. cognitive impairment F
c. late onset T
d. affective component T
e. long duration F
44. Severe CO2 retention can cause the following
a. Morning headaches T
b. Mental clouding T
c. Renal retention of bicarbonate T
d. Raised CSF pressure T
e. Reduced cerebral blood flow F
45. A 2-day history of haemoptysis
a. mitral stenosis T
b. pulmonary embolism T
c. chronic sinusitis with post-nasal drip F
d. Staph aureus pneumonia T
46.. Features suggestive of pleural effusion
a. Progressive shortness of breath T
b. decreased chest expansion on affected side T
b. trachea shift to the same side of decreased chest expansion F
c. failure to take TB medication F
49. Rheumatoid arthritis
a. occurs only in females F
b. occurs in proximal symmetrical large joints F
c. swan-neck deformity is a late sign T
d. is a known cause of mitral valve disease T??(Medscape; Rheumatic carditis)
e. Rheumatoid nodule is needed for diagnosis F

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50. Gout
a. can occur in normal uric acid levels T
b. is a feature of myeloproliferative disease T
c. pyrazinamide is a known cause T
d. metformin is associated with it F
e. may occur in patients with renal impairment T

B1&2
1. The following commonly present as PUO
a. Sickle cell bone crisis F
b. Extrapulmonary TB T
c. Community acquired pneumonia F
d. SLE T
e. Non-Hodgkin’s lymphoma T
2. The following are true of peripheral vascular disease
a. Diabetes mellitus is a cause T
b. Extremeties are very warm F
c. Intermittent claudication T
d. smoking is a risk factor T
e. caused by formation of thrombus in the saphenous vein F??
3. Typical chest pain in coronary artery disease:
a. can be brought on by coitus T
b. felt under the left breast F
c. relieved by leaning forward F
5. Intravenous verapamil is contraindicated in patient who
a. already have β-adrenergic blocking agents T
b. exhibit digoxin toxicity T(Medscape)
c. hypertrophic cardiomyopathy T(Harrison 1411 e16)
d. AV node dysfunction ??(Use with caution)
e. AV re-entrant tachycardia F(Davidson21e564;)
7. ECG shows
a. Sinus bradycardia – (sinus rate; with HR < 60bpm)
b. A-V dissociation – (no relation bn the p-waves and the QRS complexes)
c. Sick sinus syndrome – (Varying; Sinus Brady, SA block, PATachy, PAFib, AVblock) [D21e568]
d. 2:1 A-V block –
e. Complete heart block - [ Similar to AV disso]
9. The following drugs are correctly matched with respect to their adverse effect
a. digoxin - pulsus bigemini T
b. clindamycin - pseudomembranous colitis T
c. IV furosemide- ototoxicity T
d. codeine - diarrhoea F
e. bendroflumethiazide - gout T
12. The following drugs when given in high doses cause hyperglycaemia/diabetes mellitus;
a. Progesterone T(Micromedex)
b. Bendroflumethiazide T
c. Prednisolone T
d. Omeprazole F
e. Spirinolactone ??{although steroid; evidence not found}

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13. The following medications may be effective in acne vulgaris
a. Spirinolactone T
b. Cyproterone acetate T
c. Erythromycin T
d. Vitamin C T
e. Hydroquinine T

16. Which condition of childhood may cause short adult stature?

a. Congenital adrenal hyperplasia T
b. Diabetes mellitus T
c. Chronic treatment with steroids T
d. Cretinism T
e. Hypogonadism T
17. A 32 year old woman who is hypertensive presented to the hospital with weakness and
tiredness. On having done investigations, she was found to be hypokalaemic. Which of these is
most likely to be a diagnosis?
a. Addison’s disease F
b. Conn’s disease T
c. Primary hyperparathyroidism F
d. Metabolic syndrome F
e. Carcinoid syndrome F
18. A 21 year old woman is brought to the ER with vomiting, abdominal pain and nausea. Blood
test reveal:
Na+ – 127mmol/L
K+ – 4.5mmol/L
Urea – 8.9mmol/L
Ketones – 4+
Glucose – 18.9mmol/L
What fluid should be given to this patient?
a. 0.9% N/S T
b. 0.45% N/S F
c. 1.8% N/S F
d. Dextrose (5%) F
e. Ringer’s lactate F
20. Ocular signs of parathyroid disease include
a. Blepharospasm T
b. PtosisF
c. Corneal calcification T
d. Cataracts T
e. Arcus senilis F (Ofie: Solved)
21. DPP4 inhibitors are treatment options in type 2 diabetes. Which of the following statements
regarding their action is/are true?
a. enhancement of post-prandial insulin secretion T
b. inhibition of glucose induced insulin secretion F
c. reduction of hepatic glucose output T
d. reduction of gastric emptying T
e. reduction of endogenous glucagon release T
23. In the diagnosis of hepatitis B infection
a. the demonstration of hepatitis B infection in the blood is satisfactory of infection ??
b. the demonstration of HbeAg in the blood indicates active infection T
c. all infections become chronic F
d. the development of hepatocellular cancer is inevitable F
e. HbsAg may be negative despite fulminant infection T

