xNET Medical Tools

Question 54

A 48-year old male is bitten by a neighbour's dog on the left leg during a provoked attack. The dog is up-to-date on all vaccinations including rabies vaccine. The patient has history of alcoholism and works as a civil servant. He has never sought medical care for any thing in the last 20 years. His physical examination is normal except of several puncture wounds on his left calf. The wounds are clean with minimal redness and tenderness. There's no warmth or swelling. Because of his risk```html

Question 51

Death resulting from side effects of opioid analgesics, used with the intent to treat severe dyspnea in a dying patient, is an example of:

a. Acceptable medical practice

b. Assisted suicide

c. Euthanasia

d. Murder

e. Unprofessional practice

Correct Answer: a. Acceptable medical practice

Explanation: Under the ethical concept known as the rule or doctrine of double effect, providing opioid analgesia or palliative sedation with the primary clinical intent to relieve severe refractory symptoms (such as intractable pain or dyspnea) in a terminally ill patient is standard, ethically sound medical practice—even if it carries a secondary, unintended risk of hastening death.

Question 52

A 30 year old female presents with an indurated, non-tender ulcer on the labia minora. Laboratory tests confirm the diagnosis of syphilis and she receives intramuscular injections of benzathine penicillin. Which of the following can be used to determine response to treatment?

a. Four-fold decrease in RPR titer

b. Negative Treponema pallidum hemagglutination assay test

c. Disappearance of the genital lesion

d. Two-fold decrease in RPR titer

e. Two-fold decrease in VDRL titer

Correct Answer: a. Four-fold decrease in RPR titer

Explanation: Non-treponemal antibody tests (such as RPR or VDRL) are used to monitor therapeutic efficacy following antitreponemal therapy. Successful treatment is defined as a four-fold (2-dilution) drop in non-treponemal titers (e.g., a decrease from 1:32 to 1:8) within 6 to 12 months. Specific treponemal tests (e.g., TPHA, FTA-ABS) usually remain reactive for life and cannot distinguish between past and active infection.

Question 53

Which of the following is not recommended in the treatment of dermatophyte infections?

a. Clotrimazole

b. Griseofulvin

c. Terbinafine

d. Tacrolimus

e. Miconazole

Correct Answer: d. Tacrolimus

Explanation: Dermatophytosis (ringworm, tinea infections) is managed with topical or oral antifungal medications like azoles (Clotrimazole, Miconazole), allylamines (Terbinafine), or Griseofulvin. Tacrolimus is a topical calcineurin inhibitor that acts as a localized immunosuppressive agent; applying it to active fungal skin infections exacerbates the underlying fungal proliferation and is contraindicated.

Question 55

A 50-year-old male presents to AMEU with a 3-day history of cough, fever, shortness of breath, and pleuritic chest pain. He works as a police officer and has been otherwise healthy. He was recently tested for HIV and his HIV test was negative. On examination, he is ill-appearing and diaphoretic. His temperature is 39.2 °C, respiratory rate is 30 breaths per minute and lung exam reveals bronchial breath sounds on the right side with dullness to percussion. Which of the following is a possible aetiology of his illness?[cite: 19]

a. Streptococcus bovis

b. Streptococcus mitis

c. Mycobacterium tuberculosis

d. Legionella pneumophila

e. Staphylococcus epidermidis

Correct Answer: d. Legionella pneumophila

Explanation: Legionella pneumophila is an important cause of atypical community-acquired pneumonia that can present severely with high fever (>39 °C), consolidation, and systemic toxicity[cite: 19]. The other organisms listed are commensals or associated with endocarditis/colon disease rather than primary lobar pneumonia[cite: 19].

Question 56

Pain that is described as "dull and achy" and is well localized, is best described as:[cite: 19]

a. Autonomic pain

b. Neuropathic pain

c. Somatic pain

d. Vascular pain

e. Visceral pain

Correct Answer: c. Somatic pain

Explanation: Deep somatic pain originates from structures such as bone, joints, muscle, and connective tissue, classically presenting as a dull, aching, or throbbing pain that is well-localized[cite: 19]. Visceral pain, by contrast, is typically vague, poorly localized, and crampy[cite: 19].

Question 57

The following are common presenting symptoms of cervical cancer except:[cite: 19]

a. Chronic cough

b. Post-coital bleeding

c. Abnormal vaginal discharge

d. Abnormal vaginal bleeding

e. Lower abdominal pains

Correct Answer: a. Chronic cough

Explanation: Classic symptoms of cervical cancer include contact/post-coital bleeding, intermenstrual or postmenopausal bleeding, malodorous vaginal discharge, and pelvic or lower abdominal pain in advanced stages[cite: 19]. Chronic cough is a respiratory symptom and is not a local presenting symptom of cervical malignancy (unless distant pulmonary metastasis is present)[cite: 19].

Question 58

A 72-year-old man presented with increasing fatigue and sleepiness over the previous week. He had a history of small cell lung cancer, which was in complete remission after combination chemotherapy. He had completed prophylactic cranial irradiation 10 days previously. Investigations:

Investigation	Result	Reference Range
Haemoglobin	91 g/L	130–180
White cell count	3.1 × 10⁹/L	4.0–11.0
Neutrophil count	1.6 × 10⁹/L	1.5–7.0
Platelet count	100 × 10⁹/L	150–400
Serum sodium	132 mmol/L	137–144
Serum corrected calcium	2.41 mmol/L	2.20–2.60

What is the most likely cause of his symptoms?

a. Adverse effect of radiotherapy

b. Anaemia

c. Brain metastases

d. Depression

e. Hyponatraemia

Correct Answer: a. Adverse effect of radiotherapy

Explanation: Somnolence syndrome (excessive fatigue, drowsiness, and lethargy) is a classic subacute adverse effect of whole-brain radiotherapy / prophylactic cranial irradiation (PCI) that typically manifests 1 to 12 weeks after completion of radiation therapy. While the lab values show mild anemia and borderline low sodium, these do not fully account for the profound new onset of somnolence following cranial irradiation.

Question 59

The salt of barium used in Barium studies is:

a. Ba carbonate

b. Ba sulphate

c. Ba sulphide

d. Ba chloride

e. None of the above

Correct Answer: b. Ba sulphate

Explanation: Barium sulphate (BaSO₄) is an extremely insoluble radiopaque salt used as a contrast medium for GI fluoroscopy and radiography (e.g., barium swallow, meal, or enema). Because of its near-zero solubility in water and gastric juice, it passes through the gastrointestinal tract without being absorbed, rendering it non-toxic compared to soluble barium salts.

Question 60

The following are tumor suppressor genes except?

a. VEGF-A gene

b. RB gene

c. P53 gene

d. All of the above

e. None of the above

Correct Answer: a. VEGF-A gene

Explanation: Vascular Endothelial Growth Factor A (VEGF-A) encodes a pro-angiogenic growth factor that stimulates new blood vessel formation to supply tumor growth, functioning as a pro-tumorigenic factor rather than a tumor suppressor. RB and TP53 are classic tumor suppressor genes that regulate the cell cycle and induce apoptosis or cell arrest upon DNA damage.

Question 61

Which modality is commonly used to differentiate a solid mass from the cystic one:

a. Thermography

b. Mammography

c. Ultrasound

d. MRI

e. None of the above

Correct Answer: c. Ultrasound

Explanation: Ultrasonography is the primary, real-time, non-invasive imaging technique used to distinguish fluid-filled cystic structures (which show anechoic centers with posterior acoustic enhancement) from solid tissue masses (which show internal echo patterns).

Question 62

A 35-year-old female presents to clinic 5 with 4-week history of fever, chills, weight loss, myalgias, and arthralgias. Her physical examination is significant for diastolic murmur in the second intercostal space. Which of the following is not a complication of the above condition?

a. Intracranial hemorrhage

b. Glomerulonephritis

c. Heart failure

d. Meningitis

e. All of the above

Correct Answer: e. All of the above

Explanation: The clinical presentation (subacute fever, constitutional symptoms, and a new regurgitant aortic murmur in the 2nd intercostal space) indicates subacute infective endocarditis. Recognized complications of infective endocarditis include heart failure (from valvular destruction), immune-complex glomerulonephritis, septic embolization causing meningitis, and mycotic aneurysm rupture causing intracranial hemorrhage. Since all options listed are recognized complications, option e ("All of the above [are complications]") is the intended answer to "Which of the following is NOT a complication?" in standard board-style options where options A–D are valid complications.

Question 63

Which of the following conditions can cause erythroderma?

a. Psoriasis

b. Drugs

Correct Answer: Both Psoriasis and Drugs (Partial Question View)

Explanation: Erythroderma (exfoliative dermatitis involving >90% of the body surface area) is most commonly precipitated by preexisting dermatoses (predominantly psoriasis and atopic dermatitis), adverse drug reactions, cutaneous T-cell lymphoma (Sézary syndrome), and idiopathic causes.

Question 63

Which of the following conditions can cause erythroderma?

a. Psoriasis

b. Drugs

c. Seborrheic dermatitis

d. Cutaneous T-cell lymphoma

e. All of the above

Correct Answer: e. All of the above

Explanation: Erythroderma (exfoliative dermatitis involving >90% of the skin surface) is a dermatologic emergency caused by underlying dermatoses (psoriasis, seborrheic dermatitis, atopic dermatitis), adverse drug reactions, and cutaneous malignancies (such as Cutaneous T-cell lymphoma / Sézary syndrome).

Question 64

The following are oncologic emergencies except?

a. Brain Cancer

b. Spinal cord compression

c. Tumour lysis syndrome

d. Superior vena cava syndrome

e. All of the above

Correct Answer: a. Brain Cancer

Explanation: Brain cancer itself is a histologic/anatomical diagnosis rather than an acute clinical emergency condition, whereas malignant spinal cord compression, tumor lysis syndrome, and superior vena cava (SVC) syndrome represent acute, life-threatening oncologic emergencies requiring immediate medical or surgical intervention.

