The parents of a 7-year-old boy divorce. The boy lives with the mother and sees his father every-other weekend. During these visits, the boy is sullen and angry with the father, but when it is time to return home, he clings to the father and cries in a desperate manner while saying “I’m sorry! I want you and mom to live together again.” Which of the following is the most helpful statement that the father can make to the son?
(A) “Big boys don’t cry.”
(B) “I left your mother, I didn’t leave you.”
© “I’ll see you in 2 weeks.”
(D) “You’re the man of the house now.”
(E) “Your mother was too hard to live with.”
Which of the following is not a cause of membranous nephropathy?
Alports syndrome
Systemic lupus erythematous
Lymphoma
Gold
Diabetes
A 29 year old male with a history of ectopia lentis presents for a routine physical examination. He is noted to have pectus excavatum, pes planus, a high arched palate, and a positive wrist and thumb sign. Which of the following cardiac disorders is associated with his condition?
A) Aortic valve stenosis
B) Coarctation of the aorta
C) Mitral valve prolapse
D) Ventricular septal defect
E) Ebstein’s anomaly
Hints: also aneurism of Aorta /arachnodactyle…!!!
Which of the following is not a cause of membranous nephropathy?
Alports syndrome
Systemic lupus erythematous
Lymphoma
Gold
Diabetes
A 35 year old female who has recently started to train for a marathon presents with left hip pain. This is over the lateral side of her hip and radiates down her thigh and is worse when she lies on it at night. On examination there is tenderness over the greater trochanter and the pain reproduced by external rotation. What is the most likely diagnosis?
Trochanteric Bursitis
Osteoarthritis
Soft Tissue Injury
Avascular Necrosis
Impacted hip fracture
Which of the following suggests primary hyperparathyroidism as the cause of hypercalcaemia?
Normal to high PTH levels
Elevated urinary calcium
Xray showing mix of sclerotic and lytic lesions
Renal calculi
High phosphate levels
Which of the following suggests primary hyperparathyroidism as the cause of hypercalcaemia?
Normal to high PTH levels
Elevated urinary calcium
Xray showing mix of sclerotic and lytic lesions
Renal calculi
High phosphate levels
A 35 year old female who has recently started to train for a marathon presents with left hip pain. This is over the lateral side of her hip and radiates down her thigh and is worse when she lies on it at night. On examination there is tenderness over the greater trochanter and the pain reproduced by external rotation. What is the most likely diagnosis?
Trochanteric Bursitis
Osteoarthritis
Soft Tissue Injury
Avascular Necrosis
Impacted hip fracture
Which of the following suggests primary hyperparathyroidism as the cause of hypercalcaemia?
Normal to high PTH levels
Elevated urinary calcium
Xray showing mix of sclerotic and lytic lesions
Renal calculi
High phosphate levels
A 15-year-old is brought to the emergency department in a coma. An alert ambulance attendant notes that the patient’s breath smells like acetone. This observation is most consistent with which of the following diagnoses?
(A) Alcohol intoxication
(B) Diabetic hyperosmolar coma
© Diabetic ketoacidosis
(D) Heroin overdose
(E) Profound hypoglycemia
18 years old boy present to you with his mother with the c/o being unable to attend school on time because he struggles to fall asleep at night and waking up in the morning,and experiences morning tiredness ,but feels more alert by the afternoon.He is other wise healthy and “He loves watching you tube on the internet late night”.Your working diagnosis is Delayed Sleep Phase Disorder(DSPD),which is the BEST OPTION below?
1.Trial of Slow release Melatonin.
2.Trial of Zopiclone(non-BZD) tabs withn two weeks time.
3.Vigorous Exercise +Healthy Diet just prior to bed time.
4.Encourage him to Read books 1-2 hours before bed time and encourage his mother to open the blinds at wake up time to allow the sun light exposure .
5.Advise mother to strictly enforce wake up time using an alarm .