EMQs and SBAs for Medical Finals E-Book

Jonathan Bath

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 501

Veröffentlichungsjahr: 2013

Beschreibung

Prepare for final and penultimate-year exams with EMQs and SBAs for Medical Finals

• Five complete practice question papers for realistic preparation
• Each question paper contains 60 Single Best Answer questions and 30 Extended Matching Questions
• Includes topic index so that readers can target problem areas
• Detailed explanation of the knowledge behind both correct and incorrect answers

EMQs and SBAs for Medical Finals is perfect for the student looking to test their knowledge and identify weak subject areas. Practice questions cover all key topics in medicine, with the subject balance reflecting the weighting in real exams. For this edition, all content has been updated and focused to remain relevant for today's finalists and the exams they will face. Inclusion of the topic index means that the title allows for both wide-ranging and focused revision.  All in all, an essential resource for anyone facing their final medical exams.

Leseprobe

Contents

Preface

Abbreviations

Part 1: Practice Papers

Paper 1 Questions

Single Best Answer Questions

Extended Matching Questions

Paper 2 Questions

Single Best Answer Questions

Extended Matching Questions

Paper 3 Questions

Single Best Answer Questions

Extended Matching Questions

Paper 4 Questions

Single Best Answer Questions

Extended Matching Questions

Paper 5 Questions

Single Best Answer Questions

Extended Matching Questions

Part 2: Answers to Practice Papers

Paper 1 Answers

Single Best Answer Questions

Extended Matching Questions

Paper 2 Answers

Single Best Answer Questions

Extended Matching Questions

Paper 3 Answers

Single Best Answer Questions

Extended Matching Questions

Paper 4 Answers

Single Best Answer Questions

Paper 5 Answers

Single Best Answer Questions

Extended Matching Questions

Topic index

This edition first published 2011 © 2011 by John Wiley & Sons, Ltd.

Previous edition © 2007 Jonathan Bath, Rebecca Morgan & Mehool Patel. Published by Blackwell Publishing.

Wiley-Blackwell is an imprint of John Wiley & Sons, formed by the merger of Wiley’s global Scientific, Technical and Medical business with Blackwell Publishing.

Registeredoffice: John Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

Editorial offices: 9600 Garsington Road, Oxford, OX4 2DQ, UK The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK 111 River Street, Hoboken, NJ 07030-5774, USA

For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell.

The right of the author to be identified as the author of this work has been asserted in accordance with the UK Copyright, Designs and Patents Act 1988.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher.

Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought.

Library of Congress Cataloging-in-Publication Data

Bath, Jonathan.

EMQs and SBAs for medical finals / Jonathan Bath, Rebecca Morgan, Patel, Mehool. p. ; cm.

Rev. ed. of: EMQs and MCQs for medical finals / Jonathan Bath, Rebecca Morgan, Mehool Patel. 2007.

Includes bibliographical references and index.

ISBN978-0-470-65444-6 (pbk. : alk. paper)

1. Medicine–Examinations, questions, etc. I. Morgan, Rebecca. II. Patel, Mehool. III. Bath, Jonathan. EMQs and MCQs for medical finals. IV. Title.

[DNLM: 1. Medicine–Great Britain–Examination Questions. W 18.2]

R834.5.B37 2011

610.76–dc22

2011007201

A catalogue record for this book is available from the British Library.

1 2011

Preface

The idea for the first edition of EMQs and MCQs for Medical Finals was to provide a solid question book that provided detailed explanations with the answers to enable the reader to learn not only why the answer was correct, but also why the other options were incorrect. At the time of publication in 2007, the number of question and answer books with this detailed answer format was limited, allowing EMQs and MCQs for Medical Finals to establish a niche, which has been quickly recognized by subsequent question and answer books to be the preferred format for examination preparation resources.

The second edition reflects feedback from many students, doctors and other readers and has led to many improvements. The title of the book has evolved to better describe the question format used in current examinations, question stems have been shortened to allow quick and precise reading of questions, and factual information has been updated where needed to reflect changes in clinical practice. Finally, the five practice examination papers have been indexed to allow for rapid review of specific areas, for example Cardiology or Vascular Surgery, as required.

We hope that these improvements will ensure that EMQs and SBAs for Medical Finals will continue to provide an excellent resource for identifying key examination topics and, more importantly, help to focus preparation on less familiar areas of knowledge for Finals.

