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Erli Response Brain(battle)

Total questions: 10

Worksheet time: 20mins

Name
Class
Date
1.

32 year old female presents with a 4 month history of amenorrhoea.

She takes no specific therapy.

She has two children and her husband has has a vasectomy.

Examination reveals an obese individual but no other abnormality. Investigations reveal an oestradiol concentration of 100 pmol/l (NR 130 - 500), an LH of 2.1 mU/l (NR 3.0 - 6.6), an FSH of 2.2 mU/l (NR 3.3 - 10.1), a prolactin concentration of 800 mU/l (NR 50 -500 mU/l) and a testosterone concentration of 2.1 pmol/l (NR less than 3 pmol/l).

a)

Insulin tolerance test

b)

A Pregnancy test

c)

17 hydroxy-progesterone 

d)

An MRI of the pituitary

2.

A 23 year old female presents with weight gain and a 4 month history of amenorrhoea. 

Examination reveals a BMI of 33 and mild hirsuitism. Relevant investigations reveal an oestradiol concentration of 1200 pmol/l (NR 130 - 800 pmol/l), a testosterone concentration of 2.8 nmol/l (NR less than 3 nmol/l), a prolactin concentration of 1500 mU/l (NR 50 - 450 mU/l), an LH of 1.2 u/l (NR 1.2 - 8 u/l) and a FSH of 1.5 u/l (NR 1.58 u/l).

a)

Polycystic ovarian syndrome

b)

Prolactinoma

c)

Pregnancy

d)

Ovarian tumor

3.

A 44-year-old woman with type 1 diabetes mellitus has not attended the diabetic clinic for 5 years.

Her HbA1c is 10.1%. Examination shows no abnormalities. Her hemoglobin level is 9 g/dL, hematocrit is 28%, and mean corpuscular volume is 94 mcm3.

A blood smear shows normochromic, normocytic anaemia.

a)

acute blood loss

b)

chronic lymphocytic leukemia

c)

erythropoietin deficiency

d)

microangiopathic hemolysis

4.

A 58-year-old man presents with weight loss and haemoptysis.

He has smoked most of his life.

On examination he is clubbed and has clinical evidence of right pleural effusion. His serum calcium is 3.2mM.

a)

mesothelioma

b)

small cell carcinoma

c)

large cell carcinoma

d)

squamous cell carcinoma

5.

Ten individuals are admitted to casualty with profuse vomiting after attending a retirement dinner in a chinese restaurant. They all ate at roughly 7 pm and became ill at roughly midnight. Nine ate a mixture of dishes except one female who ate vegetarian dishes with her rice.

a)

Salmonleea enteriditis

b)

Staphylococcus aureus

c)

Clostridium perfringes

d)

Bacillus aureus

6.

A 60-year-old Chinese man has been started on quinine for leg cramps by his General Practitioner.

He presents, a week later, with 5 days of darkened urine and 2 days of increasing breathlessness, back pain and fatigue.

Investigations show a haemoglobin of 7.0 g/dl and raised reticulocyte count

a)

autoimmune hemolytic anemia

b)

glucose-6-phosphate dehydrogenase deficiency

c)

hereditary spherocytosis

d)

pyruvate kinase deficiency

7.

A 36-year-old man attends clinic with his wife after failing to conceive after 10 years of marriage. Examination reveals that he his tall, thin and has bilateral gynaecomastia.

Investigations show high levels of urinary gonadotrophins.

a)

Andropause

b)

Gaucher's disease

c)

Kleinfelter's syndrome

d)

Marfan syndrome

8.

A patients' arterial blood gases give the following results;

pO2 10 kPa (75mmHg), pCO2 7 kPa (52 mmHg), pH 7.47, [HCO3-] 37

a)

Chronic Hyperventilation Syndrome

b)

Acute exacerbation of COPD

c)

Several days of Pyloric obstruction

d)

Pulmonary Embolism

9.

A breathless patient undergoes pulmonary Function testing. The following results are obtained; FEV1 = 74% predicted, FVC = 68% predicted, TLC = 77% predicted, Tlco =46% predicted, Kco = 53% predicted.

a)

COPD

b)

Asthma

c)

Cryptogenic Fibrosing Alveolitis

d)

Morbid obesity

10.

A 40-year-old man with a long history of alcohol abuse is admitted with a subacute illness, comprising headache, fever, meningism and ataxia. MRI brain showed patchy high signal abnormality of the brain stem. CSF analysis showed polymphonuclear pleocytosis and low glucose. He had failed to improve after 3 days of intravenous cefotaxime treatment.

a)

Mycobacterium tuberculosis

b)

Cryptococcus neoformans

c)

Staphylococcus aureus

d)

Listeria monocytogenes