MDC Exam April Flashcards

Question

26. What is the first line drug for the treatment of yaws? a. Azithromycin b. Benzathine penicillin. c. Erythromycin d. Streptomycin

Answer 1

The correct answer is: b. Benzathine penicillin Benzathine penicillin is the first-line treatment for yaws, which is a tropical disease caused by the bacterium Treponema pallidum subspecies pertenue. A single dose of benzathine penicillin is usually effective in treating yaws. Azithromycin is an alternative treatment for patients who are allergic to penicillin. The other options, erythromycin and streptomycin, are not typically used as first-line treatments for yaws.

Answer 2

The correct answer is: b. Treatment failure A smear-negative TB case that tests positive at the end of the intensive phase of treatment is considered a treatment failure. This is because the patient has not responded to the treatment as expected, and the presence of TB bacteria is still detected. The other options are not correct because: - Chronic TB patient: This term is not typically used to describe a patient who has failed treatment. - MDR-TB patient: While treatment failure can be a sign of multidrug-resistant TB (MDR-TB), it is not the same thing. MDR-TB is a specific type of TB that is resistant to multiple drugs. - Relapse: Relapse refers to the recurrence of TB symptoms after a patient has completed treatment and been declared cured. In this scenario, the patient has not completed treatment and has not been declared cured.

Answer 3

The correct answer is: b. Probenecid Probenecid is not a β-lactamase inhibitor. Instead, it is a drug that inhibits the renal excretion of penicillin, thereby increasing its plasma concentrations and prolonging its therapeutic effects. The other options are all β-lactamase inhibitors, which are used in combination with β-lactam antibiotics to overcome antibiotic resistance: - Sulbactam - Tazobactam - Clavulanic acid - Avibactam

Answer 4

The correct answer is: b. Presence of an abnormal discharge and erythema of the vagina The Amsel criteria for diagnosing bacterial vaginosis include: - Abnormally high vaginal pH (a) - Clue cells seen on vaginal saline preparation by light microscopy (c) - Characteristic fishy odor release with addition of potassium hydroxide to vaginal secretions (d) Presence of an abnormal discharge and erythema of the vagina (b) is not one of the Amsel criteria.

Answer 5

The correct answer is: e. All of the above All of the options listed can be treated effectively with penicillin or other members of the penicillin family of antibiotics: - Primary and secondary syphilis (a and b) are typically treated with benzathine penicillin G. - Breast cellulitis (c) is often caused by Staphylococcus aureus or Streptococcus species, which can be treated with penicillin-resistant penicillins or other beta-lactam antibiotics. - Actinomyces infections related to intrauterine device (IUD) use (d) are typically treated with penicillin G or other beta-lactam antibiotics. So, all of the above options can be treated effectively with members of the penicillin family of antibiotics.

Answer 6

The correct answer is: b. Ectopic pregnancy Ectopic pregnancy should always be considered in the differential diagnosis of threatened abortion. Threatened abortion refers to vaginal bleeding during the first 20 weeks of pregnancy, and ectopic pregnancy is a life-threatening condition that can present with similar symptoms. The other options are not as directly relevant to the differential diagnosis of threatened abortion: - Paternal factors (a) are not typically considered in the differential diagnosis of threatened abortion. - Minor maternal trauma (c) may be a contributing factor to threatened abortion, but it is not a diagnostic consideration in the same way that ectopic pregnancy is. - Oral contraceptive use (d) is not typically relevant to the diagnosis of threatened abortion, as it is not a common cause of vaginal bleeding during pregnancy. Therefore, ectopic pregnancy is the correct answer.

Answer 7

The correct answer is: e. None of the above There is no proven, effective therapy for threatened abortion that has been consistently shown to improve outcomes. Threatened abortion is a condition characterized by vaginal bleeding during early pregnancy, and the management is generally focused on monitoring and supportive care. The options listed are not evidence-based treatments for threatened abortion: - Bed rest (a) has not been shown to improve outcomes in threatened abortion. - Daily morning paracetamol (b) is not a recommended treatment for threatened abortion. - Increased oral fluid intake (c) may be recommended for general health, but it is not a specific treatment for threatened abortion. - Pelvic rest (d) is not a proven or recommended treatment for threatened abortion. Therefore, the correct answer is "None of the above".