Jonathan Bath Pittsburgh

Rebecca Morgan London

Abbreviations

AAA

abdominal aortic aneurysm

ABC

airway–breathing–circulation

ABG

arterial blood gas

ACE

angiotensin-converting enzyme

ACTH

adrenocorticotropic hormone

ADH

antidiuretic hormone

A&E

Accident and Emergency

AFP

alpha-fetoprotein

ALL

acute lymphocytic leukaemia

ALT

alanine transaminase

AML

acute myeloid leukaemia

AMT

abbreviated mental test

ANCA

antineutrophil cytoplasmic antibody

A/P

antero-posterior

APTT

activated partial thromboplastin time

ARMD

age-related macular degeneration

AST

aspartate transaminase

AV

atrioventricular

BCG

Bacille Calmette Guerin

BMI

body mass index

BPH

benign prostatic hyperplasia

bpm

beats per minute

CA 15-3

cancer antigen 15-3

CEA

carcino-embryonic antigen

CK

creatine kinase

CLL

chronic lymphocytic leukaemia

CML

chronic myeloid leukaemia

CMV

cytomegalovirus

CoA

coenzyme A

COPD

chronic obstructive pulmonary disease

CPP

cerebral perfusion pressure

CREST

calcinosis

,

R

aynaud’s phenomenon, o

e

sophageal dysmotility,

s

clerodactyly and

t

elangiectasia)

