Medicine MCQ File 3

1. Question

Axillary nerve

Cutaneous branch to a palm size area of skin over the deltoid
Roots C6 C7
Muscular branch to deltoid and teres major muscles
Arises from the medial cord to the brachial plexus
Would not be injured in dislocation of the shoulder

2. Question

Concerning hydrochloric acid:

Converts pepsin into pepsinogen
Found also in gall bladder
Denatures proteins
All of the above
None of the above

3. Question

Radial nerve

Main branch of the posterior cord
Roots C5, 6, 7, 8, T1
Most common clinical finding is wrist drop
All of the above
None of the above

4. Question

Essential amino acids include all except

Isoleucine
Methionine
Histidine
Glycine

5. Question

About the ulnar, which of these is a false statement

Posterior border is completely subcutaneous
Posterior border is not crossed by any named vessels or nerve
Comprises of olecranon, trochlear fosa, coronoid process, shaft and small distal head
In pronation and supination, the head of the radius rotates against the radial notch of the ulnar
All of the above

6. Question

The following are true about rupture of the supraspinatus tendon except

The patient is unable to initiate abduction of the arm
In advanced cases of tendinitis, the necrotic supraspinatus tendon may become calcified and rupture
It is a common cause of pain in the shoulder region
None of the above
All of the above

7. Question

Causes of frozen shoulder are all except

Trauma
Chronic inflammation
Diabetes mellitus
None of the above
All of the above

8. Question

Which of these is a false statement:

Nearly all dislocation of the shoulder joint are anterior inferior
About 5% of shoulder joint dislocations are superior
No evidence of radiological changes are seen in frozen shoulder
Smith’s fracture is the reverse of colles’ fracture
In scaphoid bone fractures, fracture lines pass through the widest part of the bone

9. Question

A 12 years old girl fell with her hands stretched out while trying to climb a tress. What injury/injuries is she most likely to sustain?

Elbow dislocation
Clavicular fracture
Colles’ fracture
A and B
A, B and C

10. Question

How many muscles insert on the carpal bones

1
2
3
4
5

11. Question

A middle aged man comes to you and complains of shoulder pain that arises while abducting his arm at the gleno-humeral joint. The pain is not there until his arm passes 90 degrees. He enjoys playing tennis and swimming; however, he hasn’t been able to do either since onset of the pain. What could be the cause of this pain?

Supraspinatus tendinitus
Long head of biceps tendinitis
Degenerative changes in the subacromial bursa
A and C
A, B and C

12. Question

Regarding the radial nerve which statement is incorrect?

It passes anterior to the lateral epicondyle of the humerus
Sensory loss from injury to the superficial radial nerve will usually result in loss of sensation over the entire thumb
Injury to the deep radial nerve in the mid forearm will prevent extension only at the metacarpo-phalangeal joints
Injury to the radial nerve from the fracture of the shaft of the humerus will result in wrist drop
It is the larger terminal branch of the posterior cord of the brachial plexus

13. Question

Which of the following structure pierces the coracobrachialis

Radial nerve
Median nerve
Ulnar nerve
Axillary nerve
Musculocutaneous nerve

14. Question

The following are wrongly paired except

Loa loa- Deer fly
L. Donovani- tse tse fly
T. cruzi—Sandfly
O. volvulus- Aedes mosquito
W. bancrofti- blacklfy

15. Question

A mother brings her 6 months old to you and she complained that the child seems not to be able to move her right hand as the left. She also complains that thje hand is bent towards the body and is not able to hold her toys with the left hand. You therefore these following muscles are affected EXCEPT:

Triceps
Supraspinatus
Teres minor
Deloid
Biceps

16. Question

The following act by enhancing the action of GABA except

Midazolam
Fentanyl
Propofol
Etomidate
Thiopental

17. Question

The most common pattern of valve involvement in rheumatic heart disease is in

Mitral valve alone
Mitral and tricuspid valve
Mitral and aortic
Aortic and pulmonary
Aortic valve alone

18. Question

Which of the following is false

Median nerve C6,7,8, T1 form the medial and lateral cord of the brachial plexus
Ulnar nerve C7, 8, T1 form the medial cord of the plexus
Musculocutaneous nerve C4,5,6 continues on from the lateral cord plexus
None of the above
All of the above

19. Question

Fat contains:

9 cal/g
4 cal/g
8 cal/g
6 cal/g
9 kcal/g

20. Question

Injury to the long thoracic nerve results in:

Winged scapulaWinged scapula
Swimmer’s palsy
May result from surgery
All of the above
None of the above

21. Question

Concerning proteins:

They make up 12-20% of body mass
Vital in supplying nitrogen for DNA and RNA genetic material
Not part of every cell in the body
For enzyme production
None of the above

22. Question

Contraindications to the use of ACE Inhibitors are

Aortic stenoisis
Mitral regurgitation
Complete heart block
Early stages of congestive heart failure
Haemoptysis

23. Question

The following investigation is invasive

Tilt test
Magnetic Resonance Imaging
Echocardiography
Electrocardiography
Angiography

24. Question

Regarding hypertension in Nigeria

17-25% of Nigerian adults are hypertensive
Stepped care approach is now adopted for treatment
More than 75% of patients are symptomatic
Weight reduction is important in its control
Salt restriction is mandatory

25. Question

Concerning heart sounds and murmurs

Sounds are auditory vibrations more prolonged than murmurs
The first heart sound identifies the onset of ventricular systole
Fourth heart sounds are normal in young adults
Mitral Incompetence murmur is a diastolic murmur
Tricuspid Incompetence murmur is a diastolic murmur.

