Question 1 (2
1. Which of the following is NOT a typical injury of driver or passenger in motorcycle accident ?
| | |1. |Brush abrasions of the exposed body surfaces. |
| | |2. |Fractures of the temporo-parietal region of the skull. |
| | |3. |Fracture across the base of the skull through the pituitary fossa. |
| | |4. |Contrecoup brain contusions. |
|100.0% |[pi|5. |Fractures of the thoracolumbar spine. |
| |c] | | |
2. One of the following statements is not true about screening tests for cancer:
| | |1. |The positive predictive value of the screening test is affected by the prevalence of the cancer. |
| | |2. |The positive predictive value of the screening test is affected by the specificity of the test. |
| | |3. |The positive predictive values of the screening test is affected by the sensitivity of the test. |
|100.0% |[pi|4. |A 90% specificity of the test means that of all individuals with a positive test result, 90% of them have |
| |c] | |cancer. |
| | |5. |All of the following are important factors in deciding whether a screening test for cancer should be widely |
| | | |applied: cost, trauma due to the test, evidence of reduction in cancer mortality by applying the test.. |
3. The use of the following drugs in the elderly will require special attention because of the adverse effects listed:
| | |1. |β2 agonists and tremors |
|100.0% |[pi|2. |Aminoglycosides and renal damage |
| |c] | | |
| | |3. |Digoxin and nausea |
| | |4. |Calcium antagonists and headache |
| | |5. |Opiates and constipation |
4. which of the following factors contributing to polypharmacy is physician-related rather than patient-related?
| | |1. |inadequate reporting of current medications |
| | |2. |use of multiple pharmacies and physicians |
| | |3. |self medication with over-the-counter drugs |
|100.0% |[pi|4. |failure to simplify drug regimen as often as possible |
| |c] | | |
| | |5. |use of automatic refilling without visiting physicians |
5. Which of the following is not true when examining a case of suspected drunken driver:
| | |1. |Consent must be obtained first |
| | |2. |Some metabolic disorders may mimic alcohol intoxication |
| | |3. |Skull X-ray should be taken to exclude head injuries given any history of trauma |
|100.0% |[pi|4. |In Hong Kong, taking of blood sample for alcohol analysis is mandatory because any level exceeding the |
| |c] | |prescribed level results in automatic conviction |
| | |5. |When taking blood samples for alcohol analysis, alcohol swab must not to be used for sterilization of |
| | | |venepucture site |
6. Gastric lavage should be carried out in the following situations:
| | |1. |A patient who has swallowed petroleum compounds. |
| | |2. |A patient who has swallowed corrosive substances. |
| | |3. |A comatose patient who has swallowed sleeping pills. |
|100.0% |[pi|4. |A patient who has swallowed 20 paracetamol tablets and arrived in hospital 30 minutes later. |
| |c] | | |
| | |5. |A patient who has swallowed 100 ml of 'Dettol' (household disinfectant) and arrived in hospital 30 minutes |
| | | |later. |
7. which of the following best describes the shape of post-mortem body temperature (y-axis) plotted against post-mortem interval (x-axis)?
| | |1. |straight line with negative slope |
| | |2. |straight line with positive slope |
| | |3. |parabolic curve |
|100.0% |[pi|4. |sigmoid curve |
| |c] | | |
| | |5. |bell-shaped curve |
8. in the assessment of the plasma lipid profile which of the following parameters is usually calculated rather than measured directly?
|100.0% |[pi|1. |LDL-cholesterol |
| |c] | | |
| | |2. |HDL-cholesterol |
| | |3. |total triglycerides |
| | |4. |total cholesterol |
| | |5. |None of the above |
9. adjuvant drugs for analgesic or pain control includes:
|100.0% |[pi|1. |laxative |
| |c] | | |
| | |2. |strong opioids |
| | |3. |weak opioids |
| | |4. |doloxene |
| | |5. |morphine |
10. which of the following is the most important reason for choosing a beta-blocker as first line therapy for hypertension?
| | |1. |they are the most effective in lowering blood pressure |
| | |2. |they have few metabolic side effects |
| | |3. |they increase insulin sensitivity |
|100.0% |[pi|4. |they have proven efficacy in secondary prevention of myocardial infarction |
| |c] | | |
| | |5. |there is more clinical experience with these than with any other group of antihypertensive drugs |
11. During winter time in Hong Kong, the postmortem interval required for full rigor mortis to develop is about:
| | |1. |2 hours |
| | |2. |6 hours |
|100.0% |[pi|3. |12 hours |
| |c] | | |
| | |4. |24 hours |
| | |5. |36 hours |
12. Regarding cardiac arrest,
| | |1. |the blood pressure and heart rate of the patient increased. |
| | |2. |propranolol can be given to reverse the situation. |
| | |3. |fluid replacement can be used to restore the cardiac functions. |
|100.0% |[pi|4. |ephedrine is a drug-of-choice as it possesses cardiac stimulatory effects. |
| |c] | | |
| | |5. |it is due to the blockade of the parasympathetic innervation. |
13. what proportion of patients attending h.a. hospital medical clinics is likely to be receiving polypharmacy?
| | |1. |5% |
| | |2. |10% |
|100.0% |[pi|3. |25% |
| |c] | | |
| | |4. |50% |
| | |5. |75% |
14. which of the following drugs would be the best choice to reduce high levels of plasma triglycerides?
