MCQ's
Which one of the following statements relating to acute aortic dissection is NOT correct ? - correct
answer 1. The aneurysm may be associated with connective tissue disorders
2. Cardiac tamponade may be a consequence.
3. Chest X-ray may be helpful in the diagnosis
4. Renal failure may be a complication
5. Gangrene of the toes is commonly seen.
Answer - correct answer Unlikely to show up on plain xray
A 68 year old woman presents to the Emergency Department with chest pain followed by sudden
collapse with loss of consciousness. She has a rapid weak pulse. Her ECG shows a regular wide complex
tachycardia. Which one of the following is the MOST likely diagnosis? - correct answer
1. ventricular tachycardia
2. supraventricular tachycardia
3. ventricular fibrillation
4. atrial fibrillation
5. atrial flutter
Answer - correct answer All the rhythms listed are generally rapid in rate. The
regularity of the rhythm rules out Atrial fibrillation. In general and without aberrant conduction, atrial
fibrillation, flutter and supraventricular tachycardia all have narrow QRS complexes. Patients in
ventricular fibrillation are generally unconscious and pulseless. Therefore the most likely diagnosis is
ventricular tachycardia.
Correct answer is ventricular tachycardia
Which one of the following statements related to control of blood pressure and hypertension is NOT
correct? - correct answer 1. In established hypertension there is usually increased
cardiac output.
2. Conn's syndrome is due to excessive adrenal section of aldosterone.
,3. Most people with Mendelian inherited hypertension have defects in sodium metabolism.
4. Most people with Conn's syndrome have sodium and water retention.
5. Renal disease is the most common form of secondary hypertension.
Answer - correct answer 1. Incorrect. In established hypertension, the
pathophysiology is usually associated with increase vascular resistance rather than increased CO.
Which one of the following would be consistent with a Glasgow Coma Score of 9? - correct answer
1. The patient opens their eyes spontaneously, but has no verbal or motor response
2. The patient has no eye opening, no verbal response and no motor response.
3. The patient opens their eyes only to pain, mutters "I'm home" and withdraws to pain bilaterally.
4. The patient opens their eyes to voice, is confused but obeys motor commands.
5. The patient opens their eyes to pain, groans and has an extensor motor response.
Answer - correct answer 3. E2, M4, V3 = 9. One may dispute that "I'm home"
represents confused speech rather than inappropriate words, but it is still the only one that even comes
close.
In the management of anaphylaxis, after oxygen which one of the following is the first treatment? -
correct answer 1. adrenaline
2. fluid replacement
3. antihistamines
4. steroids
5. skin prick testing
Answer - correct answer 1. adrenaline - All other options are appropriate, but the
first line treatment of anaphylaxis is adrenaline
Which one of the following statements about radiotherapy is MOST correct? - correct answer
1. Radiotherapy can not be given together with chemotherapy.
2. Patients receiving radiotherapy should avoid close contact with others because they are radioactive.
, 3. Radiotherapy commonly involves the use of high energy protons.
4. Radiotherapy can cause a skin reaction due to a mechanism similar to that of sunburn.
5. After radiotherapy it is usually not possible to perform surgery in that area.
Answer - correct answer 4. Radiotherapy can cause a skin reaction due to a
mechanism similar to that of sunburn. - Correct
Which one of the following combinations best describes the clinical features of hypercapnia? - correct
answer 1. hypotension, pallor, sweating
2. tremor, bounding pulse, sweating
3. central cyanosis, agitation, tremor
4. drowsiness, tachycardia, sweet-smelling breath
5. confusion, agitation, tachypnoea
Answer - correct answer 2. tremor, bounding pulse, sweating - A bounding pulse is a
characteristic feature of hypercapnia, with peripheral vasodilatation, sweating and tremor and therefore
best describes this disorder. Confusion, central cyanosis, tachycardia, agitation, drowsiness and
tachypnoea are all variably described in varying degrees of hypercarbia, but are less specific.
