TAS OCTOBER 2022

EMQ
1. Questions on vitamin D
Vitamin d resistant rickets
Vitamin d dependent
x-linked hypophosphatemia
Primary parahyperthyroidism
2. STI in a male
a. Rash, sore throat and lump on glans penis – Syphyllis
b. Painful vesicles on penis – herpes
c. Non painful lumps with perianal bleed, itchy - HPV

3. Cardiovascular :
TGA, TAPVR, HPOPLASTIC LEFT HEART, TRUNCUS
ARTERIOSUS, PULMONOARY STENOSIS, TOF
a. 24 hour neonate 39weeker, sats 65% , pulses normal
volume ,
b. Mild pulmonary plethora, normal heart sounds,
Pulmonary oligeamia
c. Axis 130, Murmur in 2nd left intercostal space , ESM ,
pulmonary oligaemia , Axis of 330
Pulmonary plethora, No murmur , low pulses globally
 4. H1 Receptor Blocker
H2 receptor blocker
Alpha adrenergic
Beta1 and 2 antagonist
B1 antagonist
H1 agonist
H2 agonist
a.Ranitidine
b. Chlorpheniramine
c. Propranolol
d. Vancomycin – inhibits cell wall synthesis by inhibiting
peptidoglycan cross linkage
e. Chloramphenicol – 50s,
f. Mycophenolate mofetil – IMP

5. Preterm 29 weeks , long line, infection – organism – gram

positive cocci
Term baby meconium stained liquor developed fever after
2 days and irritable gram positive bacillus
Term baby became unwell within 24 hours of birth
Mechanisms of diarrhoea
defect in Na, K, cl
increased Camp
active osmosis
small bacterial bowel overgrowth
villus atropy and malabsorption, crypt atrophy

Cholera
Child had a viral infection and later has developed diarrhoea

Unilateral facial pain

Child had RTA has head tilt, vertical diplopia

BOF
1. Procoagulant factor synthesized in vascular endothelial
cells
a. Von Willebrand factor b Prothrombin c . fibrinogen d.
Protein C e. Thrombin 3

2. A disease z affecting 10,000 people with risk of dying as

2/1000 what is the NNT
a. 20% b. 0.2%
3. Anorexic girl with bmi 15 what will have effect on her
eventual bone density ?
a. IGF-1 b. Oestrogen c. cortisol d.

4. Circumcised = 1.88/1000 uncircumcised = 7.02/1000 what

is the 1/ARR

5. Which of the following is a potent vasoconstrictor

a. Noradrenaline b. dopamine c. dobutamine

6. A person who tests negative does not have the disease

7. Probability of testing positive when you have the disease

divided by the probability of testing positive when you do
not have the disease. TP/FP = Likelihood Ratio

8. Release of oxygen to tissues is favoured by which factor,

this Is oxygen dissociation curve – hyperventilation,
newborn , fever, alkalosis, carbon monoxide poisoning

9. A 18 month old with suspected NAI - Bone scan is better

than skeletal survey in detecting the following non
accidental injury – types of fracture –
a. Skull fracture b. rib fracture c. clavicular fracture
d. non displaced spiral tibial fracture e. fracture of proximal
humerus

10. 15 month old which will be an indication of NAI

a. Metaphyseal fracture of the femur
b. Spiral fracture of the tibia
c. Humerus
d. Radial fracture
e. Supra condylar fracture of femoral

11. Boy who started limping what is the mechanism of

the process.
a. Vascular insult causing osteo necrosis

12. Change in behaviour of 15 year old adolescent

a. Pre frontal cortex -

13. Newborn with enlarged kidneys and bladder what

test will detect obstruction ? note not USS

14. Mechanism of action of ethosuximide – calcium ,

sodium
15. Iron aborption : vitamin c from ferric to ferrous , b. is
heme or non heme form of iron easily absorbed. Iron
exists in fe 3+ and to be absorbed has to be in fe 2+

16. Gulliane barre syndrome – PROTEIN/GLUCOSE/ WBS

17. Child with eczema and weeping crusting lesions which

organism – staph, herpes, strep

18. Ceoliac disease increased TTG and total IgA

19. Seizures and developmental issues/ neurologic

problems in a condition if left untreated but can be
diagnosed in the newborn screening test – phenylamine,
isoleucine, tryptophan

20. Csf absorption main location – arachnoid villi

21. Secondary hypothyroidism from cranial irradiation –

TSH and T4 values - both low
22. Spinal muscular atrophy mode of diagnosis – FISH/
MICROARRAY/ ? WHAT is the test,