Question 65

Radio-pharmaceutical used for scanning of spleen in:

a. 99mTc-DTPA

b. 99mTc-sulphur colloid

c. Cr labelled RBC

d. Gallium citrate

e. None of the above

Correct Answer: b. 99mTc-sulphur colloid

Explanation: Technetium-99m sulfur colloid is phagocytosed by the reticuloendothelial system (macrophages) in the liver, spleen, and bone marrow, making it the primary radiopharmaceutical agent used for reticuloendothelial spleen lymphoscintigraphy/imaging. (Heat-damaged ^99mTc-labeled RBCs are also used for selective splenic imaging, whereas ⁵¹Cr-labeled RBCs are used for red cell survival/sequestration studies).

Question 66

Neuronal damage in cerebral infarction is by promoting influx of:[cite: 18]

a. Sodium

b. Chloride

c. Selenium

d. Calcium

e. None of the above

Correct Answer: d. Calcium

Explanation: Ischemic brain injury leads to severe energy failure, membrane depolarization, and excessive extracellular release of glutamate[cite: 18]. Glutamate overstimulates NMDA and AMPA receptors, causing a massive intracellular influx of calcium ($Ca^{2+}$)[cite: 18]. This intracellular calcium overload activates apoptotic pathways, proteases, lipases, and free radicals, driving excitotoxic neuronal necrosis[cite: 18].

Question 67

The following are malignancies associated with HIV except?[cite: 18]

a. Lung cancer especially in smokers

b. KS

c. Cervical cancer

d. Lymphomas

e. All of the above

Correct Answer: a. Lung cancer especially in smokers

Explanation: Kaposi sarcoma (KS), invasive cervical cancer, and non-Hodgkin lymphomas (e.g., primary CNS lymphoma, DLBCL) are classic AIDS-defining malignancies caused by opportunistic viral co-infections (HHV-8, HPV, EBV)[cite: 18]. While lung cancer incidence is elevated in people living with HIV due to high smoking prevalence and chronic inflammation, it is a non-AIDS-defining cancer driven primarily by tobacco exposure rather than direct immunosuppression-induced oncogenic viruses[cite: 18].

Question 68

An 80 year old diabetic patient presents to the hospital with fever for 14 hours. She has neck pain and appears very ill and is febrile to touch. Which of the following correctly describes Brudzinski's sign?[cite: 18]

a. Neck flexion causes pain

b. Flexion of the hip and extending the knee elicits resistance

c. Pain with dorsiflexion of the foot

d. Inspiratory arrest with upper quadrant palpation

e. None of the above

Correct Answer: e. None of the above (or Option a. as marked in local exam key)

Explanation: Classic Brudzinski's neck sign is positive when passive forward flexion of the neck induces involuntary flexion of the hips and knees due to meningeal irritation[cite: 18]. Option B describes Kernig's sign (resistance/pain upon knee extension when hip is flexed at 90°)[cite: 18]. Option C describes Homan's sign (DVT), and Option D describes Murphy's sign (acute cholecystitis)[cite: 18]. While neck flexion causes meningeal pain/resistance in meningitis, the specific cardinal sign is reflexive hip/knee flexion[cite: 18].

Question 69

Which of the following statements best describes the difference between a Native fistula and a graft fistula or arteriovenous graft (AVG)?[cite: 19]

a. An arteriovenous graft (AVG) is created if the veins are too big to allow for the formation of a native fistula

b. In the creation of a graft fistula, an artificial tube (generally made of polytetrafluoroethylene, PTFE, GoretexR) is used to connect an artery and a vein

c. A graft fistula is less likely to become infected and/ or thrombose than is a native fistula

d. The longevity of a graft is usually for more than 10 years

e. None of the above

Correct Answer: b. In the creation of a graft fistula, an artificial tube (generally made of polytetrafluoroethylene, PTFE, GoretexR) is used to connect an artery and a vein[cite: 19]

Explanation: An arteriovenous graft (AVG) utilizes a synthetic conduit—most commonly polytetrafluoroethylene (PTFE)—to bridge a native artery and vein when suitable native autogenous veins are absent or inadequate[cite: 19]. Grafts have higher rates of infection and thrombosis and shorter patency lifespans compared to native arteriovenous fistulas (AVFs)[cite: 19].

Question 70

Zonal anatomy of the prostate is best visualized with:[cite: 19]

a. Transabdominal US

b. Endorectal US

c. CT

d. MRI

e. None of the above

Correct Answer: d. MRI[cite: 19]

Explanation: Multiparametric Magnetic Resonance Imaging (mpMRI) provides superior soft-tissue contrast resolution, making it the premier imaging modality for clearly delineating the zonal anatomy of the prostate gland (peripheral, transition, and central zones) and staging prostatic lesions[cite: 19].

Question 71

When discussing bad news over the telephone the first thing you should do is:[cite: 19]

a. Ask the person to describe their understanding of the medical issues.

b. Clarify who it is you are talking to—their relationship to the patient

c. Explain that you are calling with some bad news

d. Give a fair "warning shot" that you have bad news

e. Offer to contact another family member or friend

Correct Answer: b. Clarify who it is you are talking to—their relationship to the patient[cite: 19]

Explanation: Prior to disclosing any confidential patient health information or bad news over the phone, it is critical to confirm the identity of the person on the line, verify their relationship to the patient, and establish patient authorization/consent for information disclosure[cite: 19].

Question 72

A 28 year old male is admitted to the hospital for 3 weeks for treatment of a right femur after he was involved in road traffic accident. He develops sudden shortness of breath and you suspect pulmonary embolism. Which of the following tests would confirm the diagnosis of pulmonary embolism?[cite: 19]

a. High resolution CT of the chest without contrast

b. Sleep study

c. Chest x-ray

d. Helical chest CT scan angiography

e. Right heart catheterization

Correct Answer: d. Helical chest CT scan angiography[cite: 19]

Explanation: CT Pulmonary Angiography (CTPA) is the gold-standard diagnostic modality for acute pulmonary embolism, allowing direct non-invasive visualization of intravascular filling defects/thrombi within the pulmonary arterial tree[cite: 19].

Question 73

A 38 year old HIV-infected lady with a CD4 of 285 presents with biopsy-proven cutaneous Kaposi's Sarcoma (KS). She has 3 small (<2cm) cutaneous KS lesions. There is no oral involvement. Staging abdominal and chest CT reveal no visceral involvement. She is not taking any medications. Which of the following management options would be the most reasonable?[cite: 15]

a. Start antiviral therapy with valacyclovir and begin radiation therapy

b. Start highly active antiretroviral therapy (HAART); liquid nitrogen cryotherapy of the cutaneous lesions could also be offered for immediate cosmetic purposes

c. Start highly active antiretroviral therapy (HAART). Add systemic chemotherapy with doxorubicin after 2 weeks of antiretroviral therapy

d. Start localized cutaneous radiation therapy and add systemic chemotherapy with doxorubicin after 1 week of radiation therapy

e. None of the above

Correct Answer: b. Start highly active antiretroviral therapy (HAART); liquid nitrogen cryotherapy of the cutaneous lesions could also be offered for immediate cosmetic purposes[cite: 15]

Explanation: For mild, non-visceral, limited cutaneous HIV-associated Kaposi sarcoma (T0 stage), initiation of highly active antiretroviral therapy (HAART) alone is the primary disease-modifying treatment and often leads to regression of lesions as immune function recovers[cite: 15]. Local symptomatic or cosmetic treatment (e.g., liquid nitrogen cryotherapy, radiation, or intralesional therapy) can be added as adjunctive therapy[cite: 15]. Systemic chemotherapy (such as liposomal doxorubicin) is reserved for advanced/visceral disease (T1 stage)[cite: 15].

Question 74

You are reviewing results and find the following serology result:[cite: 15]

HBsAg - Negative
HBeAg - Negative
Anti-HBs - Positive
Anti-HBE - Negative
Anti-HBc – Negative

Which of the following has caused this pattern of results?[cite: 15]

a. Acute liver failure caused by hepatitis

b. Hepatitis B carrier status

c. Incubation of infection with hepatitis B

d. Recovery from infection with hepatitis B

e. Vaccination against hepatitis B

Correct Answer: e. Vaccination against hepatitis B[cite: 15]

Explanation: Isolated presence of anti-HBs antibodies in the absence of Hepatitis B surface antigen (HBsAg) and total core antibodies (Anti-HBc) is indicative of immunity secondary to Hepatitis B vaccination[cite: 15]. If immunity were due to natural recovery from infection, total Anti-HBc would also be positive[cite: 15].

Question 75

Which of the following is not true with regard to chronic plaque psoriasis?[cite: 16]

a. It is a result of increased epidermal turnover rate

b. It is characterized by erythematous plaques with silvery scales

c. It most commonly affects extensor surfaces of the elbows and knees

d. Both oral and topical corticosteroids can be used in treatment

e. Parakeratosis is seen on histopathology

Correct Answer: d. Both oral and topical corticosteroids can be used in treatment[cite: 16]

Explanation: Systemic (oral) corticosteroids are generally contraindicated in psoriasis because their withdrawal can trigger a life-threatening rebound flare or transformation into generalized pustular psoriasis[cite: 16]. Topical corticosteroids, however, remain a mainstay of local therapy[cite: 16]. The other statements correctly describe chronic plaque psoriasis (hyperproliferation/shortened turnover time, extensor distribution, silvery scale, and retained nuclei in the stratum corneum/parakeratosis)[cite: 16].

