MEDICINE PRACTICE 4

              INSTRUCTION: SELECT THE SINGLE BEST OPTION:

1.          The following will usually necessitate a reduction in the quantity of intravenous fluid to rehydrate a patient with diabetic ketoacidosis except:
   a.       When the patient is elderly
   b.      When the patient is an adolescent
   c.       Co-morbid heart failure
   d.      All of the above
   e.      None of the above
   2.       Which of the following is incorrect about diabetic ketoacidosis and its management?
   a.       May present with acute abdomen
   b.      May present with protracted vomiting
   c.       The mortality rate of diabetic ketoacidosis is higher than that of hyperosmolar hyperglycaemic state
   d.      Nasogastric tube may be necessary in unconscious patients
   e.      There may be need to give mannitol.
   3.       The following are usual findings in a patient with Addisonian crisis except:
   a.       Hypotension
   b.      Hypokalaemia
   c.       Hypoglycaemia
   d.      Hypercalcaemia
   e.      Hyponatraemia
   4.       Addison’s disease is also known as:
   a.       Primary adrenal insufficiency
   b.      Secondary adrenal insufficiency
   c.       Tertiary adrenal insufficiency
   d.      Odine’s curse
   e.      None of the above
   5.       The following findings are usually common to both diabetic ketoacidosis and Addisonian crisis except:
   a.       Hypotension
   b.      Fever
   c.       Weakness
   d.      Abdominal pain
   e.      Tachycardia
   6.       Which of the following is not a feature of secondary hypoadrenalism?
   a.       Hyperpigmentation of the skin
   b.      Postural hypotension
   c.       Anorexia
   d.      Weightloss
   e.      Malaise
   7.       Common precipitants of Addisonian crisis does not include:
   a.       Intercurrent disease/infection
   b.      Surgery
   c.       Trauma
   d.      Sorghum meal
   e.      None of the above
   8.       A patient with vitiligo was found to have adrenal insufficiency. The most likely cause of this presentation of adrenal insufficiency is:
   a.       Autoimmune
   b.      HIV/AIDS
   c.       Amyloidosis
   d.      Metyrapone therapy
   e.      Withdrawal of suppressive glucocorticoid therapy
   9.       The following may cause adrenal insufficiency except:
   a.       Use of drugs like ketoconazole and etomidate
   b.      Haemochromatosis
   c.       Sheehan’s syndrome
   d.      Simmond’s disease
   e.      None of the above
   10.   Which of the following is incorrect about Waterhouse-Friedrichsen syndrome:
   a.       It usually causes Cushing’s disease
   b.      It may cause primary adrenal insufficiency
   c.       It is adrenal gland failure from bleeding into the adrenal glands
   d.      Neisseria meningitidis is a common cause
               e.   It is preventable by vaccination 

                                                      

                                        ANSWERS 
                                           1. b
                                           2. c
                                           3. b
                                           4. a
                                           5. b
                                           6. a
                                           7. d
                                           8. a
                                           9. e
                                          10. a