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System 'mini' examination

Attempt all questions.  Check the box next to the answers that you believe to be true.  Leave unchecked all answers that you believe to be false.  Once you have completed each question it can be marked.  One point is scored for a correct answer.  Incorrect answers score zero.  There is no negative marking.  The answers to each question can then be explained.  You can not change the answers after they have been marked!

1. The following are features of Cushing's syndrome
(a) Hypotension
(b) Increased sodium excretion
(c) A proximal myopathy
(d) Thin skin with purple striae
(e) A buffalo hump

        

2. Regarding carcinoid tumours
(a) The appendix is the commonest primary site for gastrointestinal tumours
(b) Gastric carcinoid tumours produce little 5-hydroxyindoleacetic acid
(c) Liver metastases can result in the carcinoid syndrome
(d) Plasma chromogranin B may be increased
(e) Octreotide scintigraphy may identify both the primary and secondary lesions

        

3. Hashimoto's thyroiditis
(a) Is an acute suppurative disease due to a bacterial infection
(b) Often presents has a solitary thyroid nodule
(c) Is a common cause of hyperthyroidism
(d) Anti-thyroglobulin and anti-microsomal antibodies may be increased
(e) Increases the risk of thyroid lymphoma

        

4. Thoracic outlet syndrome
(a) Is more common in men than women
(b) Vascular symptoms are more common than neurological or venous symptoms
(c) Symptoms are often worsened by carrying weights or lifting the arms above head height
(d) Diagnostic tests include the Roo's and Adson's manoeuvre
(e) Onset of symptoms is precipitated by trauma in about one-third of patients

        

5. Abdominal aortic aneurysms
(a) Risk factors include male sex, smoking and hypertension
(b) With a diameter of greater than 7 cm have a less than 20% risk of rupture at 5 years
(c) Elective surgery usually has mortality of less than 5%
(d) Emergency surgery may have a mortality of greater than 50%
(e) Over 80% of patients die from an unrelated cause

        

6. In the non-invasive assessment of the arterial system
(a) A 5 MHz doppler probe is better than an 8 MHz probe
(b) The ABPI is the ratio of the ankle to brachial diastolic pressure
(c) A normal ABPI is greater than 1.0
(d) Patients with critical limb ischaemia usually have an ABPI of greater than 0.4
(e) Distal to an arterial stenosis the pressure increases with exercise

        

7. Overwhelming post-splenectomy infection
(a) Is usually due to unencapsulated bacterial infection
(b) Strep. pneumoniae is the commonest aetiological agent
(c) Despite aggressive therapy it can have a mortality of over 50%
(d) The risk of infection can be reduced with pneumococcal and haemophilus vaccination
(e) Penicillin antibiotic prophylaxis should be considered in all children

        

8. Regarding colonic polyps
(a) Juvenile rectal polyps are adenomatous polyps
(b) Metaplastic polyps are pre-malignant
(c) The risk of malignancy is higher in tubular than villous adenomas
(d) Villous adenomas occasionally cause hyperkalaemia
(e) All patients with untreated familial adenomatous polyposis will eventually develop colorectal carcinoma

        

9. Prostate carcinoma
(a) Affects 50% of men over the age of 80 years
(b) Most present with symptoms of bladder outflow obstruction
(c) A serum prostate specific antigen concentration of greater than 10 ng/ml is highly suggestive of the diagnosis
(d) Over 80% of tumours are androgen dependent
(e) In the treatment of the disease flutamide acts as an anti-androgen

        

10. Hodgkin's lymphoma
(a) Often presents as painless cervical lymphadenopathy
(b) About 50% of patients have splenomegaly at presentation
(c) The nodular sclerosing type has the best prognosis
(d) Stage 3 disease has lymphadenopathy confined to one side of the diaphragm
(e) With modern radiotherapy techniques stage 1 disease has a 5-year survival of over 90%

        

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Authored in CALnet

 
 

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