Neurology 4 mrcp questions book - part 9 pps

2- Usually presents with fever, myalgia, and pharyngitis. 3- Renal and hepatic failures are seen. 4- The mortality rate may reach 50%. 5- No drug therapy against it can be used till now. Q8: Yellow fever, all of the followings are wrong, except: 1- Caused by an RNA togavirus infection transmitted from cows through fleas feces. 2- Fortunately has a long incubation period of 3-6 months. 3- There may be an intense neutrophil leukocytosis and even a leukemoid reaction. 4- The usual presentation is with fever, join pain, muscle pain, and headache. 5- Excellent response to lamivudine. Answer: 4 1- from monkeys through mosquitoes. 2- 3-6 days. 3- leukopenia is seen. 4- true, but not a specific picture. 5- false, no specific treatment, only supportive. Q9: Dengue, all of the followings true, except: 1- A mosquito born infection. 2- There is fever, lymph node enlargement, and skin rash. 3- All individuals in endemic areas should be vaccinated. 4- Intense headache and backache. 5- Has an incubation period of 5-6 days. Q10: Q fever, all of the followings are true, except: 1- There may be a history of exposure to animals. 2- May present as an atypical pneumonia. 3- One of the causes of culture negative infective endocarditis. 4- Poor response to tetracycline. 5- Liver dysfunction is seen. Q11: Typhus fevers in general, all of the followings are true, except: 1- Are arthropod born infection. 2- The rickettsia infects and damages the endothelium of small blood vessels. 3- The mortality is variable and depends on the infecting agent. 4- All have gastroenteritis as a common prominent feature. 5- The treatment of choice is tetracycline. Q12: Lyme disease, all of the followings are true, except: 1- History of a tick bite may not always be found. 2- The characteristic early skin rash may be not seen. 3- Cranial nerve palsies especially the facial nerve are seen. 4- Caused by spirochetes. 5- Joint involvement usually occurs in the form peripheral symmetrical small joint arthropathy. Q13: Secondary syphilis, all of the followings are true, except: 1- The rash is non itchy and characteristically spares the face. 2- Lymphocytic meningitis is seen and usually self limiting or asymptomatic. 3- VDRL is always positive. 4- Snail tract mucosal ulcerations are characteristic. 5- Even if not treated, not all patients will develop tertiary phase in the future. Q14: Paratyphoid fever when compared with typhoid fever, all of the followings are true, except: 1- Has shorter incubation period. 2- Usually presents with acute onset of vomiting and diarrhea. 3- The skin rash is much more prominent and common. 4- Less frequent intestinal complications. 5- Higher incidence of chronic carrier state. Q15: Cholera, all of the followings are true, except: 1- May cause death even before the diarrhea appears. 2- Usually occurs in epidemics. 3- The organism is motile. 4- Tetracycline is used to shorten the duration of shedding of the organism in stool. 5- Severe abdominal pain that may be confused with acute abdomen. Q16: Genital ulcers are caused by all but one of the followings, except: 1- Certain chlamydia strains infection. 2- Secondary syphilis. 3- Genital herpes infection. 4- Certain hemophillus strains infections. 5- Donavania granulomatis infection. Q17: Gonorrhea, all of the followings are true, except: 1- Short incubation period of 2-5 days. 2- Purulent uretheral discharge and dysuria are the main features. 3- Needs tetracycline therapy for at least 20 days. 4- Females tend to be more asymptomatic than males. 5- Recurrences and re-infections are common. Q18: Chemoprophylaxis is used in preventing many infectious disease, all of the followings are true, except: 1- Rifampicine is useful in hemophillus infection prophylaxis in close contacts. 2- Rifimpicine is useful in meningococcal infection prophylaxis in close contacts. 3- Erythromycine is useful in Legionares disease prophylaxis in close contacts. 4- Erythromycine is useful in diphtheria prophylaxis in close contacts. 5- Ampicilline is useful in infective endocarditis prophylaxis in high risk group before dental surgery. Q19: HIV, all of the followings are true, except: 1- ENV viral gene encodes for the envelope proteins which are important for the attachment and entry of the virus into cells. 2- Tuberculosis chest infection is much more common than pneumocyctis carinii infection in Africans. 