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25. Liver biopsy is contraindicated in which of the following?
a. INR >3 T(INR>1.6; Medscape/ >1.3 on the ward)
b. Platelet 125 ˣ109/L F (60)
c. Suspected hepatocellular carcinoma F
d. Suspected hydatid cyst T (Medscape)
e. Hb 11g/dl F
26. In cholestatic jaundice biochemical findings are
a. Increased urine urobilinogen F
b. Increased indirect serum bilirubin F
c. Increased alkaline phosphate T
d. Bilirubinemia T
e. Haemoglobinemia F
27. The following may be used in the management of acute liver failure
a. Mannitol T
b. Morphine F??
c. Lactulose T
d. Vitamin K T
e. Diazepam ??
28. Causes of microcytosis
a. Iron deficiency anaemia T
b. Thalassaemia T
c. Folate deficiency F
d. B12 deficiency F
29. The following statements are true concerning multiple myeloma
a. Bence Jones proteins found in urine are immunoglobin light chains T
b. Light chain immunoglobins found in this condition are often polyclonal F
c. ESR is often significantly elevated T
d. Hypercalcemia found in this condition is associated with increased parathyroid hormone F
e. Peak age of occurrence is 40 years F
30. The parasite ascaris lumbricoides
a. Round worm T
b. Adults migrate through the lung F
c. Diagnosis is by finding adult worm in stool F
d.severe infestation can cause intestinal obstruction T…
e. Albendazole is effective T
31. Tetanus…….
a. requires booster every 10 yrs after active immunization T
b.features are drooling, urinary and fecal incontinence F
c. risus sardonicus is characterised by abdominal contraction F
d. striated muscles such as cardiac or heart muscles cannot be tetanised T
e. it is caused by rust F
32. In patients with renal impairment……..
a. NSAIDs reduces blood flow to the kidney. T
b. Amoxicillin in normal doses are safe T
c.……
d. insulin amount should be reduced T
e. aminoglycosides in normal doses are safe. F
33. In urine
a. Red cell cast are present in nephritic syndrome T
b. Red cell cast are present in glomerulonephritis T
c. Bacterial is present in all healthy individuals F
d. Glycosuria is only present in Diabetes F
e. Ketonuria is present in starvation T

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34. Pyelonephritis
a. Mainly caused by Klebsiella F(E. coli)
b. Can occur without symptoms T
c. Fever is usually not associated with rigors F
d. Typically causes clubbing of the renal calyces T(No evidence; but some suggested seeing it)
e. Presence of red cell casts in the urine F??
36. In a patient with increased intracranial pressure false lateralising signs is associated with the
following:
a. Cranial nerve 3 F
b. Cranial nerve 4 F
c. Cranial nerve 5 F
d. Cranial nerve 6 T
e. Cranial nerve 7 F
37. Which of the following is considered a positive Romberg's test
a. The patient falls backwards when standing with eyes open when d examiner pushes
patient's sternum F
b. The patient falls wen attempting to stand with feet together and eyes open F
c. The patient falls without corrective movement when closing eyes while standing T
d. The patient starts to sway when closing eyes F
e. The patient falls without corrective movement with eyes open F
38. 21 year old female had nausea, sweating and dizziness, slumps to the ground before a
microbiology exam and loses consciousness. She fully regains consciousness and is lucid after 30
minutes. She has menorrhagia and a positive family history of epilepsy. What investigation are
most appropriate in the ER?
a. Arterial blood gases F
b. Complete blood count T
c. EEG F
d. Toxic screen F
e. Neurological consult F [From last year group; an internet source]
40. Which clinical features would you look out for?
a. Pin-point pupils T
b. Nuchal rigidity T
c. Hypertension T
d. Alteration in the level of consciousness and unconsciousness over the next few days T
e. Photophobia T??
41. Which investigations will you perform as soon as possible?
a. Carotid angiogram F
b. LP and CSF for examination T
c. Blood culture T
d. Head CT scan T
e. Widal test F
42. Schizophrenia good prognosis includes:
a. Being single F
b. Cognitive impairment F
c. Late onset disease T
d. Long duration F
e. Having an affective component to the disease T
45. A pleural friction rub:
a. May be palpable T
b. Transiently abolished by coughing F
c. Absent in the presence of pleural effusion T
d. Present only on inspiration F
e. Associated with continuous ache over the affected area F

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46. Appropriate antibiotics in community acquired pneumonia in Ghana
a. Gentamycin T
b. Clindamycin F
c. Amoxycillin T
d. Co-amoxiclav T
e. Metronidazole F
[STG]
47. Aetiological agents in an elderly man with post viral influenza pneumonia
a. Klebsiella pneumonia F
b. Haemophilus influenza T
c. Streptococcus pneumoniaT
d. Staphylococcus aureus T
e. Pseudomonas aeruginosa F
[HARRISON; strep pyogenic, grp b strep]
50. The following statements in medical ethics is/are correct:
a. The Helsinki Declaration is a modern form of the Hippocratic Oath F
b. The Helsinki Declaration describes guidelines for experimentation in human beings T
c. The doctor must tell the patient about the benefits of the procedure but not obligated to
tell the patient about risks and benefits of other procedures. F
d. The patient choice is final if patient is a minor F
e. The term ‘good clinical practice’ refers to guidelines for experimentation and not day
to-day clinical work T

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 C1&2
1. A 68years old man presents with a fever, cough productive of yellowish-brown sputum and
chest pain on inspiration. Which of these will help in assessing the severity of the condition?
A. Flaring alae nasi T
B. Confusion T
C. pulse >100bpm F
D. RR > 32bpm T
E. Hypotension T
2. Likely causes of PUO
A. SLE T
B. Extrapulmonary TB T
C. Community acquired pneumonia F
D. SCD vaso-occlusive crisis F
E. Hodgkin’s lymphoma T
3. Sickle cell vaso-occlusive crises causes
A. Severe bone pain T
B. Priapism T
C. Osteomyelitis F
D. Acute abdomen T
E. Hemiparesis T
4. In anaemia of chronic diseases
A. Iron supplement is mainstay of therapy. F
B. It’s usually normocytic normochromic initially but may become microcytic hypochromicT
C. TB can be a cause. T
D. There is increased iron absorption from the gut. F
E. Vit B complex supplementation corrects the anaemia. F
5. Concerning blood transfusions
A. The most important naturally occurring antibodies are Anti-A and Anti-B T
B. Anti-A is the only antibody present in plasma of blood group O people F
C. Anti-A and Anti-B are IgG F (IgM)
D. Presence of Rh antigen confers Rh O+ on the blood group T
E. Incompatible blood grouping may causes DIC T
6. In sickle cell disease
A. There may never be splenomegaly F
B. Its severity is reduced by the presence of Hb F T
C. Substitution of valine for Glutamic acid at position 6 of the beta globulin chain. T
D. Carriers have protection from malaria T
E. Severe cases can be managed with hydroxyurea T