| | |1. |corticosteroids |
| | |2. |hmg coa reductase inhibitors |
|100.0% |[pi|3. |fibrates |
| |c] | | |
| | |4. |bile acid sequestrants |
| | |5. |None of the above |
15. Which of the following is NOT true about screening program for colorectal cancer?
| | |1. |Screening stool for occult blood is indicated for patients age 50 or above |
| | |2. |Screening colonoscopy may detect early stage colorectal cancer |
| | |3. |Includes testing stool for occult blood annually and colonoscopy every three years. |
|100.0% |[pi|4. |CEA is a sensitive screening test |
| |c] | | |
| | |5. |Screening is indicated for familial polyposis. |
16. which of the following is a contraindication to the use of angiotension II receptor blockers in hypertension?
| | |1. |ace inhibitor induced cough |
| | |2. |heart failure |
| | |3. |diabetic nephropathy |
|100.0% |[pi|4. |bilateral renal artery stenosis |
| |c] | | |
| | |5. |history of gout |
17. Which one of the following is not true for nature of pain?
| | |1. |Neuropathic pain includes the symptoms: burning, numbness, referred pain, neurological deficit |
| | |2. |Musculoskeletal pain includes the symptoms: sharp pain, aggravated by movement, muscle spasm |
| | |3. |Colicky pain includes the symptoms: on and off cramp; intestinal, biliary, ureteric origin |
| | |4. |increased pressure and soft tissue inflammation pain may due to increased intracranial pressure, liver capsule|
| | | |distension, cellulitis |
|100.0% |[pi|5. |musculoskeletal pain includes the symptoms: burning, numbness, referred pain, neurological deficit, sharp |
| |c] | |pain, aggravated by movement, muscle spasm |
18. which of the following is not a recognised side effect of treatment with a calcium channel blocker?
| | |1. |ankle swelling |
|100.0% |[pi|2. |exacerbation of asthma |
| |c] | | |
| | |3. |rebound angina |
| | |4. |flushing |
| | |5. |exacerBation of heart failure |
19. The law authorizes the following persons to possess Dangerous Drugs except:
| | |1. |Registered medical practitioners |
| | |2. |Registered pharmacists |
| | |3. |Nurses in charge of an operating theatre |
| | |4. |Registered veterinary surgeons |
|100.0% |[pi|5. |Listed sellers of poisons |
| |c] | | |
20. Which of the following is not true for chemotherapy treatment for cancer?
| | |1. |Repeated treatment is necessary for optimal effect |
|100.0% |[pi|2. |Chemotherapy affects cancer cell mitosis but not normal cells |
| |c] | | |
| | |3. |Intravenous route is the most common route of administration |
| | |4. |Chemotherapy may induce a second malignancy in some patients |
| | |5. |Acquired resistance is resistance to drug acquired during the |
21. which of the following regarding stab wounds is true?
| | |1. |the maximum length of the weapon may be deduced |
|100.0% |[pi|2. |the cross section of the weapon may be deduced |
| |c] | | |
| | |3. |they cannot be produced by blunt objects |
| | |4. |the size of the skin wound is proportional to the severity of the injury |
| | |5. |little external bleeding means good prognosis |
22. All of the following are symptoms suspicious of cancer except:
| | |1. |a painfless lump in the breast in a 55-year-old lady |
|100.0% |[pi|2. |Sore throat, fever and a painful lump at the upper part of the neck in a 30-year-old man |
| |c] | | |
| | |3. |two episodes of middle ear infection (otitis media) in the same ear over a 3-month peroid in a 55-year-old man|
| | |4. |coughing out of blood (haemoptysis) without other symptoms, in a 50-year-old man |
| | |5. |a small amount of fresh blood on the faeces, in a 40-year-old man |
23. which of the following drugs does not increase plasma triglycerides?
| | |1. |thiazide diuretic |
|100.0% |[pi|2. |phenytoin |
| |c] | | |
| | |3. |beta-blocker |
| | |4. |retinoid |
| | |5. |oral contraceptive |
24. In an elderly male, a subcutaneous bruise always disappears
| | |1. |within 1 week |
| | |2. |within 2 weeks |
| | |3. |within 3 weeks |
| | |4. |within 4 weeks |
|100.0% |[pi|5. |none of the above |
| |c] | | |
25. In patients with renal disease, which of the following is the most important as far as drug elimination is concerned?
| | |1. |Drug absorption may be decreased by vomiting. |
| | |2. |Plasma protein binding may be decreased. |
| | |3. |Drug metabolism may be decreased. |
|100.0% |[pi|4. |Drug excretion is decreased. |
| |c] | | |
| | |5. |Drug absorption may be decreased by antacids. |
26. when we communicate,
|100.0% |[pi|1. |one of the aims is to set realistic goal with the patient. |
| |c] | | |
| | |2. |don,t look directly into the patients, eyes as they might get embarrassed. |
| | |3. |silence can be a difficult time for the patient and so we need to find something to say. |
| | |4. |if our patients cry, it is our fault. |
| | |5. |use a firm tone of voice; otherwise the patient will not listen to what we say. |
27. Therapeutic drug monitoring
| | |1. |is especially useful for drugs with a wide therapeutic range. |
| | |2. |is used for most prescription drugs. |
|100.0% |[pi|3. |is useful for drugs in which overdosing may produce symptoms similar to those of the disease being treated. |
| |c] | | |
| | |4. |is essential for drugs in which the dose given correlates well with the pharmacological effect. |
| | |5. |is not useful for drugs which produce abnormalities in renal clearance. |
28. severely burnt bodies may show:
| | |1. |scalp haematoma |
|100.0% |[pi|2. |epidural haematoma |
| |c] | | |
| | |3. |subdural haematoma |
| | |4. |subarachnoid haemorrhage |
| | |5. |intracerebral haemorrhage |
29. which of the following is the most important reason for choosing thiazide diuretics as first line therapy for hypertension?
