Nokea
Regarding diphtheria correct statement is
- A. Falling levels of immunity in the adult population is a reason for sporadic cases in the immunization era
- B. Immunization abolishes carrier state
- C. Antibiotic prophylaxis is not indicated for asymptomatic case contacts who are not carriers (negative cultures)
- D. Asymptomatic case contacts who are carriers should be administered antibiotic prophylaxis and antitoxin
Correct Answer: A
Rationale: Falling immunity levels in adults contribute to sporadic cases of diphtheria even in the immunization era.
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All of the following are true regarding attention deficit hyperactivity disorder (ADHD), except
- A. Dopamine transporter gene (DAT1) and dopamine 4 receptor gene (DRD4) are implicated in the diagnosis
- B. Impaired fine motor movement and poor coordination are 'soft' but specific signs of ADHD
- C. Developmentally inappropriate behavior must commence before 7 years of age and present for at least 6 months
- D. Maternal lead exposure is associated with ADHD
Correct Answer: B
Rationale: Impaired fine motor movement and poor coordination are not specific signs of ADHD; they are nonspecific and can occur in other conditions.
Complications of long-term TPN administration are:
- A. Selenium deficiency
- B. Abnormal liver function tests
- C. Osteopaenia
- D. Renal failure
Correct Answer: A
Rationale: Selenium deficiency is a known complication of long-term total parenteral nutrition (TPN) due to inadequate trace element supplementation.
Regarding mitral valve prolapse, all the following are true EXCEPT
- A. it is predominantly in girls
- B. it is usually sporadic
- C. the dominant abnormal signs are auscultatory
- D. antibiotic prophylaxis is recommended during surgery and dental procedures
Correct Answer: D
Rationale: Antibiotic prophylaxis is no longer universally recommended for mitral valve prolapse.
Possible causes of upper airway obstruction are:
- A. Inhaled foreign body in the main bronchus on the right side
- B. Epiglottitis
- C. Retropharyngeal abscess
- D. Viral croup
Correct Answer: B
Rationale: Epiglottitis is a serious condition that can cause acute upper airway obstruction due to swelling of the epiglottis.
In a patient with painful joint swelling the following investigations are diagnostic:
- A. C-reactive protein
- B. Antinuclear antibodies
- C. Serum C3 (complement) levels
- D. Microscopic examination of synovial fluid
Correct Answer: D
Rationale: Microscopic examination of synovial fluid can reveal crystals, infection, or inflammation, providing a definitive diagnosis.