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7. The ECG tracing above(Fig 1) with standard recording speed shows
A. Sinus tachycardia F
B. Atrial fibrillation F
C. Junctional rhythm F
D. Atrial Flutter T
E. Ventricular tachycardia F

8. 32-year old hypertensive female presented with tenderness and weakness. She also had
hypokalaemia on initial investigations. Most likely diagnosis
A. Carcinoid syndrome F
B. Addison’s disease F
C. Primary hyperaldosteronism T
D. Metabolic syndrome F
E. Phaechromocytoma F
9. Complications of myocardial infarction
A. VSD T
B. Pleural effusion T
C. Hemopericardium T
D. Cerebrovascular accident T
E. Acute renal failure T
10. Pan systolic murmur is heard in
A. Aortic stenosis F
B. Aortic regurgitation F
C. Tricuspid regurgitation T
D. VSD T
E. ASD F

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11. ECG shows
A. Ventricular tachycardia F
B. Ventricular arrhythmia F
C. Atrial fibrillation T
D. Complete heart block F
E. Sinus arrhythmia F
12. In the treatment of bacterial endocarditis
A. IV antibiotics for 2 weeks is required to cure infection in the valve F
B. Strep viridans is very common. T
C. Staphylococcal infection of mitral valve in drug addicts require fluclonazole and valve
replacement F
D. If Gentamycin used, it should not be used for more than 10 days F
E. Combination antibiotics therapy is almost always appropriate for endocarditis T

13. In treatment of hypertension, ACE inhibitors:

a. causes ankle swelling in 5% of patients F
b. Works synergistically with loop diuretics to decrease blood pressure T
c. Contraindicated in patient with renal function impairment F
d. Causes severe hypotension in Na. depleted patients T
e. worsens glucose control in hypertensives with diabetes F
14. Type 2 DM is associated with
a) Hyperinsulinaemia T
b) Increased hepatic glucose output T
c) Progressive beta cell failure T
d) Reduced effect of endogenous incretins T
e) Increased glucagon T
15. The following anti hyperglycaemic agents have been correctly linked with their mechanism
a) Metformin reduces intestinal glucose absorption F
b) Sulphonylureas are insulin secretagogues T
c) Pioglitazone – insulin sensitizer T
d) Insulin administration is effective in blocking hepatic glucose output T
e) DDP IV inhibitors reduce breakdown of endogenous incretins T

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16. Secondary hypercholestronaemia
a) Nephrotic syndrome T
b) Hypothyroidism T
c) Intravascular hemolysis F
d) Prolonged use of thiazide diuretics T
e) Obstructive jaundice T
17. Ocular manifestation of parathyroid disease
a) Blepharospasm T
b) Ptosis F
c) Corneal calcification T
d) Cataracts T
e) Exophthalmos F
18. A 78 yr old woman reported to the ER with a history of increasing weakness and urinary
incontinence. She is not a known diabetic. Her blood glucose was 35 mmol/L.Her other lab results
are as follows: Na+:150mmol/L, K+: 5mmol/L, Urea: 25mmol/L, Creatinine: 254umol/L, HCO3-:
19mmol/L. calculate the serum osmolality
a) 380 mOsm/kg F
b) 290 mOsm/kg F
c) 370 mOsm/kg T
d) 316 mOsm/kg F
e) 506 mOsm/kg F
[Osm= 2(Na+K) + Glu + Urea]
19. The following finding in consistent with diagnosis of diabetic retinopathy
a) Flame shaped retinal hemorrhages F
b) Arterio-venous nipping of retinal vessels F***
c) Bilateral cataract in a diabetic F
d) Any form of blindness occurring in a diabetic F
e) Increased intraocular pressure F***
[Microaneurysm, Ret Haem, exudates, cotton wool spots, Venous Changes, Neovascul, Pre-ret
haem, Vitreous Haem, Fibrosis]
20. Early diabetic nephropathy is associated
a) Pedal oedema F
b) Albuminuiria which cannot be detected by a dipstick T
c) Vasculopathy of the renal microvasculature F
d) Both Type 1 and type 2 diabetes T
e) Shrunken kidneys on ultrasound F
21. In minimal change glomerulonephritis in adults
a) Prednisolone therapy is of recognized benefit T
b) GFR is impaired F
c) Average urinary protein is 3g/day or more T
d) Hypertension is a frequent finding F (in adults about 30%)
e) Chlorambucil treatment is of proven benefit T
22. Pyelonephritis
a) Mainly caused by Klebsiella F (E. coli; type P fimbriae…)
b) Can occur without clinical symptoms T
c) Fever is rarely associated with rigors F (remember, chills may occur without fever)
d) Typically causes clubbing of the renal calyces T
e) Presence of red cell casts in the urine F

