Akt 22 June 16

10 Questions

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History Quizzes & Trivia

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Questions and Answers
  • 1. 
    A 55-year-old female presents with hot flushes and night sweats. Her menstrual cycle has been irregular over the last 18 months. Her last menstrual period was 4 months ago. In the last 12 months her periods have become infrequent and sometimes heavy with clots. She has no abdominal pain or bloating. She is otherwise well, is not in a relationship and has no significant past medical history. A pregnancy test today is negative. She is fed up with her irregular cycle and wants to get rid of her flushing symptoms and vaginal bleeding.Which is the single most appropriate management option? Select ONE option only.
    • A. 

      Request FSH test to confirm she has entered the menopause

    • B. 

      Advise her that she can stop taking her contraceptive as she is no longer fertile

    • C. 

      Offer topical oestrogen to prevent vaginal atrophy

    • D. 

      Offer sequential combined hormone replacement therapy

    • E. 

      Offer continuous combined hormone replacement therapy

  • 2. 
    Which is the SINGLE MOST appropriate epidemiological measure to estimate the rate at which the new cases of papilloma virus infection occur among students on a college campus? Select ONE option only.
    • A. 

      Case fatality

    • B. 

      Median survival

    • C. 

      Mortality

    • D. 

      Prevalence

    • E. 

      Incidence

  • 3. 
    A 45 year old man attends for the results of his well man check. His fasting cholesterol is 7.9. A second sample was taken. The result of the second fasting cholesterol is 7.8. His HDL is 1.8, Triglycerides 2.2, LDL 5. Fasting glucose 5.4, TSH 1.4, LFTs in normal range, renal function in normal range. He has no history of heart disease and feels well. He is taking no regular medication. His father had coronary heart disease at age 58. His mother and older brother are well. He is a smoker and has been for the last 15 years at 10 a day. On examination he has no cutaneous features of raised cholesterol other than the early stages of corneal arcus. His BMI is 26. His calculated 10 year cardiovascular QRISK score is 10.2%.
    • A. 

      Refer to the metabolic clinic for suspected familial hypercholesterolaemia.

    • B. 

      Initiate lifestyle interventions, and simvastatin 40mg daily at night.

    • C. 

      Initiate lifestyle interventions, aspirin 75mg daily and simvastatin 40mg at night

    • D. 

      Initiate lifestyle interventions in addition to simvastatin in combination with a fibrate and repeat the cholesterol test in 3 months.

    • E. 

      Advise 6 months lifestyle intervention followed by repeat fasting cholesterol.

  • 4. 
    A 52 year old male with a history of recurrent migraine attends your surgery for advice. He has been using Propranolol as a preventer and Aspirin 900mg as a reliever. Recently his headaches have worsened. His headaches are unilateral and aggravated by physical activity. During attacks he experiences nausea and is photosensitive. These symptoms have increased in severity and in addition he now experiences disorientation and confusion during and whilst recovering from attacks.Which is the MOST appropriate management choice to consider for this patients current symptoms? Select ONE option only.  
    • A. 

      Topiramate 50mg per day

    • B. 

      Amitriptyline 75mg per day

    • C. 

      Urgent Referral to Neurology

    • D. 

      Sodium Valproate 800mg per day

    • E. 

      Almotriptan 12.5 mg at onset of an attack

  • 5. 
    You are asked to produce a leaflet for the practice about the national bowel cancer screening program. Identify the incorrect statement. Select ONE option only
    • A. 

      Screening is offered to all patients aged 60-69

    • B. 

      Screening is via faecal wipes which are returned in the post

    • C. 

      Over 70s can request to be screened

    • D. 

      Screening is at 2 yearly intervals

    • E. 

      Approximately 5% of those screened will require colonoscopy

  • 6. 
    The following groups are eligible for the annual influenza vaccination EXCEPT. Select ONE option only. 
    • A. 

      Patients with chronic renal failure

    • B. 

      Immunocompromised patients

    • C. 

      Children with cystic fibrosis over the age of 6 months

    • D. 

      All those over 60

    • E. 

      Staff in nursing homes

    • F. 

      Diabetics

    • G. 

      Patients with Chronic Obstructive Pulmonary Disease

  • 7. 
    A 72 year old male presents with a five week history of an inflamed oral lesion. The lesion is painful and he has noticed light bleeding when he spits into the sink after cleaning his teeth. He has tried oral mouth washes from the pharmacist but his symptoms have failed to improve.Which is the SINGLE MOST appropriate management option? Select ONE option only.  
    • A. 

      Refer urgently to ENT

    • B. 

      Start oral fluclonazole 50mg daily for 7 days

    • C. 

      Refer routinely to ENT

    • D. 

      Advise the patient to make an appointment with his dentist

    • E. 

      Start oral nystatin for 7 days 1 ml QDS after food

  • 8. 
    An 80-year-old edentulous patient who lives alone and refuses meals on wheels, complains of constipation without rectal bleeding. Her weight is steady, abdominal and rectal examinations are normal and she is otherwise well.Which is the SINGLE MOST likely diagnosis? Select ONE option only.    
    • A. 

      Alzheimers disease

    • B. 

      Carcinoma of the colon

    • C. 

      Hypothyroidism

    • D. 

      Poor fibre intake

    • E. 

      Diverticular disease

  • 9. 
    A 30 year old gardener attends complaining of pain on opening his right eye every morning for the past one month. The pain resolves after an hour. Whilst at work a month ago he had the sensation of getting something in his right eye. Vision is normal. Examination is normal.Which is the SINGLE MOST likely diagnosis? Select ONE option only. 
    • A. 

      Ingrowing eye lash

    • B. 

      Blepharitis

    • C. 

      Foreign body

    • D. 

      Dry eyes

    • E. 

      Recurrent erosion syndrome

  • 10. 
    Rachel Simons a 36 year old presents to the surgery. Her father aged 58 has recently been diagnosed with Huntingtons disease. Her main concern today is the risk of her or her young family developing Huntingtons. She is asymptomatic.Which is the SINGLE MOST appropriate statement regarding Huntingtons? Select ONE option only.
    • A. 

      The risk of her children inheriting Huntingtons is 1 in 4.

    • B. 

      Huntingtons is an autosomal recessive condition so the chances of her inheriting the disease are approximately 1 in 2.

    • C. 

      As a female her risk of inheriting Huntingtons is low because the gene is X linked

    • D. 

      Her chance of inheriting the disorder is around 1 in 2 because Huntingtons is an autosomal dominant condition.

    • E. 

      Huntingtons is an autosomal recessive condition so the chances of her inheriting the disease are low provided her mother is not a carrier for the Huntingtons gene.