AMC recalls

MCQ QUESTIONS MAY 2006

1.Photo: Dark discolouration on the side of the nose.After excision report shows it as a Nodular malignant malanoma.WOF is next Mx- (Antho-397 picture on the Sole)
a.Observe
b. Do nothing
c. Wider local excision
d. Radiotherapy
e. Excision

2.Photo:A child with rash on the buttocks and legs .Both ankles swollen and tender, also abdominal pain,but no fever. No neck stiffness.WOF is most common major complication- (Dx:HS purpura ;AMC-286)
a.Nephritis

3.Photo: One X-ray and one Mammogram of Breast (Anthology-104).Dx:
a.Breast Cyst

4.Photo:Lipoma on the neck of a man.H/O soft swelling present for last 3 yrs, never had any trouble for that swelling.But now he came to you for your opinion.WOF you will do-
a.Reassure, nothing need to do ( Anthology-399)
b.Refer for specialist opinion
c. FNAC

5.Photo:X-ray chest of a 8 months old infant with opacity in Rt lower zone and pneumatoceles(Staph. Pneumonia).Rx- (AMC: Fig-119)
I/V Flucloxacillin

6.Photo: Psoriasis in the forearm ( Anthology Book-buttock).WOF is your Rx-
a.Topical steroids (Antho-410)
b.Erythromycinc.
Intralesional Steroids

7.Photo:Eye and dilated pupil.Man came to you with h/o pain in the eye, also has headache and vomiting.Mx-
a.Tropical Acetazolamide
b.Patch the eye to look for FB
cAtropine eye dropsd.
Topical Pilocarpine

8.Photo: A growth in the palm;developed over 2 weeks in a manual labour.Dx-
Pyogenic granuloma (Anthology-398)

9.Photo: A man came with a soft swelling in groin for last 2 years.It is soft, slowly growing over inguinal ligament & lateral to pubic tubercle.WOF is your Dx-
a. Lipoma
b. Inguinal Hernia (May-2005)
c. Femoral Hernia

10.Photo: X-ray chest of a 9 months old infant as shown in AMC book(page-119). What is the Dx?
Staph. Pneumonia( But most common in this age group is Streptococcus pneumonia)

11.Photo: CT Scan. A lady complains that she feels her left side of body she feels heavy. She also has paralysis & weakness of left side. WOF is your Dx-
a. Cerebral Tumour
b. Cerebral Haemorrhage
c. Cerebral Infarction
d. SAH

12.ECG: Wide QRS complex and tall T wave-
a.Hyperkalaemia
b.Hypokalaemia
c.Hyponatremia

13.ECG : Inferior Infarction

14.ECG: Ventricular Fibrillation

15.ECG:Vetricular Ectopic

16.ECG: WPW Syndrome.What is the Rx-
a.Surgical ablation of the extra circuit
b. Radiofrequency ablation of the abnormal tract

17.A pt. present with ptosis of left eye, left side sensory loss of face. Left side gag reflex was absent, Rt. Sided hemiparesis and incoordination of Rt. Upper and lower limb.Where is the lesion?
a.Middle Cerebral Artery
b.Internal Carotid Artery
c. Vertebral Artery
d. Multiple Sclerosis
e.Post. Cerebral Artery

18.A baby has jaundice just after delivery. Mother is Rh -ve, baby also Rh -ve. Coomb’s Test is -ve.What may be the Dx?
a.Autoimmune condition
b.ABO incompatibility
c.Rh incompatibility

19.Apparent shortening due to severe osteoarthritis of the hip is due to:
a.Fixed adduction
b.Fixed flexion
c.Degeneration of head of femur

20.Median nerve injury above the wrist.WOF is true-
paralysis of abductor pollicis brevis with inability to abduct the thumb(LOAF)

21.In pt. with pancreatitis for purpose of statistical studies ,AOF are useful EXCEPT-
a.Case control
b.Cohort
c.Case report/case study-(one study)
d.Double blind study
e.Systemic review

