41- Which of the following is a feature of Vancomycin-resistant enterococci?
1) cause resistant infective diarrhoea
2) produce an enzyme that inactivates vancomycin
3) may be found in healthy community volunteers not recently hospitalized
4) high dose ampicillin is the treatment of choice
5) are commonly vancomycin-dependent
Answers-3
42- An 85 year old patient from an elderly care home, experiences sudden onset of dyspnea and palpitations. A pulmonary ventilationperfusion scan is performed and indicates a high probability for a perfusion defect involving a pulmonary arterial branch.
Which of the following findings or conditions is the one that is the most important factor favouring development of her complaint?
1) A neutrophilia
2) An increased platelet count
3) Cirrhosis of the liver
4) Generalized atherosclerosis
5) Poor nutrition
Answers-2
43- A young man from India presents with fever of 4 months duration and splenomegaly. What is the most likely diagnosis?
1) Coccidiomycosis
2) Giardiasis
3) Tropical sprue
4) Typhoid
5) Visceral leishmaniasis
Answers-5
44- A 35-year-old man returned from a two-week holiday complaining of pain in the loins and painful swollen knees. On examination he was afebrile and had significant bilateral knee effusions. Mild penile erythema was also noted.
Laboratory investigations showed.
Hb 15.6 g/dL
WBC 16.2 x 109/l
Neutrophils 14.1 x 109/l
ESR 65 mm/h
Rheumatoid factor 10 IU/L
Urinalysis No cells, casts or bacteria seen
What is the most likely diagnosis?
1) Arthritis due to Neisseria gonorrhoeae infection
2) Lymphogranuloma venereum
3) Reactive arthritis
4) Reitter's syndrome
5) Rheumatoid arthritis
Answers-1
45- A 40-year-old man has had decreased mentation with confusion as well as increasing incoordination and loss of movement in his right arm over the past 6 weeks. An MRI scan shows 0.5 to 1.5 cm lesions in cerebral hemispheres in white matter and at the grey-white junction that suggest demyelination. A stereotatic biopsy is performed, and immunohistochemical staining of the tissue reveals JC papovavirus in oligodendrocytes. Which of the following laboratory test findings is most
likely to be associated with these findings?
1) CD4 lymphocyte count of 90/microliter
2) Haemoglobin A1c of 9.8%
3) HDL cholesterol of 0.7 mmol/L
4) Oligoclonal bands in CSF
5) Serum sodium of 110 mmol/L
Answers-1
46- Which one of the following statements concerning T-lymphocytes is correct?
1) Are the primary host response in bacterial infection
2) Compose the majority of lymphocytes in plasma
3) Are infected by Epstein-Barr virus in infectious mononucleosis
4) produce IgG
5) T cell lymphoma has a better prognosis
Answers-2
47- You are considering starting a patient on Griseofulvin. Which of the following statements concerning its pharmacology is true?
1) It is active against Candida albicans.
2) It is active against aspergillus.
3) It should not be used in renal failure.
4) It used for a maximum of 2 weeks.
5) It is associated with drug-induced Stevens Johnson syndrome.
Answers-5
48- A 14 year old boy presents with fever. Which of the following might contribute to a diagnosis of rheumatic fever?
1) The finding of target lesions on the hands.
2) The finding of tender nodules in the fingertips.
3) A prolonged PR interval on ECG.
4) A CRP of 10.
5) Positive Romberg's sign.
Answers-3
49- A 75 year old man has a history of Chronic Lymphocytic Leukaemia. He has had treatment with several courses of chemotherapy and has now been admitted to hospital with pneumonia. His past medical history revealed that he had suffered several previous upper respiratory tract infections over the previous six months.
Which of the following components of his immune system is likely to be deficient?
1) Complement
2) Immunoglobulin G
3) Macrophages
4) Mast cells
5) T lymphocytes
Answers-2
50- Which of the following is true of the the T cell response to antigen?
1) A process of affinity maturation of the T cell receptor occurs.
2) Intact antigen is presented in association with self MHC molecules.
3) Co-operation with other cell types is required for T cell recognition of antigen.
4) gamma/delta + T cells respond to antigen presented in association with MHC class II molecules.
5) Interactions of the TcR with an appropriate Ag/MHC complex activates a resting T cell.
