1F Fixed Dilated Pupils Confirm the Presence of Brain Death

1F Fixed dilated pupils confirm the presence of brain death

2T High levels of wild-type p53 protein promote apoptosis

3T Bone pain complicating cancer may be reduced by non-steroidal anti-

inflammatory drugs

4T In screening programmes, the predictive value of a positive test varies with the prevalence of the disease

5F All social classes have the same incidence of anorexia nervosa

6F Neutrophil polymorphonuclear leucocytes are the main source of IgA

7F If a drug has a low therapeutic index, it implies that the drug is of little therapeutic use

8T In untreated diabetes mellitus there is an increased sodium excretion by the kidney

9F Fibroadenoma of the breast is a premalignant condition

10F Acne is often caused by eating chocolate

11F Given: The incidence of atopic eczema is increasing in the United

Kingdom

Question: This is due to the hole in the ozone layer

12T The most common form of psoriatic nail disease is pitting

13F Alopecia areata is caused by infection with Microsporum spp

14T Erythromycin is an appropriate antibiotic for use in cases of severe diarrhoea due to Campylobacter jejuni

15T Clarithromycin is an appropriate antibiotic for use in cases of suspected atypical pneumonia

16T The RNA tumour viruses are retroviruses

17F Ethanol is a good conductor of electricity

18T Malignant hypercalcaemia causes cardiac dysrhythmias

19F The sensitivity of a diagnostic test is the number of patients who have the disease expressed as a percentage of those who are positive to the test

20T The incidence of a disease describes the rate at which new cases arise in a population

21T Only a minority of patients complete their opening statement before being interrupted by the doctor

22F If non-verbal messages contradict verbal statements, more patients take more notice of the verbal cue

23T Most patients prefer doctors who make more eye contact

24T Smoking is associated with oesophageal cancer

25T Most low grade lymphomas initially respond well to treatment

26T Chronic granulocytic leukaemia causes anaemia

27F Megaloblastic erythropoiesis produces a microcytic anaemia

28F Myeloma is a disease of myocytes

29F Reed-Sternberg cells are diagnostic of B-cell lymphoma

30F Pain in the chest caused by coronary heart disease is usually relieved by sitting forward

31T Pulmonary aspiration more commonly affects the right lung

32F Peak expiratory flow rate is the best test of the severity of an exacerbation of chronic obstructive pulmonary disease

33F Chronic obstructive pulmonary disease is rare cause of disability in old age

34T The chest radiograph is usually normal in acute pulmonary embolism

35F In a patient with acute severe asthma, the disappearance of rhonchi after treatment is a reassuring sign

36T Small intestinal tuberculosis can occur after vaccination with BCG

37F β-blockers should not be given to patients with heart failure

38F After a myocardial infarct, a statin should be prescribed if the total plasma cholesterol is 5mmol/l

39F Amoxycillin is an appropriate treatment for sore throat

40T Asthma is the commonest chronic childhood disease seen in general practice

41T Painful swallowing can suggest oesophageal candidiasis

42T The term ectopic ACTH syndrome refers to tumours outside the pituitary which secrete ACTH-related peptides

43T There is a greater incidence of major congenital malformations in

the offspring of mothers with diabetes mellitus, compared with other

mothers

44T GIVEN A 42 year old Ethiopian refugee in the United Kingdom has

tuberculosis

QUESTION Quadruple therapy should be used, pending the results of susceptibility testing

45T Shingles in a patient known to be infected with HIV commonly heralds

the onset of AIDS

46F Vitamin B12 is likely to be necessary for the treatment of anaemia arising after pregnancy

47T The blood in glandular fever characteristically contains atypical lymphocytes

48F Haemophilus influenzae type A is the commonest cause of post-influenzal pneumonia

49F In the management of severe acute asthma, it is appropriate to provide treatment with 24% oxygen

50F Children who are homozygous for sickle cell disease are usually symptomatic in early infancy

51T The main role for radiotherapy in carcinoma of the bronchus is palliative

52F Abdominal aortic aneurysm often presents with symptoms of peripheral embolism

53F The murmur of aortic incompetence is best heard using the bell of the stethoscope

54T The incubation period of influenza is less than one week

55T The presence of carious teeth can compromise the success of cardiac surgery

56F In cardiac arrest, sodium bicarbonate can be given via an endotracheal tube

57F GIVEN You are treating a patient with pulseless electrical activity (electromechanical dissociation) of the heart, and you are trying to initiate cardiac output

