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Model Paper One
Model Paper One
Model Paper One
Question 1.
12. Low serum vitamin B12 levels are least likely to be seen in which
one of the following?
A. Crohn disease.
B. Pernicious anaemia.
C. Severe folate deficiency.
D. Short bowel syndrome.
E. Transcobalamin II deficiency.
A. Decreased Decreased
B. Decreased Normal
C. Increased Decreased
D. Increased Normal
E. Normal Increased
25. The following results are obtained from a 14-year-old boy, prior
to elective hernia surgery, who gives a history of excessive
bleeding after dental extraction.
Bleeding time 6 minutes [2-9]
Prothrombin time 12 seconds [12-14]
Prothrombin time-international normalised ratio (PT-INR) 1.0
[0.9-1.2]
Activated partial thromboplastin time (APTT) 56 seconds [26-
35]
Fibrinogen 2.4 g/L [1.8-4.0]
Mixing the patient's plasma with an equal volume of normal
plasma normalises the APTT.
Which one of the following is the most likely diagnosis?
A. Antiphospholipid antibody syndrome.
B. Factor VII deficiency.
C. Haemophilia.
D. Recent aspirin ingestion.
E. Von Willebrand disease.
26. Second generation H1 receptor antagonists effectively relieve
most of the symptoms of allergic rhinoconjunctivitis.
Which one of the following symptoms is least effectively relieved?
A. Nasal congestion.
B. Nasal itch.
C. Ocular tearing.
D. Rhinorrhoea.
E. Sneezing.
33. You are asked for a second opinion regarding a 10-year-old boy
who has a long history of hyperactive, impulsive, attention-seeking
and destructive behaviour, both at home and at school. A
paediatrician and a child psychiatrist have previously diagnosed him
as having attention deficit hyperactivity disorder (ADHD). He
responded poorly to dexamphetamine but concentration and attention
have improved on methylphenidate. He is currently on 30 mg/day. His
weight is 35 kg.
Further assessment demonstrated average intelligence but with a
significant language-based learning disorder. He is at the 3rd
percentile for receptive language and the 14th percentile for
expressive language. He is making progress at school with the
provision of remedial help and an integration aide.
He also receives on-going counselling and cognitive behavioural
management from his psychiatrist.
His parents are divorced and are unable to manage him consistently.
His father is strict, distant and loses his temper with his son. His
mother is caring, finds it hard to set limits and is overwhelmed by
his demands. The boy dominates and intrudes on all aspects of family
life. His father denigrates his ex-wife in front of the boy.
A. Candidiasis.
B. Child sexual abuse.
C. Lichen sclerosis.
D. Non-specific vulvovaginitis.
E. Straddle injury.
E. Perform a gastroscopy.
45. A 30-year-old mother and her five-year-old son are both HIV
(human immunodeficiency virus)-positive. She is well and takes all
her own medication reliably. She is pregnant and would like to know
what are the chances of her baby developing HIV infection. She
understands that both baby and she will be treated with the best
available current treatments.
The risk of the baby acquiring HIV is closest to:
A. 90%.
B. 70%.
C. 50%.
D. 30%.
E. 10%.
48. You have been asked to review the biochemical profile of a 13-
year-old girl who is undergoing nasogastric feeding for severe
anorexia nervosa, which was initiated three days earlier. You
calculate that she is receiving 100 calories per hour. She had
normal biochemistry on admission.
Her current biochemical profile is:
sodium 135 mmol/L [134-142]
potassium 2.7 mmol/L [3.5-4.5]
chloride 98 mmol/L [96-110]
urea 1.0 mmol/L [2.1-6.5]
creatinine 0.02 mmol/L [0.03-0.08]
glucose 2.4 mmol/L [3.5-5.4]
calcium 1.99 mmol/L [2.10-2.60]
phosphate 0.8 mmol/L [1.1-1.8]
albumin 30 g/L [35-50]
This picture is most likely to be due to which one of the following?
A. Addisonian crisis.
B. Diuretic abuse.
C. Laxative abuse.
D. Secondary renal tubular acidosis.
E. The enteral nutrition.