22. What a 3 yrs. Old can do?
a.Draw a man with 6 parts
b.Hop on one foot
c.Climb stairs
d.Name four colours

23.AOF are used in BISHOP Score , Except-a.Cervical lengthb.Cervical dilatationc.Position relation to ischial spined.Moulding of the heade.Cervical effacement
24.WOF is X linked Recessive?Haemophilia .
25.WOF is a feature of Parkinsonism-a..Loss of postural reflexb.Hyperreflexiac.Hypotoniad Wide based gait.
26.WOF is not a feature of Lacunar Infarct?a.Fascicultionb.Spasticityc.Face weakness(sensory loss of face)d.Difficulty in walkinge.Increase Reflexes
27.A patient who was previously well comes to you with complains of weakness for last 2 weeks, his reflexes in lower limbs are absent though in upper limbs are normal.What will be the CSF findings-a.Elevated protein, elevated glucose, elevated leucocytesb.Elevated protein, normal glucose,leucocytes< title="protein" href="http://livedr.org/tag/protein/" target="_blank">protein,normal glucose, leucocytes>5mld.No ignificant abnormality
28.Child with her mother in a Supermarket picked a packet of Baloon.His mum snatched it & kept in place.The child started crying and at one stage he became unconscious but regain consciousness within 45 seconds.WOF may be the cause-a.Petitmal epilepsyb.Infantile spasmc. Breath holding attackd.Complex partial seizuree.Grand mal seizure
29. All of the following are feature of ROSS RIVER, Except-a.Chest painb.Muscle pain Davidson-107c.Feverd.Lathergye.Arthralgia
30.A man came to a country hospital in East Timor because of sudden onset of vomiting and headache after a Motor Vehicle Accident(MVA).He was conscious at the time of admission.There was no visuable major injury,so he was sent home after observation.But 3 days later he became unconscious and O/E there was unilateral fixed dilated pupil,BP-increased, Pulse-decreased.He was taken to a tertiary hospital in Dili.Which will be the immediate Mx-a.X-ray of the skullb.Immediate Bur hole of the Skull (Rx of Extra Dural Haematoma)c.Anti oedema measures [Investigation: CT Scan]d.Carotid angiogram
31.Tennis elbow,cause is-Overstretch of the common extensor tendons origin at elbow
32.A pt. complains of severe pain on pressing on nail of thumb.WOF is most likely the cause-a.Fibrosarcomab.Osteosarcomac.Glomus tumour
33.WOF is compatible with severe illness:a.Increased cortisol, increased THS Dav-552b.Both cortisone and THs decreased- (Sehan synd.)c.Increased cortisol, decreased THS(Cushing Synd.+Hyperthyroidism- worst combination )d.Decreased cortisol, increased THSe.Normal cortisol, increased THS34.WOF drugs have strongest negative ionotropic action:a.Digoxinb.Dopaminec.Adenosined.Deltiazem35. Six month old infant was brought by his parents.Had funnyturns, sudden flexion of upper and lower limbs for one week.Previously had coryzal illness.Now child not responding like previously.Dx-Infantile spasm36.On 10th day after appendectomy apatient presents with diarrhoea with fever and difficulty in passing urine, what is the most likely cause?Pelvic abscess37.In Haemochromatosis, WOF will suggest diagnosis?a.Serum Feb.Serum Ferritinc.Iron daturationd.Serum transferrin38.Mother came with her 3 month old baby,she told you that her baby cries a lot at evening time.Mother wants to know does the baby cry when he becomes hungry or any other cause, and what she needs to do when her baby cries.Reassure the mother
39. After screening with faecal blood test WOF is the correct percentage of detection of Duke A1 colonic carcinoma: Scott-323a.<3%b.15% title="muscle" href="http://livedr.org/tag/muscle/" target="_blank">muscle weakness.
