Medical Finals Quiz - June 2007

(Closing date: 1st July 2007)

With: Andrew Black, Belfast & Ian Bickle, Sheffield

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 Skills Practice for OSCEs in Medicine" By: Dr. D McCluskey - is divided into 'skills' sections – History Taking, Clinical signs, Clinical Examination, Communication Skills, Therapeutics and Pharmacology, Radiology, Interpretation of Data. Each section includes 15 to 20 OSCEs in question & answer format. 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 July 2007.

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

Question 1

Which of the following is correct regarding a Colle's fracture?

	(a) the fracture shows volar displacement
	(b) the fracture occurs within 2.5cm of the wrist joint
	(c) the fracture shows ulnar displacement
	(d) is associated with fracture of the radial styloid
	(e) is commonly described as 'green-stick' deformity

Question 2

A four week old male infant presents with difficulty feeding. Mum is worried that he vomits (forcefully) after his feeds, and this is becoming more frequent. In addition, he is constantly hungry despite feeding well and has failed to gain any weight. Stools are normal.

On examination a palpable 'olive' mass is felt in the right upper quadrant.

What is the most likely diagnosis?

	(a) gastro-oesophageal reflux disease
	(b) duodenal atresia
	(c) pyloric stenosis
	(d) UTI
	(e) Intussusception

Question 3

Which of the following is TRUE regarding a Monteggia fracture?

A Monteggia fracture is best described as a fracture of the:

	(a) ulna with dislocation of the head of the radius
	(b) radius with a dislocation of the inferior radio-ulnar joint
	(c) radius without dislocation of in inferior radio-ulnar joint
	(d) ulna without dislocation of the head of radius
	(e) ulna and the radius

Question 4

A 6 year old boy presents to A&E with a short history of abdominal and joint pain. He is otherwise well and apyrexic. You notice a non-blanching purpuric rash on his legs.

What diagnosis would be your primary concern?

	(a) Thrombocytopenic purpura
	(b) Henoch-Schonlein purpura
	(c) Erythema nodosum
	(d) SLE
	(e) Chronic urticaria

Question 5

A four month old infant presents with 'abnormal jerky movements'. Mum describes repeated violent flexor spasms of the head, trunk and limbs followed by extension of the arms. It is associated with intermittent loss of consciousness. The spasms most commonly occur in the morning, shortly after wakening.

The following EEG was obtained:

(Reprinted with permission from eMedicine.com.)

What diagnosis would you consider?

	(a) West syndrome
	(b) Lennox-Gastaut syndrome
	(c) Breath-holding attack
	(d) Rolandic epilepsy
	(e) Absence seizure

Question 6
Select which charity medicalfinals.co.uk should next give donations from 2007 to:
StreetReach - provides support services for adults and young people involved in prostitution or sexual exploitation. www.StreetReach.org.uk Treeton church tower - restoration of St Helen's church tower in Treeton, Yorkshire. Treeton partnership projects Tearfund's "Work a Miracle" project - aims to reduce HIV transmission to babies in Africa by giving anti-HIV drugs to the mother just before delivery. www.TearFund.org.uk/Miracle "Shine a Light" - Billy McCrory (52), from Belfast, who has suffered from a heart condition for 10 years, founded Shine A Light in 1997 in order to give children with cancer a better life. Newspaper writeup MIND - leading mental health charity in England and Wales. Works to create a better life for everyone with experience of mental distress. www.mind.org.uk
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