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1. Regarding oxalate renal stones, which statement is true:

A) Over 90% of oxalate comes from dietary absorption.

B) The amount of free calcium within the gut is a major determinant of oxalate absorption.

C) Low doses of ascorbic acid promote oxalate stone formation.

D) Fat malabsorption contributes to uric stones but not oxalate stones.

E) Hereditary hyperoxaluria is the most common cause of oxalate stones.

2. A 54 year old woman presents with a history of Raynaud’s phenomenon for many years, worsening symptoms of indigestion, and mild shortness of breath on exertion. On examination she had thickening of the skin over her fingers, extending to the metacarpophalygeal joints, with nailbed microangiopathy. Her blood pressure was normal, as was the cardiorespiratory examination. Which of the following statements is true:

A) Antitopoisomerase antibody is more likely to be positive than anti-centromere antibody.

B) Her chance of surviving for a further ten years is less than 20%.

C) She should be monitored for pulmonary hypertension.

D) She is at high risk of developing malignant hypertension in the future.

E) Treatment with D-pencillamine will prolong survival if respiratory complications develop.

3. A 50 year old woman has painless weakness of the shoulder girdle, hip girdle and trunk muscles. Electromyography of the weak muscles is performed. This shows no spontaneous activity and full motor recruitment patterns with many brief duration, highly polyphasic units. Which of the following diagnoses is consistent with these features?

A) post-polio syndrome

B) limb girdle muscular dystrophy

C) myophosphorylase deficiency

D) acute polymyositis

E) motor neurone disease

4. A 62 year old farmer has the following biochemistry:

Creatinine 0.27 mmol/L (0.06-0.12)

Calcium 3.12 mmol/L (2.20-2.55)

Albumin 39 g/L (39-48)

PTH 1.0 pmol/L (1.7-7.0)

1,25 dihydroxyvitamin D 240 pmol/L (40-140)

The likely diagnosis is:

A) metastatic malignancy

B) primary hyperparathyroidism

C) humoral hypercalcaemia of malignancy

D) Paget’s disease

E) Sarcoidosis

5. A 30 year old woman has the following results on biochemistry:

Bilirubin 8 umol/l ( ................
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