41.You are called to solve a problem between a nurse and a psychiatric patient. On your arrival the pt. told you that he should be allowed to remove his I/V line as he has private insurance & you being a doctor would understand this, because you would also have private insurance,and as a doctor you would not like these nurses those who has no private insurance.What is the appropriate Dx of this case? (Compare Q.17/Oct.,04 & Q.9/May’2000)a.Regressionb.Splittingc.Projectiond.Deniale.Suppression
42.A 56 yrs old man has h/o melanoma.He is suffering from depression and now he behaves very percusly.He doesn’t believe he has any depression or needs any treatment.What is your Dx?a.Relapse of depressionb. Psychotic depressionc.Effects of melanoma.43.A 3 yrs old child came with her mother.The child has been suffering an attack usually once in a month.The attack lasts for 2-3 minutes and during the attack she is seen in spinning.She does not loose conscious during that, but feels frightened & runs to her mother’s lap for comfort.WOF is your Dx:a.Minor form of epilepsyb. Benign positional vertigoc.partial complexe seizure44. A 40 yrs old man comes with short history of malaise and cachaxia when he was on a short trip to Bangkok.His wife thinks he is suffering from jaundice.Now he presents with fever and chills.Blood tests shows: S. Bilirubin- increased, Alk Phos- Much increased, AST-Slightly increased, ALT- Slightly increased.What is the Dx?a.Viral Hepatitisb.Cholengitisc.Malaria45.A lady comes to you with low BP(100/65), Pulse 120/minute.She complains of pigmentation specially around her breasts.WOF is your Dx:a. SIADHb. Addison’s diseasec. Hyperaldosteronism(In Oct.’05 : Pt. presents with lathergy, mucous membrane pigmentation and K+ : increased, Na+:123 mmol/L(decreased)’BP- low and low glucose)
46.A 54 yr old man has CRF, his MCV is 80-90.It falls even more after treatment with Erythropoietin;when the therapy was stopped he becomes anaemic within two months.His condition is due to-a.Fe def. Anaemiab. Vit B12 def.c.Folic acid def.d.Bone marrow fibrosise.Red Cell atypia47. An old man suffering from cancer.Surgeon says that the man has no chance to survive whether gone for a operation or not.Surgeon’s opinion is to send him home for rest of his life to live with his family.But you feel that the pt. deserves every chance to be operated.Your duty to explain the situation to the daughter of the patient.What will you do?a.You should say that though the surgeon does n’t want to go for a operation ,but you feel operation should be done.b. Family should make an independent decision.c.Request them to get him operated.d.Put on your view aside and tell her the Surgeon’s opinion
48.WOF is not a feature of ischaemic ulcer?a. Ulcer on the medial sideb.Ulcer on the great toe49. WOF is not a feature of Bulimia Nervosa?a. Amenoroheab. Dental decayc. Swollen tonsilsd. Hirsutism50.A 62 yr old man presents with tiredness ,weight loss,anemia and fatigability. What is the Ix you will do first?a.Barium meal Oct.’92b.Sigmoidoscopyc.Colonoscopyd.Fecal occult blood test51.A patient has hammered his nail and came to you with Subungual haematoma under his nail.WOF is your Mx-a.Oral Trebinafineb.Oral Griseoflvin OHCS-738c.Remove the naild.Expressing the blood through a hole trephined in the nail52. A 11 yr old boy has difficulty climbing stairs and walking & running.O/E there is weakness of both legs and loss of reflexes.All other exminations are normal.WOF investigations will confirm the Dx?a.CSF analysisb.Forced vital capacityc.MRId.Nerve conduction studye.X-ray53. An infant presents with a typical crowing noise on inspiration.The noise is more noticeable on crying.There is no cough.WOF is the Dx-a.Croupb. Laryngomalacia ( Forrest-596 OHCS-558)c.Bronchiolitis54. A 43 yr old man came to your surgery as he is worried about his chances of getting of colon cancer.He told you that his father and elder brother had died of colon cancer. What you will advice him?a.Sigmoidoscopyb.Colonoscopy55. Q. on repeated abortion.A