Question 76

In thrombosis of ________ artery the leg is weaker than the arm:[cite: 16]

a. Middle cerebral

b. Anterior cerebral

c. Posterior cerebral

d. Basilar

e. All the above

Correct Answer: b. Anterior cerebral[cite: 16]

Explanation: The anterior cerebral artery (ACA) supplies the medial aspect of the motor and sensory cortex representing the contralateral lower limb[cite: 16]. Therefore, occlusion or thrombosis of the ACA produces contralateral motor deficit and sensory loss affecting the leg and foot significantly more than the arm and face[cite: 16]. Conversely, middle cerebral artery (MCA) infarction predominantly affects the face and upper extremity[cite: 16].

Question 77

The following statements about Peritoneal dialysis are true except:[cite: 16]

a. The Dialysate is placed into the peritoneal cavity

b. The toxins from the splanchnic circulation are allowed to diffuse across the peritoneum (which acts as a natural semipermeable membrane) into the dialysate, which is discarded

c. Peritoneal dialysis requires a cuffed peritoneal dialysis catheter which is inserted into the peritoneal cavity either percutaneous or surgically, using a subcutaneous tunnel to the exit site

d. It generally takes about 10 weeks for the catheter to heal properly

e. None of the above

Correct Answer: d. It generally takes about 10 weeks for the catheter to heal properly[cite: 16]

Explanation: Peritoneal dialysis catheter exit sites typically heal within 2 to 4 weeks following surgical placement (with a standard break-in period of 2 weeks prior to starting full-volume continuous ambulatory peritoneal dialysis), making "10 weeks" incorrect[cite: 16].

Question 78

A 55-year-old man was referred to the outpatient clinic having been found to have microcytosis at a 'well-man' screen. He had history of blood in stool. Abdominal examination and digital examination of the rectum were normal. Investigations:[cite: 17]

Investigation	Result	Reference Range
Haemoglobin	132 g/L	130–180
MCV	76 fL	80–96
MCH	27 pg	28–32
white cell count	3.6 × 10⁹/L	4.0–11.0
platelet count	164 × 10⁹/L	150–400
serum ferritin	15 µg/L	15–300

What is the most appropriate next management step?[cite: 17]

a. Barium enema

b. Colonoscopy

c. Faecal occult blood testing

d. Flexible sigmoidoscopy

e. Small bowel enema

Correct Answer: b. Colonoscopy

Explanation: In a man over 50 years of age with microcytosis/borderline low ferritin and a history of gastrointestinal bleeding (blood in stool), evaluation for occult or overt GI malignancy is required[cite: 17]. Colonoscopy is the investigation of choice to visualize the entire large bowel and caecum, as flexible sigmoidoscopy leaves proximal/right-sided colonic lesions unexamined[cite: 17].

Question 79

A 55-year-old woman presented with a 4-week history of intermittent severe swelling affecting her face and tongue. Each episode lasted 1–2 days and slowly resolved spontaneously. Oral antihistamines were unhelpful. She had developed angina and had been found to have hypertension 6 months previously, and appropriate medication had gradually been introduced. She was otherwise well, with no relevant previous medical or family history. What medication is the most likely cause of her symptoms?[cite: 17]

a. Amlodipine

b. Atenolol

c. Bendroflumethiazide

d. Enalapril

e. Simvastatin

Correct Answer: d. Enalapril

Explanation: Angiotensin-converting enzyme (ACE) inhibitors like Enalapril prevent the degradation of bradykinin[cite: 17]. Elevated bradykinin levels can induce non-histaminergic angioedema (swelling of the face, lips, tongue, and airway) that does not respond to antihistamines[cite: 17].

Question 80

A 60-year-old woman was admitted with a 2-day history of dysuria, loin pain and rigors. On admission, she was unwell and confused. She was also febrile and tachycardic. She was transferred to the medical high-dependency unit for invasive monitoring. Which set of haemodynamic values is most likely to be hers?[cite: 18]

Option	mean arterial pressure (mmHg)	mean right atrial pressure (mmHg)	mean pulmonary arterial pressure (mmHg)	mean pulmonary arterial wedge pressure (mmHg)	mean cardiac output (L/min)
normal	85	3	15	9	5.0
a)	80	8	22	20	3.0
b)	110	18	20	11	4.0
c)	85	6	16	8	2.5
d)	66	20	22	20	2.0

Correct Answer: d) MAP 66, RAP 20, PAP 22, PAWP 20, CO 2.0

Explanation: The clinical picture (dysuria, loin pain, rigors, fever, confusion, and hemodynamic instability) describes severe urosepsis progressing to septic shock[cite: 18]. In severe sepsis/septic shock, vascular dilation and profound capillary leak lead to hypotension (low MAP) and hypoperfusion, accompanied by elevated central filling pressures (RAP/PAWP) during resuscitation or myocardial depression (septic cardiomyopathy), leading to a decompensated low cardiac output state[cite: 18].

Question 81

A 28-year old male is evaluated for a 2-month history of progressive fatigue and lower back pain that has increased in severity. He has worked as nurse on the Copperbelt Province for the last 4 years in a rural hospital. He was involved in road accident 3 months ago with multiple lower limb fractures. He had developed acute kidney injury that required dialysis. His hospital course was further```html

Question 81

A 28-year-old male is evaluated for a 2-month history of progressive fatigue and lower back pain that has increased in severity. He has worked as a nurse on the Copperbelt Province for the last 4 years in a rural hospital. He was involved in a road accident 3 months ago with multiple lower limb fractures. He had developed acute kidney injury that required dialysis. His hospital course was further complicated by Staphylococcus aureus central line-associated bloodstream infection (CLABSI) and a catheter-associated UTI with Proteus mirabilis. Exam reveals tenderness over the third lumbar vertebra. MRI of the lumbar spine is consistent with an infection of the L4 and L5 vertebral bodies and an abnormality in the intervening disc space. Which of the following is the most appropriate management?

a. Start treatment with ciprofloxacin and gentamicin

b. Biopsy of the lumbar disc space

c. Start antituberculosis therapy for Pott's disease

d. Evaluate for infective endocarditis with echocardiography

e. Start treatment with ceftriaxone and gentamicin

Correct Answer: b. Biopsy of the lumbar disc space

Explanation: In a hemodynamically stable patient presenting with imaging features of vertebral osteomyelitis and discitis (L4/L5 infection), obtaining a tissue diagnosis via image-guided aspiration or biopsy of the intervertebral disc space is essential prior to initiating empiric antimicrobial therapy. Establishing the specific causative pathogen (e.g., distinguishing S. aureus from tuberculous spondylodiscitis or gram-negative bacilli) guides targeted, long-term antibiotic administration.

Question 82

A 58-year-old woman is evaluated because of daily wheezing and breathlessness when seasons change. She has a long history of seasonal allergies and her symptoms include itchy eyes and runny nose. Her examination is normal except for watery eyes and conjunctival irritation. Spirometry shows an FEV₁ of 74% of predicted, which improves with a bronchodilator. What is your diagnosis?

a. COPD

b. Asthma

c. Pulmonary hypertension

d. Chronic pneumonia

e. Pneumoconiosis

Correct Answer: b. Asthma

Explanation: The clinical features of variable episodic dyspnea, wheezing linked to environmental seasonal changes, personal history of atopy/allergies (rhinitis and allergic conjunctivitis), and objective spirometric evidence of reversible airway obstruction following bronchodilator administration are diagnostic of bronchial asthma.

Question 83

Withdrawal of artificial feeding through a feeding tube, from a patient dying of end-stage heart disease, who is comatose with death expected within a few days, is an example of:[cite: 15]

a. Acceptable medical practice

b. Assisted suicide

c. Euthanasia

d. Murder

e. Unprofessional practice

Correct Answer: a. Acceptable medical practice[cite: 15]

Explanation: The withholding or withdrawal of life-prolonging treatments—including artificial nutrition and hydration—in terminally ill patients where such interventions are burdensome, non-beneficial, or futility-proven constitutes acceptable medical, ethical, and legal practice (passive palliation), distinct from active euthanasia or physician-assisted suicide[cite: 15].

Question 84

On FLAIR images, CSF appears:[cite: 15]

a. Hyperintense to the gray matter

b. Isointense to the gray matter

c. Hypointense to the gray matter

d. Hypointense to white matter

e. None of the above

Correct Answer: c. Hypointense to the gray matter[cite: 15]

Explanation: Fluid-Attenuated Inversion Recovery (FLAIR) MRI sequences nullify/suppress the signal from free fluid, making cerebrospinal fluid (CSF) appear dark (hypointense) relative to cerebral gray matter, which facilitates identification of periventricular lesions or parenchymal hyperintensities[cite: 15].

Question 85

What imaging studies are included in FIGO staging for cervical cancer?[cite: 15]

a. CXR, Barium enema and IVP

b. CXR and CT abdomen

c. CXR, PET CT, Bone scan

d. All of the above

e. None of the above

Correct Answer: d. All of the above[cite: 15]

Explanation: Under FIGO guidelines for staging carcinoma of the cervix, conventional imaging options (such as chest radiography, IVP, barium enema) as well as advanced cross-sectional imaging modalities (CT, MRI, PET-CT, bone scans) can be utilized depending on resource availability to assess tumor extent, nodal disease, and distant metastases[cite: 15].

Question 86

Amongst the following phases of iodinated contrast medium enhancement, CT Scan makes use of:[cite: 15]

a. Vascular enhancement

b. Tissue opacification

c. Opacification of urinary tract

d. Any of the above

e. None of the above

Correct Answer: d. Any of the above[cite: 15]

Explanation: Contrast-enhanced CT protocols acquire images during different phase delays depending on clinical indication: arterial/vascular phase (vascular enhancement), parenchymal/venous phase (tissue opacification), and delayed excretory phase (opacification of the urinary collecting system)[cite: 15].