QUESTION Calcium gluconate is the drug of choice

58F GIVEN An unconscious 60 year old man is brought into the Accident and Emergency Department

QUESTION Cardiac output should be assessed by feeling the radial pulse

59T Pleural biopsy is the best method of diagnosing pleural tuberculosis

60F Pleural effusions rarely cause breathlessness

61F Systemic arterial blood oxygen is reduced by a left to right shunt through a ventricular septal defect

62T The majority of people in employment who survive a heart attack subsequently return to work

63F After haemorrhage, fluid tends to move from the intravascular compartment into the interstitial compartment

64T Frusemide causes a reduction in renal medullary interstitial fluid osmolality

65T Captopril inhibits the conversion of angiotensin I to angiotensin II

66T Renal artery stenosis can lead to systemic hypertension

67F Most of the blood flow into the ventricles occurs during atrial contraction

68F Fibrinogen is converted to fibrin by the action of prothrombin

69T The oxygen affinity of haemoglobin is decreased by a fall in blood pH

70T The viscosity of blood is reduced when the red blood cell count is low

71F In the United Kingdom, in the under-25 year old age group, more men smoke than women

72F Twelve months after completing a smoking cessation programme, about 30 to 40% of participants still abstain from smoking

73T Cefuroxime is a standard treatment of acute exacerbations of chronic bronchitis in patients requiring hospital care

74T Chronic bronchitis is associated with hypersecretion of mucus

75T When systemic arterial hypoxia occurs in asthma, this is due to impaired distribution of inspired air within the lungs, rather than to inadequate total ventilation

76T Destruction of the walls between adjacent pulmonary alveoli occurs in emphysema

77T Asbestos exposure is a risk factor for bronchial carcinoma

78T Inflammation containing granulomas may be a feature of tissue reaction to a foreign body

79T Causes of a pleural effusion with a protein content of 50g/l include pneumonia

80T Dizziness associated with aortic stenosis occurs on exertion

81F Chronic joint deformities complicate rheumatic fever

82F Oedema of the foot is a useful sign in making a diagnosis of acute

deep vein thrombosis of the leg

83T Stones in the common bile duct may cause acute pancreatitis

84T Haematuria may follow urinary catheterisation

85T Constipation is a common cause of abdominal pain in childhood

86T Abdominal pain temporarily relieved by defecation is characteristic of the irritable bowel syndrome

87F β-blockers are nephrotoxic

88T Crohn’s disease is associated with anal fissure

89F Secondary hyperparathyroidism is a cause of hypercalcaemia

90F The duodenum is entirely retroperitoneal

91T Workers in the dye industry have an increased risk of bladder cancer

92F Hepatitis C virus infection can be diagnosed using liver enzyme estimations

93F The majority of dietary iron is absorbed

94T It is the statutory responsibility of all medical practitioners to notify a new case of hepatitis B

95T Oedema can be a consequence of increased tissue oncotic pressure

96T A goitre may increase in size after carbimazole therapy

97T Ageing is associated with impaired glucose tolerance

98T Adverse effects associated with the long-term use of glucocorticosteroid drugs include muscle wasting

99T Hormonal manipulation is a recognised treatment in papillary carcinoma of the thyroid

100T In the absence of antidiuretic hormone, urine output may exceed 10 litres in each 24 hours

101F In the United Kingdom, the recommended upper limit of alcohol consumption for a young adult woman is 7 units per week

102T Glomerular filtration rate increases when renal afferent arterioles dilate, provided the efferent arterioles do not also dilate

103T Prolonged complete obstruction to the flow of bile into the duodenum will result in increased loss of fat in the faeces

104F Mature hepatocytes are not able to divide

105F The synthesis of thyroxine involves the iodination of phenylalanine

106T Peer influence is a recognised factor in the management of diabetes mellitus in adolescents

107F The principal action of glibencamide is to stimulate glucose uptake by muscle cells

108F Infection with Clostridium difficile can be significantly reduced if routine hygienic methods are rigorously maintained

109F After a myocardial infarct, a statin should be prescribed if the total plasma cholesterol is 5mmol/l

110T Lack of insight is a common feature of schizophrenia

111T Abnormal illness behaviour is a major feature of somatisation disorder

112T Temazepam increases the risk of falls in the elderly

113F Thought broadcasting is a symptom of depressive illness

114F Selective serotonin reuptake inhibitors are more sedative than tricyclic

antidepressants

115T Old age is associated with an increased suicide risk

116F Dupuytren’s contracture results in shortening of the flexor tendon of the ring finger

117F A hyphema is bleeding into the vitreous humour

118F It is inappropriate to offer tetanus immunisation to patients with full

thickness burns

119F Patients with lung carcinoma should undergo thoracic magnetic resonance imaging to establish the extent of disease.

