MCQS 364-366:a 67-year-old football fan complains of recent onset of hoarseness and easy fatigability of his voice



Question:364
a 67-year-old football fan complains of recent onset of hoarseness and easy fatigability of his voice. He also stated that he had difficulty being heard in a crowd and complained of the recent onset of coughing that was most noticeable when drinking liquids. He had been a heavy smoker and drinker for many years. Blood tests reveal a mild microcytic anemia. The next best test is
a) laryngoscopy
b) Computed tomography of the brain
c) strobovideolaryngoscopy
d) thyroid levels
e) barium meal
f) Gastroscopy
g) magnetic resonance imaging of the brain
h) allergy evaluation
i) with 24-h Ambulatory Ph Monitoring
j) chest x-ray


Question:365
A 65 year old diabetic on treatment with insulin injections for 15 yrs is now being investigated for recurrent hypoglycemia. She is fully compliant with her treatment. A likely cause is
a) keto acidosis
b) Nonketotic Hyperosmolarity
c) autonomic neuropathy
d) Hypoglycaemia unawareness
e) peripheral neuropathy
f) infection
g) Amytrophy
h) Focal nerve palsy
i) retinopathy
j) nephropathy


Question:366
A tall thin loose jointed 18 year old myopic girl complains of increasingly blurred vision. On ophthalmic examination it is found that she has dislocated lenses. It is noted that she has long extremities, a mild scoliosis and a pan-systolic murmur. A likely diagnosis is
a) osteogenesis imperfecta type 1
b) osteogenesis imperfecta type 2
c) congenital indifference to pain
d) Hurler's syndrome
e) Marfan syndrome
f) Dysplasia epiphsalis multiplex
g) amyoplasia
h) Murquio syndrome
i) Ehler-Danlos syndrome
j) Osteodysplasty


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