female with H/O 2 abortion.56.At what level OCP works?a.Cervixb. Hypothalamusc.Uterus57.Anti D immunisation.WOF is true-a. Not required in B-ve babyb. To be useful must be given within 24 hours of delivery of the babyc. If given during second trimester can reduce the risk of autoimmunizationd. Is not required if there is associated ABO incompatibilitye. Is an active immunization58.You are called to see a psychotic patient.On your arrival you see a tall built strong man threatening with a riffle to shoot anyone who approaches him.You should-a.Command him to surrenderb.Subdue the pt. and snap the rifflec.Call the Police informing the situation59.A 5 yr old boy brought by his parents who is suffering from delayed development of speech after a period of normal development.O/E he avoids eye contact.Parents give h/o his unusual love for a toy Turtle.WOF is most probable Dx-a.Autismb.ADHDc.Deafness60. Parents of a 6 yr old boy complain that their son is overactive, not cooperative enough with other children at kindergarten, also of destructive behaviour.But when kept alone, was found to be playing happily with toys and other children.WOF is correct-a.It is a normal variantb.ADHDc.Autismd.Poor parenting61.WOF is true about ADHD-a.Children has reading disabilityb.The child responds to cognitive therapyc.They responds very well to behavioural therapyd.Commonly seen in pre-school age (5-7 yrs)
62. WOF is associated with ASD-a.Diastolic murmurb.Wide fixed split S263. A 34 yr old lady complains of weight loss.She says that she has lost interest in day to day activities, and she feels hot.Her husband says that her wife has become moody & irritable.Her conditions most probably due to-a.Hypoythyroidismb.Hyperthyroidism64.Supra condylar fracture of Humerus:structure most likely to be damaged-a.Radial nerveb.Brachial arteryc.Median nerve65.A 33 yr old man came in ER with H/O 3 days vomiting followed by mid abdominal pain.O/E abdomen is rigid, distended absent bowel sound on auscultation.Plain X-ray shows multiple air fluid level.WOF is the appropriate fluid therapy for the patient:a.2000ml of dextrose in 4.5% NaCl preoperativelyb.2000 ml of Hartmann’s solution preoperativelyc.2000ml of Hartmann’s solution during the operation
66.What is true about SCOLIOSIS ?Congenital and more common among girls than boys .
67.A 22 yr old football player during a game fell down in awkward position, and developed pain and rapidly increasing swelling of the knee. Anterior, posterior and lateral X-rays are normal.WOF injuries you expect to find-a.Tear of Medial Meniscusb.Rupture of Anterior Cruciate Ligament
68.Leg ulcer due to peripheral neuropathy commonly located in-a.Medial malleolusb.Sole of the foot
70.Treatment of Alcohol withdrawl hallucination-a.Diazepamb.Halloperidol71. Keratoacanthoma,WOF is true-Fast growing tumour with spontaneous resolution72. “Ecstasy” is very popular in Australia, commonly used by youngs; its properties are similar to-a.Cocaineb.LSDc.Methamphetaminesd.Diazepam73.A patient came with weakness in extension of hand and of pronation.O/E there is no wasting of hand muscles. Flexion normal, Biceps and Triceps reflexes also normal,No Brachioradialis jerk.Where is the lesion?a.Median nerve July-2005b.Radial nervec.Ulner nerved.Nerve to Postrior Interoseuse.Nerve to Anterior Interoseus74. What is the priority in a Motor Vehicle Accident(MVA):a.Stop bleedingb. Clear the airway @ A-B-Cc.Shine a torch in the pupils75. The time of ovulation is accurately diagnosed by WOF?a.Serial LH surgeb.Urinary LHc.Regular basal body temp.d.Estimation of progesteronein mid luteal phase
76.Treatment of Trigeminal Neuralgia-Carbamezepine
77.Function of Adductor Pollicis is lost.Which nerve is affected?a. Median nerveb. Radial nervec. Ulner nerve