| | |1. |they are the most effective in lowering blood pressure |
| | |2. |they have few metabolic side effects |
|100.0% |[pi|3. |they have well established efficacy in reducing cardiovascular events |
| |c] | | |
| | |4. |they do not cause electrocyte disturbances |
| | |5. |they improve the symptoms of prostatic hypertrophy |
30. carbon monoxide poisoning causes hypostasis to appear
| | |1. |scarlet |
|100.0% |[pi|2. |cherry pink |
| |c] | | |
| | |3. |purplish |
| | |4. |bluish |
| | |5. |bronze |
31. Which of the following drug combinations has useful additive/synergistic effects?
| | |1. |salbutamol and propranolol |
| | |2. |terfenidine and ketoconazole |
| | |3. |bethanechol and atropine |
|100.0% |[pi|4. |methylprednisolone and ondansetron |
| |c] | | |
| | |5. |tubocurarine and physostigmine |
32. in facing death
| | |1. |patients usually accept their prognosis at the end. |
|100.0% |[pi|2. |the patients, relatives also experience psychological reactions of denial, anger, bargaining, depression and |
| |c] | |acceptance. |
| | |3. |as depression is a normal psychological reaction, antidepressants are unnecessary. |
| | |4. |if patients project anger towards us, tell them that their behaviour is unacceptable. |
| | |5. |patients who still bargain for cure have no awareness of their prognosis and we need to correct their |
| | | |misconception. |
33. In Hong Kong, which of the following is not listed as a Dangerous Drug?
| | |1. |LSD |
| | |2. |Cannabis |
| | |3. |Barbitone |
| | |4. |Methadone |
|100.0% |[pi|5. |all are Dangerous Drugs |
| |c] | | |
34. Which of the following cancer is related to occupational exposure of asbestos?
| | |1. |Carcinoma of skin |
|100.0% | |2. |Leukemia |
| |[pi|3. |Mesothelioma |
| |c] | | |
| | |4. |Hepatocellular carcinoma |
| | |5. |Nasopharyngeal carcinoma |
35. Which of the following statement is NOT true?
| | |1. |Beta-carotene increases lung cancer mortality in smokers. |
| | |2. |Routine chest x-ray may detect early stage lung cancer. |
|100.0% |[pi|3. |Routine chest x-ray may reduce lung cancer mortality. |
| |c] | | |
| | |4. |Environmental tobacco smoking (second hand smoking) increases the risk of lung cancer. |
| | |5. |Tobacco smoking is the major cause of lung cancer. |
36. One of the following statements is not true regarding screening for breast cancer:
| | |1. |There is a lack of high level evidence to prove that self-examination of the breast can reduce the mortality |
| | | |due to breast cancer. |
| | |2. |There is Level I evidence for the efficacy of mammogram in reducing breast cancer mortality |
| | |3. |There is a Cochrane review on the randomized trials on mammogram screening of breast cancer, and the |
| | | |conclusion is that there is lack of evidence that mammogram can reduce mortality in the screened population. |
|100.0% |[pi|4. |The usual recommendation for mammogram screening for breast cancer is to start screening at age 30.. |
| |c] | | |
| | |5. |The usual interval for breast screening by mammogram is either once a year or once every 2 years. |
37. Carbidopa is used in the treatment of Parkinson,s disease to
| | |1. |increase L-dopa levels by inhibiting CYP3A4 |
| | |2. |reduce the metabolism of L-dopa in the brain |
|100.0% |[pi|3. |reduce the metabolism of L-Dopa in the periphery |
| |c] | | |
| | |4. |reduce the excretion of L-Dopa by the kidney |
| | |5. |potentiate the action of bromocriptine by inhibiting CYP3A4 |
38. The major mechanism of carbon tetrachloride to potentiate the sedative action pentobarbitone probably involves
| | |1. |its action to reduce GABA metabolism to potentiate the effects of pentobarbitone at the GABAA receptor |
|0.0% |[pi|2. |a displacement of pentobarbitone from albumin binding sites |
| |c] | | |
|0.0% |[pi|3. |competitive inhibition of the P450 isoenzyme system |
| |c] | | |
| | |4. |a block of histamine H1 receptors |
| | |5. |liver damage caused by free radical generation |
39. which of the following is a compelling indication to choose an angiotensin converting enzyme inhibitor for the treatment of hypertension?
|100.0% |[pi|1. |heart failure |
| |c] | | |
| | |2. |safe in pregnancy |
| | |3. |hyperkalaemia |
| | |4. |systolic hypertension |
| | |5. |peripheral vascular disease |
40. The burning of Polyurethane may produce:
|100.0% |[pi|1. |Cyanide |
| |c] | | |
| | |2. |Hydrogen sulphide |
| | |3. |Hydrogen peroxide |
| | |4. |Ozone |
| | |5. |Nitrous oxide |
41. Which of the following agents can cause renal failure?
| | |1. |Chuanwu (aconitine) |
| | |2. |Yangjinhua (atropine) |
|100.0% |[pi|3. |Guangfangji (aristolochic acid) |
| |c] | | |
| | |4. |Vegetable-borne insecticide |
| | |5. |Food-borne clenbuterol (β2 agonist) |
42. The following agents are considered to be highly toxic if ingested, except:
| | |1. |Paraquat |
|100.0% |[pi|2. |Household washing liquid |
| |c] | | |
| | |3. |Drain cleaners |
| | |4. |Automatic-dishwasher detergent |
| | |5. |Organophosphate insecticides |
43. which of the following is most correct regarding drug compliance?