23. Congenital myotonic dystrophy

24. Pupillary reflex which nerves - optic , oculomotor,

25. trigerminal, facial

26. Child with PUV seen at 20 weeks if born at 33 weeks

spontaneously what will he die from ? is it RDS, lung
hypoplasia

27. TEF common type

28. Boy found face down in garden pond , apnoeic and

bradycardic is it diving reflex, ? cerebral oedema

29. HSP – immunoglobulin IgA

30. Organophosphates how do they affect the eye ?

nicotinic/ cholinergic / activation of Edinger Westphal ?
31. ECG changes in hyperk – besides peaked T waves
what is it ? prolonged PR , increased Qtc

32. What does T wave correspond to on ECG

33. Exopthalmus, lid retraction what will be high – TPO ,

Thyroglobulin antibodies

34. TP/FP what is it

35. Formula for

36. Mechanism of diarrhoea in cholera

37. Montelukast how does it work -Montelukast

(empirical formula C35H35ClNNaO3S) is a highly selective
leukotriene receptor antagonist that binds with high
 affinity to the cysteinyl leukotriene receptor for
leukotrienes D4 and E4. Inhibits their effects

38. Single gene defect mechanism in diarrhea

39. MOA boutilinium toxin A inhibits release of ACH from

presynaptic motor neurons at NMJ

40. MOA Of rocuronium Rocuronium Mechanism of

Action: A short acting, non-depolarizing
neuromuscular blocking agent that directly
competes with acetylcholine on the
neuromuscular receptors. Indications: Used for
rapid and smooth endotracheal intubation when
succinylcholine is contraindicated or unavailable

41. A superficial partial-thickness burn is a thermal,

electrical, friction, radiation, or chemical injury to the
skin that extends through the epidermis to the upper
portion of the dermis (papillary dermis). This type of burn
manifests as erythematous, blanching skin with severe
pain – b. stratum basale, c. reticular dermis,
42. Hypo k, low cl, alkalosis, wt and ht 0.4 centile,
polyhydramnios ,urine ph 7 – proximal or distal

43. Renal stones, same in family members, no urine ph

given where is the defect ?

44. Organosphospahtes – direct muscarinic eye effects ?

direct nicotinic eye effects ? stimulates Edinger Westphal
nucleus

45. Preterm area of bleed – germinal matrix , 3rd

ventricle, 4th ventricle

46. Gram positive bacilli 2 days after newborn was born,

irritable

47. Preterm with long line organism of sepsis

48. Newborn with sepsis In 24 hrs

49. Dopamine and doubtamine, norepinephrine and
enoximone which is a potent vasoconstrictor

50. Neonate with pneumothorax why will you give higher

maintenance oxygen to the baby
a. Reduce work of breathing b. improve cerebral
oxygenation c. Nitrogen

51. Child with bronchiolitis and acidosis both metabolic

and respiratory how will you physiologically correct –
increase pulmonary blood flow/ increase oxygen to the
lungs/ improve airflow or oxygen flow

52. A rightward shift causes little change in conditions for

loading oxygen (essentially the same Sao2 at Po2 of 100
mm Hg), but it allows larger amounts of oxygen to
dissociate from hemoglobin in the tissues. This improves
tissue oxygenation. Carbon dioxide and metabolic acid
shift the oxyhemoglobin dissociation curve rightward,
whereas alkalosis shifts it leftward. Fetal hemoglobin isleft
shifted, an adaptation uniquely suited to placental
physiology. Oxygen in arterial blood is bound to
 hemoglobin and dissolved in the plasma. The blood oxygen
content is the sum of the two forms. Although amounts of
dissolved oxygen are fairly trivial at normal Po2 levels, at
high Fio2 dissolved oxygen can be physiologically and
clinically important. Although under normal conditions
only a fraction (25%) of the oxygen on hemoglobin is used,
all of the added dissolved oxygen added while giving
supplemental oxygen can be used.

53. Bilirubin
a. Unconjugated is mostly water soluble
b. Phototherapy converts Bilirubin to lumirubin and
excreted

54. Brain death new criteria in uk – hypercapnia

55. Shri Gomel is at T6 – loss of pain and temperature in a
cloak like pattern on the upper limbs. Below the lesion :
muscle spasticity
56. Cranial nerve palsy when eye is rotated up and out
57. Micronutrient that is metabolised in the
reticuoendothelial system
a. Zinc b. Copper c. ? Iron there not sure
58. Vaccine has been recently made against Which
polysaccharide capsule ? A. H.influenza b. Strep
pneumonia c. Can’t remember the rest
59. Mother with platelets of 30x10/3, baby developed
purpura etc , what is the mechanism of the problem ?
a. Immune complex b. IgE c.