78. Feature of Temporal Arteritis: Patient with loss of vision which lasted for few minutes.WOF is correct?a.Temporal arteritisb.Lacuner infarctc. Carotid artery stenosis79.A 38 yr old lady with dull contineous headache, could not do her daily work.Most appropriate Ix-a.ESRb.USGc.CT Scan80. A 35 yr old lady came to ED with twitching of fingers.Investigations done;CT normal.Reassuranca given.But after few days she came back again with twitching in hand again.Another CT & USG.Management:Give calcium because this is hypoglycaemia
81. Patient with ileal resection causing increased INR.WOF is correct-a.Non absorption of Vit. K (Normal INR 0.9-1.2)b.Bleeding disorder82.A patient with INR 2.1: An old man is on Warfarin and now he is discovered with a resectable colon cancer.Management:Stop Warfarin and start low dose Heparin; operate when INR is normal
83. A 29 yr old woman developed severe paroxysm of pain in check and lip lasting for about 15-20 minutes.There is loss of sensation in trigeminal nerve area.Most likely Dx-a.Tic dorulexb. Trigeminal neuralgiac.Multiple sclerosisd.Migraine without aura
84.A 18 yr old girl comes to you for your advice regarding Contraceptives as she is going to start her sexual relationship.WOF you will prescribe:a. OCPb.IUCDc.Condomd. Low dose progesterone85.WOF doesn’t produce keratotic scale?a. Basal cell carcinomab.Squamous cell carcinomac.Pityriasis versicolord.Keratoacanthomae.Psoriasis86.Hutchison’s Melanotic Freckle,WOF is not correct?a.Mainly occurs in the covered parts of bodyb.Irregular borderc.Malignantd.Mostly occurs in the elderly87. Q. on Submandibular Gland:Still to be recalled
88.A mother complains of her 10 months old baby who wakes up during night many times.The baby is otherwise healthy and gaining weight properly.The mother is worried about this.what is the Mx-a.Urine cultureb.Give sedative to the babyc.Tell the mother to cuddle the baby when he cries 89. A 45 year old man has fainted.His BP is 90/50 and Pulse 110/min.Serum Na-115(low), urine Osmolality-655.Most likely diagnosis is:SIADH
90. A man presents with sudden onset of Horner’s syndrome, 9 & 10 nerves palsy and loss of touch and temperarure sensation on the opposite side of the body.Where is the site of lesion?a.Vertebrobasilar arteryb.Basilar arteryc.middle cerebral arteryd.Vertebral arterye.Carotid artery
91. A lady undergone surgery for gallstones.She developed fever and tachycardia after 6 hrs.Oral Cholangiogram was done; findindings were normal.Dx-a.Atelectesisb.Wound infectionc.Allergy to dye
92.A 63 yr old man presents with 3 days vomiting and has lost 3 kilos.Five years ago he was treated with cimetidine.Over the last two months he has epigastric pain and has been treated with aspirin.Vomitus is clear in colour with identifiable food paticles.The Dx is:a.Drug induced gastritisb.Chronic duodenal ulcerc.Cancer of duodenumd.Pyloric stenosise.Cancer of cardia
93. A 45 yr old lady complains of irregular menstrual bleeding.She has been treated for CIN-II previously and a Pap smear done 6 months ago was fond normal.WOF is the most appropriate investigation for her?a.Colposcopy Repeat: March’06b.USG to detect endometrial thicknessc.Cone biopsy (see the difference: Q-40/oct’04)d.Endometrial curettagee.Repeat Papsmear94. A labourer who is a heavy smoker find difficult to perform his duties and worried about his physical conditions.On examination there is ankle oedema, raised JVP, huge hepato-splenomegaly and ascitisWOF is likely- (May’05)a.Cirrhosisb.Costrictive pericarditis due to previous tuberculosisc.SVC obstructiond.Budd Chiari Syndrome95. A foot ball player while playing got injury in his Rt.Knee.The knee is locked.Dx: [Outline of fractures-224:Locking is common & importantTear of Medial Meniscus feature of torn medial meniscus.Knee suddenly gives way]
