NURS 251 EXAM QUESTIONS WITH VERIFIED ANSWERS
A 56-year-old woman presents with depression, hirsutism, weight gain and
muscle weakness.
On examination her GP found her to be hypertensive and to have wide, purple
striae on her abdomen and thighs. Her visual fields were full to confrontation and
there was no bruising.
Which of the following tests is most likely to suggest Cushing's syndrome?
24 hour urinary free cortisol
A 26 year-old-receptionist presents with palpitations and weight loss. Although
pleased about the latter, she is concerned that her menstrual periods have
stopped and it is the anxiety related to this, she believes, that is responsible for
disturbing her sleep. Her partner has insisted that she seek a medical opinion.
Which of the the following tests will help establish the cause?
Graves' eye disease
A 26 year-old-receptionist presents with palpitations and weight loss. Although
pleased about the latter, she is concerned that her menstrual periods have
stopped and it is the anxiety related to this, she believes, that is responsible for
disturbing her sleep. Her partner has insisted that she seek a medical opinion.
Which of the following is NOT a likely differential?
Hypothyroidism
A 14-year-old girl was referred for investigation of delayed puberty. She was born
at full term, after a normal pregnancy. Her general development was normal, and
she attended a mainstream school. On examination, she was prepubertal.
What additional features in the history would support your differential diagnosis?
Ask about mum's age at menarche, and the ages of menarche of any sisters.
s the girl short compared to her peers? (Turner syndrome)
, Does she have any chronic illness such as cystic fibrosis (q.v.) that would explain her
delayed puberty?
Are there any factors in the social history that would lead you to suspect anorexia
(pressure of examinations, unusual fixation with food, unwillingness to develop adult
interests and behaviour).
A 14-year-old girl was referred for investigation of delayed puberty. She was born
at full term, after a normal pregnancy. Her general development was normal, and
she attended a mainstream school. On examination, she was prepubertal.
Which of the following make up the differential diagnosis?
Familial delayed puberty.
Turner syndrome.
Systemic illness.
Anorexia nervosa.
A 6-year-old boy was seen in the paediatric outpatient department. His parents
complained that he was the shortest boy in his class, and he could not reach the
coat pegs in school. On examination, the child's height was 106 cm (3rd centile)
All the following information from the history would be useful EXCEPT?
Hair colour
A 6-year-old boy was seen in the paediatric outpatient department. His parents
complained that he was the shortest boy in his class, and he could not reach the
coat pegs in school. On examination, the child's height was 106 cm (3rd centile)
Which of the following are plausible differentials?
He comes from a family of short people
He has constitutional delay of growth
Psychosocial causes of short stature
Isolated growth hormone deficiency
A 56-year-old woman presents with depression, hirsutism, weight gain and
muscle weakness.
A 56-year-old woman presents with depression, hirsutism, weight gain and
muscle weakness.
On examination her GP found her to be hypertensive and to have wide, purple
striae on her abdomen and thighs. Her visual fields were full to confrontation and
there was no bruising.
Which of the following tests is most likely to suggest Cushing's syndrome?
24 hour urinary free cortisol
A 26 year-old-receptionist presents with palpitations and weight loss. Although
pleased about the latter, she is concerned that her menstrual periods have
stopped and it is the anxiety related to this, she believes, that is responsible for
disturbing her sleep. Her partner has insisted that she seek a medical opinion.
Which of the the following tests will help establish the cause?
Graves' eye disease
A 26 year-old-receptionist presents with palpitations and weight loss. Although
pleased about the latter, she is concerned that her menstrual periods have
stopped and it is the anxiety related to this, she believes, that is responsible for
disturbing her sleep. Her partner has insisted that she seek a medical opinion.
Which of the following is NOT a likely differential?
Hypothyroidism
A 14-year-old girl was referred for investigation of delayed puberty. She was born
at full term, after a normal pregnancy. Her general development was normal, and
she attended a mainstream school. On examination, she was prepubertal.
What additional features in the history would support your differential diagnosis?
Ask about mum's age at menarche, and the ages of menarche of any sisters.
s the girl short compared to her peers? (Turner syndrome)
, Does she have any chronic illness such as cystic fibrosis (q.v.) that would explain her
delayed puberty?
Are there any factors in the social history that would lead you to suspect anorexia
(pressure of examinations, unusual fixation with food, unwillingness to develop adult
interests and behaviour).
A 14-year-old girl was referred for investigation of delayed puberty. She was born
at full term, after a normal pregnancy. Her general development was normal, and
she attended a mainstream school. On examination, she was prepubertal.
Which of the following make up the differential diagnosis?
Familial delayed puberty.
Turner syndrome.
Systemic illness.
Anorexia nervosa.
A 6-year-old boy was seen in the paediatric outpatient department. His parents
complained that he was the shortest boy in his class, and he could not reach the
coat pegs in school. On examination, the child's height was 106 cm (3rd centile)
All the following information from the history would be useful EXCEPT?
Hair colour
A 6-year-old boy was seen in the paediatric outpatient department. His parents
complained that he was the shortest boy in his class, and he could not reach the
coat pegs in school. On examination, the child's height was 106 cm (3rd centile)
Which of the following are plausible differentials?
He comes from a family of short people
He has constitutional delay of growth
Psychosocial causes of short stature
Isolated growth hormone deficiency
A 56-year-old woman presents with depression, hirsutism, weight gain and
muscle weakness.