120T It is unsafe to perform magnetic resonance imaging on patients with cardiac pacemakers

121F The median nerve mediates sensation to the back of the hand

122F The most commonly fractured carpal bone is the hamate bone

123T Malignant spinal cord compression typically produces a sensory level

124F Given: A man breaks his leg in a road traffic accident. Two days later, ipsilateral foot drop is noted

Question: Damage to the tibial nerve has probably occurred

125F A majority of patients with Alzheimer’s disease will show a clinically significant response to antidementia drugs

126T The duration of action of intravenous naloxone is approximately 30 minutes

127F An elevated titre of antinuclear antibody is highly specific for systemic lupus erythematosus

128F Haloperidol rarely causes extrapyramidal side effects

129F Most people having a schizophrenic relapse require compulsory admission to hospital

130F Dopamine agonists are used to treat schizophrenia

131T Benzodiazepine hypnotics reduce the proportion of sleep spent in a slow wave phase

132T Septic arthritis of the hip can result in permanent deformity due to avascular necrosis

133T Mobilisation is nearly always better than bed rest for patients with simple back pain

134F Psoriatic arthritis does not involve the sacroiliac joints

135F Given: A patient presents with a knee effusion

Question: A normal knee x-ray excludes rheumatoid arthritis

136T Cannabis abuse greatly increases the risk of relapse in schizophrenia

137F Given: A 55 year old woman has no significant past medical history. She presents with epileptic fits of recent onset. On fundoscopy, her optic discs are normal

Question: It is unlikely she has a brain tumour

138T Dizziness is a consequence of postural hypotension

139T Cholesterol is a biochemical precursor of aldosterone

140T Paget’s disease may affect membranous bones

141T Extracapsular femoral neck fractures are usually treated with a dynamic hip screw

142F The diaphragm is innervated by the second, third and fourth thoracic spinal segments.

143F General medical practitioners have little to contribute to the management of psychotic illnesses

144T Optic neuritis in multiple sclerosis is usually unilateral

145F Antidepressants should be continued at full dose for at least one year after recovery from a first episode of depression

146T For chronic disorders, the prevalence always exceeds the incidence

147T People with an anxiety disorder are at greater risk of alcohol dependency syndrome than those without an anxiety disorder

148F It is safe to detoxify alcoholics with a past history of delirium tremens as outpatients

149T Panic disorder may respond to antidepressant therapy

150F Marked weight loss in depressed patients should only be medically investigated in the absence of poor appetite

151F Depression has its highest prevalence in the middle social class

152F Electroconvulsive therapy is dangerous in patients aged over 65 years of age and should only be used as a last resort

153F Liver function tests are abnormal in about 40% of people with alcohol dependency syndrome

154T Dysphagia is a common complication of stroke

155F In dementia, the mental changes are limited to memory disorder

156T Bone is a common site for metastasis of breast cancer

157T Scoliosis can be successfully corrected by surgery

158F Tendons heal rapidly after sports injuries

159F In the initial treatment of migraine, sumatriptan is the drug of first choice

160F Given: A holder of a driving licence becomes profoundly deaf

Question: He must notify the Driving and Vehicle Licensing Authority

161T Computed tomography of the head is indicated in any patient with head injury and persistent altered consciousness level

162F Computed tomography must be performed prior to lumbar puncture in suspected meningitis

163F The headache of raised intracranial pressure tends to occur in the later part of the day

164T Paralysis of the left third cranial nerve causes ptosis on the left

165T Ankylosing spondylitis is less common in Negroes than in Caucasians

166T Vomiting may relieve the headache of raised intracranial pressure

167F Given: A 40 year old female has bilateral shoulder pain and stiffness, worse in the morning

Question: Polmyalgia rheumatica is a likely diagnosis

168F If septic arthritis is suspected, treatment should await results of synovial fluid culture

169F Ankylosing spondylitis is characterised by back pain, which is least

severe on waking and made worse by exercise

170T Autism is associated with tuberous sclerosis

171F Streptococcus pneumoniae is the commonest cause of bacterial pneumonia in adolescence

172F Suicidal thinking does not occur in children aged less than 14 years of age

173T A child is expected to be able to build a tower of five or six bricks by two years of age