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Dicm 333 :Medicine Ii Question Paper
Dicm 333 :Medicine Ii
Course:Education
Institution: Kenya Methodist University question papers
Exam Year:2014
KENYA METHODIST UNIVERSITY
END OF 2''ND ''TRIMESTER 2014 (FQE) EXAMINATION
SCHOOL : MEDICINE & HEALTH SCIENCES
DEPARTMENT : CLINICAL MEDICINE
UNIT CODE : DICM 333
UNIT TITLE : MEDICINE II
TIME : 3 HOURS
INSTRUCTIONS
Write your registration number on each paper
Attempt all Questions
MCQs
Correct response earns one mark
You lose one mark for every incorrect response
You do not lose a mark if you do not attempt
Answer all questions on MCQs paper
Question 1
In haemolytic jaundice, there is
Pale conjunctiva
Pale stolls
Dark urine
Normal lively functions tests
Raised direct biliralsin
Question 2
Concerning acute pneumatic fever
Blood culture will identify the causative organisms
The organisms respond to penicillin therapy
Emboli may cause strokes
Hepato-splenomegally is the finding
Erythromycin is the best alternative in case of patient being allergic to peniallin
Question 3
Conditions in which rheumatoid factor is positive:
Rheumatoid arthritis
Viral hepatitis
Tuberculosis
Infective hepatitis
Systemic lupus erythematosus
Question 4
Concerning leukemia
Acute leukaemias are found in the elderly
There is bleeding tendencies
Bone marrow transplant has been proven to be curative
Irradiation is the cause
Associated with chromosomal abnormalities
Question 5
Lymphomas may present with the following features
Weight loss
Night sweats
Splenomegally
Lymphadenopathy
Chest pain
Question 6
Concerning ankylostomiasis
The parasite is transmitted through oral route
Haemoptysis may be a symptom
Iron deficiency anemia may develop
Stool test for occult blood is positive
Single dose of albendazole 400mg is the best choice of treatment
Question 7
The following are true of pleural effusion
The onset is acute
Stony dull percussion note is the finding
Mediastinal structures are deviated to the affected side
Vocal resonance is increased
Breath sounds are absent
Question 8
The following statements are true
A heart disease patient complains of tachycardia
A patient with thyrotoxicosis may present with symptoms similar to one of the heart disease
A cardiac pain is usually aggravated by exertion
A true cardiac pain is situated at the pericardium
Syncope is due to inadequate blood supply to the brain.
Question 9
The following statements are true of infective endocarditis:
It is the inflammation of the outer covering of the learnt
The values are rarely affected
Bleeding into the skin can be sign
There may be proteins in urine
Erythrocyte sedimentation rate is decreased
Question 10
An Obese woman is admitted with two days history of a lower limb swelling. The leg is warm and tender:
She may be having cellutitis
Filariasis is the most likely diagnosis
Hypoproteinuria is the cause
Elavation of the limb is important treatment
Recent surgical removal of abdominal malignancy is the contributor.
Question 11
The following conditions/diseases cause chronic diarrhea.
Strongyloidosis
Shigellosis
Tropical sprue
Salmonellosis
HIV enteropathy
Question 12
John returned from Mombasa after three weeks stay with clinical features of malaria. He later developed drowsiness and convulsions. The following statements are true:
Plasmodium vivax is the likely cause
Drowsiness is purely due to parasitaemia
The drug of choice is guine
Blood slide should be done
Acute trypanomiasis is the likely diagnosis
Question 13
A patient presents with left sided abdominal mass that extends to the umbilicus. The following features suggest it to be spleen
It extends to the umbilicus
It is pulsatile
It is bimanually palpable
Cannot be palpated above sub costal margin
It is dull on percussion
Question 14
The following are the signs of lower motor neuron lesion
Muscle weakness
Increased tendon reflexes
Extensor plantar response (Babinkis sign)
Fasciulation
Hypotonia
Question 15
The following are true of typhoid fever
It is an infectious disease
Constipation may be a symptom
Rose-red spots may be noted on the skin
Haemorrhage may be a complications
Blood culture is the most diagnostic method
Question 16
The following antihypertensive drugs are correctly matched
Hydrochlorothiazide -Beta-blocker
Atenolol – angistensin receptor
Captopril – diuretic
Nifedipine – calcium channel blockers
Lorsatan – angiotensin converting enzyme inhibitor
Question 17
A patient with congestive cardiac failure presents with the following clinical features:
Non-tender hepatomegally
Crepitations at lung bases
Normal pulse rate
Pitting ankle oedema
Deripheral cyanosis
Question 18
A 24 year old man presents to your clinic with marked dyspnea and haemoptysis
Pulmonary tuberculosis is definitely the diagnosis
A murmur of mitral stenosis may be present on ausarltation
Bronchiectasis may be the cause
Intravenous aminophylline may be useful
Franol and haematinics would be sufficient treatment
Question 19
Nephrotic syndrome presents in the following ways
Massive proteunceria
Hyperalbuminemia
Generalized body malaise
Oedoma of the lower limbs
Facial puffiness
Question 20
Causes of iron deficiency anaemia include
Sickle cell disease
Prematurity
Hookworm infestation
Ulcerative colitis
Dietary deficiency
Question 21
Chronic complications of diabetes mellitus include:
Diabetic neuropathy
Diabetic nephropathy
Diabetic foot
Diabetic ketoacidosis
Hypoglycemia
Question 22
Concerning nephritic syndrome
Characterized by massive proteinuria
Oliguria
Hypertension
Gloverular filtration rate increased
Acute pyelonephritis is a differential diagnosis
Question 23
The following drugs are used in the management of status epilepticus
Tegrettol
Phenobarbitone
Slibencamide
Sodium valproate
Clonazepam
Question 24
Concerning thyroid storm
It is a life threatening complication
It may follow custoral thyroidectomy
Atrial florillation is a feature
Antibiotics have a role in management
Hypoglycaenia is a feature
Question 25
Concerning urinary retention
Renal stones can be responsible
Urethral stricture may be responsible
Suprapubic catheterization may be one way of management
Patient may have dysuria
Benign prostatic hyperplasia is the cause in the elderly.
Question 26
The following are true of a case of meningitis
Coma can be a complication
Photophobia may be a complaint
Treatment is given for a period of two weeks
Hemiplegia may be a complication
Amphotericin is drug used in the treatment
Question 27
Concerning bronchial asthma
May result from mucosal swelling
The difficulty in breathing is on inspiration
It runs in families
Woolen pillows may aggrate it
People with allergy are prove to it
Question 28
The following are true of milliary tuberculosis
It is due to droplet infection
Chest X-ray reveals opacity of the lobe affected
It runs in families
Woolen pillows may aggrate it
People with allergy are prone to it.
Question 29
Concerning cerebral vascular accident:
About 80% are due haemorhage
Aspirin is indicated in haemorhagic cases
Thrombotic events occur in infective endocarditic
Raised blood pressure may be responsible
HIV is a predisposing factor.
Question 30
The following vitamins are matched correctly with the conditions when deficient.
Vitamin A – Night blindness
Vitamin B12 – Ricketts
Vitamin C – Beriberi
Niacin – Pellegra
Vitamin K – hemolytic anaemia
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