Following a motor car accident, a young woman lying in the Emergency Department begins to complain
of left shoulder tip pain. On examination, she has a pulse of 110/min and a systolic blood pressure of
100 mmHg. Your biggest concern would be that this clinical picture most likely represents - correct
answer Select one:
1. traumatic pancreatitis
2. gas under the diaphragm
3. fractured ribs
4. a subluxation of the acromio-clavicular joint
5. a ruptured spleen
Answer - correct answer 5. a ruptured spleen - most likely explanation of L shoulder
tip pain, tachycardia, and hypotension after blunt trauma
Which one of the following statements relating to acute aortic dissection is NOT correct ? - correct
answer 1. The aneurysm may be associated with connective tissue disorders
2. Cardiac tamponade may be a consequence.
3. Chest X-ray may be helpful in the diagnosis
4. Renal failure may be a complication
5. Gangrene of the toes is commonly seen.
Answer - correct answer Unlikely to show up on plain xray
A 68 year old woman presents to the Emergency Department with chest pain followed by sudden
collapse with loss of consciousness. She has a rapid weak pulse. Her ECG shows a regular wide complex
tachycardia. Which one of the following is the MOST likely diagnosis? - correct answer
1. ventricular tachycardia
2. supraventricular tachycardia
3. ventricular fibrillation
4. atrial fibrillation
5. atrial flutter
Answer - correct answer All the rhythms listed are generally rapid in rate. The
regularity of the rhythm rules out Atrial fibrillation. In general and without aberrant conduction, atrial
fibrillation, flutter and supraventricular tachycardia all have narrow QRS complexes. Patients in
ventricular fibrillation are generally unconscious and pulseless. Therefore the most likely diagnosis is
ventricular tachycardia.
Correct answer is ventricular tachycardia
Which one of the following statements related to control of blood pressure and hypertension is NOT
correct? - correct answer 1. In established hypertension there is usually increased
cardiac output.
2. Conn's syndrome is due to excessive adrenal section of aldosterone.
,3. Most people with Mendelian inherited hypertension have defects in sodium metabolism.
4. Most people with Conn's syndrome have sodium and water retention.
5. Renal disease is the most common form of secondary hypertension.
Answer - correct answer 1. Incorrect. In established hypertension, the
pathophysiology is usually associated with increase vascular resistance rather than increased CO.
Which one of the following would be consistent with a Glasgow Coma Score of 9? - correct answer
1. The patient opens their eyes spontaneously, but has no verbal or motor response
2. The patient has no eye opening, no verbal response and no motor response.
3. The patient opens their eyes only to pain, mutters "I'm home" and withdraws to pain bilaterally.
4. The patient opens their eyes to voice, is confused but obeys motor commands.
5. The patient opens their eyes to pain, groans and has an extensor motor response.
Answer - correct answer 3. E2, M4, V3 = 9. One may dispute that "I'm home"
represents confused speech rather than inappropriate words, but it is still the only one that even comes
close.
In the management of anaphylaxis, after oxygen which one of the following is the first treatment? -
correct answer 1. adrenaline
2. fluid replacement
3. antihistamines
4. steroids
5. skin prick testing
Answer - correct answer 1. adrenaline - All other options are appropriate, but the
first line treatment of anaphylaxis is adrenaline
Which one of the following statements about radiotherapy is MOST correct? - correct answer
1. Radiotherapy can not be given together with chemotherapy.
2. Patients receiving radiotherapy should avoid close contact with others because they are radioactive.
, 3. Radiotherapy commonly involves the use of high energy protons.
4. Radiotherapy can cause a skin reaction due to a mechanism similar to that of sunburn.
5. After radiotherapy it is usually not possible to perform surgery in that area.
Answer - correct answer 4. Radiotherapy can cause a skin reaction due to a
mechanism similar to that of sunburn. - Correct
Which one of the following combinations best describes the clinical features of hypercapnia? - correct
answer 1. hypotension, pallor, sweating
2. tremor, bounding pulse, sweating
3. central cyanosis, agitation, tremor
4. drowsiness, tachycardia, sweet-smelling breath
5. confusion, agitation, tachypnoea
Answer - correct answer 2. tremor, bounding pulse, sweating - A bounding pulse is a
characteristic feature of hypercapnia, with peripheral vasodilatation, sweating and tremor and therefore
best describes this disorder. Confusion, central cyanosis, tachycardia, agitation, drowsiness and
tachypnoea are all variably described in varying degrees of hypercarbia, but are less specific.
Following a motor car accident, a young woman lying in the Emergency Department begins to complain
of left shoulder tip pain. On examination, she has a pulse of 110/min and a systolic blood pressure of
100 mmHg. Your biggest concern would be that this clinical picture most likely represents - correct
answer Select one:
1. traumatic pancreatitis
2. gas under the diaphragm
3. fractured ribs
4. a subluxation of the acromio-clavicular joint
5. a ruptured spleen
Answer - correct answer 5. a ruptured spleen - most likely explanation of L shoulder
tip pain, tachycardia, and hypotension after blunt trauma