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23. In chronic kidney disease
a) Uraemia is worsened by corticosteroids T
b) Insulin sensitivity is increased in advanced kidney disease T
c) Aspirin may precipitate kidney failure T
d) Hepatic metabolism is impaired by the presence of a dialyzable inhibitor in the blood T
e) Tetracycline worsens uraemia T
Q24. The ff Medications can impair renal function
a) Ranitidine F
b) Iodine containing contrast medium T
c) Naproxen T (NSAIDs)
d) Captopril T (ACE I & ARB)
e) Amphotericin B T
[ohcm8: pp307/ Dvdsn21;pp518; Antimicrobials(Sulphonamides, tetracycline,rifampicin,
Cephalosporins, amphotericin, acyclovir) &Aminoglycosides(gentamycin, amikacin,
streptomycin,vancomycin), Metal Poisoning(Lithium, Gold,mercury, Lead, Cadmium, Arsenic,
Bismuth), Chemotherapy(cisplatin, methothraxate ), Toxins(Insecticides, Herbicides, Amanita, snake
venom, ) Anaesthetic agents (enflurane, methoxyflurane),Organic solvents (CCl4, ethylene glycol),
Penicillamine]

Q25. Pulmonary embolism typically presents as:

a) Haemoptysis F??(but Ofie chose true)
b) Rigors n chills F
c) Pyrexia F
d) Pleuritic chest pain T
e) Loud pulmonary second heart sound T
[Typical; pleuritic chest pain, SOB, hypoxia, tachypnoe]
[Atypical; seizures, ↓consciousness, delirium(elderly pt), syncope, fever, prod cough, wheezing,
hemoptysis, flank pain, abd pain, AF] Source: Medscape

Q26. Risk factors for HCC include

a. amoebic liver abscess F
b. chronic autoimmune hepatitis F
c. Alcoholic liver cirrhosis T
d. aflatoxin ingestion T
e. heavy smoking F

Q27. Falciparum malaria

a. acute infection causes splenomegaly T
b. Has an incubation period of 8-15days T
c. Presents with periodic fever in minority of cases T (Medscape)
d. may be treated with proguanil F
e. may present as gastroenteritis T
[P. falci,P. vivax, P. ovale – tertian(48hrs) / P. malaraie – quartan(72hrs)]

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Q28. Therapeutic options in chronic pancreatitis includes
a. Pancreatectomy T
b. Insulin T
c. Corticosteriods F
d. multivitamin T
e. pancreatin therapy T

Q29.The following commonly causes Irritant Dermatitis

a. Nickel F
b. Rubber F
c. Head bleach T
d. Wool T
e. Antipersperant spray T
[Allergic Contact dermatitis – Nickel, Rubber, Dyes(textiles), Preservatives(e.g formaldehyde),
Fragrances(Doedorants,soaps, aftershaves), Corticosteroids, Neomycin, Benzocaine,]
[Irritant Contact Dermatitis – Microtrauma(wool, fibreglass, leaves, stems), Dry air, Water,
solvents(OH, xylene, turpentine, powder in Rubber gloves, Alkalies(e.g soaps, detergents)]

Q30. A 50yrs old man with recurrent tenderness occurring especially when hungry, had a
gastroduodenoscopy done which revealed chronic duodenal ulcer and antral gastritis. Following
this observation your next line of action will include
a. Multiple biopsies of antral and duodenal mucosa should be done to rule out malignancy F
b. treatment of helicobacter pylori infection should be initiated T
c. Repeat endoscopy after 1 month is mandatory F
d. Repeat proton pump inhibitors may be necessary T
e. Gastric outlet obstruction may be a complication T
Q31. Causes of mucocutaneous candidiasis include:
a. Inhaled steroid use T
b. Retroviral infection T
c. Chronic anaemia F
d. Vitamin B12 malabsorption F
e. Iron deficiency F
Q32. A 38yrs old with a known case of alcoholic liver disease presented to the emergency with
hematemesis .Endoscopy was done showing bleeding esophageal varices .Choose the most
appropriate therapy.
a. Propanolol T
b. band ligation T
c. Injection sclerotherapy T
d. Octretide T
e. Telipressin T
Q33. In the management of hypertension with ACE-I
a. causes ankle swelling in 5% of patients F
b. Works synergistically with loop diuretics to decrease blood pressure T
c. Contraindicated in patient with renal function impairment F
d. Causes severe hypotension in Na. depleted patients T
e. worsens glucose control in hypertensives with diabetes F
Q34. Leprosy associated with
a. Thickened Greater auricular nerve T
b. Excessive sweating F

Boyz AbR3!!! (CLASS OF 2013) Page 15

 c. Anaesthesia @ site of lesion T
d. Leonine Facies T
e. Smear ZN stain of skin snip of patches shows Mycobacterium bovis bacilli F
Q35. In LFTs
a. Normal LFTs excludes a normal liver F
b. Increased ALT indicates hepatocyte damage T
c. Increased ALP always indicates hepatobiliary disease F
d. Conjugated hyperbilirubinaemia is seen in G6PD deficiency F
e. GGT is often elevated in heavy alcohol drinkers T
Q36. The following may be associated with diagnosis of Pneumothorax
a. sudden onset chest pain T
b. stony dull on percussion F
c. Breathlessness T
d. Previous Emphysema T
e.TB T

Q37. In enteric fever

a. widal test remains the investigation of choice to confirm change F
b. Cipro is the drug of choice in Ghana for adult T
c. jaundice is a recognised complication T
d. myocarditis is a known complication T
e. If bowel perforation occurs, patients could be treated conservatively in tertiary centres F

Q38. A 68yr old man, recurrent falls in the past 6 months, bradykinesia, stooped posture, mind
retropulsion, no arm swing turns with 5 stops. What is the most likely diagnosis?
a. dystonia F
b. parkinsons T
c. cerebellar degeneration F
d. demylination disease F
e. B12 deficiency F

