Which ocular complaint is associated with Marfan syndrome?
1.Macular degeneration
2.Strabismus
3.Lens dislocation
4.Long sightedness
5.Raised intraocular pressure
What is the most important intervention at population level to reduce stroke incidence?
A Blood pressure control
B Diabetes treatment.
C Prophylactic aspirin
D Regular exercise
E Smoking cessation
17-year-old boy presented with a non-blanching rash over his legs, a swollen knee, and painless frank haematuria.
Investigations revealed:
Serum creatinine 210 µmol/L (60-110)
Urine dipstick analysis: Blood +++
Urine dipstick analysis: Protein +
Urine culture Negative
Ultrasound of the kidneys Normal
Which glomerular abnormality is most likely to be present at renal biopsy?
Focal and segmental sclerosis
Foot process fusion
Linear deposition of IgG on the basement membrane
Mesangial deposition of IgA
Thickening of basement membranes
A 75 year old gentleman with type 2 diabetes melllitus presents for his retinal screening. On the retinal photograph there is evidence of cotton wool spots and flame haemorrhages. There also appears to be new vessel formation very close to the optic disc. What is the next stage in management?
1.Referral for fluorescein angiography
2.Insulin
3.Referral for laser photocoagulation
4.Fenofibrate
5.Optimal glycaemic control
A patient is seen in a diabetic clinic. During fundoscopy, you notice neovascularisation near the optic disc in one eye, but not the other. Which investigation should you order?
1.Coagulation screen
2.ECG
3.Carotid Doppler
4.HbA1c
5.CT head
What is the most appropriate investigation for amaurosis fugax?
1.Carotid Doppler
2.MRI head
3.CT head
4.Fluorescein angiography
5.ECG
Which of the following is the characteristic finding for cytomegalovirus retinitis?
1.Cotton wool spots
2.Retinal haemorrhages
3.Anisocoria
4.Conjunctival injection
5.Macular oedema
A 67-year-old man with a history of metastatic lung cancer complains of lateral chest wall pain.
You review his notes and radiological investigations and note he has been diagnosed with lung cancer with metastatic deposits in his ribs. You take a full history and examine the patient; he complains of pain which radiates from his right lateral chest wall around to his sternum.
Which of the following is the most appropriate choice of analgesia to try first in this situation?
Amitriptyline
Carbamazepine
Gabapentin
Ibuprofen and tramadol
Morphine
A 67-year-old man has been diagnosed with metastatic lung cancer. He has moderate pain and has been started on morphine slow release twice a day. After a few doses he becomes nauseated and vomits on one occasion. You are working in palliative care and are asked to advise on the most appropriate antiemetic. He has no other medical history. Which of the following is the most appropriate first choice management option?
Cyclizine
Domperidone
Haloperidol
Ondansetron
Withdraw morphine
A 44-year-old woman with type 1 diabetes mellitus has not attended the diabetic clinic for five years.
Examination shows no abnormalities.
Investigations show:
Haemoglobin 90 g/L (115-165)
MCV 94 fL (80-96)
Haematocrit 28% -
HbA1c 87 mmol/mol (20-42)
10.1% (3.8-6.4)
A blood smear shows normochromic, normocytic anaemia.
Which of the following is the most likely cause?
Acute blood loss
Chronic lymphocytic leukaemia
Erythropoietin deficiency
Microangiopathic haemolysis
Sideroblastic anaemia
A 50-year-old man is admitted with cardiogenic shock due to an acute myocardial infarction.
His urine output drops over the next few days. His serum urea increases to 18 mmol/L (2.5-7.5), with creatinine of 300 µmol/L (60-110). Urinalysis reveals no protein or glucose, a trace blood, and numerous hyaline casts.
Several days later he develops polyuria and his serum urea and creatinine fall.
Which of the following pathologic findings is most likely to be seen in his kidneys?
Fusion of podocyte foot processes
Glomerular crescents
Hyperplastic arteriolosclerosis
Mesangial immune complex deposition
Patchy tubular necrosis
A 57 year old male presents to his GP with a sudden onset severe frontal headache associated with nausea and vomiting. He also had pain in his right eye and was complaining of visual blurring. On examination there is no evidence of neck stiffness or focal neurology. The right eye appears red with a ciliary flush and a non reactive mid dilated pupil. Which of the following is the most likely diagnosis?
1.Meningitis
2.Acute Closed Angle Glaucoma
3.Conjunctivitis
4.Anterior Uveitis
5.Scleritis
Which of the following suggests a trochlea nerve (CNIV) palsy?
1.Problem seeing things at a distance
2.Horizontal diplopia
5.Ear pain
4.Ptosis
5.Torsional diplopia
Which of the following does not have a role in the management of chronic cancer pain?
Carbamazepine
Clodronate
Dexamethasone
Nifedipine
Pinaverium
A 61-year-old female is reviewed in the rheumatology clinic with increasing shortness of breath. She has been on long-term drug therapy to control her rheumatoid arthritis and has a 40 pack-year history of smoking . Her oxygen saturations on room air are on 89%. Investigations reveal the following:
FEV1% 80%
Transfer factor coefficient
(TLCO) 41%
Primary action of orlistat?
Leptin antagonist
Pancreatic lipase inhibitor
HMG_COA reductase inhibitor
Blocks intestinal absorption of lipids
Centrally acting appetite suppressant
A 9 year old boy is brought to his GP. his mother has noticed him tripping up frequently. he states he has difficulty seeing in the dark. He is otherwise very well. A full neurological examination is performed and is normal. Fundoscopy is performed and reveals mid peripheral bone spicules. Which of the following is the most likely diagnosis?
1.Glaucoma
2.Retinoblastoma
3…Alport’s Syndrome
4…Usher’s Syndrome
5.Retinitis Pigmentosa
A 71 year old presents with right ptosis and anisocoria. History reveals a 25 year history of smoking 20 cigarettes a day, controlled hypertension, controlled hypercholesterolaemia and benign prostate hypertrophy. What investigation should be ordered?
1.Carotid doppler
2.Chest X-ray
3.Fluorescein angiography
4.CT head
5.Coagulation screen