MCQ Medicine 1 Exam with Accurate
Solutions
"A 19 year old man, presents to the Emergency Department with a supra-condylar
fracture of the distal humerus. Later that evening, after surgical fixation he is noted to
have a wrist drop with a patch of numbness on the dorso-radial aspect of the wrist.
What is this most likely to be due to?
A. A median nerve injury
B. An ulnar nerve injury
C. A musculo-cutaneous nerve injury
D. An anxilliary nerve injury
E. A radial nerve injury" - correct answer-E
"In the management of pneumothorax, what is the best indication that the intercostal
catheter can be removed?
A. The size of the pneumothorax is less than 25% of the lung volume on chest x-ray
B. There is lack of bubbling in underwater seal drain with suction
C. There is lack of bubbles with cough in underwater seal drain
D. There is presence of swing and no bubbling in underwater seal drain
E. There is resolution of pleuritic chest pain" - correct answer-A
"A 75 year old man, presents with painless loss of vision in the left eye one hour ago.
VAR:6/9, VAL:light perception only. There is a left afferent pupil defect. He has been on
an ACE inhibitor for hypertension. What do you see when you look into his left eye with
a direct ophthalmoscope?
A. Signs of age-related macular degeneration
B. Some blot haemorrhages and hard exudates near the macula
C. A dense nuclear cataract makes the view of a probably normal optic disc and macula
difficult
D. The macula has an orange/red spot and the surrounding retina looks pale, with
marked attenuation of the retinal arterioles and segmentation of blood in the retinal
veins
E. A swollen optic nerve and a normal retina" - correct answer-D
"A 26 year old woman has a history of wheezing as a child. She has suffered from
seasonal rhinitis in recent years. She is brought in by ambulance from a night club
having developed severe shortness of breath. Which of the following findings is in
keeping with a severe asthma attack?
A. respiratory rate of 8/min
B. blood pressure of 85/60 mmHg
C. Inspiratory rhonchi on auscultation
,D. Bilateral basal crackles on auscultation
E. 88 percent oxygen saturation on pulse oximetry" - correct answer-E
"A 26 year old nurse has had wheezy bronchitis as a child. She went to a night club and
suffered an attack of asthma. She is given nebulised salbutamol in the Emergency
Department. Which of the following is the best explanation of why Salbutamol produces
bronchodilation?
A. Antagonises muscarinic cholinergic receptors on airway smooth muscle
B. Increases cyclic AMP in airway smooth muscle cells
C. Inhibits the sodium channels in airway epithelial cells
D. Increases the firing rate of neurones in the brain stem respiratory centre
E. Antagonises beta adrenergic receptors on airway smooth muscle" - correct answer-B
"A 25 year old man who sustains a clean, fairly superficial, 3cm long laceration to his left
forearm on a piece of broken glass. Which one of the following statements about
management is true?
A. Prophylactic antibiotics are required
B. Thorough cleansing with saline is the decontamination method of choice
C. Immediate tetanus prophylaxis is required as this is a tetanus-prone wound
D. X-ray is required even if the whole length and depth of the wound can be visualized
E. The wound should be closed in layers" - correct answer-B
"regarding the anatomy of the lungs, which of the following statements is correct?
A. The left lung is larger and heavier than the right
B. The lungs are supplied with oxygenated blood by the pulmonary arteries
C. The lungs are invested by parietal pleura
D. The middle lobe is the smallest lobe of the left lung
E. The apices of the lungs may pass above the thoracic inlet (1st rib)" - correct answer-
E
"A 30 year old woman, presents with a 2-day history of fever, vomiting and mild right-
sided flank pain. She has evidence of right renal angle tenderness on examination.
Urinalysis shows the presence of polymorphonuclear leucocytes and nitrates. What
would be the next most appropriate investigation?
A. Abdominal ultrasound
B. Urine microscopy and culture
C. Intravenous pyelogram
D. serum creatinine levels
E. Cystourethroscopy" - correct answer-B
"Which of the following does the median nerve innervate?