Q39. In a man with pinpoint pupils, bilateral extensor plantar sign, disconjugate gaze, pause or
cramps after respiration. The most likely site of stroke is
a. bilateral cerebal cortex F
b. thalamus F
c. midbrain F
d. pons T
e. medulla F
Q40. Regarding doctor patient relationship, respect for confidentiality
a. is required even for info obtained in non-clinical setting T
b. allows discussion of sensitive issue T
c. encourages care seeking behaviour T
d. is not necessary in prisoners and those who have broken the law F

Boyz AbR3!!! (CLASS OF 2013) Page 16

Q41. A 65yr old woman brought to the ER after a fall. On examination, she opens her eyes to
voice, does not obey commands but localizes noxious stimuli, she cannot make conversations with
a single word appropriately. Calculate her GCS
a. 5 F
b. 8 F
c. 11 T
d. 14 F
e. 9 F
Q42. Type I respiratory failure
a. Asthma T
b. Lobar collapse T
c. Morphine overdose F
d. fibrosing alveolitis T
e. Guillaire Barré syndrome F

Q43. A 30 year old female complains of drooping of her eyelids and horizontal diplopia and feeling
“dead tired” by the end of the day. On examination in the clinic there are no abnormal physical
signs. What is a possible explanation for her presentation?
a. Transverse myelitis F
b. Guillain-Barre syndrome F
c. Polymyositis F
d. Myasthenia gravis T
e. Malingering F
Q44. Rapid onset dyspnea indicates
a. Acute PE T
b. Acute pulmonary oedema secondary to MI T
c. Acute pneumothorax T
d. Acute Asthma T
e. Gulliane Barre syndrome F
Q45. A 72yrs old woman comes to the emergency with a stroke .A CT scan shows a right
hemisphere infarct. She cannot see in one side of the eye. Where is the lesion .

a. Bil Hemianopia F
b. Binasal hemianopia F
c. Left homonymous hemianopia F
d. Right homonymous hemianopia T
e. Upper quadrantic bitemporal hemianopia F

Boyz AbR3!!! (CLASS OF 2013) Page 17

FINAL NEUROLOGY REVISION MCQ’S – CLASS OF 2012

1. In stroke
a. Weakness in face and arm more than leg suggests anterior cerebral artery lesion. F
b. Weakness in legs more than face and arm suggests middle cerebral artery lesion. F
c. Homonymous hemianopia suggests subcortical lesion. T
d. Neglect, apraxia and aphasia suggests posterior circulation involved. F
e. Amauroxis fugax implies involvement of internal carotid artery. T

2. A patient with a "scissors" gait from increased adductor tone would most likely be suffering from a
lesion in which of the following parts of the nervous system?
a. Lesion in the right hemisphere. F
b. Compression of the thoracic spinal cord. T
c. Guillain-Barré syndrome if the onset was subacute. F
d. Proximal muscle weakness from a myopathy. F
e. Compression of the cervical spinal cord. T

3. A 68-year-old man is brought into the clinic because of a problem of falling for the past six
months. The family has also noticed a progressive problem with his memory. On gait examination
the patient has bradykinesia, a stooped posture, no arm swing, and he completed a turn with five
steps. There is mild retropulsion. What is the most likely etiology of his falling over the past six
months?
a. a. Hereditary cerebellar degeneration. F
b. Tremor dominant Parkinson disease. T
c. akinetic rigid Parkinson disease . T
d. Possible demyelinating disease. F
e. None of the above. F

4. A 60-year-old woman awakens with inability to walk and is found on the floor by her family. Her
examination shows left face, arm, and leg weakness and numbness. Her head CT shows no acute
changes. What is the most likely cause of her inability to walk?
a. A right cerebellar infarction. F
b. A right hemisphere infarction. T
c. Both a and b are possible causes. F
d. Drug toxicity. F
e. A left hemisphere infarction. F

5. A 30-year-old obese woman presents with a constant headache for the past 6 months. She also
has had intermittent graying out of her vision in one eye or the other when arising from a seated
position over the past month. What is the most likely diagnosis in this patient?
a. Benign intracranial hypertension. T
b. Cluster headache. F
c. Migraine with aura. F
d. Postural headache. F
e. Optic neuritis. F

Boyz AbR3!!! (CLASS OF 2013) Page 18

6. A 21-year-old college student describes nausea, sweating, and dizziness prior to slumping to the
ground and losing consciousness during her first microbiology lab. She awakens fully lucid after 30
seconds. She is menstruating heavily. She has a family history of epilepsy. The most appropriate
evaluation in the ED would include which of the following:
a. Arterial blood gas. F
b. Complete blood cell count. T
c. EEG. F
d. Evaluation by a neurologist. F
e. Toxicology screen. F

7. A 45-year-old man comes to the ED after being found unconscious at a construction site. He was
found near the bottom of a ladder and is suspected of having fallen. Which of the following would
be the most appropriate immediate test?
a. Cervical spine series. T
b. EEG. F
c. Neurology consultation. F
d. Oculocephalic testing. F
e. Toxin screen and naloxone. F

8. . A 62-year-old man is referred for balance difficulty. His wife reports that over the past several
months he has started having difficulty with his memory for recent events. She also reports that he
occasionally has urinary incontinence. On examination his MMSE score is 24/30, and he has slow,
short steps with low height. What is the most likely diagnosis?
a. Benign prostatic hypertrophy. F
b. Early-onset Creutzfeldt-Jakob disease. F
c. Normal pressure hydrocephalus. T
d. Parkinson disease. F
e. Multi-infarct dementia. F

9. An examination revealing pinpoint but reactive pupils, bilateral extensor plantar responses,
disconjugate gaze and a pause or cramp after respirations would be most likely to indicate disease in
which part of the nervous system:
a. Bilateral cerebral cortex. F
b. Thalamus. F
c. Midbrain. F
d. Pons. T
e. Medulla. F