3- AIDS dementia complex may be a presenting feature. 4- Cryptosoridium diarrhea can prove fatal in AIDS patients. 5- Kaposi sarcoma of the GIT is usually gravely symptomatic. Q20: Anti HIV medications, all of the followings are true, except: 1- Zidovudin can cause ragged red fibers on muscle biopsy. 2- Zalcitabine can cause esophageal ulceration. 3- Lipodystrophy is seen with protease inhibitors. 4- Non-nucleoside reverse transcriptase inhibitors can cause severe skin rashes. 5- Nail pigmentation is characteristically seen with squanavir. Q21: Poor prognostic factors in Pneumocystis carinii pneumonia (PCP) in HIV positive patients; all of the followings are true, except: 1- If occurs in a patient on no PCP prophylaxis. 2- High serum LDH. 3- High hypoxemia ratio. 4- Extensive chest radiographic changes. 5- A pre-existent chest infection. Q22: HIV patients are having a greater risk than the normal population of all of the followings, except: 1- Of reactivating a latent infection. 2- Of acquiring TB from an open contact. 3- Of developing a progressive primary disease. 4- Of developing an extra-pulmonary TB. 5- Of developing a mild CNS TB infection. Q23: The atypical chest x ray appearances of Pneumocystis carinii pneumonia in HIV patients include all of the followings, except: 1- Bilateral perihilar ground glass infiltrates. 2- Upper lobe infiltrates. 3- Unilateral involvement. 4- Lobar cavitations. 5- Focal consolidation. Q24: CMV retinitis in HIV infected patients, all of the followings are true, except: 1- There is a 90% fall in its incidence after the introduction of HAART. 2- 30% of patients have a bilateral disease at presentation. 3- Should be differentiated from acute retinal necrosis syndrome. 4- Vision will improve gradually in almost all cases. 5- Macular disease is rare. Q25: Cryptosporidium diarrhea in HIV infected patients, all of the followings are true, except: 1- Responsible for 20% of the causes of diarrhea in those patients. 2- It becomes chronic when the CD4 count is below 200/mm3. 3- Can cause malabsorption. 4- Immuno-fluorescence stains can detect the organism in stool. 5- May respond to interferon alpha. Q26: Mycobacterium avium intracellulare infections in HIV positive patients, all of the followings are true, except: 1- It is an environmental organism found in food and water. 2- All organs can be affected by a heavy infiltration of the organism. 3- Anemia and raised alkaline phosphatases are very commonly found. 4- Hepatosplenomegally are against the diagnosis. 5- Can be diagnosed by a positive blood culture. Q27: Filariasis, all of the followings are true, except: 1- Can cause a very high eosinophil count. 2- Microfilariae survie for 2-3 days only. 3- W. bancrofti is transmitted through a bite of Culex mosquito. 4- Calabar swelling is seen in Loasis. 5- Onchocerciasis produces a severe visual impairment. Q28: Tropical infections not associated with esosinophilia include all of the followings, except: 1- Malaria. 2- Trypanosomiasis. 3- Leishmaniasis. 4- Giardiasis. 5- Ascariasis. Q29: Tropical infections that are associated with eosinophilia include all of the followings, except: 1- Toxocariais. 2- Cysticercosis. 3- Strongyloidiasis. 4- Trypanosomiasis. 5- Schistosomiasis. Q30: The following infections correctly match their corresponding finding, except: 1- Onchocerciasis- diffuse dermatitis. 2- Fascioliasis- urticarial skin rashes. 3- Strogyloidiasis- meningitis. 4- Trichinosis- myositis. 5- Cysticercosis- malabsorption. Q31: Infective skin lesions in the tropics, all of the followings are true, except: 1- Myiasis can cause subcutaneous swellings. 2- Burruli ulcer is caused by mycobacterium ulcerans infection. 3- Larva currens is caused by strongyloidiasis. 4- Oreintal sore is caused by treponema infection. 5- Calabar swellings is caused by loa loa. Q32: During the 1 st month following solid organ transplantation; the following infections are common, except: 1- Herpes simplex. 2- Wound infections. 3- Pneumonias. 4- Cather-related bacteremia. 5- Nocardia brain abscess. Q33: During the 2 nd to 6 th months following solid organ transplantation; the following infections are common, except: 1- Listeria monocytogenes. 2- CMV. 3- Aspergillus. 4- Cryptococcus. 5- Staph aureus Q34: All of the following infections are associated with the presence of fecal leukocytes on stool examiantion, except: 1- Cholera. 2- Shigella. 