| | |1. |compliance is better in actual practice than during clinical trials |
|100.0% |[pi|2. |poor compliance includes talking more medication than prescribed as well as taking less |
| |c] | | |
| | |3. |compliance denotes more active patient-physician treatment collaboration than adherence |
| | |4. |poor compliance usually improves treatment outcomes |
| | |5. |compliance usually increases over time |
44. a 60-year-old man presented with haemoptysis (coughing out of blood) and mild pain over the lumbar spine. his chest x-ray showed a 6cm diameter shadow in the left lung field and x-ray of the lumbar spine showed that L2,L3,L4 vertebrae were involved by cancer (the radioloigst reviews the x-ray and confirms that there is no doubt that the x-ray lumbar spine showed cancer involvement). a biopsy of the left lung mass showed adenocarcinoma (which is a form of "non-small cell lung cancer"). All of the following statements are true except one:
| | |1. |This patient has incurable cancer |
|100.0% |[pi|2. |the tumor in the left lung should be resected. |
| |c] | | |
| | |3. |how the biopsy of the lung tumor was taken was not mentioned in the question, but it is likely that the biopsy|
| | | |was obtained through the bronchoscope or via a needle inserted into the lung through the skin under imaging |
| | | |guidance |
| | |4. |that the patient presents with haemoptysis does not necessarily mean that the cancer is incurable, since |
| | | |bleeding can occur in an early-stage or advanced stage cancer |
| | |5. |if we take a sputum specimen from the patient for cytology examination, it may show cancer cells |
45. in breaking bad news, which is the following statements is least likely to be true?
| | |1. |give information in small chunks. |
| | |2. |if the patient wishes to know, tell according to his needs and pace. |
| | |3. |listen to the patient,s agenda and blend your agenda with his. |
|100.0% |[pi|4. |do not attenpt to ask how the patient feels after breaking bad news; wait till another day when he has calmed |
| |c] | |down emotionally. |
| | |5. |check whether the patient has taken in the information; if not clarify and explain again. |
46. in who analgesic ladder, the general principles include all but one of the following:
| | |1. |move up the ladder if pain is not well controlled, instead of moving laterally. |
| | |2. |analgesics are given on a regular basis, prn prescription is used only for breakthrough pain between regular |
| | | |medications or acute exacerbation of pain. |
| | |3. |oral route is preferred to and as effective as parenteral route unless it is not feasible. |
| | |4. |there are 3 steps in who analgesic ladder. |
|100.0% |[pi|5. |there are 4 steps in who analgesic ladder. |
| |c] | | |
47. management of bone metastases include all except:
| | |1. |radiotherapy |
| | |2. |anti-cancer treatment |
| | |3. |surgery |
| | |4. |bisphosphonates |
|100.0% |[pi|5. |ventolin inhaler |
| |c] | | |
48. In patients liver disease, the following drugs can precipitate hepatic encephalopathy, except:
| | |1. |Benzodiazepines |
| | |2. |Opioid analgesics |
|100.0% |[pi|3. |Paracetamol |
| |c] | | |
| | |4. |Drugs causing constipation |
| | |5. |Diuretics causing hypokalaemia |
49. "Sexual asphyxia" mostly involve:
| | |1. |Elderly male |
|100.0% |[pi|2. |young adult male |
| |c] | | |
| | |3. |elderly female |
| | |4. |young adult female |
| | |5. |child |
50. Which of the following is true for radiation therapy for cancer?
| | |1. |Radiation therapy is most often given by implanting radioisotopes |
|100.0% |[pi|2. |Localized unresectable cancer is suitable for radiotherapy |
| |c] | | |
| | |3. |Radiation therapy damages cell wall of cancer cells |
| | |4. |A single treatment is usually adequate with radiotherapy |
| | |5. |Radiotherapy does not damage skin but is effective for deep seated cancer |
51. For patients on lithium,
| | |1. |the in vivo half-life of the drug is of the order of weeks. |
| | |2. |therapy can usually be carried out without therapeutic drug monitoring. |
|100.0% |[pi|3. |toxicity can result in polyuria. |
| |c] | | |
| | |4. |levels in plasma are generally measured 3 hours following the last dose. |
| | |5. |urine samples are usually collected for therapeutic drug monitoring. |
52. Concerning the teratogenic effects of drugs:
| | |1. |Only the structural development of the foetal organs may be affected. |
| | |2. |The second trimester is the most critical time period for a teratogenic effect. |
| | |3. |The central nervous system is vulnerable to drug effects only in the first and second trimesters. |
|100.0% |[pi|4. |Drugs belonging to the U.S. Food Drug Administration Drug Risk Category C are generally safer than drugs in |
| |c] | |Category D. |
| | |5. |In a patient whose epilepsy is under control, the early part of pregnancy is the best time to switch to a new |
| | | |drug treatment. |
53. Which of the following statements about blunt force injury to the abdomen is INCORRECT ?
| | |1. |Absence of external injury to the abdominal walls does not exclude internal injury. |
| | |2. |Hepatic lacerations can be caused by aggressive cardiopulmonary resuscitation. |
|100.0% |[pi|3. |Parenchymal laceration to the spleen is always associated with capsular rupture. |
| |c] | | |
| | |4. |Mesenteric laceration, in the absence of other significant injuries, can result in death due to massive |
| | | |intraperitoneal haemorrhage. |
| | |5. |Lacerations of the pancreas may result in a chemical peritonitis. |
54. which of the following is the primary action of the hmg coa reductase inhibitors (statins)?
