MCQ

1) A middle aged housewife complains that her husband has become more and more detached from her and her family and has become obsessed with his work as a medical laboratory worker. He tells her 'I'm more important than you and so is my work.' and when she complains of lack of attention he says 'I'm an unrecognized genius. You just don't see it how special I am' . He seems to lack empathy with their children and neglects them. A possible diagnosis is

a) Mania
b) Narcissistic Personality Disorder
c) Delirium tremens
d) Toxic confusional state
e) Psychotic depression




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2) ‎60 year old white woman complains of a 'droopy left eyelid' for two weeks. She also has pain affecting the left side of the head, face, and neck. There was no history of trauma. She is on Premarin treatment and is an ex-heavy smoker , having quit 7 years ago. On examination she appears to be anorexic and has a hoarse voice. She is noted to have miosis of the affected pupil. A likely diagnosis is:

a) Complicated otitis media
b) Carotid-cavernous fistula
c) orbital pseudotumor
d) pancoast Tumor
e) mucocel

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3) A 73 year old man had sudden vision loss in his left eye. He developed the vision loss immediately after a selective angiogram of the internal carotid artery. Examination revealed is retinal edema in the macula and subretinal pallor. A cherry red spot is seen at the fovea A likely diagnosis is:

a) Kawasaki's disease
b) ophthalmic artery obstruction
c) Lyme disease
d) thyroid ophthalmohathy
e) cluster headache

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4) A student decides to do some work on a construction site on order to earn some extra money. He spends the first day at work in a cement mixing area. A few hours later he notices a severe burn forming on his lower limbs. What is the next best treatment of choice?

a) hydrotherapy
b) humidified oxygen
c) non-humidified oxygen
d) IV methylene blue
e) oral charcoal

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5) A farmer is exposed to a 10% skin contact burn with formic acid . He becomes rapidly confused and is transferred immediately to hospital. Here is is found to have a metabolic acidosis with a high anion gap. What is the next best treatment of choice?

a) 10% calcium gluconate administered IV
b) sodium bicarbonate 1 mEq/kg IV
c) oral sodium bicarbonate
d) hypertonic intravenous crystalloid fluid
e) hypotonic intravenous crystalloid fluid

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