Answer 8

The correct answer is: c. Threatened abortion The patient presents with vaginal spotting, which is a common symptom of threatened abortion. The transvaginal sonography reveals a gestational sac with an embryo and fetal heart motion, indicating a viable pregnancy. The diagnosis of threatened abortion is made when there is vaginal bleeding during the first 20 weeks of pregnancy, and the cervix is closed, and the pregnancy is viable. The other options do not match the clinical presentation and ultrasound findings: - Missed abortion (a) is diagnosed when there is fetal demise, but the pregnancy has not been expelled. - Incomplete abortion (b) is diagnosed when there is partial expulsion of the products of conception. - Blighted ovum (d) is diagnosed when there is a gestational sac without an embryo, which is not consistent with the ultrasound findings in this case. Therefore, the correct answer is threatened abortion.

Answer 9

The correct answer is: b. Presence of an abnormal discharge and erythema of the vagina The Amsel criteria for diagnosing bacterial vaginosis include: - Abnormally high vaginal pH (a) - Clue cells seen on vaginal saline preparation by light microscopy (c) - Characteristic fishy odor release with addition of potassium hydroxide to vaginal secretions (d) - Presence of a thin, homogeneous vaginal discharge (not specifically mentioned in the options, but it's the fourth Amsel criterion) Presence of an abnormal discharge and erythema of the vagina (b) is not one of the Amsel criteria.

Answer 10

The correct answer is: d. All of the above Acquired defects that may lead to recurrent miscarriage include: - Leiomyoma (a): Uterine fibroids can cause distortion of the uterine cavity, leading to miscarriage. - Asherman syndrome (b): Intrauterine adhesions or scar tissue can cause recurrent miscarriage. - Cervical incompetence (c): Weakening of the cervical muscles can cause the cervix to dilate prematurely, leading to miscarriage. All of these conditions can contribute to recurrent miscarriage, so the correct answer is "All of the above".

Answer 11

The correct answer is: c. Administration of Rho [D] immunoglobulin, if the patient is Rh negative Completed miscarriage is defined as the complete expulsion of the products of conception. In this case: - Transvaginal sonography (a) may not be necessary, as the diagnosis of completed miscarriage is typically made clinically. - Dilatation and curettage (b) is not required, as the products of conception have already been expelled. - Administration of Rho [D] immunoglobulin (c) is appropriate for Rh-negative patients to prevent isoimmunization. - Misoprostol administration (d) is not necessary, as the miscarriage is already complete. Therefore, the correct answer is the administration of Rho [D] immunoglobulin, if the patient is Rh negative.

Answer 12

The correct answer is: b. Prior ectopic pregnancy A prior ectopic pregnancy is the strongest risk factor for a subsequent ectopic pregnancy. The risk of recurrence is estimated to be around 15-20%. The other options are also risk factors for ectopic pregnancy, but they carry a lower risk compared to a prior ectopic pregnancy: - Smoking (a) increases the risk of ectopic pregnancy, but the risk is lower than with a prior ectopic pregnancy. - More than five lifelong sexual partners (c) and positive test result for cervical Chlamydia trachomatis (d) are associated with an increased risk of ectopic pregnancy, likely due to the increased risk of pelvic inflammatory disease. - Alcohol intake (e) has been linked to an increased risk of ectopic pregnancy, but the evidence is not as strong as for the other options.

Answer 13

The correct answer is: A. Cough The most common complaint by patients taking ACE inhibitors is a dry, persistent cough. This occurs in up to 20% of patients and is thought to be due to the increased levels of bradykinin, a peptide that can cause coughing. The other options are not as commonly associated with ACE inhibitors: - Headache (B) can occur, but it is less common than cough. - Vomiting (C) and diarrhea (D) are not typical side effects of ACE inhibitors. - Hypotension (E) can occur, especially in patients who are volume-depleted or have heart failure, but it is not the most common complaint. So, the correct answer is A. Cough.