26. Question

The following X-ray findings may be signs of Congestive heart failure

Kerly B lines
Kerly C lines
Elevation of the left dome of the diaphragm
Rib notching
Unfolded aorta

27. Question

Atrial fibrillation in a 50-year-old-man may be due to all the following except

Thyrotoxicosis
Rheumatic heart disease
Cardiomyopathy
Pericardial diseases
Unknown cause

28. Question

A collapsing pulse may be due to

Persistent ductus arteriosus
Aortic stenosis
Mitral stenosis
Coarctation of the aorta
Hypothyroidism

29. Question

Toxic and side effects of digoxin therapy include

Ventricular bigeminy
Bradycardia
Nausea and vomiting
All of the above
None of the above

30. Question

The following are laboratory findings in Infective endocarditis:

Leucopenia
Low ESR
Hyperkalaemia
Erythrocytosis
Valvular vegetations.

31. Question

Symptoms and signs of right heart failure include:

Parotid fullness
Hard hepatomegaly
Varicose veins
Basal crepitations
Tachypnoea

32. Question

The following are true of jugular venous pulsation except:

It is measured at an angle of 45
Only the external jugular vein is used.
It assesses events in the right atrium
Gentle pressure over the liver is used to elicit abdominojugular reflux
The height is related to the manubrium.

33. Question

Digital clubbing can be caused by:

Atrial myxoma
Familial dysautonomia
Pericarditis
Amoebic liver abscess
Arrhythmogenic right ventricular dysplasia

34. Question

The following are predisposing factors of atheroma

Cigarette smoking
Hypocholesterolaemia
Strenuous exercise
Slimness
Diabetes insipidus

35. Question

Causes of central cyanosis include all these except:

Tetralogy of fallot
Ventricular Septal Defect with reversal of shunt
Sinus venosus atrial septal defect
Acute pulmonary oedema
Acute severe asthma.

36. Question

Known contraindication to the use of ACE Inhibitors include:

Aortic regurgitation
Bilateral renal artery stenosis
Third degree A-V block
Congestive heart failure
Diabetic nephropathy.

37. Question

With regard to hypertension in Nigeria

Stepped care approach is now adopted
Weight reduction is an important life style modification
Salt restriction is recommended for prevention
Prevalence is lower than in the United Kingdom
Low dose thiazide diuretics are not recommended.

38. Question

In CCF secondary to coarctation of the aorta the following could be found In the chest radiograph:

Kerly C lines
Rib notching
Unfolded aorta
Patchy opacities in the lung fields
Elevation of the left dome of the diaphragm

39. Question

A collapsing pulse is not usually found in:

Aortic regurgitation
Aortic stenosis
Severe Anaemia
Coronary aretio-venous fistula
Tlhyrotoxicosis

40. Question

Diagnotic ECG changes may occur in:

Hyponatramia
acute pericarditis
pulmonary infarction
Lobar pneumonia
Primary Tuberculosis of the lungs

41. Question

In the investigation of heart disease:

PA radiograph is the best method of diagnosing right ventricular enlargement.
barium swallow may be helpful in mitral stenosis
Calcification of aortic and mitral valves can be most easily identified on a right lateral radiograph
ECHO (echocardiography) is of value in suspected pulmonary tuberculosis.
ECHO is seldom of used in the diagnosis of pericardial
effusion./

42. Question

The patient most likely has infective endocarditis

the sputum is usually copious and frothy
the blood pressure is always high
coarse crepitations at the lung bases are characteristic
oedema of the leg is often present
cardiomegaly is invariably present on a plain chest x-ray.

43. Question

Characteristic features of mitral valve stenolsis are:

an opening snap
apical loud fourth heart sound
a mid-diastolic murmur with pre-systolic accentuation
exertional dyspnoea
all of the above.

44. Question

Characteristic features of long standing occlusive arterial disease in a lower Limb include:

atrophic changes
positive Homan’s sign
warm extremeties
recurrent cough
weight loss

45. Question

The follwing are characteristic features of chronic constritive Pericarditis

orthopnoea
low volume pulse
cardiomegaly
a fourth heart sound
marked leg swelling.

46. Question

In a patient with hypertension the following physical signs may provide a clue to its cause

central obesity with a moon face
a diastolic murmur at the left sternal edge
delayed femoral pulse
a systolic bruit in the abdomen
all of the above.

47. Question

A person is hypertensive if his blood pressure is persistently any of the Following;

140/90 mmHg
120/100- mmHg
170/80 mmHg
170/100 mmHg
all of the above

48. Question

The following are hypertensive emergencies in a patient presenting with Blood pressure of 210/130 mmHg except:

evidence of cerebrovascular accicdent
biochemical evidence of chronic renal failure
acute left ventricular failure
pre-eclamptic toxaemia of pregnancy
encephalopathy

49. Question

The following are non-invasive investigations:

Electroncardiography
Chest radiography
Angiography
Stress tests
Echocardiography

50. Question

In conventional Electrocardiogram

The standard speed of the machine is 25mm/s
Normal PR interval is from 0.12 to 0.24sec.
Standard amplitude is 5mV
The graphic recording paper is the electrocardiogram
P-duration or width of 0.08secs. signifies atrial enlargement.