3- Salmonella enteritidis. 4- Compylobacter jejuni. 5- Vibrio parahemolyticus. Q35: Which one of the following organism is the cause of Chagoma? 1- Toxoplassma gondii. 2- Leishmania donavani. 3- Hemophilus species. 4- Trypanosoma cruzi. 5- JC virus. Q36: Those who have cats at home are more liable for certain cat related infections that the general poulation, all of the following infections are true, except: 1- Toxacariasis. 2- Toxoplasmosis. 3- Strogyloidiasis. 4- Dermatomycosis. 5- Skin candidiasis. Q37: All of the followings are the cause of a biologic chronic false positive Rapid Plasma Reagent (RPR) testing, except: 1- Systemic lupus erythematosus. 2- Lepromatous leprosy. 3- Intravenous drug addicts. 4- Pregnancy. 5- Rheumatoid arthritis. Q38: The following can cause a positive monospot test, except: 1- Hepatitis viruses. 2- Lymphoma. 3- Serum sickness. 4- Infectious mononucleosis. 5- Streptococcus skin infections. Q39: Lock jaw is classically seen in tetanus; all of the followings can cause low jaw and trismus, except: 1- Pheothiazines. 2- Sarcoma of the jaw. 3- Strychnine poisoning. 4- Guillain Barre syndrome. 5- Ludwig's angina. Q40: In which sexually transmitted disease does the "groove sign" appear: 1- Lymphogranuloma venereum. 2- Granuloma inguinale. 3- Secondary syphilis. 4- Gonorrhoea. 5- Herpes simplex type I infection. End of Infectious disease… Chapter XIII / Immunology Q1: Immunoglobulins, all of the followings are true, except: 1- IgA is mainly found in body fluids 2- IgM is a high molecular weight immunoglobulin that is the largest of all immunoglobulins. 3- IgG is the only one that passes the placental barrier. 4- IgE is involved in Type IV hypersensitivity reactions. 5- IgD is found on the surface of B cells and may be involved in the maturation of them. Q2: Immunoglobulins, all of the followings are true, except: 1- IgA may cause hyperviscosity in multiple myeloma. 2- IgE is very high in allergic bronchopulmonary aspergillosis. 3- IgG is the usual immunoglobulin detected as a rheumatoid factor by the slide agglutination test. 4- Selective IgA deficiency prevalence is 1/700 of the general population. 5- Anti-nuclear factor is usually an IgG autoantibody. Q3: The complement system, all of the followings are true, except: 1- The classical pathway can be activated by IgG immune complexes. 2- Properdin deficiency is usually X linked. 3- Deficiency of late complement components is associated with disseminated Niesseria infection. 4- SLE may be induced by congenital deficiency of the early complements components. 5- C1 esterase inhibitor deficiency is autosomal dominant and the defect is qualitative in 90% of cases. Q4: Hypogammaglubuinemia is associated with all of the followings, except: 1- Thymoma. 2- Phenytoin treatment. 3- Myotonia dystrophica. 4- Protein losing enteropathy. 5- Chronic active hepatitis. Q5:In common variable immune deficiency (CVID), all of the followings are true, except: 1- 30% of cases have an associated lymphopenia and lymphadenopathy. 2- IgA is virtually absent, but IgG is usually severely decreased but still detectable. 3- Although defective cell mediated immunity is documented but opportunistic infections due to this defect is rare in clinical practice. 4- In theory the presentation may be at any age ,but usually in the 3 rd decade. 5- First degree relatives are at increased risk of IgG subclass deficiency. Q6: Long term complications of hypogammaglobulinemia, all of the followings are true, except: 1- Induction of varieties of autoimmune diseases. 2- High risk of lymphoreticular malignancies. 3- Bronchiectasis. 4- Malabsorption. 5- Chronic active hepatitis. Q7: X linked agammaglobulinemia, all of the followings are true, except; 1- T cell number and function are normal. 2- There are no mature B cells in the peripheral blood. 3- IgG is usually still detectable but extremely low. 4- The presentation is usually after 3-6 months after birth. 5- It is a very common disease. Q8: Selective IgA deficiency, all of the followings are true, except: 1- Its incidence is 1/700 of the general population and usually sporadic. 2- In theory, checking serum IgA level should be done in all patients prior to truncal vagotomy. 3- All suspected patients should be tested for IgA auto-antibodies. 4- It is seen in 50% of celiac disease patients. 5- Can be found in patients with rheumatoid arthritis. Q9: In HIV infection, all of the followings are true, except: 1- There are M-tropic and T tropic strains. 