Answer 14

The correct answer is: e. Coma Chronic Hepatic Encephalopathy (CHE) is a neurological complication of liver disease, and it is classified into four stages based on the severity of symptoms. Stage IV CHE is the most severe stage, and it is characterized by: - Coma: a state of deep unconsciousness, unresponsiveness, and lack of awareness. The other options are not specific to Stage IV CHE: - Restlessness (a) can occur in earlier stages of CHE. - Asterixis (b) is a flapping tremor of the hands, which is a characteristic feature of CHE, but it can occur in earlier stages. - Hyperactive Reflexes (c) can occur in various neurological conditions, not just Stage IV CHE. - Insomnia (d) is not a typical manifestation of Stage IV CHE, as patients in this stage are usually comatose. Therefore, the correct answer is e. Coma.

Answer 15

The correct answer is: C. 3 stages Malarial febrile paroxysms, also known as malarial paroxysms, typically consist of three stages: 1. Cold stage (Chills): The patient experiences chills, rigors, and a feeling of coldness. 2. Hot stage (Fever): The patient's body temperature rises, and they experience fever, flushing, and sweating. 3. Defervescence stage (Sweating): The patient's fever subsides, and they experience sweating, weakness, and exhaustion. These three stages can recur at regular intervals, depending on the type of malaria.

Answer 16

The correct answer is: c. Pulmonary Tuberculosis Pulmonary Tuberculosis (TB) is a separate infectious disease caused by Mycobacterium tuberculosis, and it is not a direct complication of severe pneumonia. The other options are potential complications of severe pneumonia: - Para-pneumonic effusion (a) is a collection of fluid in the pleural space that can occur as a complication of pneumonia. - Empyema (b) is a collection of pus in the pleural space, which can occur as a complication of pneumonia. - Septic shock (d) is a life-threatening condition that can occur when an infection, such as pneumonia, causes a severe inflammatory response. - Meningitis (e) is an infection of the membranes surrounding the brain and spinal cord, which can occur as a complication of pneumonia, especially if the causative organism is Streptococcus pneumoniae. Therefore, the correct answer is c. Pulmonary Tuberculosis.

Answer 17

The correct answers are: c. Isosorbide dinitrate and b. Lisinopril Isosorbide dinitrate (c) is a nitrate that acts as a vasodilator, decreasing preload and afterload, and reducing the workload on the heart. Lisinopril (b) is an angiotensin-converting enzyme (ACE) inhibitor, which also has vasodilatory properties, reducing afterload and improving cardiac output. The other options are not primarily vasodilators: - Nifedipine (a) is a calcium channel blocker, which can cause vasodilation, but it is not typically used as a first-line agent in heart failure management. - Methyldopa (d) is an antihypertensive agent that works centrally, but it is not a primary vasodilator. - Furosemide (e) is a loop diuretic that reduces fluid overload, but it is not a vasodilator. So, the correct answers are c. Isosorbide dinitrate and b. Lisinopril.

Answer 18

The correct answer is: E. Rupture of the liver The other options are potential complications of ascites: - Spontaneous bacterial peritonitis (A) is an infection of the ascitic fluid that can occur in patients with cirrhosis and ascites. - Hepatopulmonary syndrome (B) is a condition characterized by shortness of breath and hypoxemia, which can occur in patients with liver disease and ascites. - Hepatorenal syndrome (C) is a type of kidney dysfunction that can occur in patients with liver disease and ascites. - Rupture of the umbilicus (D) is a rare complication of ascites, where the increased pressure from the ascitic fluid can cause the umbilicus to rupture. Rupture of the liver (E) is not a direct complication of ascites. Liver rupture can occur due to trauma, tumors, or other conditions, but it is not typically associated with ascites.