CSF

cerebrospinal fluid

CT

computed tomography

CT-PA

computed tomography with pulmonary angiography

DC

direct current

DCIS

ductal carcinoma

in situ

ds-DNA

double-stranded DNA

ECG

electrocardiogram/electrocardiography

ECT

electroconvulsive therapy

EMDR

eye movement desensitization and reprocessing

ENT

ear, nose and throat

ERCP

endoscopic retrograde cholangiopancreatogram

ESR

erythrocyte sedimentation rate

ETT

exercise tolerance test

FAST

focused assessment with sonography for trauma

FENa

fractional excretion of sodium

GBM

glomerular basement membrane

GCS

Glasgow coma scale

γ-GGT

gamma glutamyl transpeptidase

GORD

gastro-oesophageal reflux disease

GP

general practitioner

G6PD

glucose-6-phosphatase

GTN

glyceryl trinitrate

hCG

human chorionic gonadotropin

5-HIAA

5-hydroxyindoleacetic acid

HIDA

hepatobiliary iminodiacetic acid

HIV

human immunodeficiency virus

HMG CoA     

3-hydroxymethylglutaryl coenzyme A

HMMA

4-hydroxy methyl mandelate

HPV

human papilloma virus

HSV

herpes simplex virus

HTLV

human T-cell lymphotropic virus

ICP

intracerebral pressure

ICU

Intensive Care Unit

IgA

immunoglobulin A

IgE

immunoglobulin E

IgG

immunoglobulin G

IL

interleukin

IM

intramuscular

INR

international normalized ratio

IUCD

intrauterine contraceptive device

IV

intravenous

IVU

intravenous urogram

JVP

jugular venous pressure

LDH

lactate dehydrogenase

LFT

liver function test

LKM1

liver/kidney microsomal type I antibodies

LSD

lysergic acid diethylamide

MAOI

monoamine oxidase inhibitor

MAP

mean arterial pressure

MCV

mean corpuscular volume

MI

myocardial infarction

MMR

measles, mumps and rubella

MRI

magnetic resonance imaging

NMDA

N-methyl-D-aspartic acid

NSAID

non-steroid anti-inflammatory drug

NSE

neurone specific enolase

OGD

oesophagogastroduodenoscopy

PaCO

2

partial pressure of carbon dioxide in arterial blood

PaO

2

partial pressure of oxygen in arterial blood

PAS

Periodic acid Schiff

pCO

2

partial pressure of carbon dioxide in blood

PCP

phencyclidine

PDA

patent ductus arteriosus

PEFR

peak expiratory flow rate

PEG

percutaneous endoscopic gastrostomy

PFT

pulmonary function test

pO

2

partial pressure of oxygen in blood

PSA

prostate-specific antibody

PSC

primary sclerosing cholangitis

PTCA

percutaneous transluminal coronary angioplasty

PUVA

psoralen plus ultraviolet A

SA

sinoatrial

SIADH

syndrome of inappropriate ADH secretion

SLE

systemic lupus erythematosus

SSRI

selective serotonin reuptake inhibitor

TCA

tricyclic antidepressant

TFT

thyroid function test

THC

δ-1-tetrahydrocannabinol

TIBC

total iron binding capacity

TNF-α

tumour necrosis factor

α

TPN

total parenteral nutrition

TRH

thyroid-releasing hormone

TSH

thyroid-stimulating hormone

TURP

transurethral resection of the prostate

vWF

von Willebrand factor

V/Q

ventilation–perfusion

VZV

varicella zoster virus

PART 1

Practice Papers

PAPER 1

Questions

Single Best Answer Questions

1 Which area of the breast is most commonly affected by breast cancer?

a. Upper outer quadrant

b. Upper inner quadrant

c. Lower outer quadrant

d. Lower inner quadrant

e. Retro-areolar

2 A 75-year-old man is referred to cardiology for management of his newly diagnosed atrial fibrillation. His heart rate is 70–90 beats/minute (bpm) and he suffers from palpitations and occasional shortness of breath. He has no past history of cardiovascular disease. Which one of the following is the most appropriate next stage in his management?

a. Start digoxin for rate control

b. Warfarinization to reduce the risk of thromboembolism formation

c. Start a beta-blocker for associated hypertension

d. Organize an echocardiogram

e. Refer back to his general practitioner (GP) as his case can easily be managed in the community

3 Which one of the following is NOT a risk factor for breast cancer?

a. Nulliparity

b. Late pregnancy (>30 years)

c. Early menarche

d. Late menopause

e. High dietary dairy intake

4 A 38-year-old man attends Accident and Emergency (A&E) complaining of 12 hours of intermittent chest pain. His pain is central in location with no radiation but some associated nausea. He has a family history of cardiovascular disease. His troponin I is 0.05 (significant >0.1) and his electrocardiogram (ECG) shows no ischaemic changes. He asks you what will happen next. What should you tell him?

a. He needs to be admitted for further bloods tests

b. He requires an exercise tolerance test (ETT) before he is discharged

c. An echocardiogram will be useful in his further management

d. He can be safely discharged without further follow-up

e. He should be started on aspirin

5 A 31-year-old man presents to his GP complaining of an itchy rash on his hands. On questioning, he reveals that he works as a dishwasher for a Chinese restaurant. On examination of his hands, there are multiple excoriated sites on the dorsum and over the fingers of both hands with cracking of the skin over an erythematous base. The most likely diagnosis is:

a. Dermatitis

b. Lichen planus

c. Chemical burn

d. Porphyria cutanea tarda

e. Psoriasis

6 Optimal assessment of a breast lump in a 55-year-old woman is best described by which one of the following?

a. Clinical examination, ultrasound, biopsy

b. Clinical examination and mammogram

c. Ultrasound, mammogram and biopsy

d. Clinical examination, mammogram and biopsy

e. Clinical examination, chest X-ray and biopsy

7 A 16-year-old boy with type I diabetes mellitus presents to hospital complaining of abdominal pain, nausea and vomiting. He has been feeling unwell for the last 3 days since he ‘caught a cold’ from his younger sister. Urine dipstick was taken that showed protein +, ketones ++, glucose +++. Which one of the following insulin regimens should this man be started on?

a. Normal subcutaneous insulin with hourly blood glucose monitoring

b. Sliding scale of insulin with hourly blood glucose monitoring

c. Constant insulin infusion with hourly blood glucose monitoring

d. Change of normal insulin regimen to once-daily longacting insulin

e. Increase of normal insulin regimen to double requirements

8 A 35-year-old man is admitted to the intensive care unit (ICU) with respiratory failure secondary to a fungal chest infection. His past medical history reveals acute myelogenous leukaemia, splenomegaly and a recent bone marrow transplant. His blood results reveal neutropenia and anaemia. Which one of the following should be avoided, unless absolutely necessary?

a. Incision and drainage of a 4-cm subcutaneous abscess

b. Digital rectal examination

c. Regular suction of nasopharyngeal secretions

d. Daily bloods taken via a central venous catheter

e. Regular turning to avoid pressure sores

9 An 84-year-old woman re-presents to A&E 2 weeks after admission for control of an ‘irregular heart beat’ when she was started on digoxin. She now complains of dizziness and intermittent shortness of breath. Her drug history includes atenolol 100 mg od. Her ECG today shows a rate of approximately 40 bpm with no association between P waves and QRS complexes. What is the next step in her management?

a. Insert a temporary pacing wire