Medicine MCQs

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An 11 year old boy presents with unilateral facial droop. The entire half of his face is paralyzed. Taste seems to be in tact. There are vesicles inside his ear. Most appropriate treatment?

  • A. Acyclovir alone
  • B. Steroids alone
  • C. Acyclovir and steroids
  • D. Wait for it to self-resolve
  • Correct Answer: Option C

10 year old girl diagnosed with optic neuritis 3 months ago. She is currently asymptomatic. How do you counsel her mother:

  • A. Chance of recurrence is low: Nelson’s says it can occur, esp if develops MS
  • B. The gamma globulin she received protects against recurrence
  • C. Risk of macular degeneration
  • D. She is at significant risk of developing MS
  • Correct Answer: Option D

An 18 month-old female presents to the emergency department with a febrile seizure secondary to an acute otitis media. This is her third febrile seizure in three months. What is the next step in management?

  • A. EEG
  • B. CT head
  • C. Neurology consult
  • D. Reassure parents, and no further investigations
  • Correct Answer: Option D

18 month old boy with first episode febrile seizure. What factor influences likelihood of repeat febrile seizure?

  • A. MRI result
  • B. EEG result
  • C. Family history of febrile seizures
  • D. Etiology of fever
  • Correct Answer: Option C

An infant has a sacral dimple. What would make you more concerned about spinal dysraphism?

  • A. Slate-gray nevus over dimple
  • B. Located 2 cm from anal verge
  • C. 3 mm in diameter
  • D. Located above the gluteal cleft
  • Correct Answer: Option D

2-year-old child presents with proximal muscle weakness and decreased DTRs in the legs, what is the diagnosis?

  • A. Congenital myopathy
  • B. Neuromuscular junction
  • C. Peripheral neuropathy
  • D. Spinal cord injury
  • Correct Answer: Option A

A child presents with polyuria, and polydipsia. Her serum sodium is 150, and her urine is very dilute (low specific gravity). Administration of vasopressin results in the rapid decrease in serum osmolality, and increase in urine osmolarity. MRI brain demonstrates thickening of the pituitary stalk. What is the diagnosis?

  • A. Histiocytosis (LCH)
  • B. Craniopharyngioma
  • C. Prolactinoma
  • D. Hypothalamic hamartoma:
  • Correct Answer: Option A

A 3 year old girl presents to your clinic, with concerns that she has had a recent increase in falling. She was noted by her mother to walk at 11 months of age. On examination you note bilateral increased tone in her lower extremities. What is your diagnosis

  • A. X-linked Adrenoleukodystrophy
  • B. Metachromatic leukodystrophy
  • C. Spastic diplegic cerebral palsy
  • D. Myotonic dystrophy:
  • Correct Answer: Option C

A child who is typically on clobazam for seizures has a GTC seizure at home witnessed by the father. His father gave him a dose of IN midazolam that stopped the seizure in 2 minutes. 10 minutes after arriving to the ED, he has another GTC. What will be your INITIAL treatment?

  • A. IV phenytoin
  • B. IV fosphenytoin
  • C. Intranasal midazolam
  • D. IV midazolam
  • Correct Answer: Option D

Seizures kid on Clobazam at home. Got one IN midaz what is next step.

  • A. Iv fospheny
  • B. Iv phenytoin
  • C. Iv midaz
  • D. IN midaz
  • Correct Answer: Option D