96.Two sisters are living together in a house.Elder sister thinks that their neighbours are trying to poison them with germs,so they have sealed their house.Younger sister believes what her sister says.But she is normal when she is away from her elder sister.This is an example of-a.de clerabault syndrome (Oct.-2004)b.Induced delusionc.Capgras syndromed.Folieodoux syndrome97. A 29 yr old lady comes to you with obesity, irregular cycles and hirsutism.What will help you to Dx her condition-a.Increased FSH : increased LHb.Incrased LH: increased FSH (Dx-Polycystic Ovarian Synd.)c.Increased Prolactine level98A 32 yr old primi in her 33 weeks of gestation informs you that her baby’s movement suddenly become decrease for the last 28 hrs.Before that her pregnancy was going normal without any problem.WOF would be your management to combat the concern:a.USG [October'03]b. Do Cardiotopography(CTG)c.Fetal Scalp pHd.Immediate delivery of the baby99. A 38 yr old primi of 39 weeks pregnancy admitted in Labour Unit with the onset of regular uterine contraction,her cervix is 8 cm dilated, fully effaced,station +1, initially fetal hear rate was 155 but after a while on the progress of labour fetal heart beats suddenly falls from 155 to 80 per minute; otherwise normal in respect of mother’s general condition.What would be your next step of Mx:a.Fetal scalp pHb.Cardiotopography (Oct.2003)c.Vaginal examination to exclude any cord prolapsed.Emergency delivery by C/Se.Percutaneous umbilical sampling100.A 57 yr old lady develops sudden onset of left sided weakness and right eye blindness.This is most likely due to-a.Vertebro-basilar insufficyb.Pituitary tumourc.Carotid artery stenosisd.Cerebellar lesione.Retinal detachment101.A girl lost her father 6 months ago.She can not get over it.She lost weight 10 kg.Most important thing you need to enquire about her:a.Eating pattern (May’05)b.Suicidal ideasc.Menstrual regularity102. Pleural Effusion: Typical presention.Stony dull on percussions,bronchial breath sound above the area, restricted movements on the affected side.
103.A patient presents with impaired sensation on medial aspect of the hand, 4th and 5th fingers of the hand are flexed.Where is the lesion?Ulner nerve at elbow104.A pt. was on warfarin, he developed haematemesis and melena.His INR is 10 times normal.WOF should be the management? (Sept.’05)a.Fresh plasma infusionb.I/V Fluidsc. Oral Vit-Kd.Transfuse bloode.Intra muscular Vit-K105.What is the best medication to give as Postcoital Contraception ?a.OCPb.Levonogestrol within 72 hrs,and second dose 12 hrs after the first one.
106.A lady recently married comes to you with vaginal infection(cystitis).This is 3rd episode.Most appropriate Ix-a.Vaginal swabb.Husband’s urethral swabc.Colposcopy107.A female comes to you for infertility.Her LH increased, FSH increased, Oestradiol -decreased.Rx:a.Clomiphen citrateb.Give her Oestrogen dailyc.IVF108.A young obese 24 yr old female with hirsutism, oligomenorrhoea and irregular periods, was found to have endometrial hyperplasia(benign)on curettage.AOF are appropriate treatments,Except-a.Progesterone from 14 to 21 day of each cycleb.Diane35c.Clomiphene citrated.OCPe.Oestrogen alone109.Pain in epigastrium which does not releifs by eating or any effort.Has no relation with food.Dx-Hiatus hernia110.Question on Basal cell carcinoma111.Rx of ADHD: Dexa amphetamine112.Management of Supracodyler # of Humerus(Anthology book)113.A boxer comes to the ED after a fight in which he was knocked out.His left pupil is dilated, but otherwise he is normal and he feels ok.WOF would you do-a.Give Manitolb.CT Scan of head