A. All the muscles moving the thumb
B. Opponens pollicis
C. Adductor pollicis
D. The skin on the dorsum of the 5th digit
E. The medial two lumbricals" - correct answer-B
, "A 69 year old man presents to the doctor with an acutely swollen right knee. He has
had previous episodes of acute pain and swelling in his big toes and ankles over the
last 10 years. What is the most appropriate initial investigation to determine the
diagnosis?
A. X-ray of the knee
B. Microscopy of synovial fluid
C. Full blood count
D. serum uric acid
E. MRI of the knee
" - correct answer-B
"A 75 year old woman who presents with a six-month history of pain in her right knee,
which is worse with prolonged walking. She has no relevant past history. Physical
examination reveals a small effusion and crepitus on movement. Her body mass index
is 32. You make a diagnosis of osteoarthritis Which of the following is the most
important initial aspect of treatment?
A. Paracetamol
B. Non-steroidal anti-inflammatory drugs
C. Arthroscopy plus lavage
D. Avoidance of walking
E. Weight loss" - correct answer-B
"Mrs betty Smith is a 75 year old woman with osteoarthritis for whom you prescribe
diclofenac. Which one of the following statements about diclofenac sodium is correct?
A. It inhibits both Cox I and Cox II isoenzymes
B. It does not affect platelet aggregation
C. It does not reduce renal blood flow in normal kidneys
D. It has no analgesic properties
E. It does not affect prostaglandin-mediated protection of the gastric mucosa" - correct
answer-A
"A 22 year old woman who is an active intravenous drug user presents to her general
practitioner, six weeks pregnant. On investigation she is found to be positive for anti-
hepatitis C virus (HCV). Her hepatitis A and B and HIV serology are negative. What
advice is most appropriate for this patient at this point?
A. The risk of transmission of Hepatitis C to the fetus is > 80%
B. She should be vaccinated against hepatitis A and B unless she is already immune
C. She should commence antiviral treatment
D. She can expect to develop symptoms of hepatitis as her pregnancy progresses
E. She should reduce her alcohol consumption" - correct answer-B
"What is the most important direct action of the hormone 1,25 Dihydroxyvitamin D?
A. Decrease bone resorption
B. reduce urine phosphate losses
C. reduce urine calcium losses
Solutions
"A 19 year old man, presents to the Emergency Department with a supra-condylar
fracture of the distal humerus. Later that evening, after surgical fixation he is noted to
have a wrist drop with a patch of numbness on the dorso-radial aspect of the wrist.
What is this most likely to be due to?
A. A median nerve injury
B. An ulnar nerve injury
C. A musculo-cutaneous nerve injury
D. An anxilliary nerve injury
E. A radial nerve injury" - correct answer-E
"In the management of pneumothorax, what is the best indication that the intercostal
catheter can be removed?
A. The size of the pneumothorax is less than 25% of the lung volume on chest x-ray
B. There is lack of bubbling in underwater seal drain with suction
C. There is lack of bubbles with cough in underwater seal drain
D. There is presence of swing and no bubbling in underwater seal drain
E. There is resolution of pleuritic chest pain" - correct answer-A
"A 75 year old man, presents with painless loss of vision in the left eye one hour ago.
VAR:6/9, VAL:light perception only. There is a left afferent pupil defect. He has been on
an ACE inhibitor for hypertension. What do you see when you look into his left eye with
a direct ophthalmoscope?
A. Signs of age-related macular degeneration
B. Some blot haemorrhages and hard exudates near the macula
C. A dense nuclear cataract makes the view of a probably normal optic disc and macula
difficult
D. The macula has an orange/red spot and the surrounding retina looks pale, with
marked attenuation of the retinal arterioles and segmentation of blood in the retinal
veins
E. A swollen optic nerve and a normal retina" - correct answer-D
"A 26 year old woman has a history of wheezing as a child. She has suffered from
seasonal rhinitis in recent years. She is brought in by ambulance from a night club
having developed severe shortness of breath. Which of the following findings is in
keeping with a severe asthma attack?
A. respiratory rate of 8/min
B. blood pressure of 85/60 mmHg
C. Inspiratory rhonchi on auscultation
,D. Bilateral basal crackles on auscultation
E. 88 percent oxygen saturation on pulse oximetry" - correct answer-E
"A 26 year old nurse has had wheezy bronchitis as a child. She went to a night club and
suffered an attack of asthma. She is given nebulised salbutamol in the Emergency
Department. Which of the following is the best explanation of why Salbutamol produces
bronchodilation?