Question 87

Mr. Phillips is in a home hospice program with end-stage COPD. He has lost 25 pounds in the last two months. His wife calls you and expresses concern that he is lethargic and appears dehydrated. She wonders whether an intravenous line should be started at home so that he can receive fluids. Your response should be to:[cite: 16]

a. Admit the patient to an inpatient hospice program for terminal care.

b. Begin home intravenous therapy.

c. Place a nasogastric (NG) tube and give plain water through the tube.

d. Reassure the wife that dehydration is an expected aspect of dying.

e. Recommend inpatient hospital care to manage terminal symptoms.

Correct Answer: d. Reassure the wife that dehydration is an expected aspect of dying.[cite: 16]

Explanation: Terminal dehydration is a normal and natural part of the dying process[cite: 16]. Parenteral hydration in end-stage dying patients often increases discomfort by producing peripheral edema, pulmonary congestion, bronchial secretions, and ascites without extending survival or improving quality of life[cite: 16]. Reassuring the family and focusing on comfort measures (such as mouth care) is the most appropriate approach[cite: 16].

Question 88

In which of the following patients with pleural effusion would you observe the patients instead of doing a diagnostic thoracocentesis?[cite: 16]

a. Patient with a large parapneumonic effusion

b. Patient with a tuberculous effusion

c. Patient with heart failure and bilateral pleural effusion

d. Patient with suspected malignant effusion

e. Patient with chylothorax

Correct Answer: c. Patient with heart failure and bilateral pleural effusion[cite: 16]

Explanation: Patients with symmetric bilateral pleural effusions in the setting of clinical congestive heart failure (CHF) typically have transudative effusions and can be safely observed while receiving trial diuretic therapy[cite: 16]. Diagnostic thoracentesis is reserved for cases with atypical features (e.g., asymmetric effusions, fever, chest pain, or failure to respond to diuresis)[cite: 16].

Question 89

A tall thin smoking 35-year-old male presents to the emergency department with severe shortness of breath and chest pain. Shortly after admission, the dyspnea becomes worse and lung exam reveals diminished breath sounds, diminished tactile vocal fremitus and decreased chest movement on the right side. In addition, he has marked tachycardia, hypotension, and mediastinal and tracheal shift on chest x-ray. What is the most likely diagnosis?[cite: 16]

a. Severe pneumonia

b. Myocardial infarction

c. Pulmonary embolism

d. Pulmonary hypertension

e. Pneumothorax

Correct Answer: e. Pneumothorax (Tension Pneumothorax)

Explanation: The sudden onset of dyspnea and chest pain in a tall, thin smoker points toward a spontaneous pneumothorax[cite: 16]. Progression to hypotension, marked tachycardia, severe respiratory distress, and contralateral tracheal/mediastinal deviation on chest radiograph confirms a life-threatening tension pneumothorax[cite: 16].

Question 90

Apoptosis takes place via the following pathways:[cite: 17]

a. Death receptor and mitochondrial pathways

b. Extrinsic pathway

c. Angiogenic pathway

d. All of the above

e. None of the above

Correct Answer: a. Death receptor and mitochondrial pathways[cite: 17]

Explanation: Apoptosis proceeds via two main, well-defined signaling pathways: the extrinsic (death receptor-mediated) pathway involving ligands like FasL/TNF-alpha, and the intrinsic (mitochondrial) pathway regulated by the Bcl-2 family of proteins in response to cellular stress or DNA damage[cite: 17].

Question 91

Which of the following drugs is not recommended for treatment of leprosy?[cite: 17]

a. Rifampicin

b. Clofazimine

c. Dapsone

d. Isoniazid

e. All of the above

Correct Answer: d. Isoniazid[cite: 17]

Explanation: Standard WHO multidrug therapy (MDT) for leprosy consists of Rifampicin, Dapsone, and Clofazimine[cite: 17]. Isoniazid is a first-line agent for Mycobacterium tuberculosis, but it has no clinical efficacy against Mycobacterium leprae and is not recommended for treating leprosy[cite: 17].

Question 92

Which of the following statements are true regarding Electroencephalography (EEG)?[cite: 17]

a. EEG recorded from scalp electrodes (16 channels simultaneously) is of value in epilepsy and diffuse brain diseases.

b. Videoteletelemetry (combining EEG with video) cannot be used in attacks difficult to diagnose.

c. Spikes, or spike-and-wave abnormalities, are not hallmarks of epilepsy

d. EEG may not be of value in diagnosis of encephalitis

e. None of the above

Correct Answer: a. EEG recorded from scalp electrodes (16 channels simultaneously) is of value in epilepsy and diffuse brain diseases.[cite: 17]

Explanation: Scalp EEG recorded simultaneously across standard electrode arrays (typically 16 or more channels) is an essential non-invasive clinical tool for evaluating seizure disorders, encephalopathy, and diffuse cerebral dysfunction[cite: 17]. Generalized spike-and-wave discharges are classic hallmarks of primary generalized epilepsy, and video-EEG telemetry is the standard diagnostic tool for characterization of paroxysmal events[cite: 17].

Question 93

Which anti-cancer drug is strongly associated with neurotoxicity?[cite: 17]

a. Cisplatin

b. Doxorubicin

c. Etoposide

d. Vincristine

e. All of the above

Correct Answer: d. Vincristine[cite: 17]

Explanation: Vincristine is a vinca alkaloid that inhibits microtubule polymerization during mitosis[cite: 17]. Peripheral neuropathy (presenting as distal sensory paresthesias, motor weakness, diminished deep tendon reflexes, or autonomic dysfunctions like paralytic ileus) is the dose-limiting classic neurotoxic adverse effect of vincristine therapy[cite: 17].

Question 94

A 23 year old man was admitted to hospital with a 3-day history of fever and breathlessness. On examination, his temperature was 38.9°C, his pulse was 110 beats per minute, his blood pressure was 105/70 mmHg and his respiratory rate was 18 breaths per minute.[cite: 18]

Investigations:[cite: 18]

Investigation	Result	Reference Range
haemoglobin	105 g/L	130–180
wbc	18.5 × 10⁹/L	4.0–11.0
Serum sodium	128 mmol/L	137–144
serum urea	9.5 mmol/L	2.5–7.0
chest X-ray	Consolidation of left lower lobe with a pleural effusion on same side

Which finding is most indicative of severe pneumonia?[cite: 18]

a. blood pressure of 105/70 mmHg

b. pleural effusion on chest X-ray

c. respiratory rate of 18 breaths per min

d. serum urea concentration of 9.5 mmol/L

e. white cell count of 18.5 × 10⁹/L

Correct Answer: d. serum urea concentration of 9.5 mmol/L[cite: 18]

Explanation: Under the CURB-65 clinical prediction validation score for community-acquired pneumonia, a serum urea concentration exceeding 7.0 mmol/L (U = Urea > 7 mmol/L) scores 1 point and directly indicates increased severity, risk of complications, and higher 30-day mortality[cite: 18]. The patient's blood pressure (105/70 mmHg) and respiratory rate (18/min) do not fulfill the severity criteria for the CURB-65 scale[cite: 18].

Question 95

You are the junior resident medical doctor at Ndola central Hospital and you have a 4 years old female patient presenting with an abdominal mass, associated abdominal pain, hematuria, fever and hypertension. What is the most likely diagnosis?[cite: 18]

a. Wilms tumor

b. Neuroblastoma

c. Bladder cancer with abdominal extension

d. Colon cancer

e. All of the above

Correct Answer: a. Wilms tumor[cite: 18]

Explanation: Wilms tumor (nephroblastoma) is the primary renal malignancy of early childhood (typically presenting between ages 2 and 5)[cite: 18]. Classic presentation includes a smooth, firm, unilateral flank or abdominal mass, frequently accompanied by hypertension (secondary to renin secretion), hematuria, abdominal discomfort, and low-grade fever[cite: 18].

Question 96

A recent clinical trial assessed the effect of digoxin on morbidity and mortality in patients with chronic congestive heart failure (CHF). In the trial, more than 7000 patients with a left ventricular ejection fraction of 0.45 or less were randomly assigned to receive digoxin or placebo. All patients were treated with diuretics and an ACE inhibitor. The patients were observed for an average of 37 months. During the clinical trial, 34.8% of patients treated with digoxin and 35.1% of patients treated with placebo died (relative risk = 0.99; 95% confidence interval = 0.91–1.07; p = 0.80). Which is the most appropriate interpretation of these data?[cite: 19]

a. digoxin has a small beneficial effect to reduce mortality in CHF

b. digoxin has no effect on mortality in CHF

c. digoxin is likely to reduce morbidity in CHF

d. there is no clinically significant therapeutic effect of digoxin in patients with CHF

e. there is no conclusive evidence of an effect of digoxin because of the limited power of the study

Correct Answer: b. digoxin has no effect on mortality in CHF[cite: 19]

Explanation: The trial results (based on the landmark DIG trial) demonstrate a relative risk of 0.99 with a 95% confidence interval spanning 1.0 (0.91–1.07) and a p-value of 0.80, indicating no statistically significant difference in overall mortality between the digoxin and placebo groups[cite: 19]. While digoxin reduces heart failure hospitalizations (morbidity), it has no demonstrable effect on overall mortality in chronic heart failure[cite: 19].

Question 97

Which anti-cancer drug is strongly associated with nephrotoxicity?[cite: 19]

a. Cisplatin

b. Doxorubicin

c. Cyclophosphamide

d. Fluoro-uracil

e. None of the above

Correct Answer: a. Cisplatin[cite: 19]

Explanation: Cisplatin is a platinum-based chemotherapeutic agent whose major dose-limiting toxicities are nephrotoxicity (acute kidney injury and renal tubular damage) and ototoxicity[cite: 19]. Vigorous intravenous hydration with isotonic saline before and after administration is standard practice to mitigate cisplatin-induced renal impairment[cite: 19].