114.A man presents with pain over the L4 region.His X-ray shows multiple metastatic lesions in the spine.WOF investigations is most appropriate:a. Prostate specific antigenb. CT Scanc. MRI115.A young man comes to you with epigastric pain.His wife is pregnant and he is “on edge”.AOF would support you inference that he is an alcoholic,EXCEPT-a.Attempt to Cut down in the pastb.Anger on enquiry CAGE- 1.cut down 2.anger 3.guilty 4.eye openerc.Guilty about drinkingd.Eye opener (drink first thing in the morning)d. Two bottle of light beer/day
116. A 12 yr old boy presented with painless lump in the scrotum for the last 6 months.He is otherwise healthy grown up.What is the most likely Dx?a.Herniab.Seminomac.Encysted hydrocelc of the cordd.Saphena varixe.Haematocele117.A mother of a 4 yr old child noticed that there is a solid mass in the Rt. Loin area of her child which she noticed for the first time with occasional blood in urine.WOF is your initial Dx: OHCS-220a.Neuroblastoma Wilm’s tumour:Commonest intraabdominal tumour ofb.Wilms tumour childhood.Haematuria not common,but fever,flank pain c c.Hydronephrosis abdominal mass found. US-pelvicdisortion,hydronephrosisd.Plycystic kidney disease .118.Two months old child’s mother noticed a firm lump in her baby in the left side of upper abdomen while bathing.Child has bilateral periorbital ecchymosis.what is the most likely cause?a.Neuroblastoma May-2000b.Wilm’s tumour
119.Mother of a 3 year old child noticed a mass in the abdomen on the left side.AOF could be the cause,except-a.Hydronephrosis October’96b.Neuroblastomac.Nephroblastoma(Wilm’s tumour)d.Poly cystic kidneys-(Die before 1 year of age )e.Chr. constipation
120.In minimental examination WOF indicate severe outcome for the patient:a.Unable to recognize youb.Unable to recall own identity121. A 73 yr old woman presented with polymyalgia rheumatica.Most likely characteristic of this disorder-There are fatigue,fever and depression122.A baby with Down’s syndrome is born to a couple who definitely refuse to take the child home after failure to convince them.The most appropriate course of action:Arrange temporary foster care123.An 8 yr old girl presents with abdominal protusion,anaemia and tenderness.O/E there is a big irregular and mobile mass crossing the midline.Dx-NeuroblastomaDerived from sympathetic neuroblasts,most common solid tumour in children<5yr.likely title="male" href="http://livedr.org/tag/male/" target="_blank">male birth.125.All are autosomal recessive , Except-a.Neurofibroblastomab.Phenylketonuriac.Galactossemiad.Cystic fibrosise.Sickle cell anaemia126.After his baby sister was born, a 6 yr old boy began suck his thumb and wetting his bed, behaviour he had grown out of long before.This is an instance of-a. Regression127.A child has swollen joints and cries whenever the napkin is changed, irritable, ecchymoses and hyperplastic gums. WOF is Dx ?a.Ricketsb.Scurvy128.A multigravida presents at 37 weeks gestation, not in labour, with a breech presentation and ruptured membranes.What should you do initially?a.Immediately C/Sb.Vaginal examination129.A 23 yr old man limped into ED and stated that he was kicked in the post. Aspect of the leg during a game of foot ball.He experienced immediate sharp pain which subsided.O/E there is decreased planter flexion.What is the Dx-Rupture of achillis tendon130.Peritonsilar abscess(Quinsy): Caused by Streptococcus& Trismus seen.131.Zygomatic bone (maxillo facial) fractures characterized by-a. Involvement of infraorbital nerveb. Subconjuctival hge. with no definitive posterior limitc. Loss of senstion over canine & first premolarsd. Partial trismuse. All of the above132.In senile dementia WOF would be least likely to be lost(last to lose) :a.Memory for facesb.Memory fpr neighbourhoodc.Arithmetic memoryd.Language memory(vocabulary)e.Short term memory133.WOF is most likely to be damaged during carotid endarterectomy:a .Vagus nerveb.Hypoglossal nerve NMS-132c.Facial nerve ( 1.vagus 2.hypoglossal 3.Recurrent laryngeal 4.Marginal mandibular)d.Laryngeal nerve