KENYA MEDICAL T DEPART! LINING COLLEGE - NYAMIRA-CAMPU. ENT OF CLINICAL MEDICINE, MOCK EXAMINATION | THIRD YEAR MARCH 2021 CLASS COURSE NAME: MEDICINE jon . All Pes i Data Assi from the exqip room 4. All que: fiont re compylsor f - We CANDIDATE humber un all sheets of paper used. \ Aq questions orkthe answer sheets provided n a (PDA) must be switched offand be aleSECTION A: MULTIPLE CHOICE QUESTIONS-CHOS Q.L. Conceming syphilis which one is FALSE i) Incubation period is 3 weeks b) [t ecan affect the central nervous system c) Gentamycin is the drug of choice 4) Presents with lymphadenopathy Q.2, Concerning community acquired pneumonia [CAP] which statement is FALSE a) H influenza causes i expecially in elderly patients b) Klepsiella is the commonest cause in adults cy Mygoplagma pneumonia und chlamydia pneumur 4) Vishl inféction especially in young children especiafly young adults Which one pf the following is u bacterial hnir follicles infectio a) Tinea ungium b) Fezenta ¢) Pityrifsis versicolor dl) Sycudis barbae Q4. Which one of the following is a serious GIT diseases 5) Weight loss 6) Indigestion ee) Nausea d) Belehin: \ On Ni WN wppharanicd al bect ns est iret a ‘ Ve a) Gastritis \ by Cogs as \ \ \ c) Acha a ai dl) Chron! shayitis: | Q.d A36 year olll woman a eae to th easualty with fatigue, Yeu as CC intern take furt history i naemia, You take bloog for fll oP ram [ itre : Hb: 7. CV: 59.8FL; MCH: 23 pp; Platelets: 100. Frop the above findings what is the most likely diagnosis? ee from those af srongyloidas Fe ce) May bl Hy thd pancreatic duct causing pancreatitis dy th eably uge Jmoy present ry cough and asthmatic hate a middle ave mag prescits with acute onset of ade lever ancl pleuritic chest He also ‘complains of productive cough rusty in calour. Physiegl amination reveals dys ‘ caine Sea Ore 39¢ ond features of consolidmion ou left infrascapular. What 9) Bronchial asthina 24 ‘Lobar pneuma ©) “Bronchapnewinania : Gd) Polsshyey tuberealosis4. sung itl come: ; Qe “\ suung gat comes ia the muieal climie with history of breathlessnes Jor ane year, After auscultation of precordium you ma and palpiutions diugnosis of mitral sunosis. The most inportunt sign on which this diagnosis is bascd is’? a4) Pan systolic murmur 6) Mid diastolic murmur pusit thways normal creamy and thic] Hlowigh tor {like milk cds} Ss avatet Q.L1. Cancerminy tuberculos| a) Chest X-Ray is dfdgnosic b) Pyrazinamide cages gout ¢) Resistance to Etljambutal and isonigzid is considered MDR 4) TB Adenitis is une of the serious infections. QU2. ‘The commonest cause of chronic renal Jailure is infection Q.. vor the follawing Statement is corredt Insulin suppresses Insulin med wie Prediabetis is s develupment of 2 diabetes Qs. Cuncernin tne ato a) Ren: ire tl b) May lead to gram fr «) Conuaon in mol a) I's of special imy ¢ Q.LS. Diabetes affect tuberculosis by pl of the following EXCEPT a) Worseniny the f of 13 b) Poplin (eee ti TB i ie resistant ly Q46. Atypi coi a z a) Strepiococei pneumonia &) Crypiveacal a ud) HAntuenza ease if diawles . since benelit as been shuwi ro-wivanisn Q.17. Concerning Rabies a) Is a bacterial disease b) AU dus have nibie ¢) Hydrophobia is a featune WY) Anti-rabies vaccine given'ay stil dose is enough:S ¢) Frequent malaria treutntent al prophylaxis Q.1Y, The following are true about herpes simplex virus type 11 except a) Is sexually transmitted by Is caused by varicella 2uster ¢) Causes genital ulcers d) Idoes not affect the recium | Q.20. Inthe current management of eure bronchial asthma a) Aminophylline injection fs the first line ingatment dru inyportant ¢) Beta-blockers are piven | dl) Nebutization with salbugimol is key in management | G21 about Cv | stroke] ‘ib Ischuemie stroke is the anast cvmanian 6) Hacinurrhagic stroke is less sevens ¢) Aspirin is indicaved if haememhayic stroke is conlirmed J) Haemorrhagic stroke is the mast common type Q22, In haemolytic jaundice there is i) Pale stout ‘ b) Pale conjunctiva. mucoug membrane \ \ <) Itching and scratching. skint al) Ca head of punereas is a cquse | cell disease? a) Hydruxyurea reduces the level §f haemoglobin bb} Proquanil is indicated in proy ‘ <) Lifelong eee [ d) Pheumevoe Isai pl \ 24. True about hyperthyroidism. 1 |p Which one of the following is a rps fe management of sickle a) Weight gain is # feature b) TSH is increased ©) Propranolol is indicated | d) Treatment involves thro rope ment wfth Len hy osine QPS. A 16 year uld boy i fom Kiedis by ht to you with History of bi litigability and seneral malaise forthe last 3 weeks. Oh examination, th i slitus is pale with splenomegaly afi MSe Which ane isuntue 4 | wer Iyphoidl “The staat fihely oh ave for microscopy 8 dingnustic 4) The druy uf choice is sodium stibuglueonate 226. Conceming renal stones, the main chemical component is 8) Uric acid by Coleium . . . 