MEDICINE: PRACTICE 12

  

SINGLE BEST OPTION SERIES

         INSTRUCTION: SELECT THE SINGLE BEST OPTION

1.        Contraindications to intensive glycemic control in patients with diabetes mellitus does not usually include:
   a.       Advanced renal disease
   b.      Elderly patients
   c.       Children under 7 years of age
   d.      All of the above
   e.      None of the above
   2.       Features of type 2 diabetes mellitus does not include:
   a.       Tissue resistance to the action of endogenous insulin
   b.      Decreased  free fatty acid flux and triglyceride levels
   c.       Ketoacidosis may occur as a result of corticosteroid therapy
   d.      Altered mental status may occur
   e.      None of the above
   3.       Which of the following is incorrect about continuous subcutaneous insulin infusion devices?
   a.       Insulin reservoir, tubing and infusion set need to be changed using sterile techniques every 2 to 3 days
   b.      Their use is encouraged for patients with diabetes mellitus unable to obtain target control while on multiple injection regimens
   c.       Pregnancy is an indication for these device
   d.      The devices are external closed-up pumps for insulin delivery
   e.      None of the above
   4.       Which of the following is incorrect about gestational diabetes mellitus?
   a.       Insulin resistance is most pronounced in the second trimester of pregnancy
   b.      The usual cause is not pancreatectomy nor pancreatitis
   c.       It is usually noted for the first time during pregnancy
   d.      Placental hormones are implicated in the pathogenesis
   e.      None of the above
   5.       The following are risk factors for hyperosmolar hyperglycaemic syndrome in patients with diabetes mellitus except:
   a.       Inadequate oral hydration in elderly patients
   b.      Peritoneal dialysis and haemodialysis
   c.       Use of phenytoin and diuretics
   d.      Beta blocker or steroid therapy
   e.      None of the above
   6.       Treatment options for severe hypoglycaemia manifesting with stupor include the following except:
   a.       20-50ml of 50% glucose solution by intravenous infusion over a period of 2-3 minutes.
   b.      1mg of glucagon either subcutaneously or intramuscularly
   c.       Small amounts of honey or syrup inserted into the buccal pouch
   d.      Dextrose tablets, glucose gel or any sugar containing beverages
   e.      None of the above
   7.       Which of the following is incorrect about complications of insulin therapy in diabetes mellitus?
   a.       Human and analog insulin have markedly reduce the incidence of insulin allergy
   b.      A low titre of circulating IgG anti-insulin antibodies that neutralize the action of insulin to a negligible extent develops in most insulin-treated patients, resulting in insulin resistance.
   c.       Systemic autoimmune processes such as lupus erythematosus occur commonly
   d.      Lipoatrophy is almost never seen since the development of human and analog insulin preparations of neutral P^H.
   e.      Lipohypertrophy may be avoided by avoiding specific injection site and/or liposuction.
   8.       Which of the following is false about urticaria?
   a.       It is an area of focal dermal oedema from leaky dermal capillaries due to mainly histamine from cutaneous mast cell degranulation.
   b.      Demographism refers to urticaria at sites of mechanical pressure on the skin
   c.       Exercise, anxiety and emotional factors may precipitate it.
   d.      They are usually non-pruritic
   e.      Oral 10mg cetirizine daily is helpful in management.
   9.       Which of the following is incorrect about peliosis hepatitis?
   a.       Withdrawal of azathioprine leads to remission in renal transplant patients
   b.      It is typically symptomatic
   c.       There are both phlebectatic and parencymatous types
   d.      It is linked to the use of steroids and HIV/AIDS.
   e.      It is a cause of haemoperitoneum
   10.   Which of the following is true about ventricular septal defects?
   a.       They are the least common congenital cardiac defect
   b.      Surgical closure is indicated if Eisenmenger’s syndrome develops
   c.       ‘Maladie de roger’ is a large defect producing a loud murmur
   d.      It may present as cardiac failure in infants.
   e.      Chest X-ray shows pulmonary plethora
   
   
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