| | |1. |increased expression of ldl-receptors in the liver |
| | |2. |decreased release of vldl particles by the liver |
| | |3. |reduced activity of lipoprotein lipase |
| | |4. |increased production of hdl particles |
|100.0% |[pi|5. |inhibition of endogenous cholesterol synthesis |
| |c] | | |
55. "asphyxia" means:
| | |1. |upper airway obstruction |
| | |2. |lower airway obstruction |
| | |3. |obstruction of airways due to external force |
| | |4. |low oxygen saturation of blood pigment |
|100.0% |[pi|5. |Lack of oxygen |
| |c] | | |
56. Which of the following is not a recognized form of cancer treatment?
| | |1. |Chemotherapy |
| | |2. |Hormonal therapy |
| | |3. |Immunotherapy |
| | |4. |Radiation therapy |
|100.0% |[pi|5. |None of the above |
| |c] | | |
57. "Aborescent" mark may be found on victim s of:
|100.0% |[pi|1. |electrocution by lightning |
| |c] | | |
| | |2. |electrocution by any household electric supply |
| | |3. |electrocution by faulty electric equipment |
| | |4. |electrocution by electric equipment falling into bathtub or swimming pool |
| | |5. |electrocution when two body parts are in touch with good conductors |
58. Patient responses to drugs may be altered because of liver disease, including:
| | |1. |Increased sensitivity to the anticoagulant effect of warfarin |
| | |2. |Increased risk of bleeding with aspirin |
| | |3. |Increased risk of liver damage with isoniazid |
| | |4. |Decreased diuretic response to frusemide |
|100.0% |[pi|5. |All of the above |
| |c] | | |
59. which of the following is correct regarding the fibrates?
| | |1. |they interfere with intestinal absorption of other drugs |
|100.0% |[pi|2. |they increase reverse cholesterol transport |
| |c] | | |
| | |3. |They are poorly tolerated because they cause flushing |
| | |4. |they have not been shown to improve cardiovascular outcome |
| | |5. |they are mainly metabolised and excreted in the bile |
60. multiple, parallel, horizontal streaks of intradermal bruises on the back of a child may be caused by:
| | |1. |Factor Viii deficiency |
| | |2. |christmas disease |
|100.0% |[pi|3. |coin rubbing |
| |c] | | |
| | |4. |cupping |
| | |5. |herpes zoster |
61. Which of the following statements about exit gunshot (bullet) wounds is INCORRECT ?
| | |1. |They may appear slit-like resembling stab wounds. |
| | |2. |They may be absent in a victim sustaining firearms injury. |
| | |3. |Gunshot wounds with abraded margins could not be exit wounds. |
|0.0% |[pi|4. |They are not associated with gunpowder tattooing. |
| |c] | | |
|0.0% |[pi|5. |They usually show everted margins. |
| |c] | | |
62. A mother habitually fabricates medical disorders in her baby boy in order to obtain unnecessary medical treatment. this condition is:
| | |1. |Munchausen syndrome |
|100.0% |[pi|2. |Munchausen syndrome by proxy |
| |c] | | |
| | |3. |battered-child syndrome |
| | |4. |shaken impact syndrome |
| | |5. |shaken baby syndrome |
63. which of the following actions is least likely to help doctors cope with the stresses associated with caring for dying patients?
| | |1. |locate resources for help with managing difficult cases. |
| | |2. |exercise, rest, and have time-out. |
| | |3. |acknowledge periodic feelings of grief, helplessness, and fear |
|100.0% |[pi|4. |let go of attachments to family and outside interests and concentrate solely on professional activities. |
| |c] | | |
| | |5. |understand the need to care for self before caring for others. |
64. which of the following deaths must be reported to the Coroner?
| | |1. |acute myocardial infarction |
| | |2. |carcinomatosis from unknown primary |
| | |3. |fetal death at 9th weeks of gestation |
|100.0% |[pi|4. |carbon monoxide poisoning |
| |c] | | |
| | |5. |severe acute respiratory syndrome |
65. Which of the following drug combinations has useful additive/synergistic effects?
| | |1. |phenylbutazone and warfarin |
|100.0% |[pi|2. |probenacid and penicillin |
| |c] | | |
| | |3. |methadone and naltrexone |
| | |4. |quinidine and digoxin |
| | |5. |mepyramine and ethanol |
66. for patients with terminal illness causing dyspnoea; one should:
|100.0% |[pi|1. |explain the cause of dyspnoea gently, use simple words that patient can understand |
| |c] | | |
| | |2. |give false hope, set un-realistic goal |
| | |3. |leave patient alone |
| | |4. |avoid anxiety drug therapy |
| | |5. |accept as a symptom and avoid antidepressant |
67. A 45 year old hepatitis B virus carrier presents with general fatigue and elevation of serum alfa-fetoprotein to 120 ng/dl. Abdominal ultrasonography showed only cirrhosis. The follow-up investigation should be:
| | |1. |Hepatic angiogram |
| | |2. |3-phase CT scan of abdomen |
|100.0% |[pi|3. |Repeat serum alfa-fetoprotein in 1 month |
| |c] | | |
| | |4. |Liver biopsy |
| | |5. |Magnetic resonance imaging of liver |
68. Regarding septic shock,
|100.0% |[pi|1. |it is a systemic response to infection. |
| |c] | | |
| | |2. |it is caused by the consumption of wild poisonous mushroom. |
| | |3. |a sedative should be given to patient as he/she is in a state of shock. |
| | |4. |the first-line treatment is haemodialysis. |
| | |5. |activated charcoal can be given orally to adsorb the toxin. |
69. In patients with renal disease:
| | |1. |Aminoglycosides have a wide therapeutic index. |
|100.0% |[pi|2. |Dose adjustment and therapeutic drug monitoring are essential during the use of vancomycin. |
| |c] | | |
| | |3. |Metformin rarely causes lactic acidosis. |
| | |4. |Non-steroidal anti-inflammatory drugs (NSAIDs) rarely causes deterioration in renal function |
