Medicine MCQ File 10

1. Question

In pharmaco-therapy of peptic ulcer disease, the following drugs are useful except:

Dexamethasone
Sucralfate
Clarithromycin
Rabeprazole
Nizatidine

2. Question

In an asymptomatic patient, diabetes cannot be diagnosed if

Fasting blood glucose is 11.1 mmol/L
Fasting blood glucose is 6.0 mmol/L
Random blood glucose is 14 mmol/L
Glycosylated Hb is 10%
A 2-hr post prandial glucose is 14 mmol/L

3. Question

Local anesthetic causing methamoglobinemia

Lignocaine
Prilocaine
Bupivacaine
All of the above
None of the above

4. Question

Helicobacter pylori has a role to play in the causation of the following

Acute pancreatitis
Colonic polyps
Alphthous ulcer
Gastric adenocarcinoma
Micronodular liver cirrhosis

5. Question

The following condition may cause secondary diabetes mellitus except

Prolonged treatment with corticosteroids
Hemochromatosis
Tuberculosis of the adrenal glands
Acromegaly
Cushings syndrome

6. Question

Bier block is used for

Sub-arachnoid block
IV regional block
Extradural block
Local anesthesia
None of the above

7. Question

Which of the following drugs is indicated in the treatment of hepatitis C virus infection

Lamivudine
Acyclovir
Zidovudine
Ribavirin
Fluconazole

8. Question

The following is incorrect regarding hypoglycemia

Commonest complication of insulin therapy
Observed in patients receiving sulfonylurea
Caused by a delay in taking a meal
Is recognized by appearance of confusion and disorientation
Treated with intravenous administration of calcium gluconate

9. Question

In trypanosomiasis secondary to T. gambiense, the following are true except:

Winterbottom’s sign- enlarged lymph nodes prominent in the posterior triangle of the neck is common
Generalized pruritus and characteristic thickening of facial tissues with sad or strangely expressionless appearance may occur in the early stages
Weight loss is an early manifestation
Splenic enlargement is moderate
Most deaths occur after central nervous system (CNS) invasion

10. Question

Cutaneous manifestation of cirrhosis of the liver include all except:

Palmar erythema
Spider nevi
Loss of axillary and pubic hair
Gynecomastia
Leukonychia

11. Question

In leptospirosis, the following are true except

Is commonly spread by rodents who are reservoirs of the organism
May cause aseptic meningitis in humans
Commonly persists as asymptomatic or subclinical infection
May be associated with Weil’s syndrome- a classical presentation of jaundice, hemorrhagic diathesis and renal failure
In the early stages, pulmonary hemorrhage and adult respiratory distress syndrome may occur

12. Question

The kussmaul sign is seen in which of the following disorders

Cardiomyopathy
Left ventricular infarction
Right ventricular infarction
Septal wall dysfunction
Tricuspid regurgitation

13. Question

In leptospirosis, the following statement is false

Incidence of infection is higher after heavy rainfall
Leptospires penetrate through cuts or mucosa
There is poor recovery of renal failure following Weil’s disease
It may be complicated by hepatosplenomegaly, lymphadenopathy and conjunctival suffusion
Penicillin-based antibiotics are preferable as drug of treatment

14. Question

Concerning pericarditis

Uremia causes chronic pericarditis
It could be related to hypersensitivity
A slow accumulation of 100 mls of fluid can cause tamponade
Tuberculous pericarditis is less than 6 weeks in duration
Myocardial injury is not a cause of pericarditis

15. Question

In borrelia infection, the following are true except

Is the causative organism of relapsing fever transmitted by lice or ticks
Petechiae and hemorrhage are rare complications
Borrelia is visible in dark field or phase contrast microscopy
Splenomegaly is common and may be associated with an increased risk of rupture
Occurs in epidemics in situations of poor hygiene and overcrowding such as in prisons and among refugees, displaced and homeless populations

16. Question

Concerning heart sounds and murmurs

Heart sounds are a series of prolonged auditory vibrations
The first heart sound identifies the onset of ventricular systole
Mitral regurgitant murmurs are diastolic murmurs
Young adults may have normal fourth heart sounds
A grade 2 murmur is very loud

17. Question

In leishmaniansis, the following statement is false

Is caused by leishmanial donovani, and spread by sandflies
Chronic leishmaniasis may present with progressive lymphadenopathy, splenomegaly and hepatomegaly
Splenomegaly may be moderate to massive in size, firm, regular and tender
Papule and nodules may develop years after treatment
Sodium stibogluconate is first line drug of treatment

18. Question

Features of congestive heart failure secondary to hypertension are

Rib notching on chest Xray
An initial dry nocturnal cough
Allergy to dust
Pleuritic chest pain
Unilateral leg swelling

19. Question

In onchocerciasis, the following are true except

Eye disease is particularly likely when nodules are on the head and upper body
Ocular onchocerciasis may lead to blindness
Microfilaria are responsible for eye disease in onchocercal infection
The hanging groin and leopard skin appearances occur in chronic onchocercal infection
Doxycycline has no role in the treatment of onchocercal infection

