(MCQS 331-333):A 4 boy with eczema has a recurrent wheeze which worsens whenever he gets a viral respiratory tract infection

Correct Answer: J
The diagnosis of multiple sclerosis rests solely on a high index of suspicion. The main indicator are signs and symptoms charactersied by remissions and exacerbation. A mnemonic for the clinical features of multiple sclerosis is VISUAL: V: Visual disturbances such as blurring, double vision. I: Internuclear ophthalmoplegia (ie, of the brain stem pathway that coordinates eye movement), which causes paresis of the medial rectus muscle on lateral conjugate gaze, but not on convergence; nystagmus is seen in the abducting eye. S: Sensory sensations (tingling, pins and needles, numbness, dead-feeling limbs, band-like tightness). U: Unusual clumsiness, extremity weakness, leg dragging, muscle stiffness, limb heaviness. A: All symptoms provoked and/or intensified by hyperthermia. L: Lhermitte's sign. Flexion of the neck produces an electrical sensation that runs down the back and into the legs. This sign suggests intramedullary disease of the cervical cord.

Correct Answer: I

Correct Answer: F
It has been recommended that for children under the age of 5 years who have chronic stable asthma both corticosteroids and bronchodilator therapy should routinely delivered by Pressurised Metered Dose Inhaler (pMDI) and spacer system, with a facemask where necessary. Where this combination is not clinically effective for the child, and depending on the child's condition, nebulised therapy may be considered and in the case of children aged 3 to 5 years, a dry powder inhaler (DPI) may also be considered.


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