| | |5. |Dose adjustment is not required for digoxin. |
70. Which of the following is not the common lethal cancer in children?
| | |1. |Osteosarcoma |
| | |2. |Leukemia |
| | |3. |Central nervous system cancer |
|100.0% |[pi|4. |Pancreatic cancer |
| |c] | | |
| | |5. |Lymphoma |
71. Concerning adverse drug reactions in the elderly:
|100.0% |[pi|1. |These are usually predictable and avoidable. |
| |c] | | |
| | |2. |These are often mild and do not lead to hospital admission. |
| | |3. |Inappropriate prescribing is uncommon. |
| | |4. |Frequent changes in drug regimens will reduce the risk. |
| | |5. |Patient counselling will not reduce the risk. |
72. the time required for discernible hypostasis to develop is about:
| | |1. |1 hour |
| | |2. |4 hour |
|100.0% |[pi|3. |8 hour |
| |c] | | |
| | |4. |12 hour |
| | |5. |24 hour |
73. Which of the following statements about shotgun injuries is INCORRECT ?
| | |1. |Complete disruption of cranium with ejection of brain is not an uncommon sequel to a suicidal shotgun |
| | | |discharge into the mouth. |
|100.0% |[pi|2. |At ranges of about 5 - 10 metres, there is a uniform peppering of pellet holes. |
| |c] | | |
| | |3. |At point-blank range, there may be severe burning of skin and singeing of hairs. |
| | |4. |Shotguns rarely produce an exit wound when fired into the chest or abdomen. |
|0.0% |[pi|5. |In addition to lead pellets, paper or plastic wads may be recovered from deep inside the wound. |
| |c] | | |
74. a fetus 30 cm in crown-heel length is roughly:
| | |1. |between 5 and 6 weeks |
| | |2. |15 weeks |
| | |3. |30 weeks |
| | |4. |150 days, i.e. 21 weeks |
|100.0% |[pi|5. |6 months |
| |c] | | |
75. The following drugs are thought to be safe in pregnancy, except:
| | |1. |Methyldopa in the treatment of hypertension |
| | |2. |Insulins in the treatment of diabetes mellitus |
| | |3. |Antacids in the treatment of epigastric pain |
| | |4. |Inhaled corticosteroids in the treatment of asthma |
|100.0% |[pi|5. |Non-steroidal anti-inflammatory drugs (NSAIDs) in the treatment of pains |
| |c] | | |
76. The first leading cancer in male population in Hong Kong in 1999 is:
| | |1. |Colorectal cancer |
|100.0% |[pi|2. |Lung cancer |
| |c] | | |
| | |3. |Breast cancer |
| | |4. |Gastric cancer |
| | |5. |Liver cancer |
77. A dead body is found. Which of the following findings would be most suspicious of homicide?
|100.0% |[pi|1. |one stab wound on chest, two cut wounds on back of left forearm and one cut wound on right palm |
| |c] | | |
| | |2. |five stab wounds on chest |
| | |3. |twenty cut wounds on front of proximal left forearm |
| | |4. |single cut wound on left wrist |
| | |5. |five cut wounds on left wrist and five cut wounds on left neck |
78. in who analgesic ladder, all of the following are true except:
| | |1. |ladder 1 analgesics include non-opioids |
|100.0% |[pi|2. |ladder 1 analgesics include weak opioids |
| |c] | | |
| | |3. |ladder 2 analgesics include weak opioids |
| | |4. |ladder 2 analgesics include doloxene |
| | |5. |ladder 3 analgesics include strong opioids |
79. Which of the following measures is useful in preventing poisoning?
| | |1. |Safe storage of medicines packed in plastic bags |
| | |2. |Safe package of medicines placed in drawers |
| | |3. |Precautionary advice for toddlers |
| | |4. |Adequate boiling of pig viscera contaminated by clenbuterol |
|100.0% |[pi|5. |Adequate rinsing of vegetables contaminated by insecticides |
| |c] | | |
80. in Hong kong, the maximum penalty for rape is
|100.0% |[pi|1. |life sentence |
| |c] | | |
| | |2. |20 years |
| | |3. |10 years |
| | |4. |7 years |
| | |5. |5 years |
81. Therapeutic drug monitoring for phenytoin
| | |1. |is rarely undertaken. |
|100.0% |[pi|2. |typically shows a non-linear relationship between dose and plasma concentration. |
| |c] | | |
| | |3. |should not be done in patients recently started on the treatment. |
| | |4. |should not be done for patients with epilepsy. |
| | |5. |can only be performed at exactly 10 hours following drug administration. |
82. The following drugs can affect the foetal growth and development, except:
| | |1. |Angiotensin converting-enzyme inhibitors |
| | |2. |Benzodiazepines |
|100.0% |[pi|3. |Cephalosporins |
| |c] | | |
| | |4. |Warfarin |
| | |5. |Tetracyclines |
83. Which of the following is advantage of surgical treatment of cancer?
|100.0% |[pi|1. |Complete eradication of localized cancer |
| |c] | | |
| | |2. |Does not damage normal tissue |
| | |3. |Repeat surgery can be done for metastatic disease |
| | |4. |Surgery can cut off blood supply and kill the cancer |
| | |5. |Surgery is least traumatic compared to other modalities |
84. which of the following is NOT an elective site for suicidal cut wounds?
