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1.
Mavis is 82 years old and recently she fell, landing face down on the floor. She was very shaken and had bruising about her lower face. Two weeks later her family started to notice that Mavis seemed very withdrawn and was sleeping a lot more than usual. Mavis would spend the whole day in bed and she was not really herself. When her family visited, she was increasingly abrupt and moody. Mavis was usually very gentle and quietly spoken. What is the most likely diagnosis?
2.
Which of the following statements regarding carcinoma of the lung is correct?
3.
Lulu is a three-year-old child who has swallowed kerosene and is brought immediately to the hospital casualty department. Which of the following measures should be undertaken in the immediate management of Lulu's problem?
4.
The aim of surgery in patients with perforation and infection of the tympanic membrane is to:
5.
Little Andrew, aged 18 months, was 'helping' Dad in the shed, when he began screaming and rubbing his eyes. He had climbed onto the workshop bench, on which was kept a variety of potential ocular hazards. Which of the following substances is potentially most harmful to Andrew's eyes?
6.
Which of the following statements about Dupuytren's contracture is correct?
7.
John is a 28-year-old unemployed man with multiple complaints, including headache, low backache, upper abdominal pain, pain in both feet, nausea, bloating, impotence, and weakness in both forearms and left leg. Physical examination shows no abnormal clinical signs. Previous investigations including chest X-ray, full blood count, biochemical profile, and abdominal ultrasound show no abnormality. What is the most likely diagnosis?
8.
Marty is a 42-year-old man who presents complaining of chronic headaches. He says he has come to see you only because his wife insisted. On questioning, he is not very informative but admits to having a few beers after work most days. On examination, you note his complexion is flushed, there is facial telangiectasia, and some periorbital puffiness. His BP is 150/95 mm Hg. You suspect that Marty's problems relate to hazardous drinking. Which one of the following strategies would be best for obtaining confirmation of your suspicions?
9.
Each of the following is characteristic of adult rheumatoid arthritis except:
10.
Melinda has just started to menstruate (experience periods). She is 16 years old and has Down syndrome (Trisomy 21). She wants to know all about her periods and why she has to bleed. Which of the following statements should you not tell Melinda regarding menstruation (periods)?
11.
Where both parents have schizophrenia, what is the probability of their child developing schizophrenia?
12.
Which of the following statements regarding Duchenne muscular dystrophy is incorrect?
13.
Camila, aged 58 years, complains that she loses control of her "waterworks" when she puts her key in the front door. Given this history, which form of incontinence is she most likely to have?
14.
The classical signs of congenital rubella (German measles) include all of the following except:
15.
Kari is 7 months old and has not received any immunisations. She presents with two weeks of paroxysmal coughing and vomiting, but is relatively happy between paroxysms. You suspect she may have whooping cough (pertussis). Kari lives at home with her mother, father, and older brothers, aged 2 and 4 years. Neither of her brothers have been immunised against pertussis. Choose the best initial management option from the list below:
16.
Sam and Mary have two daughters. Their second daughter has Cystic Fibrosis, but their elder daughter does not. They are considering having another baby. The likelihood of Sam and Mary having another child with Cystic Fibrosis is?
17.
Mel always loved playing girls' games as a child and had fantasies about being female. When puberty arrived, he was distressed by the physical changes that occurred in his body. As soon as he left home, he adopted a complete female appearance and female role in public and private. He obtained a driver's license and was able to work and live in society as a woman. Mel takes ethinyl estradiol 0.10 mg/day and has nearly completed 2 years of living completely as a woman. Mel has requested sex reassignment surgery. What is Mel's diagnosis?
18.
Sanjay, a 45-year-old man, presents with a one-year history of progressive ankle swelling, difficulty with speaking due to an enlarged tongue, pain and paraesthesiae in the forearm and hand, particularly at night, and easy bruising. What is the most likely diagnosis?
19.
Which of the following is correct? Epistaxis is often:
20.
Herman, a 58-year-old businessman, finds it difficult to travel by air or train. When he has no option but to travel, he finds the journey very difficult and gets out of the aircraft or train as soon as possible. Because of this, he mostly avoids travel, and this difficulty is interfering with his work. What is the most likely diagnosis?
21.
Kylie is pregnant. She has smoked 25 cigarettes per day for the past 10 years and continues to smoke even now that she is pregnant. Early in her pregnancy, you outline to her that, compared with infants born to non-smoking mothers, her infant is more likely to experience a number of disadvantages. These include all of the following except:
22.
On examining Fatima (aged 18 months), whom you are seeing for the first time, you hear a heart murmur. Which of the following clinical findings would suggest that this is an innocent heart murmur?
23.
Robyn, aged 43 years, is known to have gallstones. On this occasion, she presents with the acute onset of severe pain that was initially central in location but has now moved to the right costal margin and radiates to the back. She is pyrexic, slightly tachycardic, and has tenderness over the area of the gall bladder but no rigidity of the abdomen. The most appropriate management would be to:
24.
Which of the following statements concerning nappy rash is correct?
25.
All the following characteristics describe the 'ideal' vaccine, except?