2- There is polyclonal B cell activation. 3- NK cell number and function are usually impaired. 4- There is no single mechanism to explain the progressive CD4 positive cells attrition over time. 5- The macrophages are CD4 negative cells and hence protected from infection. Q10: The major histocompatibility complex (MHC) and human leukocyte antigen (HLA), all of the followings are true, except: 1- MHC class II antigen is restricted in distribution to certain cell types. 2- The inheritance is autosomal co-dominant 3- The loci encoding the complement components are located near by at chromosome number 6. 4- Certain HLA haplotypes are associated with varieties of autoimmune diseases. 5- HLA DR2 confers a high risk of developing type I diabetes mellitus. End of immunology… Chapter XIV / Psychiatry Q1: The followings, except one, are consistent with acute confusional state rather than dementia in evaluating a patient with abnormal cognition: 1- Fluctuated level of consciousness. 2- Rapid development. 3- Visual hallucination. 4- The presence of fever. 5- Gradual loss of short term memory over time. Q2: Anorexia nervosa, all of the followings are true, except: 1- The blood levels of prolactin, cholesterol, and glucagons are raised. 2- Bradycardia and hypotension are found. 3- Prominent sexual and physical retardation. 4- Amenorrhea is usually present for more than 3 months. 5- Usually starts around adolescence. Q3: Which one of the followings is true regarding Bulimia Nervosa? 1- Weight loss is prominent. 2- Usually starts around puberty. 3- Hospital admission is required to treat it. 4- Loss of self control and binge eating behavior is present. 5- Grossly disorganized perception of body image and weight. Q4: Good prognostic factors in schizophrenia, all of the followings are true, except: 1- Acute onset of true disorder. 2- Good job records. 3- The presence of a clear cut precipitating event. 4- Normal premorbid personality. 5- Absence of affective symptoms. Q5: In depression, all of the followings are true, except: 1- The presence of low self esteem is prominent. 2- Some patients lose weight. 3- Loss of pleasure and loss of libido. 4- Presence of irritability is against the diagnosis. 5- Some patients have early insomnia. Q6: Antipsychotic drugs, all of the followings are true, except: 1- The newer generation like olanzapin is more effective at the negative symptoms of schizophrenia. 2- In general, no one drug is superior in efficacy over the others. 3- Extrapyramidal features are uncommon in those antipsychotics with prominent anticholinergic side effects like thioridazine. 4- May be used in the control of acute mania. 5- Some of them may be used in the control of nocturnal enuresis. Q7: Tricyclic antidepressants, all are true except 1- Mainly inhibit the reuptake of noradrenalin and serotonin at receptor sites in the brain. 2- Should be used with caution in elderly people as they may cause cardiac toxicity. 3- May cause postural hypotension. 4- Their effect is usually seen after 2-4 weeks, some times up to 6 weeks. 5- Are the first line agents in severe depression with attempted suicide. Q8: Alcohol abuse is suspected in all but one of the followings? 1- Unexplained atrial fibrillation. 2- Unexplained hypertension. 3- Unexplained diarrhea. 4- Unexplained gout in pre-menopausal female. 5- Unexplained papulomacular skin rash. Q9: The risk of a success after an attempted suicide is increased in the followings, except: 1- Being a young female rather than a male. 2- Living alone. 3- Presence of a malignant disease. 4- Using a gun rather than self poisoning. 5- Being divorced rather than happily married. Q10: All of the followings are indications for electro-convulsive therapy in depression, except: 1- Severe depression with a failed suicidal attempt using a gun. 2- Severe depression interfering with daily eating causing nutritional problems. 3- Mildly depressed patient intolerant to the oral tricyclics. 4- Severe depression with prominent psychotic symptoms. 5- Agitated depression. End of Psychiatry… [...]