|100.0% |[pi|1. |face |
| |c] | | |
| | |2. |neck |
| | |3. |wrists |
| | |4. |groins |
| | |5. |none of the above |
85. uncommon side-effect of opioids include:
| | |1. |constipation |
| | |2. |nausea |
| | |3. |drowsiness |
| | |4. |vomiting |
|100.0% |[pi|5. |respiratory depression |
| |c] | | |
86. One of the following items of advice is not correct regarding methods to reduce the chance of dying from cancer in Hong Kong:
| | |1. |Do not smoke |
|100.0% |[pi|2. |Do not take even small amounts of alcohol |
| |c] | | |
| | |3. |Take plenty of fruits and vegetables in the diet |
| | |4. |Avoid sexual promiscuity |
| | |5. |Vaccinate against Hepatitis B virus if there is Hepatitis B carrier(s) among one's close contacts |
87. which of the following responses in the patient coping with their illness is most likely to improve compliance with drug therapy?
| | |1. |denial |
| | |2. |revolt |
| | |3. |bargaining |
| | |4. |depression |
|100.0% |[pi|5. |acceptance |
| |c] | | |
88. neuropathic pain can be treated with adjuvant drugs such as:
|100.0% |[pi|1. |anti-depressant – e.g. amitriptyline |
| |c] | | |
| | |2. |doloxene |
| | |3. |morphine |
| | |4. |paracetamol |
| | |5. |naproxen |
89. Which of the following is/are the significance of cancer epidemiology?
i. Identifying risk factors and causes of cancer
ii. Describing and explaining cancer occurrence in a community.
iii. Estimating individual risks of cancer patients.
iv. Assisting in developing, prioritizing and evaluating public health programs and health policy formulation concerning cancer patients.
| | |1. |ii only |
| | |2. |i and ii |
| | |3. |i, ii and iv |
|100.0% |[pi|4. |All of the above |
| |c] | | |
| | |5. |None of the above |
90. Mammography is:
| | |1. |An effective screening test for women of all ages. |
|100.0% |[pi|2. |The only screening test that is proven to reduce the breast cancer mortality |
| |c] | | |
| | |3. |An expensive screening tool. |
| | |4. |Not a diagnostic test |
| | |5. |Not indicated in patient with history of breast cancer |
91. which of the following is indicative of previous vaginal penetration?
| | |1. |crescent-shaped hymen |
| | |2. |a v-shaped hymenal notch at 3 o,clock |
|100.0% |[pi|3. |a complete vaginal transection at 7 o,clock |
| |c] | | |
| | |4. |hymenal bumps |
| | |5. |any asymmetrical hymenal configuration |
92. One of the following statements is not true regarding screening for cervix cancer:
| | |1. |There are several high quality prospective randomized trials showing a reduction in cervix cancer mortality by Pap|
| | | |smear in the screened population compared to the unscreened population. |
|0.0% |[pi|2. |It is recommended that screening by Pap smear should start from 3 years after the beginning of having sexual |
| |c] | |intercourse. |
| | |3. |The interval of screening should be at least once every 3 years. |
| | |4. |If a teenager starts having sexual intercourse, it is not necessary to start Pap smear screening below the age of |
| | | |21. |
| | |5. |Screening usually stops at age 65-70 if there are 3 previous consecutive negative Pap smears. |
93. A 40-year-old lady complains of impaired hearing in her right ear and epistaxis (nose bleeding) for 3 weeks. on examination there was a 3cm diameter mobile lymph node at the upper part of the right side of her neck. nasopharynx cancer is being suspected. which of the following statements is true?
| | |1. |The lymph node should be removed by surgery for histological examination to confirm it contains cancer |
|100.0% |[pi|2. |if the patient is confirmed to have nasopharynx cancer and the lymph node also contains cancer cells, it is |
| |c] | |regarded as a form of regional spread from nasopharynx cancer through the lymphatics |
| | |3. |this patient was confirmed to have nasopharynx cancer and underwent curative-intent radiotherapy treatment. if|
| | | |she remains alive with no evidence of cancer 5 years after the treatment she can be considered cured. |
| | |4. |if fine needle aspiration for cytological examination of the lymph node shows cancer, there is no need to |
| | | |investigate for the original site of the cancer since this would not affect the management |
| | |5. |if a blood test for tumor marker for nasopharynx cancer (iga to the viral capsid antigen of the epstein-barr |
| | | |virus) is positive in this patient, it is 100% certain that she has nsopharynx cancer |
94. Which of the following is an autosomal dominant inherited cancer syndrome?
|100.0% |[pi|1. |Familial adenomatous polyposis of colon |
| |c] | | |
| | |2. |Xeroderma pigmentosa |
| | |3. |Familial breast cancer |
| | |4. |Bloom syndrome |
| | |5. |Faconi anemia |
95. For an abrasion, it is easier to figure out the direction of the impact if
| | |1. |the whole thickness of the dermis is breached |
| | |2. |this is no bleeding |
| | |3. |the shape of the impacting object is well preserved |
|100.0% |[pi|4. |skin tags are present |
| |c] | | |
| | |5. |there is no concomitant subcutaneous bruising |
96. use of bisphosphonates:
|100.0% |[pi|1. |hypercalcaemia of malignancy |
| |c] | | |
| | |2. |gastrointestinal symptoms |
| | |3. |numbness |
| | |4. |constipation |
| | |5. |nausea |
97. Which of the following statements about traumatic subarachnoid haemorrhage (isolated traumatic subarachnoid haemorrhage) is INCORRECT ?