Question 98

A 40 year old HIV positive male presents with a rash on the foreskin and pubic area. The individual lesions are dome-shaped with a central umbilication. They are non-itchy and not painful. A cheesy-like material is extracted from one of the lesions. What is the most likely diagnosis?[cite: 19]

a. Syphillis

b. Molluscum contagiosum

c. Scabies

d. Genital warts

e. Chancroid

Correct Answer: b. Molluscum contagiosum[cite: 19]

Explanation: Molluscum contagiosum, caused by a poxvirus, presents classic smooth, firm, dome-shaped papules with central umbilication[cite: 19]. Expressing the core yields a curd-like or cheesy material containing viral inclusion bodies (molluscum bodies)[cite: 19]. In immunocompromised adults (such as HIV-positive patients), lesions frequently appear in the anogenital and pubic regions[cite: 19].

Question 99

Common skin conditions that arise in patients with Albinism and Xeroderma pigmentosum include all the following except:[cite: 15]

a. Sun-burn

b. Basal cell carcinoma

c. Pompholyx

d. Squamous cell carcinoma

e. None of the above

Correct Answer: c. Pompholyx[cite: 15]

Explanation: Both oculocutaneous albinism (deficient melanin protection) and xeroderma pigmentosum (defective nucleotide excision repair) lead to extreme susceptibility to ultraviolet-induced skin damage[cite: 15]. Patients frequently suffer severe sunburns and early-onset cutaneous malignancies such as basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma[cite: 15]. Pompholyx (dyshidrotic eczema) is an endogenous pruritogenic vesicular dermatitis of the palms and soles and is unrelated to UV vulnerability or genetic DNA repair defects[cite: 15].

Question 100

A 72-year-old man developed sudden severe breathlessness and left-sided chest pain while working in his garden. A few minutes later, he collapsed and was taken to the emergency department. Several years previously, he had been found to have a systolic murmur at a routine medical examination and an echocardiogram had shown mitral valve prolapse. He had no other significant medical history. On examination, he was very breathless and cyanosed, with an oxygen saturation of 88% (94–98) breathing air. His pulse was 130 beats per minute and regular, and his blood pressure was 80/50 mmHg. His neck veins were markedly distended. There was no cardiomegaly. He had crackles up to the mid-zones of his lungs. His respiration was very noisy, and his heart sounds could not be easily heard. Investigations:[cite: 15]

Test	Finding
ECG	Sinus tachycardia
Chest X-ray	Cardio-thoracic ratio 15:30; pulmonary edema

What is the most likely diagnosis?[cite: 15]

a. Acute mitral regurgitation

b. Acute myocardial infarction

c. Infective endocarditis

d. Pulmonary embolism

e. Rupture of sinus of Valsalva

Correct Answer: a. Acute mitral regurgitation[cite: 15]

Explanation: The patient has a background history of mitral valve prolapse (MVP), which predisposes to spontaneous chordae tendineae rupture[cite: 15]. Sudden rupture leads to acute severe mitral regurgitation, resulting in a rapid, massive volume overload on a non-compliant left atrium[cite: 15]. This produces acute severe pulmonary edema, respiratory failure, cardiogenic shock (hypotension, tachycardia), elevated systemic venous pressures, and a normal heart size (normal cardio-thoracic ratio) on chest radiograph because the left ventricle has not had time to dilate[cite: 15].

Question 1

Which of following is a tumor marker for breast cancer?[cite: 16]

a. Ca 125

b. CEA

c. PSA

d. Ca 15.3

e. β-hCG

Correct Answer: d. Ca 15.3[cite: 16]

Explanation: CA 15-3 (along with CA 27.29) is a serum tumor marker primary used to monitor treatment response and recurrence in patients with invasive breast cancer[cite: 16]. CA 125 is used for ovarian cancer, PSA for prostate cancer, and β-hCG for gestational trophoblastic disease/germ cell tumors[cite: 16].

Question 2

Palliative care for cancer patients includes which of the following?[cite: 16]

a. Pain management

b. Spiritual counselling

c. Palliative radiotherapy

d. End life care

e. All of the above

Correct Answer: e. All of the above[cite: 16]

Explanation: Palliative oncology addresses the physical, psychological, social, and spiritual aspects of suffering[cite: 16]. It incorporates symptom control (e.g., pain management), medical interventions to alleviate symptoms (such as palliative radiotherapy for bone metastases), holistic psychosocial/spiritual support, and end-of-life care[cite: 16].

Question 3

Which blood test or tests are ordered in order to assist in the diagnosis of Cancer of the Testes?[cite: 16]

a. Beta hCG

b. PSA

c. AFP

d. LDH

e. a, c and d

Correct Answer: e. a, c and d[cite: 16]

Explanation: Serum tumor markers used for diagnosis, staging, and monitoring of testicular germ cell tumors include serum Beta-human chorionic gonadotropin (β-hCG), Alpha-fetoprotein (AFP), and Lactate dehydrogenase (LDH)[cite: 16]. PSA is a marker specific for prostate disease[cite: 16].

Question 4

Which is most common type of skin cancer?[cite: 16]

a. Squamous cell carcinoma

b. Basal cell carcinoma

c. Melanoma

d. Cutaneous T cell lymphoma

e. None of the above

Correct Answer: b. Basal cell carcinoma[cite: 16]

Explanation: Basal cell carcinoma (BCC) is globally the most common skin cancer (accounting for approximately 75–80% of all non-melanoma skin cancers), followed by squamous cell carcinoma (SCC)[cite: 16].

Question 5

EBV is associated with which type of cancer.[cite: 16]

a. Hydrovaccine Lymphoproliferative disorders

b. Non-Hodgkin's Lymphomas

c. NK/T cell Lymphomas

d. NPC

e. All of the above

Correct Answer: e. All of the above[cite: 16]

Explanation: Epstein-Barr Virus (EBV) is an oncogenic virus strongly linked to a spectrum of malignancies, including Nasopharyngeal Carcinoma (NPC), Burkitt lymphoma, NK/T-cell lymphomas, post-transplant lymphoproliferative disorders, and hydroa vacciniforme-like lymphoproliferative disorder[cite: 16].

Question 6

What is the tumor marker for Pancreatic Cancer?[cite: 16]

a. PSA

b. CEA

c. Ca 19.9

d. Ca 125

e. Ca 15.3

Correct Answer: c. Ca 19.9[cite: 16]

Explanation: Carbohydrate antigen 19-9 (CA 19-9) is the primary tumor marker used in the clinical monitoring, assessment of therapeutic response, and detection of recurrence in pancreatic ductal adenocarcinoma[cite: 16].

Question 7

What age (group) is being targeted for the cervical cancer vaccine that is undertaken by the ministry of health in Zambia?[cite: 17]

a. 14 years

b. 11 years

c. 9 years

d. 9 to 13 years

e. None of the above

Correct Answer: d. 9 to 13 years (or 9 to 14 years)

Explanation: The Ministry of Health of Zambia targets young adolescent girls (specifically aged 9 to 14 years) for the Human Papillomavirus (HPV) vaccination campaign to protect against HPV infection and prevent cervical cancer later in life[cite: 17]. Since 9 to 13 years falls squarely into this target demographic, d is the designated answer choice.

Question 8

What is the gold standard imaging modality of Hodgkin's Lymphoma?[cite: 17]

a. CT scan

b. CXR

c. Ultrasound

d. PET/CT

e. MRI

Correct Answer: d. PET/CT[cite: 17]

Explanation: 18F-FDG PET/CT is the gold standard imaging modality for initial baseline staging, interim response evaluation, and post-treatment assessment of remission or residual disease in Hodgkin Lymphoma[cite: 17].

Question 9

Which virus is the common cause for Kaposi's Sarcoma?[cite: 17]

a. HPV

b. HIV

c. HHV8

d. HSV

e. Both HPV and HIV

Correct Answer: c. HHV8[cite: 17]

Explanation: Kaposi sarcoma is caused by Human Herpesvirus 8 (HHV-8)[cite: 17], also known as Kaposi sarcoma-associated herpesvirus (KSHV). While HIV infection severely increases the risk by suppressing cell-mediated immunity, HHV-8 is the essential causative viral pathogen[cite: 17].

Question 10

What imaging can be used in metastatic work up of breast cancer?[cite: 17]

a. CT chest /Abdomen and Pelvis

b. CXR

c. Abdominal/Pelvis Ultrasound

d. PET/CT in a few special cases

e. All of the above

Correct Answer: e. All of the above[cite: 17]

Explanation: Systemic evaluation for distant metastases in breast cancer staging incorporates chest radiography (CXR), ultrasound of the abdomen/liver, CT scans of the chest/abdomen/pelvis, bone scintigraphy, and PET/CT imaging in select clinical situations[cite: 17].

Question 11

What staging system is used for staging Lymphomas?[cite: 17]

a. TNM staging

b. European Staging

c. FIGO staging

d. Ann Arbor staging

e. All of the above

Correct Answer: d. Ann Arbor staging[cite: 17]

Explanation: The Ann Arbor staging system (and its Lugano classification modification) is the established anatomical staging system utilized for both Hodgkin and non-Hodgkin lymphomas[cite: 17]. FIGO is used for gynecologic cancers, and TNM for solid organ tumors[cite: 17].

Question 12

A 40 year old HIV+ lady has a 4 cm by 2 cm cervical mass involving both parametria. Abdominal ultrasound shows left mild hydronephrosis. Cystoscopy confirms bladder infiltration. CT scan shows paraaortic nodal involvement. What is the stage for her cervical cancer?[cite: 17]

a. IVA

b. IIIC1

c. IIIA

d. IIIC2

e. None of the above

Correct Answer: a. IVA[cite: 17]

Explanation: Under the FIGO staging criteria for cervical carcinoma, direct extension of the primary tumor to involve the mucosal lining of the bladder or rectum defines Stage IVA disease[cite: 17], which takes precedence regardless of parametrial or nodal status.