Answers-3
1) cause resistant infective diarrhoea
2) produce an enzyme that inactivates vancomycin
3) may be found in healthy community volunteers not recently hospitalized
4) high dose ampicillin is the treatment of choice
5) are commonly vancomycin-dependent
Answers-3
42- An 85 year old patient from an elderly care home, experiences sudden onset of dyspnea and palpitations. A pulmonary ventilationperfusion scan is performed and indicates a high probability for a perfusion defect involving a pulmonary arterial branch.
Which of the following findings or conditions is the one that is the most important factor favouring development of her complaint?
1) A neutrophilia
2) An increased platelet count
3) Cirrhosis of the liver
4) Generalized atherosclerosis
5) Poor nutrition
Answers-2
43- A young man from India presents with fever of 4 months duration and splenomegaly. What is the most likely diagnosis?
1) Coccidiomycosis
2) Giardiasis
3) Tropical sprue
4) Typhoid
5) Visceral leishmaniasis
Answers-5
44- A 35-year-old man returned from a two-week holiday complaining of pain in the loins and painful swollen knees. On examination he was afebrile and had significant bilateral knee effusions. Mild penile erythema was also noted.
Laboratory investigations showed.
Hb 15.6 g/dL
WBC 16.2 x 109/l
Neutrophils 14.1 x 109/l
ESR 65 mm/h
Rheumatoid factor 10 IU/L
Urinalysis No cells, casts or bacteria seen
What is the most likely diagnosis?
1) Arthritis due to Neisseria gonorrhoeae infection
2) Lymphogranuloma venereum
3) Reactive arthritis
4) Reitter's syndrome
5) Rheumatoid arthritis
Answers-1
45- A 40-year-old man has had decreased mentation with confusion as well as increasing incoordination and loss of movement in his right arm over the past 6 weeks. An MRI scan shows 0.5 to 1.5 cm lesions in cerebral hemispheres in white matter and at the grey-white junction that suggest demyelination. A stereotatic biopsy is performed, and immunohistochemical staining of the tissue reveals JC papovavirus in oligodendrocytes. Which of the following laboratory test findings is most
likely to be associated with these findings?
1) CD4 lymphocyte count of 90/microliter
2) Haemoglobin A1c of 9.8%
3) HDL cholesterol of 0.7 mmol/L
4) Oligoclonal bands in CSF
5) Serum sodium of 110 mmol/L
Answers-1
46- Which one of the following statements concerning T-lymphocytes is correct?
1) Are the primary host response in bacterial infection
2) Compose the majority of lymphocytes in plasma
3) Are infected by Epstein-Barr virus in infectious mononucleosis
4) produce IgG
5) T cell lymphoma has a better prognosis
Answers-2
47- You are considering starting a patient on Griseofulvin. Which of the following statements concerning its pharmacology is true?
1) It is active against Candida albicans.
2) It is active against aspergillus.
3) It should not be used in renal failure.
4) It used for a maximum of 2 weeks.
5) It is associated with drug-induced Stevens Johnson syndrome.
Answers-5
48- A 14 year old boy presents with fever. Which of the following might contribute to a diagnosis of rheumatic fever?
1) The finding of target lesions on the hands.
2) The finding of tender nodules in the fingertips.
3) A prolonged PR interval on ECG.
4) A CRP of 10.
5) Positive Romberg's sign.
Answers-3
49- A 75 year old man has a history of Chronic Lymphocytic Leukaemia. He has had treatment with several courses of chemotherapy and has now been admitted to hospital with pneumonia. His past medical history revealed that he had suffered several previous upper respiratory tract infections over the previous six months.
Which of the following components of his immune system is likely to be deficient?
1) Complement
2) Immunoglobulin G
3) Macrophages
4) Mast cells
5) T lymphocytes
Answers-2
50- Which of the following is true of the the T cell response to antigen?
1) A process of affinity maturation of the T cell receptor occurs.
2) Intact antigen is presented in association with self MHC molecules.
3) Co-operation with other cell types is required for T cell recognition of antigen.
4) gamma/delta + T cells respond to antigen presented in association with MHC class II molecules.
5) Interactions of the TcR with an appropriate Ag/MHC complex activates a resting T cell.
Answers-3
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