MEDICINE PRACTICE 7

               SINGLE BEST OPTION SERIES
   INSTRUCTION: SELECT THE SINGLE BEST OPTION:

1.         Which of the following route of body temperature measurement is most representative during assessment of fever?
   a.       Rectal
   b.      Aural
   c.       Axillary
   d.      All of the above
   e.      None of the above
   2.       The following are causes of excessive sweating without temperature elevation except:
   a.       Alcohol consumption
   b.      Anxiety
   c.       Thyrotoxicosis
   d.      Infective endocarditis
   e.      Excessive environmental heat
   3.       The following findings on ophthalmoscopy are matched with appropriate causes except:
   a.       Salt and pepper retinopathy........................toxoplasmosis
   b.      Roths spots...................................................infective endocarditis
   c.       Exudates.......................................................cytomegalovirus retinitis
   d.      Choroid tubercles.........................................tuberculosis
   e.      Loss of red reflex...........................................endophthalmitis
   4.       Which of the following is incorrect:
   a.       Fever implies an elevated core body temperature greater than 38.0⁰C
   b.      In cellulitis, the depth of affectation is usually limited to the epidermis and dermis.
   c.       Fever may be missed because oral temperatures are usually unreliable in older people.
   d.      Bacterial abscess may be a cause of recurrent fever
   e.      Rigors imply a rapid rise in body temperature.
   5.       Which of the following investigation is inappropriate for a patient presenting with fever:
   a.       Chest X-ray
   b.      Full blood count
   c.       Clostridium difficile assay
   d.      Urinalysis
   e.      None of the above
   6.       Which of the following is an inappropriate management management option in a patient with fever:
   a.       Tepid sponging
   b.      Administering paracetamol
   c.       Cold saline lavage
   d.      Replacement of salt and water
   e.      None of the above
   7.       Which of the following is correct about pyrexia of unknown origin (PUO)?
   a.       It is defined as temperature persistently above 38.0⁰C for more than one week without diagnosis despite investigations
   b.      It is defined as temperature persistently above 38.0⁰C for more than two weeks without diagnosis despite investigations
   c.       It is defined as temperature persistently above 38.0⁰C for more than three weeks without diagnosis despite investigations
   d.      It is defined as temperature persistently above 38.0⁰C for more than four  weeks  without diagnosis despite investigations
   e.      It is defined as temperature persistently above 38.0⁰C for more than five  weeks  without diagnosis despite investigations
   8.       The following are known causes of pyrexia of unknown origin except:
   a.       Hepatobiliary abscess
   b.      Extrapulmonary tuberculosis
   c.       Polymyalgia rheumatic
   d.      Factitious fever
   e.      Myxoedema coma
   9.       Which of the following is incorrect about periodic fever syndromes?
   a.       They are characterized by recurrent episodes of fever and organ inflammation with an elevated acute phase response.
   b.      The major complication of familial Mediterranean fever is amyloidosis
   c.       Recurrent attacks of fever, abdominal pains and diarrhoea are usual features of
   Hyper-IgD  syndrome (HIDS).
   d.      Hibernian fever is a known autosomal recessive periodic fever syndrome
   e.      The defect in hyper-IgD syndrome is a mutation in the gene for mevalonate kinase which is involved in cholesterol metabolism.
   10.   Pyrexia of unknown origin is not a usual feature of:
   a.       Ebola viral disease
   b.      Pheochromocytoma
   c.       Amoebic liver abscess
   d.      Hypertriglyceridaemia
   e.      Drug hypersensitivity reactions
   
   
   
   
   
   
   ANSWERS
   1. a
   2. d
   3. a
   4. b
   5. e
   6. e
   7. c
   8. e
   9. d
   10. a