MCQS 310-312:A 75 year old woman complains of weakness and fatigue

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Question:310
An elderly gentleman feels that his neighbours want to kill him because they think he is a homosexual. He is having difficulty in sleeping with these thoughts. These fears are found to be unfounded. What type of disorder would you call this?

a) sexual disorder
b) Anxiety disorder
c) Genetic disorder
d) Delusional disorder
e) Depressive disorder
f) Anorexic disorder
g) Sleep disorder
h) Somatoform disorder
i) Movement disorder
j) Personality disorder

Question:311
A 75 year old woman complains of weakness and fatigue. On examination she is noted to be pale and she has multiple purpura on her hands and legs and particularly large bruising in the peri-orbital area. A blood picture demonstrates a normocytic, normochromic anemia. A serum protein electrophoretic pattern shows a peak band while immunofixation of the urine reveals an M-protein. A most appropriate next investigation would be

a) anti-mitochondrial antibodies
b) urinary magnesium levels
c) salicylate levels
d) paracetomol levels
e) look for lytic lesions on plain radiographs
f) CT of the abdomen
g) lumbar puncture
h) transilluminate scrotum
i) urinary reducing substances
j) fundoscopy

 

Question:312
A patient with documented venous thrombosis develops severe shortness of breath. Ventilation/perfusion scintigraphy confirms a mismatched perfusion defect. The appropriate management should include

a) reassurance
b) warfarin
c) balloon angioplasty
d) laparoscopy
e) bypass grafts
f) endarterectomy
g) embolectomy
h) Blalock-Taussig shunt
i) venous thrombectomy
j) intravenous heparin


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