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MCQs – 19 Mar 2015

Q.1

AGE-RELATED HEARING LOSS (PRESBYACUSIS)

Normally begins at around 60 years of age.

Is caused by deterioration of hair cells in the cochlea.

Makes tones, especially lower-frequency ones, less audible.

Is coped with better by women than by men.

Patients should be advised to stop using a hearing aid if they have not adapted to it within a month.

Q.2

TOPICAL HYDROCORTISONE 1 PER CENT

Should not be used on the face.

Cream is best for chronic, dry, lichenified conditions.

Is an effective treatment for acute sunburn.

Can be bought over the counter from a pharmacist.

Should not be used for more than seven days.

Q.3

IN A 60-YEAR-OLD PATIENT WITH WHEEZING AND BREATHLESSNESS, THE FOLLOWING FEATURES WOULD SUGGEST A DIAGNOSIS OF COPD RATHER THAN OF ASTHMA

‘Morning dip’ of PEFR.

Was a ‘chesty’ child.

Good, objective response to steroid trial.

Smoker or ex-smoker.

History of winter bronchitis.

Q.4

CHARACTERISTIC FEATURES OF CLUSTER HEADACHES INCLUDE

Affects females rather than males.

Excruciating pain located behind or around one eye.

Repetitive jabs of pain lasting for seconds.

Clustered episodes lasting three-to-16 weeks.

Associated ipsilateral nasal or eye symptoms.

Q.5

CLUES FOR RECOGNISING ANOREXIA NERVOSA IN CHILDREN INCLUDE THE FOLLOWING

Excessive interest in cooking.

No interest in sport or exercise.

Unusual behaviour at meal times.

Feeling cold.

Temper outbursts.

A.1

False. It begins at around 50.

True. It is a natural part of the ageing process.

False. It makes sounds less clear and higher frequency notes less audible.

True. Through lip-reading and other strategies.

False. When first worn, sound seems too loud and the patient has to be encouraged to persevere so that neural readaption can take place.

A.2

False. Though prolonged use in large quantities probably undesirable.

False. Ointment is. Cream best for subacute, moist conditions.

True. Cream TDS.

True. Though patient may have to say ‘I’m not going to use it on my face’.

False. Parents should not be afraid to use it properly in children with eczema. In ordinary use, local side-effects are extremely uncommon.

A.3

False. And day-to-day variability or reversibility of PEFR suggests asthma.

False. Far more likely to be asthma.

False. Partial response only in 10 per cent or so of COPD patients.

True. Nearly always a history of smoking for more than 20 pack-years.

True. Common in COPD.

A.4

False. 0.5 per cent prevalence in males, 0.1 per cent in females.

True. May radiate to temple, jaw, nose, chin or teeth.

True. Unlike trigeminal neuralgia, pain lasts 15-180 minutes.

True. At intervals of six months to five years.

True. At least one of lacrimation, mitosis, ptosis, eyelid oedema, nasal congestion, rhinorrhoea, forehead and facial sweating.

A.5

False. No interest in food and restricted food intake.

False. Increase in sport, exercise and time spent on homework.

True. With restricted range of food eaten.

True. Or dizzy and bradycardia, amenorrhoea, lanugo hair.

True. And an inability to tolerate unplanned events, especially those involving food.

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