Question 13

Cervical cancer stage IVB means the tumor has spread to?[cite: 17]

a. Liver

b. Bladder

c. Rectum

d. Vagina

e. All of the above

Correct Answer: a. Liver[cite: 17]

Explanation: FIGO Stage IVB cervical cancer is characterized by distant metastasis to organs outside the pelvis, such as distant visceral metastases (liver, lungs, brain) or distant lymph nodes beyond the para-aortic region[cite: 17]. Direct invasion of adjacent pelvic organs like the bladder or rectum constitutes Stage IVA[cite: 17].

Question 14

Which of the following is not a group of anticancer medication?[cite: 18]

a. Alkylating agents

b. Bleomycin

c. Antitumor antibiotics

d. Antimetabolites

e. All of the above

Correct Answer: b. Bleomycin[cite: 18]

Explanation: Alkylating agents, antitumor antibiotics, and antimetabolites represent entire drug classes (groups) of antineoplastic agents[cite: 18]. Bleomycin is a specific individual drug (which belongs to the antitumor antibiotic class) rather than a general drug group[cite: 18].

Question 15

Cisplatin belongs to which type of anticancer drug?[cite: 18]

a. Alkylation agents

b. Antimetabolite

c. Topoisomerase inhibitors

d. Cytotoxic

e. Plant alkaloids

Correct Answer: a. Alkylation agents[cite: 18]

Explanation: Cisplatin is a platinum-based chemotherapeutic agent that acts as an alkylating-like agent by forming intra-strand and inter-strand DNA cross-links, inhibiting DNA replication and transcription[cite: 18].

Question 16

Which one of the following is least commonly seen in tumor lysis syndrome?[cite: 18]

a. Hyperuricemia

b. Hypercalcemia

c. Hyperkalaemia

d. Hyperphosphatemia

e. All of the above

Correct Answer: b. Hypercalcemia[cite: 18]

Explanation: Tumor lysis syndrome (TLS) is characteristically defined by hypocalcemia (resulting from precipitation with released phosphate), along with hyperkalemia, hyperphosphatemia, and hyperuricemia[cite: 18]. Therefore, hypercalcemia is not expected and is least commonly seen[cite: 18].

Question 17

The superior venae cava is formed by which veins?[cite: 18]

a. Internal jugular and subclavian veins

b. Left and Right brachiocephalic veins

c. Right and left subclavian veins

d. It's a continuation of the internal jugular vein

e. None of the above

Correct Answer: b. Left and Right brachiocephalic veins[cite: 18]

Explanation: The superior vena cava (SVC) is formed by the union of the right and left brachiocephalic (innominate) veins posterior to the lower border of the first right costal cartilage[cite: 18].

Question 18

Helicobacter pylori is believed to be associated with which cancer?[cite: 18]

a. Prostate cancer

b. Gastric cancer

c. Lung cancer

d. Colon cancer

e. Vaginal cancer

Correct Answer: b. Gastric cancer[cite: 18]

Explanation: Chronic Helicobacter pylori infection is a major cause of gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach[cite: 18].

Question 19

Colorectal cancer screening include all of the following, EXCEPT:[cite: 18]

a. Fecal occult blood testing

b. Papanicolaou smears test

c. Digital rectal examination

d. Barium contrast studies

e. None of the above

Correct Answer: b. Papanicolaou smears test[cite: 18]

Explanation: The Papanicolaou (Pap) smear is a cytological screening test specifically used for detecting cervical dysplasias and cervical cancer, not colorectal cancer[cite: 18].

Question 20

Brachytherapy is a type of therapeutic radiation of cancer tissue in which:[cite: 18]

a. Beams of radiation generated at a distance and aimed at the tumor within the patient

Explanation: Brachytherapy involves placing sealed radioactive sources directly inside or immediately adjacent to the tumor target area (internal radiation therapy)[cite: 18], contrasting with external beam radiation therapy described in option a.

Question 21

What lesions are usually seen in vitiligo?[cite: 19]

a. Plaques

b. Excoriations

c. Patches

d. Bulla

Correct Answer: c. Patches[cite: 19]

Explanation: Vitiligo presents as circumscribed, depigmented macules (when < 1 cm) or patches (when > 1 cm) resulting from autoimmune destruction of cutaneous melanocytes[cite: 19].

Question 22

What lesions are present in acne vulgaris?[cite: 19]

a. White heads

b. Black heads

c. Comedones

d. All of the above

Correct Answer: d. All of the above[cite: 19]

Explanation: Acne vulgaris is characterized by non-inflammatory comedones—which include open comedones (blackheads) and closed comedones (whiteheads)—as well as inflammatory papules, pustules, and nodules[cite: 19].

Question 23

Regarding psoriasis, primary lesions present in psoriasis are:[cite: 19]

a. Plaques

b. scales

c. fissures

d. All of the above

Correct Answer: a. Plaques[cite: 19]

Explanation: The primary lesion of psoriasis vulgaris is an erythematous, well-demarcated elevated plaque[cite: 19]. Silver-white scales and skin fissures represent secondary changes/lesions that develop on top of or as a consequence of the primary plaque[cite: 19].

Question 24

What nail changes are commonly seen in psoriasis?[cite: 19]

a. Leukonychia

b. Oil spots

c. Nail pitting

d. All of the above

Correct Answer: d. All of the above[cite: 19]

Explanation: Psoriatic nail disease demonstrates various manifestations depending on matrix or bed involvement, including nail matrix changes (pitting, leukonychia, red spots in the lunula) and nail bed changes (salmon patches/oil drop discoloration, subungual hyperkeratosis, and onycholysis)[cite: 19].

Question 25

What drug is contraindicated in psoriasis?[cite: 19]

a. Methotrexate

b. Prednisolone tablets

c. Coal tar shampoo

d. Clobetasol propionate ointment

Correct Answer: b. Prednisolone tablets[cite: 19]

Explanation: Systemic corticosteroids (such as oral prednisolone tablets) are relative or absolute contraindications in psoriasis because tapering or sudden discontinuation frequently triggers severe, life-threatening disease flares, including generalized pustular psoriasis or erythrodermic rebound[cite: 19].

Question 26

A 45 year old male presents with massive growth on the face and neck after suffering trauma 10 years ago during a road traffic accident. The growth is beyond the extent of initial injury. It is occasionally itchy and sometimes oozes pus. What is the most likely diagnosis?[cite: 19]

a. Keloids

b. Hypertrophic scar

c. Dermatofibrosarcoma

d. Scleroderma

Correct Answer: a. Keloids[cite: 19]

Explanation: Exaggerated dermal fibroblastic tissue proliferation following trauma that extends beyond the boundaries of the original wound margin and fails to regress spontaneously over time is the clinical hallmark defining a keloid[cite: 19]. Hypertrophic scars remain confined within the original wound margins[cite: 19].

Question 27

Which cells in the skin are involved in the pathogenesis of the above condition?[cite: 19]

a. Langerhans cells

b. Merkel cells

c. Keratinocytes

d. Fibroblasts

Correct Answer: d. Fibroblasts[cite: 19]

Explanation: Pathologically, keloid formation is driven by dysregulated dermal fibroblasts that display overresponsiveness to cytokines (such as TGF-beta), producing excessive synthesis and accumulation of disorganized type I and III collagen fibers[cite: 19].

Question 28

A 29 year old female presents with grouped vesicles on an erythematous base affecting the right side of the upper face. The lesions are burning and painful at the same time. They contain clear fluid. What is the most likely causative agent for this rash?[cite: 19]

a. Human herpes virus

b. Human papilloma virus

c. Treponema pallidum

d. Varicella zoster

Correct Answer: d. Varicella zoster[cite: 19]

Explanation: Unilateral dermatomal distribution of painful, burning grouped fluid-filled vesicles on an erythematous base (particularly along a cranial nerve branch like V1 in the upper face) is pathognomonic for Herpes Zoster (shingles), caused by reactivation of Varicella Zoster Virus (VZV)[cite: 19].

Question 29

Which of the following agents is ideal in the treatment of this condition?[cite: 19]

a. Fluconazole

b. Acyclovir

c. Mupirocin

Correct Answer: b. Acyclovir[cite: 19]

Explanation: Systemic antiviral therapy with nucleoside analogs such as oral acyclovir, valacyclovir, or famciclovir is the primary indicated pharmacotherapy for acute Herpes Zoster to reduce viral shedding, speed lesion healing, and decrease neuropathic pain duration[cite: 19].

Question 30

A 34 year old male presents with filiform, keratotic, painless growths on the penile shaft. He noticed them 2 months ago and states that new projections continue to develop at regular intervals. What is the most likely cause of this condition?

a. Chlamydia

b. Human papilloma virus

c. Human herpes virus

d. Treponema pallidum

Correct Answer: b. Human papilloma virus

Explanation: Anogenital warts (condylomata acuminata) present as painless, filiform, verrucous, or hyperkeratotic lesions on genital skin and are caused by infection with low-risk subtypes of Human Papillomavirus (predominantly HPV types 6 and 11).

Question 31

What cells in the skin are involved in the pathogenesis of the lesions?

a. Fibroblasts

b. Keratinocytes

c. Langerhans cells

d. Macrophages

Correct Answer: b. Keratinocytes

Explanation: Human Papillomavirus infects basal layer epidermal keratinocytes. Viral replication and gene expression drive epidermal proliferation and induce pathognomonic cytologic changes (koilocytosis) within superficial differentiation-competent keratinocytes.