10. Which of the following would be considered to be a Romberg sign?

a. The patient falls backward when standing with the eyes open and the examiner pushes the
patient's sternum. F
b. The patient falls when attempting to stand with the feet together and the eye open. F
c. the patient fall without corrective movements when closing the eyes when standing. T
d. The patient starts to sway to and fro when closing the eye. F

SOURCE: http://www.aan.com/go/education/curricula/internal/
COURTESY: MERVIN, featuring… HENRY…

Boyz AbR3!!! (CLASS OF 2013) Page 19

 GROUP D1 & D2
1. A 32 yr old woman brought to the ER is found to have asterixis. The following could account for
the presentation.
a. Chronic respiratory failure T

b. Chronic cardiac failure T??

c. Brainstem lesion ??**

d. Uraemia T

e. Compensated liver cirrhosis F [OHCM8pp 472]

[Asterixis 1-2 jerks /sec(metabolic flap, flapping tremor); ↓Na, ↑CO2, Gabapentin, thalamic
stroke(unilat)]

2. Herpes simplex of the ophthalmic branch of the trigeminal nerve

a. Lesion does not cross the midline (Classically ispsilateral, but can’t say never)

b. There is never residual pain F(PHN)

c. May cause hypertrophic keratitis T( also iritis, iridocyclitis, glaucoma)

d. Could lead to encephalitis T

e. Can cause blindness T??

3. A 53yr old woman present to c/linic with Hb of 10g/dL, WBC of 50 x 109/L and Spleen of 15cm
below the costal margin. Which of the ff is most likely?

a. Bacterial endocarditis T

b. Chronic lymphocytic leukaemiaT

c. Chronic myelocytic leukaemiaT

d. Megaloblastic anaemia F

e. Iron deficiency anaemia F

4. The following drugs used to treat hypertension are correctly paired with their side effects

a. Bendroflumethiazide – hyperuricemia T
(Glucose Intolerance,↑Uric acid, Ca, Lipids/Chol&↓K, Mg, Na, Cl, HCO3 )

b. Furosemide – ototoxicity T (tinnitus, vertigo) Medscape

(Glucose intolerance, Glycosuria, Anaemia,↑Uric acid &↓K, Mg, Na, Cl, HCO3 )

c. Candesartan – Cough T (Medscape)

d. Nifedipine – ankle swelling T

e. Propranolol – Claudication T***[BDavidson pp758]

Boyz AbR3!!! (CLASS OF 2013) Page 20

5. Concentric left ventricular hypertrophy causes include

a. Obstructive hypertrophic cardiomyopathy F

b. Aortic stenosis T

c. Pulmonary hypertension F

d. Systemic hypertension T

e. Mitral regurgitation F

7. The following are true of ECG

a. The normal PR interval is 0.36seconds F [Normal 0.12s -0.20s(3-5small boxes)]

b. The PR interval is from the beginning of the P wave to the beginning of the QRS complex T

c. The normal QRS complex is 1.2s and more F (not > 1.2s)

d. The QRS complex is the beginning of the Q wave to the end of the complex T

e. The absence of P wave is diagnostic of atrioventricular block F

8. In complete AV block

a. Pulse is irregularly irregular T***

b. P wave is faster than QRS T

c. QRS complex is always broad F

d. AV dissociation T

e. Cannon waves T

9. The following are associated with severe hypokalaemia

a. Respiratory paralysis T( Muscle paralysis → acute Respiratory failure)

b. Oliguria F

c. Diarrhoea T(as a cause)

d. Cardiac arrest T(arrhythmias)

e.

10. In treatment of bacterial endcarditis

a. IV antibiotics for 2weeks is required for treatment F

b. Streptococcus viridans is common T(> 35% OHCM8)

c. Staphylococcus infection of mitral valve in drug addicts require flucloxacillin and valve
replacement. F

d. If gentamycin is used, it should not be used for more than 10 days F[Davidson-627]

e. Combination antibiotic therapy is almost always used T[Medscape]

Boyz AbR3!!! (CLASS OF 2013) Page 21

11. A 62 year old admitted with provisional diagnosis of acute pneumonia. He was previously well
until the illness started and now looking ill. The chest X-ray showed consolidation with
microabscesses. What will be your choice of antibiotics?

a. Ciprofloxacin F

b. Co-amoxiclav and flucloxacillin T

c. Co-amoxiclav and tetracycline F

d. Co-amoxiclav and clindamycin F

e. Anti-koch’s F???

12. Pnuemonia

a. If acquired in the hospital is due to Strep. Pneumonia F

b. If there are cavitations it is due to Mycoplasma pneumonae F

c.

d.

e.

13. Extrapulmonary tuberculosis

a. Is treated the same type and category as pulmonary tuberculosis T

b. Is treated for the same duration as pulmonary tuberculosis F

c. Normocytic normochromic anaemia is common association F

d. Lymphadenitis is the commonest presentation in adults T

e. Ethambutol, ciprofloxacin and pyrazinamide are first line agents F

14. A 50 year old farmer presents with a few hypopigmented patches on the trunk and arms he
noticed recently. The following are features suspicious of leprosy (Hansen’s disease)

a. Anaesthesia of the patches T

b. excessive sweating over the extremities F

c. Palpable nodular greater auricular nerve T

d. Leonine faciesT

e. Smear ZN stain of skin snip shows Mycobacteria bovis bacilli F[bovis, slit skin]

15. Erythema multiforme is associated with the following

a. Chronic kidney disease T???

b. Herpes simplex virus T

c. Adverse drug reaction from sulphonamides T

d. Malignancy T

e. Streptococcal Infection T

Boyz AbR3!!! (CLASS OF 2013) Page 22

Viral: HSV, CMV, Hep A/B/C, Echo, Entero, EBV, Coxsack B5, Adeno, Infleuz, Measles,Mumps,
Variola, Paravaccina, ParvoB19, polio, VZV

