HPCSA exam

MCQ 18th March 2011

Instruction: No negative marking.

Choose one correct best answer.

1. HIV positive with a temperature of 38.7 presenting with cough of 2 weeks duration, productive of sputum. Running nose and retrosternal pain.
Reacts to penicillin. What will you do?
a). Erthromycin 500mg qid
b) Amoxycillin
c) Ceftriazone
d) Rifampicin Isoniazid Pyrazinamde Ethambutol
e) Penicillin

2. Bleeding PV in a 23 week old pregnancy. Cervical os is closed. No abdominal pains. What is the likely diagnosis?
a). APH – Placenta Praevia
b). Inevitable miscarriage
c). Threatened miscarriage
d). Incomplete miscarriage
e). APH – Placenta Abruptio

3. 10 wks pregnancy presenting with vaginal discharge. Choose the most appropriate combination?
1. Ceftriazone 250mg IM Stat
2. Doxycyline 100mg
3. Amoxycillin
4. Metronidazole 400mg tds
5. Metronidazole 2g stat

a). 1+3+5
b). 1+2+3

4. 70 year old man, no history of family disease, drinks alcohol and smokes 10 cigarretes a day. Height – 1.6m, Weight – 96Kg. Abdominal
circumference – 105cm. Hypertensive. Not diabetic. ECG – left bundle band block. Mmol/lCholesterol 7 How many cardiovascular risk factors
does he have?
a). 1
b) 2
c) 3
d) 4
e) 5

5. A young man was hit on the inner side of the knee, he presents with a limp, there is tenderness on the medial side of the knee

McMurrays – positive
Draws – negative (normal)
Valgus and varus – negative (normal). What is injured?
a). Medial Collateral ligament
b). Lateral Collateral ligament
c). Medial menisci
d).Lateral menisci
e). Anterior cruciate

6. A young man strangulated his grandmother saying he heard some voices telling him that the grandmother plans to poison his food. Symptoms has
been on for the last 7 months. Stays locked up in room. The examination done by the Dr.did not reveal anything conclusive. What is the likely
diagnosis?
a). Acute psychosis
b). Schizophreniform disorder
c). Schizophrenia

7. Contraindication to Morphine use?

a). Acute Asthma
b). Acute pulmonary edema

8. 13 year old boy. BMI 29 presenting with abduction of the hip (voir bats)
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a). Septic arthritis

b) Perthes disease
c) slippery upper femoral epiphyses

9. HIV positive with a CD4 count of 500, now 360. Presenting with weight loss and vaginal candiasis. What is the next thing to do?
a). Monitor closely
b). Prophylactic treatment
c). Repeat CD4 in 6 months
d) Commence ARVs.

10. Needle prick while taking samples from a patient. What immediate action will you take?
a). Take consent from the patient to test the sample for HIV
b). Report to your Clinical manager
c). Wash with water and soap

11. Features in keeping with UTI and Prostatis. Prostate tender on examination. How will you manage?
a). IM Ceftriazone 1 mg stat
b). Tabs Doxycycline
c). Tabs Ciprofloxacin 500mg b.d for 14 days

12. Diabetic that has been managed on dietary modification. Random blood sugar = 13.1 mmol/l. Could not sleep all night – devised a style of being
propped up sitted to sleep. O/E HBP. Basal Crepitations. No organomegaly.
What would be your Management?
a). Hydrochlorothiazide 25mg + Enalapril 10mg + Metformin 500mg once daily
b). Furosemide 40mg once daily + Enalapril 10mg + Metformin 500mg once daily
c) Spironolactone + Enalapril + Metformin

13. Making a diagnosis of DM in a woman with polyuria and weight loss?

a). DM symptoms + RBS ≥ 11.1 mmol/l
b). Fasting blood sugar ≥ 7.0 mmol/l
c). Fasting plasma sugar ≥ 6.0 mmol/l
d). 2 hour glucose tolerance = 7.1 mmol/l

14. Patient presenting with Bradycardia, High Blood pressure, sensitive to light, vomiting and severe headache. What is the likely diagnosis?
a). Subdural hematoma
b). Subarachnoid haemorrhage
c). Extradural hematoma
d).intracranial hemorrhage
e) subdural haemorrhage

15. Child took overdose of mothers sleeping tablet. Which antidote would you use?
a). Flumazenil
b). Naloxone
c). Atropine

16. Red eye slightly painful. No response to antibiotics used for a week. Likely diagnosis?
a). Viral conjunctivitis
b). Acute closed angle glaucoma
c). Anterior Uveitis
d). Foreign body