Answer 19

The correct answer is: A. Severe pneumonia Severe pneumonia is not typically considered a differential diagnosis for bronchial asthma, as it is a distinct clinical entity with different underlying pathophysiology and presentation. The other options are all possible differential diagnoses for bronchial asthma, as they can present with similar symptoms such as wheezing, coughing, and shortness of breath: - Infectious Bronchiolitis (B) can present with wheezing and respiratory distress, especially in young children. - Congestive Heart Failure (C) can cause wheezing and shortness of breath due to pulmonary edema. - Pulmonary Embolism (D) can cause sudden onset of shortness of breath and wheezing. - Chronic bronchitis (E) can cause chronic coughing and wheezing, and can be difficult to distinguish from asthma. Therefore, the correct answer is A. Severe pneumonia.

Answer 20

The correct answer is: b. Odynophagia Odynophagia is the medical term for painful swallowing, which is a common symptom of esophagitis. It is a specific type of dysphagia that is characterized by pain or discomfort while swallowing. The other options are not correct: - Dysphagia (a) is a broader term that refers to difficulty swallowing, which can be caused by a variety of conditions, including esophagitis. - Dyspepsia (c) refers to indigestion or upper abdominal discomfort, which is not directly related to swallowing. - Dysphonia (d) refers to a change in voice or hoarseness, which is not related to swallowing. - Aerophagia (e) refers to swallowing air, which can cause bloating or discomfort, but is not typically associated with painful swallowing. Therefore, the correct answer is b. Odynophagia.

Answer 21

In that case, I'll try again. A better answer would be: e. Full Blood Count While a Full Blood Count (FBC) is an important diagnostic test, it is not directly relevant to the acute management of hypertension. The other options, such as Fundoscopy, Renal function test, Liver Profile, and Lipid Profile, are more directly related to the evaluation and management of hypertension. Am I correct this time?

Answer 22

None of the options listed are the most important modifiable risk factor for coronary heart disease (CHD). The correct answer is not listed, but it is: Hyperlipidemia (specifically, elevated LDL cholesterol) or more broadly, Dyslipidemia. However, among the options provided, the most important modifiable risk factor for CHD would be: a. Hypertension Hypertension is a major risk factor for CHD, and managing hypertension through lifestyle changes and medications can significantly reduce the risk of CHD. The other options are not modifiable risk factors in the same way: - Stroke (b) is a complication of CHD, not a risk factor. - Congestive Heart Failure (c) is a potential outcome of CHD, not a risk factor. - End-Stage Renal Disease (d) is a complication of various diseases, including diabetes and hypertension, but it is not a direct risk factor for CHD. - Peripheral Vascular Disease (e) is a manifestation of atherosclerosis, which is also a risk factor for CHD, but it is not a modifiable risk factor in the same way that hypertension is.

Answer 23

The correct answer is: e. Obstructed bowel in a hernia Obstructed bowel in a hernia typically causes a mechanical bowel obstruction, which is a different entity from paralytic ileus. Paralytic ileus is a condition characterized by a temporary cessation of the normal contractions of the bowel muscles, leading to a buildup of food, fluids, and gas in the intestine. The other options are all potential causes of paralytic ileus: - Complication of abdominal surgery (a): Surgical manipulation of the bowel can cause paralytic ileus. - Peritonitis (b): Inflammation of the peritoneum can cause paralytic ileus. - Spinal injury (c): Spinal cord injuries can disrupt the nerve supply to the bowel, leading to paralytic ileus. - Drugs (d): Certain medications, such as narcotics and anticholinergics, can slow down bowel motility and cause paralytic ileus. Therefore, the correct answer is e. Obstructed bowel in a hernia.

Answer 24

I choose: c. Perforation Perforation is a serious and common complication of acute appendicitis, where the appendix ruptures and spills bacteria and pus into the abdominal cavity, leading to peritonitis.

Answer 25

In that case, the correct answer is: e. All of the above Given the recurrence of the swelling and the lack of a prior histopathologic diagnosis, it would be prudent to consider all options, including incision biopsy, excision biopsy, and Trucut biopsy, to obtain a tissue diagnosis and guide further management. Each of these options has its own advantages and disadvantages, and the choice of which one to use would depend on the specific clinical scenario and the patient's individual needs.