Bacterial: Heamolytic Strep, Staph, Proteus, Neisseria m, Pseudomonas, Salmonella, Yersinai,

Mycoplasma pneu, Pneumococci, Tb, MAC, Leprosy, diphtheria, Borreliosis, Treponema pallidum,
Vibrio paraH,Chlamydia, Rickettsia

Fungal&Parasite: (coccidiodomycosis, dermatophytosis, histoplasmosis)&(toxo, trichomonas)

Drugs: AntiBio( Sulphonamides, Penicillin, ampicillin, tetra, amoxi, cefotaxime, cephalexin, cipro,
erythro, vanco, rifampicin, isoniazid, pyrazinamide), quinine, corticosteroids, albedazole,
griseofluvin, NSAIDs, aspirin, fluconazole, quinine, cimetidine,

Immunologic( Collagen dx, vasculitudes, sarcoidosis, NonHL, Leukaemia, MM, Polycythemia)

Malignancy, flavorings and preservatives, Foods,

16. The following are skin manifestation associated with diabetes mellitus

a. Necrobiosis lipoidica T

b. Furunculosis T

c. Lipoatrophy T( also lipodystrophy)

d. Acanthosis nigricans T

e. Intetrigo T

17. Autoimmunity is characteristically a cause of the following

a. Hypothyroidism T [Chronic Lymphocytic(Autoimmune) thyroiditis; Hashimoto thyroiditis]

b. Cushing syndrome F

c. Jaundice with elevated liver enzymes T(Autoimmune Hepatitis)

d. Hyperparathyroidism F

18. Insulin preparations considered to have rapid insulin acting profile include

a. Insulin aspart T

b. Insulin glargine F

c. Insulin detemir F

d. Regular/normal insulin F

e. NPH insulin F

[Fast-acting Onset(5-15min) Duration(3-4hrs): aspart, lispro, glusine]

[Short-acting(Onset 30min, duration 5-8hrs): regular insulin]
[Intermediate(Onset 1-3hrs, duration 16-24hrs): NPH insulin]
[Long-acting(Onset 1-2hrs,duration about 24hrs without major peaks): glargine(aslo called lantus),
detemir]
[Ultra-long acting: degludec]
[Combinations: eg Mixtard(70/30)]

Boyz AbR3!!! (CLASS OF 2013) Page 23

19. A patient suspected to have cushing syndrome had a cortisol level drop from 940nmol/L
(normal range 140-700nmol/L) to 400nmol/L in the morning after 1mg dexamethasone was given
at 23HRS.

a. Patient does not have Cushing Syndrome so an alternative diagnosis should be sought F

b. The patient undoubtedly has Cushing syndrome (further tests needed to localize the

lesion) T

c. Patient has Cushing disease (the lesion is in the pituitary) F

d. The patient is likely to be on a drug like prednisolone F

e. The findings are consistent with a patient who is an alcoholic or has depression T[D772]

20. Uncomplicated diabetic. What is the frequency of retinal assessment?

a. Monthly F

b. Yearly T

c. Every 5 years F

d. A every clinic visit or appointment F

e. When there is blurred vision F

[ADA recommendations; yearly dilated eye examination, annual microalbumin checks, and foot
examination at each visit and daily by patient]

21. Hyperprolactinaemia is associated with the following

a. Thyrotoxicosis F (Primary hypothyroidism due to high TRH)

b. Metoclopramide use T

c. Administration of chlorpromazine T

d. Renal function impairment T(Chronic renal failure)

e. Pituitary microadenoma T[Macro also]

[ Pregnancy, Lactation, mental stress, Drugs; phenothiazines, trifluoperazine, haloperidol, risperidone,
quetiapine, metoclopramide, domperidone, cisapride, alpha-methlydopa, reserpine, TRH, estrogen.
Diseases; CRF, hypothyroidism, pituitary tumours, bronchogenic Ca, sarcoidosis, PCOS]

27. The following potentiate effect of Warfarin with concomitant administration causing increased
risk of bleeding.

a. Carbamazipine F( decreases level and effect)

b. Paracetamol T[Harrison]

c. Dipyridamole T

d. Rifampicin F

e. Streptokinase T***

[anabolic steroids,

Boyz AbR3!!! (CLASS OF 2013) Page 24

28. 29 year old woman recurrent history of thrombosis with 3 episodes last year. What
investigastions will you do?

a. Antithrombin T

b. Protein C T

c. Protein S T

d. Fasting Lipids T

e. Antiphospholipids ??[Choose with caution]

29. Patient with history full G6PD defect presents with intravascular haemolysis. What drug is the
most likely culprit?

a. Co-trimoxazole T

b. Ciprofloxacin F

c. Doxycycline F

d. Aspirin F

e. Paracetamol F

30. Food poisoning

a. Deep frozen chicken was a cause T

b. H. pylori is a common causative organism F

c. Caused by enterogenic salmonella presents with symptoms immediately F

d. Diarrhea and vomiting can cause circulatory collapse T

e. Management is mainly by Broad spectrum antibiotics F

31. Clostridium tetani

a. Diagnosis based on positive wound culture F

b. Wound debridement is essential to stop toxin production T

c. Sympathetic overdrive may occur T

d. Both active and passive immunization is required ???{abst}

e. Human immune globulin is associated with similar side effects as horse serum. F