17. 22 year old girl, hard, mobile discreet lump. What is the likely diagnosis?
a). Fibroadenoma
b). Breast cyst
c). Mastitis

18. A young girl living with her 10 week pregnant Aunty has features in keeping with chicken pox. What should she do?
a). Stay away from her Aunty till the pregnancy is 13 weeks
b). Stay away from her Aunty till 14 days after the rash disappears
c). Stay away from her Aunty till the vesicles get crusted

19. Boy on Salbutamol PRN, now wheezing and coughing more often. What would you add to his management?
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a). Beclomethasone inhaler

20. Road to Health Chart of a 2 year old referred by the nurse to the Dr. showing eclampsia, in a woman who had C/S at 32 wks. Birth weight = 2.1 kg.
Child was 7.5kg at 2 years. Examination reveals an essentially no abnormality. Diagnosis?
a). Normal
b). Low for age
c). Marasmus
d) Kwashiokor
e). Marasmic – Kwashiokor

21. 56 year old woman who smokes presenting with hot flushes, insomnia. What is the information you need to proceed with managing her?
a). Her last normal menstrual period
b). Oestradiol level
c) progesterone level

22. Alcoholic presenting at the hospital with confusion, sweating, irritability. What is the special investigation you need to do?
a). Random blood sugar
b). Oxygen saturation level
c) Haemoglobin

23. Progressive jaundice, abdominal pain, fever, WBC increased, Gamma glutaryl severely elevated, Alkaline phosphates marginally increased. ALT
elevated. What will you see on Sonar?
a). Normal
b). Echogenic Liver lesion
c). Dilated bilary duct
d). Subphrenic abscess

24. Dog bites the owner’s boy while playing, presenting 2 days later with a small painfull supurative wound in the hand. WBC norma, no feverl. What is
the immediate treatment?
a) Surgical exploration
b) Antirabies immunologlobin
c) Elevate limb and immortalize
d) Topical antibiotics
e) suture

25. Patient trachea shifted to the right, hyperresonance on the left side of the chest, what is the diagnosis?
a)Left pneumothorax
b)Right pneumothorax
c)Pleural effusion
26. Otitis externa

Extended Matching Questions

Three ECG tracings

Clinical features:
27. Patient complain of his heart stop beatings sometimes
28. Features of myocardial infarction
29. Patient complaining of heart beating fast as it wants to come out of the chest
a). Sinus arrythmia
b). Myocardial infarction
c). Sinus Tachycardia
d) Ventricular tachycardia

Gynaecological
a). combined oral contraceptives
b). Levonorgestrel
c). IUCD
d). Oestrogen cream
e) Oestradiol
f) Progesterone
g) Sterilisation
…
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30. Atrophic vaginitis

31. Dysmenorrhea
32. Meno-metrorrhagie
33. prevention of pregnancy for long period
…

Anaemia (cfr Octobre 2010)

34.Iron defisciency
35. sicklecell anemia
36. pernicious anemia
37.

Psychiatry

38. Mania
39. early dementia
40. psycho-affective disorder
41.Schizophrenia

Cases of Asthma
Cases of Diabetes
Cases of Diarrhoea in adults and children

Public Health

Choose the most appropriate answer that best suits the scenario:

a) Accessibility to health care

b) Inappropriate allocation of funds / resources
c) Insufficiency in human ressoureces
d) Distributive justice
e)Unitarism

A man on TB treatment in the Soweto clinic where you work as medical officer is not getting better. While investigation the reasons, the sister working
with you found out that he is not attending regularly the clinic because his family still living in Soweto but he’s working permanently in a mine in north
west where he’s renting a room because it is impossible for him to come back every day. Which principle is implied in this case?

You are treating a patient with a terminal chronic kidney disease, you recommend for this patient an hemodialysis but the clinical manager of the hospital
tells you that there is only peritoneal dialysis available in the hospital and that the hemodialysis is not in the budget and too expensive. Which principle is
implied in this case?

You prescribe medications to a patient but the pharmacist told him that it is finished but you know that the district pharmacy is well provided with these
drugs. Which principle is implied in this case?

An intern in psychology is allocated in one of the district clinics where he is providing his service in research purposes; after seeing one of your patients,
you refer him to that clinc so that he can be seen by this psychologist. The patient returns to you saying that this service is no longer available in the clinic
because the intern who was providing it completed his internship one week ago. You as a medical practitioner thinks that this service is highly needed in
this area.

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