Answer 26

The correct answer is: c. Anterior abdominal wall and the liver Given the location of the stab wound in the right upper quadrant (RUQ) of the abdomen, the structures most likely to be damaged are: 1. Anterior abdominal wall: The skin and muscles of the abdominal wall would be directly affected by the stab wound. 2. Liver: The liver is located in the RUQ of the abdomen, and a stab wound in this area could potentially damage the liver. The other options are less likely: - The bladder (a) is located in the pelvis, not in the RUQ. - The spleen (b) is located on the left side of the abdomen, not in the RUQ. - The pancreas (d) is located in the upper abdomen, but more centrally and not typically in the RUQ. - The left kidney (e) is located on the left side of the abdomen, not in the RUQ.

Answer 27

The correct answer is: c. Hypovolaemic shock The patient's clinical presentation is consistent with hypovolaemic shock, which is a state of inadequate blood circulation due to insufficient blood volume. The signs and symptoms that support this diagnosis include: - Grossly enlarged and fluctuant right thigh, suggesting significant blood loss into the thigh due to the femur fracture - Low blood pressure (80/50 mmHg) - Tachycardia (160 beats per minute) - Thready pulse - Cold and sweaty skin These signs indicate that the patient is experiencing significant blood loss, leading to a decrease in blood volume and subsequent hypovolaemic shock. The other options are not supported by the clinical presentation: - Endotoxic shock (a) typically occurs in response to a severe infection, which is not indicated in this scenario. - Neurogenic shock (b) typically occurs in response to a spinal cord injury, which is not mentioned in this scenario. - Anaphylactic shock (d) typically occurs in response to a severe allergic reaction, which is not indicated in this scenario. - Severe dehydration (e) may cause hypovolaemia, but the clinical presentation suggests blood loss rather than dehydration.

Answer 28

The correct answer is D. Have a 65-70% chance of survival if admitted to a NICU. Babies born at 25 weeks gestation are considered extremely preterm and are at high risk for complications and mortality. However, with advances in neonatal care, the survival rate for these babies has improved. According to the American Academy of Pediatrics, babies born at 25 weeks gestation have a survival rate of around 65-70% if they receive care in a neonatal intensive care unit (NICU). The other options are not accurate: - A. Have an 80% chance of survival: This is an overestimation of the survival rate for babies born at 25 weeks. - B. Cannot be fed breast milk until 34 weeks: This is not true. Breast milk can be fed to preterm babies, including those born at 25 weeks, as soon as possible after birth. - C. Have 20% chance of blindness from retinopathy of prematurity: While retinopathy of prematurity (ROP) is a risk for preterm babies, the incidence of blindness from ROP is lower than 20%.

Answer 29

The correct answer is B. It is associated with breech position. Developmental dysplasia of the hip (DDH) is a condition where the hip joint doesn't form properly, leading to instability and potential dislocation. DDH is more common in: - Girls (not boys, so option A is incorrect) - Breech babies (option B is correct) - First-born babies - Babies with a family history of DDH The other options are incorrect: - C. Polyhydramnios is a condition where there is excess amniotic fluid, but it's not directly associated with DDH. - D. A dislocatable hip would actually have limited abduction (movement of the leg away from the body), not easy abduction. Early detection and treatment of DDH are crucial to prevent long-term complications and ensure proper hip development.

Answer 30

The correct answer is B. 4 weeks. According to the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), premature infants should receive their first vaccinations at 4 weeks of chronological age, regardless of their gestational age or weight. This means that premature infants typically start receiving vaccinations at 4 weeks after birth, which may be earlier than their due date. The other options are incorrect: - A. 5 weeks: This is too late for the first vaccinations. - C. 7 weeks: This is also too late for the first vaccinations. - D. 8 weeks: This is even later and not recommended. It's essential to follow the recommended vaccination schedule to ensure premature infants receive timely protection against vaccine-preventable diseases.

MDC Exam April Flashcards

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