Question 32

What is the most important aspect of counselling given to the patient above?

a. Partner notification

b. Use of barrier methods of protection

c. Compliance to treatment

d. All of the above

Correct Answer: d. All of the above

Explanation: Comprehensive management of sexually transmitted infections like HPV requires holistic counseling covering partner notification/screening, barrier protection (condom use) to reduce transmission risks, and strict treatment adherence to ensure lesion clearance and lower recurrence rates.

Question 33

A twenty-four year old newly diagnosed HIV-positive female presents to the emergency section with a bullous eruption affecting approximately 45% of her body surface area. The eruption also involves the eyes and other mucosal areas. This eruption developed 8 days after commencing Septrin* prophylaxis. What is the most likely diagnosis?

a. Toxic epidermal necrolysis

b. Erythema multiforme

c. Epidermolysis bullosa

d. Dermatitis herpetiformis

Correct Answer: a. Toxic epidermal necrolysis

Explanation: Severe drug-induced mucocutaneous reactions causing widespread full-thickness epidermal detachment with mucosal involvement are categorized by affected body surface area (BSA): Stevens-Johnson Syndrome (< 10%), SJS/TEN overlap (10–30%), and Toxic Epidermal Necrolysis (> 30% BSA). At 45% BSA detachment following co-trimoxazole (Septrin) initiation, TEN is the definitive diagnosis.

Question 34

What is commonly seen on histology?

a. Parakeratosis

b. Fibrosis

c. Epidermal necrosis

d. Acanthosis

Correct Answer: c. Epidermal necrosis

Explanation: The hallmark histopathologic finding of Toxic Epidermal Necrolysis (TEN) is full-thickness keratinocyte apoptosis leading to confluent epidermal necrosis and subepidermal bullae detachment from an intact dermis.

Question 35

What is the most important aspect in the initial management of this patient?

a. Broad spectrum antibiotics

b. Withdrawal of the causative agent

c. Use of high potency steroids

d. All of the above

Correct Answer: b. Withdrawal of the causative agent

Explanation: Immediate prompt identification and discontinuation of the suspected offending drug (e.g., Septrin/co-trimoxazole) is the single most critical intervention that significantly improves survival and outcomes in SJS/TEN patients.

Question 36

What complications are commonly anticipated?

a. Acute renal failure

b. Metabolic encephalopathy

c. Pneumonitis

d. All of the above

Correct Answer: d. All of the above

Explanation: Widespread epidermal loss in TEN impairs barrier function, causing massive fluid shifts and systemic inflammatory damage. Expected systemic complications include acute kidney injury (from hypovolemia or acute tubular necrosis), pulmonary involvement (epithelial sloughing causing tracheobronchial lesioning/pneumonitis), fluid-electrolyte dysregulation leading to metabolic encephalopathy, and sepsis.

Question 37

A 34 year old newly diagnosed HIV positive male patient comes to the emergency department with a three day history of cough, fever and difficulty breathing. On examination, there are multiple purple plaques and papules affecting the legs. He states that these occurred 3 months ago, are non-painful and increasing in amount. What is the most likely diagnosis?

a. SJS

b. pemphigus vulgaris

c. bacillary angiomatosis

d. Kaposi's sarcoma

Correct Answer: d. Kaposi's sarcoma

Explanation: Non-painful, violaceous/purple macules, papules, or plaques on the lower extremities in an HIV-positive patient are classic for AIDS-related Kaposi's sarcoma. Respiratory symptoms (cough, fever, dyspnea) suggest pulmonary involvement by Kaposi's sarcoma or opportunistic infections like Pneumocystis jirovecii pneumonia.

Question 38

What is the most common cause of the above condition?

a. Viral infections

b. Drugs

c. Autoimmune

d. All of the above

Correct Answer: a. Viral infections

Explanation: Kaposi's sarcoma is etiologically caused by viral infection with Human Herpesvirus 8 (HHV-8), also designated as Kaposi sarcoma-associated herpesvirus (KSHV).

Question 39

What is commonly seen on histology?

a. Spindle cells

b. Hemosiderin deposition

c. Extravasated RBCs

d. All of the above

Correct Answer: d. All of the above

Explanation: The characteristic histopathology of Kaposi's sarcoma includes a proliferation of malignant spindle-shaped endothelial cells forming slit-like vascular spaces containing extravasated erythrocytes, paired with prominent hemosiderin pigment deposition.

Question 40

Which group of drugs may be beneficial in treating the above condition?

a. corticosteroids

b. antiretroviral agents

c. antibiotics

d. anti-fungal drugs

Correct Answer: b. antiretroviral agents

Explanation: Initiation of Combination Antiretroviral Therapy (cART) is the foundational treatment for AIDS-associated Kaposi's sarcoma. Reconstitution of immune function and suppression of HIV replication often leads to dramatic regression of lesions.

Question 41

Enteroclysis is synonymous with:

a. Hypotonic duodenography

b. Ba meal follow through

c. Small bowel enema

d. All of the above

Correct Answer: c. Small bowel enema

Explanation: Enteroclysis is a fluoroscopic imaging procedure directly synonymous with a small bowel enema, where contrast medium is infused directly into the duodenum or jejunum via a specialized naso-enteric tube to evaluate the small intestine.

Question 42

The advantage of mammography is:

a. Detects non-palpable abnormalities of breast

b. Can differentiate cystic vs solid

c. No radiation

d. All of the above

Correct Answer: a. Detects non-palpable abnormalities of breast

Explanation: The primary diagnostic and screening strength of mammography lies in detecting non-palpable breast lesions, microcalcifications, and early architectural distortions before they become clinically detectable. Ultrasound (not mammography) is superior for distinguishing cystic from solid masses and avoids radiation.

Question 43

Dilated jejunal loops on plain x-ray abdomen are identified by:

a. Haustrations

b. Valvulae conniventes

c. Characterless bowel

d. Air fluid levels

Correct Answer: b. Valvulae conniventes

Explanation: Dilated jejunal loops display prominent circular mucosal folds termed valvulae conniventes (plicae circulares) that traverse the complete width of the lumen, giving a characteristic "concertina" appearance on plain abdominal radiographs. Haustrations are seen in the large bowel.

Question 44

Intravenous urography is contraindicated in all, except[cite: 18]

a. Pregnancy

b. Renal insufficiency

c. Renal trauma

d. Multiple myeloma

Correct Answer: c. Renal trauma[cite: 18]

Explanation: Pregnancy (radiation risk), renal insufficiency, and multiple myeloma (high risk of contrast-induced acute kidney injury/precipitation of Bence-Jones proteins) are classic relative or absolute contraindications for IV urography[cite: 18]. Renal trauma is an indication for urinary tract contrast evaluation rather than a contraindication[cite: 18].

Question 45

HSG helps to evaluate all except[cite: 18]

a. Uterine cavity

b. Tubal configuration

c. Tubal patency

d. Ovarian size and volume

Correct Answer: d. Ovarian size and volume[cite: 18]

Explanation: Hysterosalpingography (HSG) instills radiopaque contrast into the cervical canal to delineate the uterine cavity architecture and fallopian tube contour/patency[cite: 18]. It does not directly visualize solid parenchymal structures like the ovaries; pelvic ultrasound or MRI is used for evaluating ovarian size and volume[cite: 18].

Question 46

All include measures of reducing radiation exposure in the radiology department except[cite: 18]

a. Increasing the distance

b. Reducing the exposure factors

c. Shielding

d. Wearing the TLD

Correct Answer: d. Wearing the TLD[cite: 18]

Explanation: The fundamental principles of radiation protection are Time, Distance, and Shielding, along with optimizing technical parameters (reducing exposure factors)[cite: 18]. A Thermoluminescent Dosimeter (TLD) is a passive monitoring device that measures accumulated radiation exposure; it does not physically reduce or block exposure[cite: 18].

Question 47

During carotid angiography, the vessels catheterized include[cite: 18]

a. Bilateral internal and external carotid

b. Bilateral internal carotid and one vertebral artery

c. Bilateral external carotid and one vertebral artery

d. Bilateral external and internal carotid and vertebral artery

Correct Answer: d. Bilateral external and internal carotid and vertebral artery[cite: 18]

Explanation: Complete diagnostic cerebral angiography (four-vessel or pan-angiography) involves selective catheterization of both internal and external carotid arteries as well as the vertebral arteries to comprehensively map anterior and posterior intracranial circulation[cite: 18].

Question 48

The biological half-life of an isotope is 6 hours, and the physical half-life is 12 hrs, what is the effective half-life?[cite: 18]

a. 6 hrs

b. 12 hrs

c. 2 hrs

d. 4 hrs

Correct Answer: d. 4 hrs[cite: 18]

Explanation: Effective half-life ($T_{eff}$) is calculated using the formula $\frac{1}{T_{eff}} = \frac{1}{T_{p}} + \frac{1}{T_{b}}$, which yields $T_{eff} = \frac{T_{p} \times T_{b}}{T_{p} + T_{b}}$[cite: 18]. Substituting the given values: $T_{eff} = \frac{12 \times 6}{12 + 6} = \frac{72}{18} = 4\text{ hours}$[cite: 18].

Question 49

Which of the following measures absorbed doses?[cite: 18]

a. Millicurie

b. Becquerel

c. Gray

d. All of the above

Correct Answer: c. Gray[cite: 18]

Explanation: The Gray (Gy) is the SI unit of absorbed radiation dose (defined as 1 Joule of radiation energy absorbed per kilogram of matter)[cite: 18]. Becquerel and Curie/Millicurie are units of radioactive decay/activity[cite: 18].

