Medical Finals Quiz - July 2006

(Closing date: 1st August 2006)

With Paul Hamilton, (and one question by Stephen Bridgett)

Please take part in our monthly quiz. This quiz is open to all.

This month for the quiz winner, there is a very useful book on "Essential Revision Notes in Medicine for Students" By: Dr Philip Kalra. (This book focuses on what is essential learning for medical undergraduates and gives readers an 'all round' knowledge of medicine at this level.) This book is very kindly provided by PasTest.

The winner will be picked at random from all entries (ie. does not matter if your answers are correct or not).

In order to contact the winner of the book, please enter your name and email address at the bottom of this page.

The closing date is 1st August 2006.

Learn as you test yourself. Detailed answers with teaching points will be given after you complete this page.

Question 1

Which of the following measures is not a poor prognostic indicator in patients with pneumonia?

	(a) Patient age of 82 years
	(b) Respiratory rate of 28 breaths per minute
	(c) Diastolic blood pressure of 45 mmHg
	(d) Confusion
	(e) Serum urea level of 20 mmol/l

Question 2

The following picture is of a Star-Edwards mechanical heart valve

(Picture from: EMedicine)

Which of the following medications should a patient with a mechanical heart valve be taking:

	(a) Aspirin 300 mg
	(b) Warfarin aiming for an INR of 2.0
	(c) Prednisolone 40 mg, or Aziothioprine, to reduce rejection of the valve
	(d) Warfarin aiming for an INR of 3.0
	(e) Regular Penicillin V 500mg QID to reduce risk of infection and endocarditis

Question 3

Which of the following is a feature of life threatening asthma?

	(a) Peak expiratory flow rate 35% of the patient's best
	(b) Sinus tachycardia at 135 beats per minute
	(c) Marked expiratory wheeze all over the chest
	(d) Sinus bradycardia at 40 beats per minute
	(e) Ability to talk in full sentences

Question 4

For patients with chronic obstructive pulmonary disease (COPD), which of the following is one of the true indications for consideration for long-term oxygen therapy (LTOT)?

	(a) FEV₁ = 1.8 litres
	(b) PaO₂ = 10.1 kPa when breathing 28% oxygen
	(c) PaO₂ = 7.1 kPa when breathing 21% oxygen
	(d) Currently a smoker
	(e) More than 2 hospital admissions with COPD in the preceding 6 months

Question 5

Which of the following renal conditions is most strongly linked with pulmonary embolism?

	(a) Renal artery stenosis
	(b) Urinary tract infection
	(c) Polycystic kidney disease
	(d) Acute tubular necrosis
	(e) Nephrotic syndrome

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