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Dicm 333 :Medicine Ii Question Paper

Dicm 333 :Medicine Ii

Course:Clinical Medicine

Institution: Kenya Methodist University question papers

Exam Year:2014

KENYA METHODIST UNIVERSITY

END OF 3''RD ''TRIMESTER 2014 (FQE) EXAMINATION
SCHOOL : MEDICINE & HEALTH SCIENCES
DEPARTMENT : CLINICAL MEDICINE
UNIT CODE : DICM 333
UNIT TITLE : MEDICINE PAPER II
TIME : 3 HOURS

INSTRUCTIONS

Write your University number and not name
Use a pen
Attempt all Questions
Multiple choice Questions
Mark T for True and F for False
You score a mark for every correct response
You lose 1 mark for every wrong response
You do not score nor lose any mark for not responding
Answer all the Questions on MCQ’s paper

PAPER TWO

Question One

The following are true of nephritic syndrome

Massive proteinuria
Hyperalbuminaemia
Generalized body malaise
Cedema of the lower limbs
Facial puffiness.

Question Two

Causes of iron deficiency anaemia include the following

Congenital defects as in sickle cell disease
Prematurity
Worm indestation by ascariasis
Ulcerative colitis
Pernicious anaemia

Question Three

The following drugs are used in the management of status epilepticus

Tegrettol
Phenobbarbitone
Glibencamide
Sodium valproate
Clonazepam

Question Four

The following are true of space occupying lesions

Haematoma may cause
Convalsions may be a feature
Vomiting is usually accompanied by nausea
X-ray of the skull always confirms the cause
Papiloedemia may lead to poor vision.

Question Five

Concerning thyroid storm

It is a life threatening meical emergency
It may follow austeral thyroidoctomy
Atrial fibrillation is a feature
Actibistics have a role in the management
Hypoglycaemia is a feature.

Question Six

HIV/AIDs is transmitted through

Sexual contact
Innoculation with infected blood products
Use of contaminated needles
Vertical transmission from mother to child
Fecal – oral route.

Question Seven

Regarding schistosomiasis

Man is intermediate host in the life cycle of schistosoma mansoni
Eosinophilia is common in the acute invasive stage of the disease
Maturing males and female S. mansoni pairs are usually found in venules of the bladder
Tissue granulomatous response is triggered by schistosome eggs rather than adults
Portal hypertension is a common complication of S. haematobium.

Question Eight

Clinical features of thyrotoxicosis include

Weight loss
Diarrloeas
Palpitations
Anxiely
Interlity

Question Nine

In Diabetic Keto Acidosis (DKA)

Characterized by ketonuria
Patient presents with blood ouger levels above 30 mmos litre
I/V fluids are essential in management
Most patient are likely to have metabolic acidosis
Insuli therapy is indicated

Question Ten

Causes of anaemia include

Severe malaria
Sickle cell disease
Leukemia
Leshmaniasis
Castroenteritis

Question Eleven

The following are diseases of the joints

Felty’s syndrome
Rheumatic fever
Osteoarthritis
Psoriasis
Infective endocarditis

Question Twelve

The causes of hypertension include

Renal disease
Cushing’s syndrome
Thyrotoxicosis
Family history
Phoechromocytoma

Question Thirteen

The causes of lower gastro-intestinal bleeding are;

Perforated duodenal ulcer
Chronic gastritis
Diverticular disease
Esopharyngeal varices
Epistaxis

Question fourteen

The following are the causes of acute gastro Enteritis

Chronic pancreatitis
Lymphoma
Bacterial infection
Food poisoning
Hookworm infestation

Question Fifteen

A 46 year old obese woman is admitted with two days history of a lower limb swelling. The limb is warm and tender;

She may be having cellulites
Filariasis is the most likely diagnosis
Deep venous thrombosis is likely
Elevation of the limb is important in treatment
Recent surgical removal of abdominal malignancy is the contributing factor

Question Sixteen

Regarding ankystomiasis

The parasite is fransmitted through oral route
Haemoptys may be a symptom
Iron deficiency anaemisa may develop
Stool for occur blood test is positive
Albenalazole 400mg is given for a period of five days

Question Seventeen

Concerning cerebral vascular accident

About 80% are due to haemorrhage
Aspirin is indicated in haemorrhagic cases
Thrombotic events occur in infective endocard it is
Raised blood pressure may be responsible
HIV is a predisposing factor

Question Eighteen

The following are true of urinary retension

Renal stones may be responsible
Urethral stricture may cause
Suprapubic catheterization is one way of management
Patient may have dysuria
Berign Arostatic hyperplasia is the cause in the elderly.

Question Nineteen

Regarding nephritic syndrome

Characterised by massive proteinuria
Oliguria is a sign
There is hypertension
Glomerular filtration rate is increased
Acute pyclonephritis is a differential diagnosis.

Question Twenty

The following are signs of upper motor neuron lesion

Hypertonic mucles
Decreased tendon reflexes
Extensor plantar response (Babinskis sign)
Fasciculation
Muscle wasting is pronounced

Question Twenty One

The following statements are true of infective endocarditis

It is the inflammation of the outer covering of the heart
Values are affected mostly
Bleeding into the skin is a sign
There is proteinuria
Erythrocyte sedimentation rate (ESR) is decreased.

Question Twenty Two

Concerning a case of pleural effusion

The onset of the disease is acute
Story dull percussion not is the finding
Mediastinal structures are deviated to the affected side
Vocal resonance is abscent
Breath sounds are increased.

Question Twenty Three

The following are true of leukemia

Acute leukamias are found in the elderly
There is bleeding tendencies
Bone marrows transplant has been proven to be curative
Irradiation doesn’t cause it
It is associated with chromosal abnormalities

Question Twenty Four

Concerning acute rheumatic fever

Blood culture will identify the causative organisms
The organisms respond to penicillin therapy
Emboli may cause strokes
Hepato-splenomegally is the finding
Erythromycin is an alternative in case of a patient being allergic to penicillis

Question Twenty Five

Peripheral neuropathy may be a complication of the following

Leprosy
HIV infection
Alcoholism
Diabetes mellitus
Hypoglycaemia

Question Twenty Six

In the case of severe bronchial asthma

May be treated as an outpatient case
Oxygen administration is indicated
The attacks may have persisted for more than 12 hours
I/V aminophylline in normal saline after a padding dose is advisable
An antibiotic is indicated.

Question Twenty Seven

The following features are suggestive of a grossly enlarged spleen

It extends to the umbilicus
It is pulsatile
It is bimannually palpable
It cannot be palpated above subcostal margin
It is dull on percussion.

Question Twenty Eight

The following are true of typhoid fever

It is an infectious disease
Constipation may be a symptom
Rose-red spots may be need on a light skin patient
Haemorrhage may be a complication
Blood culture is the most diagnostic method.

Question Twenty Nine

Regarding pneumothorax

It is the presence of air in the chest
Patrogenic causes are the commonest
Females are most affected
There is always an underlying lung disease in the elderly patients
Pleuritic chest pain is of sudden on set

Question Thirty

A comatose patient is brought to a Health Centre where you are the in charge. You decide on the following about the patient

Refer him immediately to level 5 hospital
Do thorough physical examination after obtaining relevant history
Give an injection of corticosteroid drug
Order for blood slide for malarial parasites
Do a lumber puncture.

Dicm 333 :Medicine Ii Question Paper

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