Question 50

The advantages of MRI are[cite: 18]

a. MRI is harmless as it is not connected with ionizing radiation

b. MRI produces an image of all organs and systems of the human body - especially soft tissue structures

c. MRI provides a study area, cuts in any plane and create three-dimensional reconstruction of the investigated objects

d. all the above

Correct Answer: d. all the above[cite: 18]

Explanation: Magnetic Resonance Imaging (MRI) offers several clinical advantages: it uses non-ionizing radiofrequency pulses and strong magnetic fields, provides high soft-tissue contrast, and allows multiplanar imaging and 3D volumetric reconstructions across anatomical regions[cite: 18].

CT-scan Images

Make a Selection:

Welcome to community medicine PastPapers for 6th year Mbchb

Make a Selection:

Question Text:

2. The MBChB team of Kabwe General Hospital surveys adult patients' systolic blood pressure. The readings are as follows: 109, 115, 118, 120, 125, 127, 130, 132, 135, 136, 138, 139, 140, 142, 145, 150, 155, 158, 160, 162, 165, 170, 172, 175, 178, 180, 182, 185, 188, 190, 195, 198, 200, 205, 210, 212, 215, 220, 225, 230, 235, 240, 245, 250, 255, 260, 265, 270, 275, 280, 285, 290, 295, 300, 302, 304, 305, 310, 315 and 319.[cite: 1]

A. Determine the width and number of classes (2 MARKS)[cite: 1]

B. Construct a frequency distribution with frequency, relative frequency, cumulative frequency and relative cumulative frequency (8 MARKS)[cite: 1]

Answer & Solution:

Part A: Width and Number of Classes

Total sample size ($N$) = 60 observations[cite: 1].

Minimum = 109, Maximum = 319[cite: 1].

Number of classes ($k$): Using Sturges' Rule: $k = 1 + 3.322 \log_{10}(60) \approx 1 + 3.322(1.778) \approx 6.9 \approx 7$ classes.
Class Width ($w$): $w = \frac{\text{Maximum} - \text{Minimum}}{k} = \frac{319 - 109}{7} = \frac{210}{7} = 30$.

Part B: Frequency Distribution Table

Class Interval	Frequency ($f$)	Relative Frequency	Cumulative Frequency	Relative Cumulative Frequency
109 – 138	11	0.1833 (18.33%)	11	0.1833 (18.33%)
139 – 168	11	0.1833 (18.33%)	22	0.3667 (36.67%)
169 – 198	10	0.1667 (16.67%)	32	0.5333 (53.33%)
199 – 228	7	0.1167 (11.67%)	39	0.6500 (65.00%)
229 – 258	6	0.1000 (10.00%)	45	0.7500 (75.00%)
259 – 288	6	0.1000 (10.00%)	51	0.8500 (85.00%)
289 – 319	9	0.1500 (15.00%)	60	1.0000 (100.00%)
Total	60	1.0000 (100%)	—	—

Question 2:

2. Can you provide examples of how applied research has successfully addressed real-world problems in industries such as healthcare? (10 Marks)[cite: 2]

Answer:

Examples of Applied Research in Healthcare:

Vaccine and Therapeutic Development: Translating basic microbiological research into clinical trials to develop target-specific vaccines (e.g., mRNA vaccine platforms for SARS-CoV-2, malaria vaccines like RTS,S/AS01 and R21/Matrix-M), directly reducing morbidity and mortality in global populations.
Implementation of Diagnostic Protocols: Applying rapid diagnostic tests (RDTs) for malaria, HIV, and tuberculosis at point-of-care primary health facilities, drastically reducing diagnosis turnaround times and ensuring rapid therapeutic initiation in resource-limited settings.
Quality Improvement & Infection Control: Investigating post-operative infection rates in surgical wards to implement standardized WHO surgical safety checklists and hygiene protocols, resulting in lower hospital-acquired infection (HAI) rates.
Epidemiological Disease Control: Utilizing applied epidemiological studies to map vector distribution (e.g., Anopheles mosquitoes) and evaluating the real-world effectiveness of Insecticide-Treated Nets (ITNs) or Indoor Residual Spraying (IRS) in reducing endemic disease transmission.

Question 3:

3. How do ethical considerations play a role in the design and implementation of applied research studies, especially when dealing with sensitive or potentially harmful subjects? (10 Marks)[cite: 2]

Answer:

Role of Ethical Considerations in Applied Research:

Informed Consent and Voluntariness: Ensuring participants receive clear, comprehensible, and culturally appropriate information regarding the study's purpose, risks, and benefits, while ensuring participation remains entirely voluntary without coercion.
Beneficence and Non-Maleficence: Maximizing potential benefits while minimizing physical, psychological, social, or legal harm. Designing protocols with safety stop-rules and risk mitigation measures for high-risk interventions.
Protection of Vulnerable Populations: Applying extra safeguards when researching vulnerable groups (e.g., pediatric patients, pregnant women, prisoners, or socio-economically marginalized communities) to prevent exploitation.
Confidentiality and Data Anonymization: Safeguarding sensitive personal health details using anonymization, data encryption, and restricted access protocols, particularly when handling sensitive topics such as mental health or stigmatized conditions.
Institutional Review Board (IRB) / Ethics Committee Approval: Independent ethical oversight to ensure study designs adhere to international guidelines (e.g., Declaration of Helsinki) before patient recruitment and study execution begins.

Question 4:

4. What are the key criteria for selecting an appropriate research design, such as qualitative, quantitative, or mixed methods, and how do these designs influence the data collection and analysis process? (10 Marks)[cite: 2]

Answer:

Key Selection Criteria:

Nature of the Research Question / Objective: Questions seeking to measure prevalence, causality, or relationships require quantitative designs; questions aiming to explore lived experiences, perceptions, and nuanced social phenomena require qualitative designs; complex questions needing both statistical generalization and contextual depth require mixed methods.
State of Existing Literature: Well-established fields with valid tools favor quantitative hypotheses testing, whereas underexplored areas require qualitative exploratory approaches.
Resource and Feasibility Constraints: Availability of time, budget, expertise, access to target populations, and specialized analytical software.

Impact on Data Collection and Analysis:

Quantitative Designs:
- Data Collection: Structured instruments such as closed-ended surveys, biological measurements, or formal clinical trials.
- Data Analysis: Statistical software (e.g., SPSS, R, Stata) using descriptive and inferential statistics to test hypotheses and determine statistical significance ($p$-values, confidence intervals).
Qualitative Designs:
- Data Collection: Unstructured or semi-structured interviews, focus group discussions (FGDs), key informant interviews, and direct observation.
- Data Analysis: Non-numerical analysis techniques such as thematic analysis, content analysis, or grounded theory to extract recurring themes, codes, and narrative meanings.
Mixed Methods Designs:
- Data Collection: Sequential or concurrent integration of quantitative instruments and qualitative interviews/observations.
- Data Analysis: Triangulation and integration of statistical outputs with qualitative themes to provide a unified, comprehensive understanding of the research problem.

Make a Selection:

Welcome to file downloads

Make a Selection:

Welcome to 5th year files for download

1. Pediatrics Downloads

2. Internal Medicine Downloads

3. Surgery Downloads

4. OBGY Downloads

5. Medical Ethics Downloads

Welcome to my collection:

Internal Medicine OSCE stations:

Pediatrics OSCE stations:

Surgery OSCE stations:

Welcome to 7th year files for download

X-Ray Images

Make a Selection:

Tension pneumothorax

Comparison of Simple vs. Tension Pneumothorax on Chest Radiograph

1. Simple Pneumothorax

2. Tension Pneumothorax

Pneumonia

Comparison of Normal Lung Anatomy vs. Pneumonia (Alveolar Consolidation)

1. Normal Lung Anatomy (PA View)

2. Pneumonia (Alveolar Consolidation)

Pleural effusion

Comparison of Normal Lung Anatomy, Moderate Pleural Effusion, and Massive Pleural Effusion

1. Normal Lung Anatomy (PA View)

2. Panel A: Moderate Pleural Effusion

3. Panel B: Massive Pleural Effusion (Tension)

Pulmonary edema

Pulmonary Edema (Acute Heart Failure) Chest Radiograph (CXR) Findings

Panel A: Pathophysiology and Key Signs

Panel B: ABCDE of CXR Interpretation

Pulmonary TB

Pulmonary Tuberculosis (Primary & Post-Primary) Chest Radiograph (CXR) Findings

Panel A: Primary TB Pathophysiology and Key Signs

Panel B: Post-Primary TB Interpretation

Atelectasis

Atelectasis (Lung Collapse) Chest Radiograph (CXR) Findings

Panel A: Pathophysiology and Key Signs

Panel B: Types and CXR Interpretation

COPD

COPD / Emphysema (Hyperinflation) Chest Radiograph (CXR) Findings

Panel A: Pathophysiology and Key Signs

Panel B: Radiographic Features and Interpretation

Bronchogenic carcinoma

Bronchogenic Carcinoma (Lung Mass) Chest Radiograph (CXR) Findings

Panel A: Pathophysiology and Key Signs

Panel B: Multi-focal Lung Carcinoma & Systemic Effects

Sarcoidosis

Sarcoidosis Chest Radiograph (CXR) Findings

Panel A: Pathophysiology and Key Signs

Panel B: Sarcoidosis Manifestations and Systemic Effects

Aortic Dissection

Aortic Dissection & Widened Mediastinum Chest Radiograph (CXR) Findings

Panel A: Pathophysiology and Key Signs

Panel B: Diagnostic Imaging and Clinical Effects

Radiology Past Paper MCQs

END OF ROTATION TEST: FEB 2021

SECTION A: Term Definitions

1. Basement membrane zone

2. Lichenification

3. Erythema Nodosum

4. Bullae

5. Merkel cell

Question 1

Question 2

Question 3

Question 4

Question 11

Question 12

Question 13

Question 14

Question 15

Question 16

Question 17

Question 18

Question 19

Question 20

Question 21