1. A 63-year-old man with a history of high blood pressure presents at emergency with sudden onset tearing chest pain radiating to the back
2. A 45-year-old man complains of cold numb fingers and difficulty in swallowing. On examination he has tight skin, thickening of the fingers and telangiectasia.
3. Gastro-duodenal ulcer can cause the following complications except one. Which one?
4. In community acquired pneumonia, the following signs exist except one. Which one?
5. Systemic corticotherapy is commonly used in dermatology. In which of the following diseases is it contraindicated?
6. Among the following metals which one is often responsible for contact eczema?
7. Anemia is said to be regenerative when the reticulocyte level is:
8. Among the following aetiologies of a transient ischaemic cerebral accident of a young subject which one is the commonest?
9. The diagnosis of Alzheimer’s disease has the following feature except one?
10. Concerning neuro-meningeal cryptococcosis, only one of the following statements is true. Which one?
11. The management of peripheral neuropathies due to antiretrovirals (ARV) consists of the following measures except one. Which one?
12. You are called to assist a patient who is having a generalized tonico-clonic crisis. Crisis. What should you do immediately (one correct answer only)?
13. The following constitute elements of management of cerebral toxoplasmosis except one. Which one?
14. Diagnostic criteria for tuberculosis meningitis are the following except one. Which one?
15. A 25 years old man has been referred to a rheumatology clinic with multiple painful stiff joints and uveitis. He also complains of ulcers on his penis and mouth
16. A 45 years old woman presents with dryness in the eyes and mouth. Her Schirmer’s positive.
17. A 25 years old man presents with enlarged painless lymph nodes in the neck. His peripheral blood film shows reed-sternberg cells
18. A 45 years old man presents with fever, weight loss tiredness and gout. On examination, there is splenomegaly. White blood count is 112x109/l. The Philadelphia chromosome is detected.
19. A 22 years old HIV positive individual on antiretroviral therapy presents with pneumocystis jiroveci pneumonia
20. A 19-year-old man contracts pneumonia with symptoms of headache; fever and dry cough. Serology shows evidence of chlamydia infection
21. Standard therapy for community acquired pneumococcal pneumonia not requiring hospital admission is
22.A previously healthy 65-years-old smoker with early COPD complains of shortness of breath on exertion.
23. A 22-year-old student with mild asthma that needs treatment for occasional early morning wheezes.
24. Kerley B lines, bat-wing shadowing, prominent upper lobe vessels, cardiomegaly
25. A 65-year-old smoker presents with shortness of breath, gallop rhythm and production of pink sputum.
26. A 22-year-old man presents with fever, night sweats, weight loss and cough productive of blood. Zeihl-Nelsen stain is positive for acid-fast bacilli.
27. A 63-year-old man presents to emergency with weight loss, cough, haemoptysis and shortness of breath. On examination, he is anaemic, clubbed and apyrexial.
28. Radio femoral delay of pulse in patient with hypertension:
29. Pulsus paradoxus, jugular venous pressure rises on inspiration, heart sounds muffled
30. A 65-yras-old man with heart failure requires rate control to treat coexisting atrial fibrillation
31. A 65-year-old woman being treated with large doses of loop diuretic requires add-on therapy for edema refractory to treatment.
32. A 70-year-old woman with a history of chronic heart failure presents with severe pulmonary edema.
33. A 56-year-old insulin dependent diabetic mellitus (IDDM) male presents with persistently elevated BP of 180/110mmHg. Blood tests are unremarkable. What is the most appropriate medication?
34. An anxious 26-year-old woman presents with episodes of chest pain and palpitations precipitated by stress and smoking. Her 24-hour urine shows elevated catecholamines
35. A 45-year-old man presents with right sided hemiparesis. There is a bruit on neck auscultation. What is the single most appropriate investigation?
36. A 50-year-old woman presents with weight gain, muscle weakness and hirsutism. On examination, she is hypertensive and has pedal edema.
37. A 52-year-old woman on hormone replacement therapy presents with a swollen left calf, chest pain and shortness of breath
38. A 78-year-old man has been short of breath for few weeks. His chest radiography shows a right basal shadow rising towards the axilla. It is
39. A 49-year-old woman presents with polyuria, haematuria, abdominal pain and bone aches. On examination, her blood pressure is 170/100mmHg
40. A 76-year-old man fell to the floor while standing in a long queue. He regained consciousness within 2minutes. He was not incontinent of urine or stools.
PEDIATRICS
Instructions: Questions 41-46 : For each presentation below, choose the most correct answer from the list of options proposed.
41. Which of the following aetiologies does not cause cardiac failure in the child 7?
42. With respect to the ejection of breast milk, choose the correct statement among the following propositions.
43. The following signs are features that can be observed in a case of viral diarrhoea except one. Which one?
44. The Apgar score measures the following parameters except one. Which one?
45. In the new-born, which clinical symptom constantly observed can lead to the suspicion of oesophageal atresia?
46. A child of 8 years has a recent primary tuberculosis. His tuberculin skin test is positive but he does not present any clinical, radiological or biological signs. Choose among the propositions below the single best means of management.
47. A child dresses and undresses almost independently:
49. A 2-year-old boy present with fever, increased salivation and a swollen left neck.
50. A 2-year-old boy present with a 12-hour history of fever, cough and hoarseness of the voice. While waiting in the consultation room, he develops stridor.