1 Magnesium " \ dy Cyy 2.27. Which one of the follossi 0 ing 14am articular manifestation af cheumatoi ri a uinteaie siativn of rheumatoid sarthritis by Peri itis (Q.28. About cerebellar lesion, which one is not a finding a) Rigidity b) Treniors cs) A d) Negitiye Romberg’s sign 29, {bout staphylococcus epidermis a) Is a copgulase positive organism b) The of sm is usually sensitive to all penicillin ce) Growth in blood cultures are due lo contamination and should be ignored Wd) Ave dgstroyed by pos icone ineine Q.2b. Physiological consequences ul obstiuctive steep apheds usually include whieh of the follow: a) Pulmonary vasodilation b) Stimulation of deep sleep cy Activation of macrophag () Stimulation of eeythropan patient prtsents io you svith convulsions the possible investigations thal you will ao include all the following exeept iy) CSF exehnination Shall Xs San \ ee an] F rolyte ey \ \ \ a) Randam oI Ae | i fo. The tlt r bosib 1 eatise o's val hypertension. except i i pl ‘adone inwase af adrenal insutlicieney fc} Correct other metabolic abaurmalities dl) Identity and treat the cause <) No need of iy fluids beeau it will cause hypertensionfollow a) Pa b) NV <) Mi i € Cushing syndrome is not true coneeniny iviewt tend to have truncal obesity be caused by pituitary adenom result rom peolonged adininisteation of prediisulone ‘aused by deficiency of glucocorticoids When dealing with cholen) disease whieh of the follow ing is true it MN pusilive bacteria MEAL e) Patient die of toxaemin 1) Anti-diarrhoel drug are indicated complication of duadend! fileves respective of treatment | d) Epiyastric pin tend ty be worse soon after meals in duodenal ulcet A filty year old man presents with heat intol Examination reveals Escept a) Diplopia by Plosis ©) Lid retetivn #h Proptusis \ Q39. Concerning epilepsy iazepam is 1! in an acute epileptic attack Ne factory Ae Niun is associated with grandma epilepsy vattack is nbt predisposed by stress hocardiography is a relevant investigation | ig encephalypathy include the following except i i i \ a itn she present acl tencler ait the wall’ Moni i ' Q.40, QL. Moni tea swollen ty Mombasa 3 day's avo int a bus, Tos hellett leg is swollen. waem rofl bet Few. | sit is 4 tt he dlagiosis and the management of the above patient i ielfive steps you will take un a patient presenting to you in the outpatien: | depurtitent with dehydnnion, kussmals breathing and signs of shock. Has a random bloow of 28 mmoV! and ketonurin D3 428 years obi ably PFOSEHS othe Lospital eamplaining of blige: dizziness, blumed Jainling episudle and bryathlessness tor 2 Weeks. She is pale and Hb is 3 tion ul the above conditiva vision, headache \ vl, Outline the classiti v4a ga. A 20 year old KMTC male stuwlent presents with histor with thick yellowish per urethral discharge for 2 days. v of pain on micturition. assoc tater (This followed unprotected sex tial imercourse + days ago ay What is the syidrosti¢ dh bp Give 2 differentia: tag ep aint 2 mast conic: ine cause above problem [ 2 xs} ny. fater he presented songs ina churely { 5mks) went lar pit He started sing! 1 anticipate fram above paiet 42.3. Erastus ndemo a KMTC stude: with headieh crusade. Klentify 10 complications )o" pwith history of sudden conse of and he has Heen taking PPIs 0 neni sun in farmer presents ta you in coffee pround ypmitus le es history of abdow nal pi quick examninaffon reveals pallor weal wachyeardia, Identify the diagnos and mane of the above patient (5 niks] Qo) 150 yeareld liver cirrhosis Oy. Quiline the mghagement of a patient complains of se-ere w te the easualty depar » uf joint pains Ife has be ting various health during mainy seasons. Or undliced. Hb of 7grdl. Bs for MIPS % nt | 3 mks] \ \ senis to te emergency department wit I- day history wiry you are Ql \ of difficulty it athing, cough nel chest pains. On further } thld that the symptoms began ufier she wus rained on and shp wi s given On exam a febrile temp 30.7e, has central cyanosis, i] wanting for air any ; ya) What isthe { ) Ouling Ihe ipitial ereatment of this patient [ 6 mks] ) Ouuindltour Welevant diagnostic (est that you will do mk: \ ) Curlin the tr siment when the patient stabilizes [ Sms] x d) Ouiling{thah that you will give the patfeat{3 piks| ) Ng oy | SHCT.ON acy cre ESS. (25 year old git! pre: the chest is silent ast probable diagnosis | ? inks] q i