| | |1. |Have been reported to result from traumatic rupture of the vertebral arteries. |
| | |2. |Commonly associated with alcohol intoxication of the deceased. |
| | |3. |Death is usually very rapid (within minutes) after the injury was sustained. |
| | |4. |Typically results from a blow to the head and neck at around the region of the base of skull. |
|100.0% |[pi|5. |Usually patchy in distribution and spreads over the outer surface of the cerebral hemispheres. |
| |c] | | |
98. In patients with liver disease, drug elimination may be altered because of:
|100.0% |[pi|1. |Interactions between drugs that are used to treat liver disease and co-existing conditions |
| |c] | | |
| | |2. |Hepatocellular damage with increase in enzyme activity |
| | |3. |Altered hepatic blood flow due to hypotension |
| | |4. |Hypoalbuminaemia with increase in protein binding |
| | |5. |Hepatorenal syndrome with increase in renal excretion of drugs |
99. Regarding patient with pheochromocytoma,
| | |1. |isoprenaline is given to overcome the cardiac stimulatory effect. |
| | |2. |a massive dose of aprotinin is given to eradicate the tumor. |
|100.0% |[pi|3. |phenoxybenzamine is administered to reduce the arteriole contraction. |
| |c] | | |
| | |4. |the plasma level of acetylcholine is elevated. |
| | |5. |if not properly treated, oedema will result. |
100. Which of the following is correct description of cancer?
| | |1. |Cancer is characterized by enormous amount of dead cells due to excessive mitosis |
| | |2. |Cancer only affects the organ that it involves |
|100.0% |[pi|3. |Cancer is clonal in origin |
| |c] | | |
| | |4. |Cancer can be benign |
| | |5. |Cancer only occur in old people |
101. Therapeutic drug monitoring for aminoglycoside antibiotics
| | |1. |typically involves measurement of the peak level only. |
| | |2. |typically involves measurement of the trough level only. |
| | |3. |should not be done in patients with impaired renal function. |
| | |4. |should not be done in patients with severe bacterial infections. |
|100.0% |[pi|5. |can be used to govern the frequency of drug administration. |
| |c] | | |
102. Primary cancer prevention includes:
| | |1. |Early detection |
| | |2. |Positron emission tomography |
| | |3. |Chemoprevention. |
| | |4. |Routine chest x-ray |
|100.0% |[pi|5. |Screening program |
| |c] | | |
103. the skin in a victim of heat stroke is often
| | |1. |cold and moist |
| | |2. |cold and dry |
| | |3. |hot and moist |
|100.0% |[pi|4. |hot and dry |
| |c] | | |
| | |5. |unremarkable |
104. for nausea and vomiting in cancer patients, all of the followings are true except:
|100.0% |[pi|1. |constipation is not a common cause of nausea and vomiting |
| |c] | | |
| | |2. |in gastrointestinal obstruction, do not prescribe metoclopramide and laxative |
| | |3. |in early gastrointestinal obstruction, low dose dexamethasone is useful |
| | |4. |in terminal gastrointestinal obstruction, ,drip and suck, may not be appropriate |
| | |5. |somatostatin and venting gastrostomy (X-ray guided) have specific indications, and may be very helpful in |
| | | |selected patients |
105. Regarding anti-fibrinolytic treatment,
| | |1. |it is recommended for patient with high cholesterol level. |
|100.0% |[pi|2. |it is for emergency use to prevent an excessive blood loss. |
| |c] | | |
| | |3. |it is used in patients with myocardial ischaemia as it can dissolve the clot. |
| | |4. |it cannot be given to female patients as it interacts with oestrogen. |
| | |5. |it is given to people before they have their wisdom-teeth removed. |
106. which of the following is a reason for NON-COMPLIANCE?
| | |1. |forgetfulness |
| | |2. |side effects |
| | |3. |incorrect knowledge on dosage and frequency |
| | |4. |incorrect concept about appropriate use of drugs |
|100.0% |[pi|5. |all of the above |
| |c] | | |
107. In patients with acute poisoning:
|100.0% |[pi|1. |It is important to ensure that the airway, ventilation and blood pressure are adequate. |
| |c] | | |
| | |2. |Admission to the Intensive Care Unit for supportive care is often necessary. |
| | |3. |Prevention of absorption of the drug or chemical is always indicated. |
| | |4. |Toxicology screening should be arranged routinely. |
| | |5. |Antidotes are available for most poisons. |
108. A 45-year-old woman was diagnosed to have breast cancer on her right breast 2 years ago and underwent curative-intent surgery (right mastectomy). she was well on follow-up until this week when she consulted the doctor because she had cough for 2 weeks without improvement. on examination her general condition was good and no abnormal physical sign was detected. chest x-ray showed multiple roundish opacities in both lung fields compatible with lung metastases. if we assume that she has developed lung metastases, one of the following statements is true:
| | |1. |if we give chemotherapy treatment there is a reasonable chance that her cancer can be cured again, since her |
| | | |general condition is good. |
| | |2. |she has incurable cancer and is terminally ill |
| | |3. |it is unusual for the cancer to recur so early (2 years) after the initial curative-intent treatment. |
| | | |Recurrences usually occur later than 5 years after the initial treatment. |
|100.0% |[pi|4. |there may not necessarily be tumor recurrence at the site of surgery although she has developed lung |
| |c] | |metastases. |
| | |5. |since she got cancer in the lungs and coughs, she may spread the cancer to others throught coughing, and other|
| | | |people in close contact with her should take precautions. |
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