20. Question

The following refer to treatment of hypertension in Nigeria

Most patients will respond to drug combination with a beta blocker
Treatment is usually for life
Treatment should be stopped when BP is the normal range
Follow-up is not necessary once BP has normalized
Symptom of headache is usually used to determine when to treat

21. Question

In Wucheria bancrofti infection, the following is false

Is transmitted by masonian mosquitoes and causes brancroftian lymphatic filariasis
Chronic bancroftian filariasis leads to lymphatic damage and eventually elephantiasis
Bilateral hydrocele is a chronic manifestation of the disease
Predilection for nocturnal periodicity is common in Wucheria bancrofti filariasis
The filarial ‘dance sign’ may be demonstrated in scrotal ultrasound scan

22. Question

The following X-ray findings may be signs of congestive heart failiure

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

23. Question

The following hormones are secreted by the anterior pituitary gland except

ACTH
Prolactin
Growth hormone
FSH
Vasopressin

24. Question

The administration of local anesthetic may result in the following except

Tachycardia
Vasodilation
Myocardial depression
Seizures
All of the above

25. Question

A collapsing pulse may be due to

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

26. Question

These clinical features do not match the disease indicated

Visual field defects, spade-like hands and feet: Acromegaly
Weakness, postural hypotension, hypoglycemia: Addisson’s disease
Progantism, thickened skin, increased frontal sinuses: hyper parathyroidism
Menstrual irregularity, galactorrhea, tender breast: Hyper-prolactinemia
Constipation, non-pitting pedal edema, coarse hair: Hypothyroidism

27. Question

In Loa-Loa, the following are true except

Chrysops (the red fly) is the vector for the transmission of loa-loa
Calabar swellings- provoked inflammatory reactions following trauma to migratory adult worms in extremities- is common in loa-loa infections
Treatment of loa-loa with DEC may trigger encephalopathy
Peripheral blood microfilaremia peaks between 10 am – 3 pm
Treatment of co-infection of loa-loa and onchocerciasis with ivermectin improves prognosis

28. Question

Toxic and side effects of digoxin therapy include

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

29. Question

Hypoglycemia is not a recognized factor of

Acute hepatic failure
Insulinoma
Addison’s disease
Falciparum malaria
Cushing’s syndrome

30. Question

Ketamine causes all except

Potent analgesic effect
Muscle relaxation
Completely excreted by the liver
Used in hypotension
All of the above

31. Question

The following are laboratory findings in infective endocarditis

Leucopenia
Low ESR
Hyperkalemia
Erythrocytosis
Vavular vegetations

32. Question

With a u 100 strength insulin

1 ml contains 40 IU of insulin
1 ml contains 100 IU of insulin
0.5 ml contains 25 IU of insulin
0.5 ml contains 60 IU of insulin
0.2 ml contains 12 IU of insulin

33. Question

Trypanosomiasis secondary to T. rhodensiense may manifest with the following complications except

Pleural effusion
Pericardial effusion
Myocarditis
Painless chancre
Lymphadenopathy involving the axillary, inguinal and epitrochlear lymph nodes

34. Question

Digital clubbing can be caused by

Atrial myxoma
Familial dysautonomia
Pericarditis
Amebic liver abscess
Arrhythrogenic right ventricular dysplasia

35. Question

One of the following is an incorrect statement

Humulin 70/30 contains 30 IU of soluble insulin
Humulin 70/30 contains 30 IU of NPH insulin
Long acting insulins are cloudy
Insulin lispro, aspart and glulisin are short acting human insulin analogues
Insulin detemir and and insulin glargine are long acting human insulin analogue

36. Question

Chagas disease is associated with the following chronic complications exceot

Megaesophagus
Romana’s sign
Biventricular cardiomyopathy
Megaureter
Megacolon

37. Question

The following are predisposing factors of atheroma

Cigarette smoking
Hypocholesterolemia
Strenuous exercise
Slimness
Diabetes insipidus

38. Question

Realistic treatment goals for the diabetic patient exclude

Avoidance of hypoglycemia
Blood sugar of 4-7 mmol/L before meals and less than 9 mmol/L after meals
Glycosylated Hb of 6.5-7%
Fructosamine estimation
Avoidance of complex carbohydrates

39. Question

In schistosomiasis, the following are true except

Common and heaviest in children between 5-10 years
Itchy popular rash (swimmer’s itch or fisherman’s itch) may occur
May be associated with hepatosplenomegaly
Terminal hematuria is the cardinal symptom of S. hematobium
Bowel diarrhea/hematochezia may occur in S. mansoni/japonicum

40. Question

Common cause of lower GIT hemorrhage include

Achalasia
Hirschsprung’s disease
Cholera
Crohn’s disease
Acute appendicitis

41. Question

Insulin treatment is not indicated in

Type 2 diabetes
Patients with a history of hypoglycemia
Elderly patients
Patients wwith impaired fasting glucose
Pregnant women

42. Question

Chronic complications of Schistosomiasis include the following except:

Iron deficiency anemia
Pseudo-polyposis of the colon
Squamous cell cancer of the bladder
Pipe-stem fibrosis in the liver
Early-onset ascites