PAPER 2
21. Subcutaneous nodules are a typical finding in:
a. neurofibromatosis
b. hydatid disease
c. cysticercosis
d. onchocerciasis
e. trichinosis
Answer 21
22. Characteristic features of kwashiorkor include:
a. patient aged less than 1 year
b. anorexia
c. flakey discoloured skin
d. hepatomegaly
e. splenomegaly
Answer 22
23. Concerning meningococcal disease:
a. vaccine is available for meningococci groups A and C
b. sporadic outbreaks in the UK. are usually due to type B meningococcus
c. close contacts should be treated prophylactically with oral amoxycillin 3g as a single dose
d. outbreaks of disease occur seasonally in parts of sub-Saharan Africa.
e. is the most common cause of bacterial meningitis in the UK.
Answer 23
24. Staphylococcus epidermidis:
a. is coagulase positive
b. on microscopy are Gram positive cocci in chains
c. are usually sensitive to penicillin
d. grown in blood cultures are due to contamination and should be ignored
e. are destroyed by povodine iodine
Answer 24
25. Concerning tuberculin skin testing:
a. patients with tuberculous pericarditis are usually tuberculin positive
b. previous BCG vaccination usually results in a strongly positive reaction
c. pulmonary sarcoidosis gives a positive tuberculin test in about 30% of cases
d. if the sputum microscopy and culture are negative for mycobacteria, pulmonary tuberculosis can only be diagnosed if the tuberculin test is positive.
e. the test is usually negative in miliary tuberculosis
Answer 25
26. Hookworm
a. is usually spread by the faeco-oral route
b. is usually diagnosed by microscopy of adhesive tape prints taken from the perianal area
c. may block the pancreatic duct causing pancreatitis
d. eggs can be readily distinguished microscopically from those of Strongyloides sp.
e. commonly causes diarrhoea in non-immunes
Answer 26
27. The following are associated with an increased risk of vertical transmission of HIV
a. breast feeding
b. high titres of p24 antigen in maternal serum perinatally
c. low maternal CD4 counts during pregnancy
d. prolonged labour
e. HIV-1 compared to HIV-2
Answer 27
28. Concerning African trypanosomiasis
a. it has an incubation period of 4-6 months
b. it may cause erythema chronicum migrans in light skinned persons
c. the Gambian form progresses more rapidly
d. the Gambian form is associated with a more prominent chancre
e. the Gambian form can be treated with pentamidine
Answer 28
29. Vivax malaria
a. may be complicated by anaemia
b. may be complicated by jaundice
c. in a traveller may present more than six months after exposure
d. is sensitive to chloroquine
e. may co-exist with falciparum malaria in the same patient
Answer 29
30. The following infections are zoonoses
a. salmonellosis
b. leprosy
c. tularaemia
d. Weil's disease (leptospirosis)
e. cholera
Answer 30
31. A fever of two weeks' duration associated with neutropaenia is characteristically due to
a. disseminated tuberculosis
b. brucellosis
c. malaria
d. influenza B
e. amoebic liver abscess
Answer 31
32. Quinine
a. is gametocidal for mature gametocytes of Plasmodium falciparum.
b. is active against schizonts of Plasmodium malariae
c. resistance occurs in Plasmodium falciparum in South East Asia
d. cerebrospinal fluid levels are much lower than serum levels following oral or intravenous administration
e. causes hypoglycaemia
Answer 32
33. Rheumatic fever
a. is most common in the third decade
b. is more common in areas of social deprivation
c. causes erosive arthritis
d. relapse rate may be reduced by prophylactic antibiotics
e. is more common following streptococcal pharyngitis than streptococcal cellulitis
Answer 33
34. The following are correctly paired
a. erythema nodosum tuberculosis
b. erythema marginatum Lyme disease
c. erythema multiforme orf
d. erythema induratum syphilis
e. erythema infectiosum parvovirus B19
Answer 34
35. HIV-associated Kaposi's sarcoma is
a. radiosensitive
b. chemosensitive
c. a cause of pleural effusion
d. more common in intravenous drug abusers than homosexuals
e. associated with infection by HHV-8 (Herpes hominis virus type 8)
Answer 35
36. Cholera
a. Vibrio cholera of the 01 serotype is the only cause of clinical disease
b. low gastric pH protects against infection
c. cholera toxin produces its effect by reducing intracellular levels of cAMP
d. hypoglycaemia is a recognised complication in children
e. fever is usual in adults
Answer 36
37. The following drugs are contraindicated or should be used with caution in epileptics:
a. doxycycline
b. chloroquine
c. ciprofloxacin
d. mefloquine
e. metronidazole
Answer 37
38. Hepatitis C
a. cirrhosis develops in most untreated cases
b. blood transfusion is the commonest mode of transmission in the UK.
c. most children born to hepatitis C infected mothers will have the infection
d. a normal serum alanine transaminase level excludes active liver disease
e. genotype 1 has the most favourable response to treatment
Answer 38
39. Coagulopathy is a recognised complication of
a. epidemic typhus
b. relapsing fever
c. pneumococcal septicaemia
d. envenomation by Latrodectus spiders (black widow spiders)
e. envenomation by Physalia physalis (Portuguese-man-of-war)
Answer 39
40. Cryptococcal meningitis
a. is caused only by Cryptococcus neoformans neoformans
b. is more common than cryptococcal pneumonia
c. characteristically causes leucopaenia
d. only occurs in the immunosuppressed
e. should be treated with ketoconazole
Answer 40