51. A 5-year-old child develops severe diarrhoea, nausea and vomiting 1 day after returning from a school trip.
52. A healthy full new-born becomes jaundiced at day two. His total bilirubin is 10mg/dl. His jaundice gradually disappears over the next few days.
53. A full-term new-born becomes jaundiced 14 hours after delivery. His blood results confirm indirect bilirubinaemia and metabolic acidosis. His parents are both rhesus negative.
54. A male child infertile with testicular atrophy, gynaecomastia and learning difficulties.
55. Flat face slanting eyes, simian crease, hypotonia and learning difficulties.
56. A 3-year-old boy with history of recurrent chest infections presents with worsening shortness of breath. On examination, there was a systolic thrill at the lower sternal edge pansystolic murmur and accentuated second heart sound.
57. A 12-year-old girl present with marked oedema. Blood tests show hypo-albuminemia. Urine shows heavy proteinuria
58. A 3-year-old girl present with a large left-side abdominal mass. Intravenous urography (IVU) shows a mass within the left kidney, which encroaches, on the collecting system. Chest radiography shows multiple pulmonary nodules.
59. Reduced synthesis of alpha-globin chains leading to haemolysis is called
60. A 7-year-old boy who presents with night blindness has
61. A 14-year-old boy presents with a 2-week history of abdominal pain and severe watery diarrhea with occasional bright blood mixed with stools. He complains of poor sleep as he has about 20 motions per day. Examination reveals mild diffuse abdominal tenderness and perioral skin tags.
62. A 4-year-old girl present with bloody diarrhea and crampy abdominal pain. Blood Tests show anemia and thrombocytopenia
63. A 6-year-old boy presents with mild fever and maculopapular rash. His mother reported that the rash started on the face then became generalized. On examination, there is palpable cervical and occipital lymphadenopathy.
64. A 9-year-old boy present with conjunctivitis and maculopapular rash. The rash started on the head and spread downward
65. A 14-year-old girl presents an intensely pruritic rash with pustules. On examination, the rash is generalized but is more in the folds between the fingers and toes.
66. A 4-year-old boy presents with a vesicular rash that appears in crops
67. A 6-year-old girl is presents with fever, frequency of micturition, dysuria and abdominal pain.
68. A 3-week-old child presents with projectile vomiting, appearing hungry after each emesis. On examination dehydration is present and there is a mass in the abdomen.
69. A 1-year-old child presents with vomiting, crying and lifting her legs. Nappy is strained red. On examination, a sausage shaped mass is palpated on the abdomen.
70. Child with vomiting and diarrhea. Brother had a similar problem 2 weeks ago.
71. A 14-year-old boy complains of sudden pain his groin after cycling 10 kilometers. What is the single most likely diagnosis??
72. A 14-year-old boy, with breathlessness and swollen lips after eating a peanut butter-sandwich.
73. A nine-year-old girl with chronic asthma presents to emergency with rapidly worsening wheeze not relived with inhaled bronchodilators
74. Child who is HIV positive is due for measles, mumps and rubella (MMR) vaccine
75. History of convulsions. Child due for DPT, Haemophilus influenza vaccines etc
76. A young boy with polyuria, has very high blood glucose levels
77. A 1-year-old child develops swollen lips after eating peanuts. What is the single most appropriate management?
78. A 10-year-old child presents with 15% body area burns. What is the single most appropriate management?
Question 79-80: for the presentation given below, choose the single most likely mechanism of the disease from the list of options proposed 79. Bronchiolitis
80. A boy with mental retardation and learning difficulties. Father and uncle had similar problems
PUBLIC HEALTH
Instructions: Questions 81-86 : For each presentation below, choose the most correct answer from the list of options proposed.
81. Dialogue structures
82. Concerning the functioning of dialogue structure
83. Concerning the functioning of the dialogue structure
84. Concerning the organization of the health district
85. Suppose that the blood sugar level is approximately normal for a group of women whose standard deviation is unknown. What is the appropriate test to compare the means?
86. To test an association between tobacco use (yes/no) and pneumonia (yes/no), a Chi square value of 2.96 was found. What decision will you take?
87. In a bid to compare at 5% the CD4 cell counts between 20 men and 22 women, a p-value of 0.06 was found. What conclusion can be drawn?
88. Which oh the following sets of three elements constitutes characteristics of central tendency?
89. We want to test whether there is an association between obesity (I, II, III) and religion. The number of subjects in one of the cells is 2.4, which test is the most appropriate?
90. In which case in the Chi-square test and variance not applicable?
91. Which set of pairs below always go together?
92. In which circumstances is it necessary to use a non-parametric test?
93. A group of male workers between the ages of 20 and 39 year are being screened for lung disease by spirometry. Nine subjects are examined. Their forced expiratory volume in 1 second (FEV1) divided by forced vital capacity (FEV1/FVC %) results are 80, 76, 73, 61, 64, 79, 64, 64 and 78 . What is the modal reading?
94. What is the median value?
96. A new screening test for prostate cancer becomes available. You assess whether this will be useful to your practice by reviewing the following the operating characteristics of the test. The test’s ability to correctly classify diseases persons having disease is called what?
97. The laboratory test has a sensitivity of 85% and a specificity of 70%. You want to have 1000 people take the test. To estimate the positive predictive of the test for this population. You need to know which of the following?
98. Among the observation study designs, the prospective cohort design offers which of the following advantages?
99. Which of the following is not a health program in Cameroon?
100. In Cameroon health System the district hospital is considered as:
