MEDICAL REVIEW OFFICER 400
COMPREHENSIVE TEST PAPER QUESTIONS
AND SOLUTIONS GRADED A+
◉ Nephrolithiasis.
Answer: Calcium oxalate stones, hypercalciuria, hyperoxaluria, low
urine volume
◉ Presentation of nephrolithiasis.
Answer: Sudden severe colicky flank pain radiating to the groin,
microscopic hematuria
◉ Asbestosis.
Answer: Inhaled fibers cause chronic inflammation and fibrosis of
the lung parenchyma
◉ Risk factors for asbestosis.
Answer: Associated with shipbuilding, roofing, plumbing
◉ A1-antitrypsin deficiency.
Answer: Normal - protease inhibitor produced by the liver that
inhibits neutrophil elastase in the lungs
,◉ Severe A1-antitrypsin deficiency.
Answer: PiZZ; misfolded gene product protein aggregates in
hepatocellular ER → unopposed elastase destroys alveolar walls
◉ PAS positive.
Answer: Diastase resistant globules in liver
◉ PANACINAR emphysema.
Answer: Affects lower lobes vs emphysema is centriacinar and
affects upper lobes
◉ Serum alpha 1 antitrypsin.
Answer: Confirm with genotyping or phenotyping; lung disease -
smoking cessation, bronchodilators
◉ Pleural effusion.
Answer: Accumulation of fluid in the pleural space between the
visceral and parietal pleura
◉ Transudative pleural effusion.
Answer: Clear fluid; causes include CHF, cirrhosis, nephrotic
syndrome
,◉ Exudative pleural effusion.
Answer: Cloudy fluid; causes include pneumonia, malignancy, TB
◉ Light's criteria.
Answer: Exudative if pleural fluid protein/serum protein > 0.5,
pleural fluid LDH/serum LDH > 0.6, or pleural fluid LDH > ⅔ upper
limit of normal serum LDH
◉ Thoracentesis.
Answer: Procedure to remove fluid from the pleural space
◉ Streptococcus pneumoniae meningitis.
Answer: Polysaccharide capsule is a major virulence factor, IgA
protease
◉ MOPS.
Answer: Common cause of bacterial meningitis in adults, elderly, and
asplenic patients
◉ Positive Kernig, Brudzinski.
Answer: Signs of meningitis
, ◉ CSF findings in meningitis.
Answer: Neutrophils and protein, low glucose
◉ Prevention of pneumococcal meningitis.
Answer: PPSV23 (polysaccharide capsule only), PC15/PCV20
(conjugated to protein carrier)
◉ Treatment of pneumococcal meningitis.
Answer: Vancomycin + ceftriaxone (or cefotaxime); add ampicillin if
age > 50 or immunocompromised
◉ Complete hydatidiform mole.
Answer: Results from fertilization of an empty ovum by one sperm
that duplicates its chromosome
◉ Thiamine (B1) deficiency.
Answer: Normal cofactor for several dehydrogenase enzyme
reactions
◉ Wernicke encephalopathy.
Answer: Confusion, ophthalmoplegia, ataxia
◉ Korsakoff syndrome.
COMPREHENSIVE TEST PAPER QUESTIONS
AND SOLUTIONS GRADED A+
◉ Nephrolithiasis.
Answer: Calcium oxalate stones, hypercalciuria, hyperoxaluria, low
urine volume
◉ Presentation of nephrolithiasis.
Answer: Sudden severe colicky flank pain radiating to the groin,
microscopic hematuria
◉ Asbestosis.
Answer: Inhaled fibers cause chronic inflammation and fibrosis of
the lung parenchyma
◉ Risk factors for asbestosis.
Answer: Associated with shipbuilding, roofing, plumbing
◉ A1-antitrypsin deficiency.
Answer: Normal - protease inhibitor produced by the liver that
inhibits neutrophil elastase in the lungs
,◉ Severe A1-antitrypsin deficiency.
Answer: PiZZ; misfolded gene product protein aggregates in
hepatocellular ER → unopposed elastase destroys alveolar walls
◉ PAS positive.
Answer: Diastase resistant globules in liver
◉ PANACINAR emphysema.
Answer: Affects lower lobes vs emphysema is centriacinar and
affects upper lobes
◉ Serum alpha 1 antitrypsin.
Answer: Confirm with genotyping or phenotyping; lung disease -
smoking cessation, bronchodilators
◉ Pleural effusion.
Answer: Accumulation of fluid in the pleural space between the
visceral and parietal pleura
◉ Transudative pleural effusion.
Answer: Clear fluid; causes include CHF, cirrhosis, nephrotic
syndrome
,◉ Exudative pleural effusion.
Answer: Cloudy fluid; causes include pneumonia, malignancy, TB
◉ Light's criteria.
Answer: Exudative if pleural fluid protein/serum protein > 0.5,
pleural fluid LDH/serum LDH > 0.6, or pleural fluid LDH > ⅔ upper
limit of normal serum LDH
◉ Thoracentesis.
Answer: Procedure to remove fluid from the pleural space
◉ Streptococcus pneumoniae meningitis.
Answer: Polysaccharide capsule is a major virulence factor, IgA
protease
◉ MOPS.
Answer: Common cause of bacterial meningitis in adults, elderly, and
asplenic patients
◉ Positive Kernig, Brudzinski.
Answer: Signs of meningitis
, ◉ CSF findings in meningitis.
Answer: Neutrophils and protein, low glucose
◉ Prevention of pneumococcal meningitis.
Answer: PPSV23 (polysaccharide capsule only), PC15/PCV20
(conjugated to protein carrier)
◉ Treatment of pneumococcal meningitis.
Answer: Vancomycin + ceftriaxone (or cefotaxime); add ampicillin if
age > 50 or immunocompromised
◉ Complete hydatidiform mole.
Answer: Results from fertilization of an empty ovum by one sperm
that duplicates its chromosome
◉ Thiamine (B1) deficiency.
Answer: Normal cofactor for several dehydrogenase enzyme
reactions
◉ Wernicke encephalopathy.
Answer: Confusion, ophthalmoplegia, ataxia
◉ Korsakoff syndrome.
