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Questions 31-40

31. Infantile hypertrophic pyloric stenosis

a. Occurs with a male : female ratio of 4:1.

b. Sons of affected mothers have a 20% risk of developing the lesion

c. Invariably presents between six and eights months of age

d. Typically presents with bile stained projectile vomiting

e. Surgical treatment is by Heller's Cardiomyotomy

32. Oesophageal atresia

a. Is often associated with a distal trachea-oesophageal fistula

b. Polyhydramnios is often present late in pregnancy

c. 50% have other associated congenital abnormalities

d. Contrast X-ray studies are necessary to confirm the diagnosis

e. Post-operatively over 30% develop oesophageal strictures

33. The following are features of Fallot's Tetralogy

a. An atrial septal defect

b. Pulmonary stenosis

c. Right ventricular hypertrophy

d. A left to right cardiac shunt

e. Cyanotic attacks during feeding and crying

34. Phaeochromocytomas

a. Are neuroendocrine tumours of the adrenal cortex

b. Are benign in 90% of cases

c. Occur as part of the MEN type I syndrome

d. Can be imaged with a meta-iodobenzylguanidine scan

e. Require only beta-blockade prior to surgery

35. Regarding Cushing's Syndrome

a. 80% of cases are due to pituitary adenomas (Cushing's Disease)

b. Most ACTH secreting pituitary adenomas are more than 2 cm in diameter

c. Is characterised by loss of the diurnal rhythm of cortisol secretion

d. Cortisol production is suppressed by low-dose dexamethasone

e. Adrenal carcinomas are more common than adrenal adenomas

36. The following are complications of parenteral nutrition

a. Hyperglycaemia

b. Hypoglycaemia

c. Hypokalaemia

d. Hyperkalaemia

e. Hypercalcaemia

37. The functions of a tracheostomy are to

a. Bypass an upper airway obstruction

b. Increase the anatomical dead space

c. Increase airway resistance

d. Protect against aspiration

e. Allow frequent airway suction

38. Regarding Hydatid disease

a. Is due to Entamoeba histolytica

b. Man is an accidental intermediate host

c. The liver is the commonest site of infection

d. Can be diagnosed by the Casoni test

e. Is resistant to treatment by metronidazole

39. Medullary carcinoma of the thyroid

a. Is a tumour of the parafollicular C cells

b. Produce thyroxine as the principle hormone

c. 10% of cases are sporadic

d. Can occur as part of the MEN type II syndrome

e. Total thyroidectomy is the surgical treatment of choice

40. The following are features of thyrotoxicosis

a. Weight gain

b. Palpitations

c. Proximal myopathy

d. Increased skin pigmentation

e. Pretibial myxoedema


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