32. Rabies

a. Rabies belong to the DNA rhabdovirus family F(ssRNA)

b. Majority of cases worldwide are caused by bat bites F

c. Human Rabies vaccine is a live attenuated vaccine T

d. The animals involved in transmission vary from country to country T

e. The diagnosis may not be made by serology T

Boyz AbR3!!! (CLASS OF 2013) Page 25

33. A long time resident of Ghana presented with general malaise and fever. Blood film showed
the presence of trophozoites of Plasmodium falciparum

a. Splenomegaly may be found on clinical examination T

b. If symptoms of gastroenteritis present then diagnosis of malaria is unlikely and that of

falciparum on BF was an incidental finding F

c. He can be treated with proguanil 100mg for 7 days F

d. Fever is an unlikely finding F

e. the incubation period is 8-15day T (7/8/9-14/15d)(Vivax&Ovale 12-17/18d) (Mal 18-40)

34. Dialysis

a. Indicated in all stages of renal failure F

b. Several methods can be used T

c. Peritoneal dialysis has no known complications F

d. Haemodialysis cause peritonitis F

e. Arteriovenous fistula is the preferred access T

35. Concerning ultrasonography in renal disease

a. Differentiate between solid and cystic masses T

b. Can be used to assess prostate enlargement in males T

c. High sensitivity for determining acute renal injury F

d. Can determine the functional capacity of the kidney F

e. Outlines the ureters F

36. Angular stomatitis is seen in

a. Vit B1 deficiency F

b. Vit B2 deficiency T

c. Iron deficiency T

d. Vit B3 deficiency T

e. Oral candidiasis T (staph aureus, b-H Strep,)

[ Vit B12,B7, B5, Zn]

37. Diagnosis of schizophrenia

a. Visual hallucination T

b. Auditory hallucination with person discussing the patient T

c. Aggressive behaviour ???[abst]

d. Believe that he owns central bank T

Boyz AbR3!!! (CLASS OF 2013) Page 26

 e. Speech that is incomprehensible ???[abst]

38. Motor neurone disease

a. early onset of Lower motor neurone manifestation is rare F

b. sensory conduction studies are normal T[bDavidsn663]

c. Fasciculations can occur T

d. Muscle relaxation is present F

e. All patients die within one year F

39. 40 year old man with status epilepticus after treatment with maximum dose of diazepam.
What is the preferred next steps?

a. Give more diazepam F

b. Loading dose of phenytoin T???

c. Investigate with EEG T

d. Propofol and intubate T

e. IV glucose with thiamine T

40. A patient with ‘’scissor’’ gait could be due to

a. Cervical cord compression T

b. Right hemisphere lesion F

c. Thoracic cord compression T

d. Proximal myopathy F

e. Gulliane-Barre of subacute onset F

41. Cause of delayed sexual maturity

a. Congenital adrenal hyperplasia F?? [Both delayed(17a-hydroxylaseDef) and precocious]

b. Polycystic ovarian syndrome F??(Heterosexual pubertal devpt: Few case have delayed menarche)

c. Turner’s syndrome T

d. Sickle cell disease T

e. Diabetes mellitus T

42. A labourer found unconscious at the foot of a ladder was brought to the emergency. He was
believed to have fallen from the ladder. What is the most important immediate test to do?

a. X-ray of the cervical spine T

b. EEG F
c. ECG F
d. Occulocephalic testing F (Contraindicated)
e. CT scan of the head F

Boyz AbR3!!! (CLASS OF 2013) Page 27

43. The following are recongized complications of morphine overdose

a. Confusion T

b. Pin point pupil T

c. Cold clammy skin T

d. Shallow breathing T

e. Bounding pulse F(Hypotension/Shock)

44. Mental state examination. Which of following is true of thinking disorder?

a. Circumstantiality and looseness of association are both disorder of form of thinking T

b. Thought block is a disorder of thought possession T (insertion, withdrawal, broadcasting)

c. de Cleranbaut is a delusional disorder T(Erotomania – delusion of love)

d. Knight move thinking is also known as derailment T

e. Autochthonous delusion is also known as primary delusion T

45. Alcoholic with ascites, tinge of jaundice…Which of the following will worsen his condition and
therefore should be avoided.

a. IV furosemide 120mg tds T

b. Lactulose 30mls tds F

c. Spirinolactone 50mg bd F

d. Ascitic fluid tap of 4L stat T

e. Diazepam to calm patient T

46. Patient with severe lung condition. Pa O2=60mmHg, PaCO2= 110mmHg, pH= 7.2

a. may have had status epilepticus T

b. Fibrosing Alveolitis F

c. Rehydration could be cause of acidosis F

d. 40% of Oxygen (at 8L/min) could be helpful F [28%]

e. Patient should be treated with propofol and ventilated ????

47. The following should be present before declaring a patient dead

a. Coma – cause cerebral lesion F

b. Loss of spinal reflex F

c. Loss of pupillary reflex T

d. Prolonged apnoea ???

e. Loss of corneal reflex T

Boyz AbR3!!! (CLASS OF 2013) Page 28

48. What are the aetiological agents in an elderly man with post viral influenza pneumonia?

a. Kleibsiella neumonia F

b. Haemophilus Influenzae T

c. Streptococcus pneumonia T

d. Staphylococcus aureus T

e. Pseudomonas aeruginosa F

49. 32 year old present with migratory polyarthritis for 4 weeks. Diagnosis to consider include

a. SLE T

b. Chron’s disease ???

c. Rheumatoid Arthritis T

d. Sarcoidosis T

e. Typhoid F

50. 45 year old woman with 5 months history of painful swelling of wrist and fingers and 6months
history of 1hr early morning stiffness. Which of the following findings is important to making a
diagnosis?

a. Erythema nodosum F

b. Subacute nodule T??[Rheumatoid nodule]

c. Anti-cyclic citrullinated peptide T

d. Mother with history of Rheumatoid arthritis T

e. Family history of psoriasis T [DDx psoaritic arthritis]

Boyz AbR3!!! (CLASS OF 2013) Page 29