Typical clinical features of coarctation of the aorta include

a) An association with bicuspid aortic valve

b) Cardiac failure developing in male adolescents

c) Palpable collateral arteries around scapulae

d) Rib notching on chest X-ray associated with weak femoral pulses

e) ECG showing right ventlc-ular hypertrophy

34. In Pallet's tetralogy

a) pulmonary and aortic stenosis arecombined with a ventricular septa) defect

b) both finger clubbing and bentral cyanosis are present at birtk

c) the second heart sound is loud and widely split on inspiration

d) the bhest X-ray and ECG are typically normal

e) cyanotic spells occur due to episodes of dysrhythmia

Cardiovascular changes In normal pMgnancy Include.

a) an increase in cardiac output of 150% by 12 weelys

b) tachycardia, elevated jugular venous pressure and third heart sound

c) reduction in systemic diastolic pressure

d) pulmonary systolic murmur

e) increased blood coagulability

The autoantibodies listed below are associated with the following diseasas

a) antinuclear antibodies-rheumatoid arthritis

b) anti-topoisomerase-progressive systemic sclerosis -(P$,S)

c) anti-SSA (anti-Roy--Sjog.en's syndrome

d) anti-centromere anti bodies--.dermatomyositis

e) antinuclear, cytoplasmic antibodies-CREST syndrome

The following features suggest a mechanical rather than Inflammatory cause of back pain

a) radiation of pain down the back of one teg to the ankle

b) an elevated C-reactive protein (CRP)

c) localised tenderness over the greater sciatic notch

d) gradual mode of onset in an elderly patient

e) back pain and stiffness exacerbated by resting

Osteoarthritis is

a) evident radiologically in at least 80% of patients > 65 years old

b) more likely to be generalised and severe in males

c) characterised by degeneration of cartilage and synovial inflammation

d) associated with increased collagen synthesis in the affected cartilage

e) best managed with anti-inflammatory doses of NSAIDs

In the treatment of gout

a) NSAID therapy increases urinary urate excretion

b) salicylates control symptoms and accelerate resolution of the acute attack

c) allopurinol inhibits xanthine oxidase and hence urate production

d) tophi should resolve with control of hyperuricaemia

e) allopurinol or probenecid should be given within 24 hours of onset of the acute attack

The following statements about shock syndromes are correct

a) in severe hypovolaemia, a source of blood/fluid loss is Invariably apparent clinically

b) in cardiogenic shock, the peripheries are characteristically warm

c) massive pulmonary embolism typically presents with shock

d) anaphylactic shock is associated with profound alleigen-induced systemic vasoconstriction

e) arteriovenous shunting is a significant contributory factor in septic shock

Typical clinical features of acute circulatory failure due to anaphylactic shock include

a) elevated jugular venous pressure

b) warm'dry skin

c) stridor

d) confusion

e) polyuria

Acute circulatory failure with an elevated central venous pressure are typical findings in

a) acute pancreatitis

b) massive pulmonary embolism

c) ruptured ectopic pregnancy

d) acute right ventricular infarction

e) pericardial tamponade

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