A. Antagonises muscarinic cholinergic receptors on airway smooth muscle
B. Increases cyclic AMP in airway smooth muscle cells
C. Inhibits the sodium channels in airway epithelial cells
D. Increases the firing rate of neurones in the brain stem respiratory centre
E. Antagonises beta adrenergic receptors on airway smooth muscle" - correct answer-B
"A 25 year old man who sustains a clean, fairly superficial, 3cm long laceration to his left
forearm on a piece of broken glass. Which one of the following statements about
management is true?
A. Prophylactic antibiotics are required
B. Thorough cleansing with saline is the decontamination method of choice
C. Immediate tetanus prophylaxis is required as this is a tetanus-prone wound
D. X-ray is required even if the whole length and depth of the wound can be visualized
E. The wound should be closed in layers" - correct answer-B
"regarding the anatomy of the lungs, which of the following statements is correct?
A. The left lung is larger and heavier than the right
B. The lungs are supplied with oxygenated blood by the pulmonary arteries
C. The lungs are invested by parietal pleura
D. The middle lobe is the smallest lobe of the left lung
E. The apices of the lungs may pass above the thoracic inlet (1st rib)" - correct answer-
E
"A 30 year old woman, presents with a 2-day history of fever, vomiting and mild right-
sided flank pain. She has evidence of right renal angle tenderness on examination.
Urinalysis shows the presence of polymorphonuclear leucocytes and nitrates. What
would be the next most appropriate investigation?
A. Abdominal ultrasound
B. Urine microscopy and culture
C. Intravenous pyelogram
D. serum creatinine levels
E. Cystourethroscopy" - correct answer-B
"Which of the following does the median nerve innervate?
A. All the muscles moving the thumb
B. Opponens pollicis
C. Adductor pollicis
D. The skin on the dorsum of the 5th digit
E. The medial two lumbricals" - correct answer-B
, "A 69 year old man presents to the doctor with an acutely swollen right knee. He has
had previous episodes of acute pain and swelling in his big toes and ankles over the
last 10 years. What is the most appropriate initial investigation to determine the
diagnosis?
A. X-ray of the knee
B. Microscopy of synovial fluid
C. Full blood count
D. serum uric acid
E. MRI of the knee
" - correct answer-B
"A 75 year old woman who presents with a six-month history of pain in her right knee,
which is worse with prolonged walking. She has no relevant past history. Physical
examination reveals a small effusion and crepitus on movement. Her body mass index
is 32. You make a diagnosis of osteoarthritis Which of the following is the most
important initial aspect of treatment?
A. Paracetamol
B. Non-steroidal anti-inflammatory drugs
C. Arthroscopy plus lavage
D. Avoidance of walking
E. Weight loss" - correct answer-B
"Mrs betty Smith is a 75 year old woman with osteoarthritis for whom you prescribe
diclofenac. Which one of the following statements about diclofenac sodium is correct?
A. It inhibits both Cox I and Cox II isoenzymes
B. It does not affect platelet aggregation
C. It does not reduce renal blood flow in normal kidneys
D. It has no analgesic properties
E. It does not affect prostaglandin-mediated protection of the gastric mucosa" - correct
answer-A
"A 22 year old woman who is an active intravenous drug user presents to her general
practitioner, six weeks pregnant. On investigation she is found to be positive for anti-
hepatitis C virus (HCV). Her hepatitis A and B and HIV serology are negative. What
advice is most appropriate for this patient at this point?
A. The risk of transmission of Hepatitis C to the fetus is > 80%
B. She should be vaccinated against hepatitis A and B unless she is already immune
C. She should commence antiviral treatment
D. She can expect to develop symptoms of hepatitis as her pregnancy progresses
E. She should reduce her alcohol consumption" - correct answer-B
"What is the most important direct action of the hormone 1,25 Dihydroxyvitamin D?
A. Decrease bone resorption
B. reduce urine phosphate losses
C. reduce urine calcium losses
