Professional Practice III

1. A patient is angry about the amount of time he spent in the waiting room.
What is the appropriate response to this situation?

Apologise to the patient for any inconvenience. Stay away from efforts to explain the delay

Move the patient up in the waiting list without telling the patient and your colleagues.

Suggest that the patient speak directly to the registrar to ask for information

Leave him there as it is.

B- Conflict of interest
Others- too much or too less effort of approach
A is just right

Explanation

B- Conflict of interest
Others- too much or too less effort of approach
A is just right

2. Which of these are not detectable in plain abdominal X-rays?

Calculi- gall bladder, kidney, appendix

Bowel obstruction- small and large bowel

Free intraperitoneal air (perforation of GIT)

Lacerations of organs- oesophagus, kidney

Lacerations of organs- oesophagus, kidney not clear in X-rays, sometimes it can be still perfused after lacerations (CT scan)

Explanation

Lacerations of organs- oesophagus, kidney not clear in X-rays, sometimes it can be still perfused after lacerations (CT scan)

3. Evaluation of Diagnostic Test.
Which one of these are TRUE about Diagnostic Test?

High value in sensitivity is desirable for ruling in disease (low false-positive rate)

High value in specificity is desirable for ruling out disease (low false- negative rate)

Positive predictive value is the probability that person actually has the disease given a positive test result.

Negative predictive value is the probability that person is actually disease-free although given a positive test result.

High value in sensitivity is desirable for ruling OUT disease (low false-negative rate)
High value in specificity is desirable for ruling IN disease (low false- positive rate)
Negative predictive value is the probability that person is actually disease-free given a negative test result.

Explanation

High value in sensitivity is desirable for ruling OUT disease (low false-negative rate)
High value in specificity is desirable for ruling IN disease (low false- positive rate)
Negative predictive value is the probability that person is actually disease-free given a negative test result.

4. Which of these scenarios does not involve the conflict of interest?

IOC delegates accomodated at luxury hotel at the expense of local government bidding for Olympics

Male medical student receives free pen from very attractive female drug rep

Vascular surgeon writes a job reference for his female registrar (who is also his current sexual partner)

Politician buys shares in Boral - may be OK, if the politician has NO POWER with respect to decisions affecting Boral

Real estate agent tells young couple that the house they are inspecting (to buy) is a great deal, and that they better act quickly

Sleazy guy in pub asks young female med student for phone number

(Non- conflict of interest)

Explanation

Politician buys shares in Boral - may be OK, if the politician has NO POWER with respect to decisions affecting Boral

Real estate agent tells young couple that the house they are inspecting (to buy) is a great deal, and that they better act quickly

Sleazy guy in pub asks young female med student for phone number

(Non- conflict of interest)

5. A 2 year old girl has an increase in abdominal girth, failure to thrive, and skin and hair depigmentation.
What is the diagnosis?

Melanoma

Kwashiorkor

Vitamin D3 deficiency

Albinism

Kwashiorkor results from a protein-deficient MEAL
M-Malabsorption
E-Edema
A- Anaemia
L-Liver (fatty)

Explanation

Kwashiorkor results from a protein-deficient MEAL
M-Malabsorption
E-Edema
A- Anaemia
L-Liver (fatty)

6. These are the correct ways to reduce bias in a research except...

Blind studies

Placebo responses

Crossover studies

Specific selection criteria

Specific selection criteria- Induce selection bias (nonrandom)
C. each subject acts as own control

Explanation

Specific selection criteria- Induce selection bias (nonrandom)
C. each subject acts as own control

7. One hour after eating custard at a picnic, a whole family began to vomit.
After 10 hours, they were better.
What is the organism causing this?

Staphylococcus aureus

Clostridia botilinum

Klebsiella

Vibrio parahaemolyticus

S. aureus (produced performed enterotoxins)
Toxin-mediated disease: rapid-onset food poisoning

Clostridia botilinum-found in honey(causes flaccid paralysis)
Klebsiella- pnuemonia in alcoholics and diabetics, also cause nosocomial UTIs
Vibrio parahaemolyticus-food poisoning in contaminated seafood

Explanation

S. aureus (produced performed enterotoxins)
Toxin-mediated disease: rapid-onset food poisoning

Clostridia botilinum-found in honey(causes flaccid paralysis)
Klebsiella- pnuemonia in alcoholics and diabetics, also cause nosocomial UTIs
Vibrio parahaemolyticus-food poisoning in contaminated seafood

8. Which of these points are TRUE about disease prevention?

Vaccination is a secondary disease prevention

Having Pap Smear and rectal examination are the primary disease prevention

Tertiary prevention is to reduce disability from the disease.like exogenous insulin for diabetes

Reporting infectious disease in workplace is the main prevention of disease

Primary- prevent disease occurence
Secondary-early detection of disease
Tertiary-reduce disability from the disease.

Explanation

Primary- prevent disease occurence
Secondary-early detection of disease
Tertiary-reduce disability from the disease.

9. Choose the wrong match between the disease and its association.

Fatty liver- alcoholism

String sign on x-ray- Crohn's disease

Waxy casts- Acute pyelonephritis

Mallory-Weiss syndrome- Oesophagogastric lacerations

WBC casts in urine= Acute pyelonephritis
WBC in urine- Acute cystitis
Waxy cast- Chronic end-stage renal disease

Explanation

WBC casts in urine= Acute pyelonephritis
WBC in urine- Acute cystitis
Waxy cast- Chronic end-stage renal disease