... appearance of acneform rash: 1- Systemic steroids 2- Androgenic steroids 3- Lithium carbonate 4- Phenytoin 5- Isotretinoin Q4: Rosacea , all of the followings are wrong, except : 1- Usually seen in adolescents 2- Prominent white and black comedons are present 3- Unfortunately there is a poor response to tetracyclines 4- Facial telangiectasias and erythema are rarely seen 5- Conjunctivitis and keratitis... except: 1- Dusky red painful and tender nodules on the shin 2- Infiltration of long standing skin scars 3- Purplish plaques on the nose 4- Hypopigmented papules 5- Erythroderma Q18: Causes of erythema multiforme, all of the followings are true, except: 1- Mycoplasma infections 2- Barbiturates 3- Treatment of internal malignancies with radiotherapy 4- Human herpes virus type 8 infection 5- Orf Q 19: Pyoderma... steroids 5- Regular use of cyclosporine Q 24: Drug induced hirsutism in women, all of the followings can be a cause, except: 1- Pheytoin 2- Cyclosporine 3- Minoxidil 4- Androgens 5- Oral contraceptive pills Q25: Investigations used in eczema in general, all of the followings are true, except: 1- Patch test 2- Total and specific IgE blood level 3- Prick skin testing 4- Bacteriology swab from the skin lesion... true, except: 1- In 50% of cases, no cause can be identified for its development  2- Skin biopsy is greatly helpful in the diagnosis 3- Can be a recurrent event 4- May respond to minocycline 5- Local infections should be treated aggressively Q20: The followings are the skin manifestations of porphyria cutanea tarda, except: 1- Excessive skin fraglity 2- Small skin erosions 3- Milias 4- Diffuse skin... failure 4- Pregnancy 5- Treatment with rifampicin Q7: Intense disabling itching is characteristically seen in all but one of the followings: 1- Scabies  2- Lichen planus 3- Dermatitis herpetiformis 4- Atopic eczema 5- Vitiligo Q8: Nail examination can be very helpful in providing a clue to many diseases, all of the followings are true, except: 1- Blue nail lunulae may indicate Wilson's disease 2- Beua's... hypopigmentation 5- Facial hypertrichosis Q21: Causes of generalized skin hyperpigmentation, all of the followings are true, except: 1- Nelson's syndrome 2- Primary biliary cirrhosis 3- Chronic renal failure 4- Phneylketonuria 5- Addison's disease Q22: The followings might cause a flare up of psoriasis, except: 1- A medication given to treat systemic hypertension 2- A medication given to a bipolar patient 3- A prophylactic... with fine telangiectasia 4- Best treated by surgery 5- Mainly seen on the face Q11: Risk factors for malignant melanomas, all of the followings are true, except: 1- Ultra violet radiation exposure 2- Fair skin 3- Positive family of malignant melanoma 4- Atypical melanocytic naevi 5- Diabetes mellitus Q12: Malignant melanoma of the skin; all of the followings are true, except: 1- Two thirds of invasive... central Africa 4- Skin surgery to remove a small benign nevus 5- A medication given to treat an acute attack of asthma Q23: general principles in the treatment of eczemas, all of the followings are true, except: 1- Explanation and reassurance and encouragement of the patient 2- Avoidance of contacts with ittitants 3- Regular use of greasy emollients 4- Appropriate use of topical steroids 5- Regular use... except: 1- Can produce a scarring alopecia 2- Mouth mucosal involvement is common but frank mucosal ulceration is rare 3- The absence of itching is against the diagnosis 4- The disease is disabling and persists for life with relapses and remissions 5- Nail changes are seen Q6: Causes or pruritis, all of the followings are true, except: 1- Oral contraceptive pills 2- Iron deficiency anemia 3- Chronic... transplantation 2- Dystrophic epidermolysis bullosa 3- Chronic cutaneous ulceration 4- Dark skin 5- Over treatment with PUVA therapy for long time Q15: Regarding skin tumors and their precursors in general, all of the followings are wrong, except: 1- Seborrhoeic warts are malignant tumors that are seen mainly in young people 2- Actinic keratosis lesions are having a full thickness dysplasia in the skin 3- Bowen's . Onchocerciasis- diffuse dermatitis. 2- Fascioliasis- urticarial skin rashes. 3- Strogyloidiasis- meningitis. 4- Trichinosis- myositis. 5- Cysticercosis- malabsorption. Q31: Infective skin lesions. except: 1- Malaria. 2- Trypanosomiasis. 3- Leishmaniasis. 4- Giardiasis. 5- Ascariasis. Q 29: Tropical infections that are associated with eosinophilia include all of the followings, except: 1- Toxocariais. 2-. reaction. 4- The usual presentation is with fever, join pain, muscle pain, and headache. 5- Excellent response to lamivudine. Answer: 4 1- from monkeys through mosquitoes. 2- 3-6 days. 3- leukopenia