MCQS 220-222 :The average age of patients presenting with schizophrenia is

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Question:220
The average age of patients presenting with schizophrenia is

a) at birth
b) 1-5 months
c) 6-24 months
d) 2-5 years
e) 6-14 years
f) 15-20 years
g) 20-30 years
h) 30-40 years
i) 40-60 years
j) over 60 years

 

Question:221
An elderly nun is brought to the gynecologist by her fellow nuns. She shyly complains of a large mass in her vagina. A pelvic examination reveals protrusion of the entire uterus past the vaginal introitus. Appropriate management would include

a) surgical repair
b) intermittent catheterization
c) Diuresis renography
d) anticholinergic agents
e) phenylpropanolamine
f) Gellhorn pessary
g) biofeedback-assisted behavioral treatment
h) Oral Estrogen therapy
i) Vaginal Estrogen therapy
j) Ring pessary

 

 

Question:222
A 50 year old woman with generalised abdominal pain and fever is found on ultrasound examination to have a pelvic collection. Collections in the pelvis may sometimes be extensions of collections in another location. The collection in this patient is most likely to have extended from

a) anterior pararenal space
b) aryepiglottic space
c) vestibule space
d) epidural space
e) sub-arachnoid space
f) space of Disse
g) middle ear
h) posterior pararenal space
i) supraglottic space
j) lesser sac

 

Question:220
Correct Answer: G

Explanation:
Although schizophrenia and its counterpart disorder of briefer duration, schizophreniform disorder, may have an onset in late adolescence (or in later adulthood), the most common age at onset is in early adult life. There is a distinct sex difference in median age at onset for the first psychotic episode of schizophrenia: for men the onset is in the early to middle 20s; for women the onset is in the late 20s

 

Question:221
Correct Answer: F

Explanation:
If you suspect uterine prolapse a pelvic examination should be performed. A pelvic examination (with the woman bearing down) reveals protrusion of the cervix into the lower third of the vagina (mild or first degree prolapse), past the vaginal introitus/opening (moderate or second degree prolapse), or protrusion of the entire uterus past the vaginal introitus/opening (severe or third degree prolapse). First- and second-degree uterine prolapse are usually managed with a ring pessary. The donut and inflatable pessaries are also useful in the treatment of mild to moderate uterine prolapse. If the uterine prolapse is associated with a cystocele, a ring pessary with support is useful. The cube pessary is designed to manage third-degree uterine prolapse. Because the cube is held in place by suction, removal can be somewhat difficult for some patients. This type of pessary can support the uterus even with a lack of vaginal tone. The cube pessary should be removed and cleaned daily, because it has no drainage capability. A donut, inflatable or Gellhorn pessary can also be used in patients with third-degree uterine prolapse. The Gellhorn pessary is designed to manage severe uterine or vaginal prolapse. While the Gellhorn offers strong support, it can also be difficult for the patient to remove. If a cystocele or rectocele accompanies the third-degree uterine prolapse, a Gehrung pessary may be the most helpful. However, the Gehrung can be difficult to insert

 

Question:222
 
Correct Answer: H

Explanation:
The posterior perirenal space opens laterally into the properitoneal space and inferiorly to the pelvis and contains no organs. The kidneys and associated adrenal glands are surrounded by varying degrees of perinephric or perirenal fat, and these together are loosely enclosed by the perirenal fascia, commonly called 'Gerota's fascia'. Gerota's fascia also serves to contain perinephric fluid collections, whether of pus (abscess), urine (urinoma), or blood (hematoma). These processes rarely cross the midline because of the fusion of Gerota's fascia over the great vessels medially. When very large, such collections can and do, however, extend into the pelvis, following the potential space where Gerota's fascia does not fuse inferiorly.


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