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Concerning asthma:

A. Inhaled steroids are useful in the treatment.

B. Wheeze on auscultation is pathognomonic.
C. It is seldom a cause of hospital admission.
D. Exacerbation of symptoms can occur with exercise.
E. Sufferers should be excluded from sport at school.

Correct Answer- T F F T F

Asthma is a common chronic inflammatory disease of the

airways characterized by variable and recurring symptoms,
airflow obstruction, and bronchospasm.The airway
obstruction in asthma is usually reversible.
Classical Symptoms are recurrent wheezing, cough, chest
tightness, and shortness of breath.

Recurrent wheezing is not pathognomonic to Asthma.

Other causes of recurrent wheezing

1. Transient early wheezing with viral infection

2. Non atophic wheezing due to RSV infections
3. Bronchiolitis
4. Recurrent aspiration of feeds
5. Cystic fibrosis
6. Inhaled foreign body
7. Cow's milk protein intolerance
8. Cardiac failure

Other Exacerbating factors

Dust, house mites, animal dander (especially cat and dog
hair),molds,Perfumes,virus and bacterial infections of the
upper respiratory tract
Concerning systemic lupuserythematosus (SLE):
A. It causes a characteristic "butterfly rash".
B. Is more common in males.
C. Arthralgia is a rare feature.
D. Maternal SLE can cause heart block in the neonate.
E. Anti-nuclear antibodies are usually present.
Correct Answer - T F F T T

Systemic lupus erythematosus is an autoimmune disease

characterized by acute and chronic inflammation of various
tissues of the body.It is more common in women than men
(about eight times more common) especially between the
ages of 15 and 50.

1. Common initial and chronic complaints include fever,

malaise, joint pains, myalgias, and fatigue and
photosensitive rash
2. Dermatological manifestations - classic malar rash (or
butterfly rash),Alopecia
3. Musculoskeletal manifestations - Arthralgia and
arthritis(small joints of the hand and wrist usually
4. Hematological manifestations - Pancytoppenia
5. Cardiac manifestations - Pancarditis,valvular heart
6. Renal involvement - membranous glomerulonephritis
7. Neurological manifestations - lupus headache,cognitive
dysfunction, mood disorder, Strokes, seizures,
8. SLE in a pregnant mother increases the risk of
spontaneous abortion, intrauterine fetal death,
preeclampsia, intrauterine growth retardation, preterm
birth and Neonatal lupus.
9. Neonatal lupus manifests as congenital heart block or
as lupus rash.It is rare in SLE pregnancies.Anti-Ro and
anti-La antibodies (for the risk assessment of neonatal
lupus) should be performed before pregnancy.

Antinuclear antibody (ANA) testing is the mainstay of

serologic testing for SLE. sensitivity = 99%; specificity =

Anti-dsDNA antibodies are highly specific for SLE; they are

present in 70% of cases

Compared with cow's milk, human breastmilk contains:

A. Less sodium.
B. Less calcium.
C. Less protein.
D. Less fat.
E. Less carbohydrate

Correct Answer - T T T F F
There are many differences between breast milk and cow’s
milk / formula. Cow’s milk is much more difficult for an
infants digestive system to break down and is not
nutritionally equal to breast milk.

Breast Milk contains

Secretory IgA Antibodies
Fat – Breast milk contains more fat than cow’s milk and is
more easily absorbed by the baby.
Carbohydrates – Breast milk contains more carbohydrates
than cow’s milk.
Protein – The amount of protein in breast milk is less than
cow's milk
Less amount of Sodium, Calcium and phosphorus than cow's
milk and more Iron than cow's milk

Which of the following are recognised causes of clubbing:

A. Cystic fibrosis.
B. Familial.
C. Bacterial endocarditis.
D. Fallot's tetralogy.
E. Ulcerative colitis.
MCQ 01 Correct Answer - T T T T T

Pulmonary disease

* Lung cancer
* Tuberculosis
* Bronchiectasis
* Cystic fibrosis
* Interstitial lung disease
* Idiopathic pulmonary fibrosis
* Sarcoidosis
* Lipoid pneumonia
* Empyema
* Pleural mesothelioma
* Pulmonary artery sarcoma
* Cryptogenic fibrosing alveolitis
* Pulmonary metastases
Cardiac disease
* Cyanotic congenital heart disease
* Bacterial endocarditis
* Thyroid cancer
* Thymus cancer
* Hodgkin's disease
* Disseminated chronic myeloid leukemia
Gastrointestinal disease
* Ulcerative colitis
* Crohn's disease
* Primary biliary cirrhosis
* Cirrhosis of the liver
* Pachydermoperiostosis
* Familial clubbing
* Hypertrophic osteoarthropathy
* Acromegaly
*Graves' disease

Autosomal dominant conditions are

A. Gilbert syndrome.
B. Becker muscular dystrophy.
C. Turner syndrome.
D. Tuberous sclerosis.
E. Cystic fibrosis.
MCQ 02 Correct Answer - T F F T F
Cystic fibrosis:
A. It is most common in sub-Saharan Africa.
B. The most common mutation is called delta-F508.
C. The responsible gene is located on chromosome 14.
D. Can present in neonates with intestinal obstruction.
E. Can be investigated by measuring sweat electrolytes.

MCQ 03 Correct Answer - F T F T T

Cystic fibrosis is the most common potentially lethal

autosomal recessive disorder in Caucasian populations,
characterised by chronic suppurative lung disease and
chronic exocrine pancreatic insufficiency.
The predominant symptoms of Cystic fibrosis are attributed
to epithelial abnormalities in the respiratory, digestive and
reproductive tracts:
* Recurrent respiratory infection is a major presenting
* Pancreatic insufficiency (85%)
* 10% of Cystic fibrosis newborns suffer meconium ileus
* Hepatic cirrhosis
* Male infertility
The defective protein is a cAMP-regulated chloride channel
called the cystic fibrosis transmembrane conductance
regulator (CFTR).This defective channel leads to a high
concentration of sodium and a low concentration of chloride
in exocrine secretions.
Deletion of phenylalanine at position 508 on the long arm (q)
of chromosome 7 is the most common

Diagnostic investigations in cystic fibrosis include:

* immunoreactive trypsin in neonates
* sweat test
* nasal potential difference testing

Sweat test -The sweat test is diagnostic of cystic fibrosis.The

mass of sweat should be greater than 100mg for an
interpretable result.Sweat is induced by intra-dermal
injection of pilocarpine.
In cystic fibrosis, the chloride concentration if greater than
60 mmol/l and the sodium concentration is greater than 70
mmol/l. Sodium concentration is greater than chloride
concentration in the sweat.