Austin Block 5

1

Which of the following statements about metastatic cancer is correct?


  Colon cancers commonly metastasize to bone

  Meningiomas commonly metastasize to the lungs

  Ovarian cancer commonly spreads to the peritoneum

  Testicular cancers commonly metastasize to the liver

  Basal cell carcinomas commonly metastasize to local lymph nodes

2

Surgical excision is the primary treatment for each of the following neoplasms except:


  Small cell carcinoma of the lung

  Adenocarcinoma of the esophagus

  Melanoma

  Villous adenoma of the rectum

  Adenocarcinoma of the gall bladder

3

Which of the following is the least likely cause of iron deficiency in a 65 year old female?


  colonic angiodysplasia

  caecal carcinoma

  coeliac disease

  Crohn's disease

  Hepatoma

4

All of the following are features of an enlarged spleen except:


  lt is possible to palpate a space between it and the left costal margin

  lt moves downwards and medially on inspiration

  lt is usually not ballottable

  lt has a notch

  lt is dull to percussion

5

Which of the following is most consistent with an anaemia of chronic disease?


  Microcytic hypochromic red cells and a high neutrophil count

  Macrocytic normochromic red cells and hypersegemented neutrophils

  Normochromic normocytic red cells and a high ESR

  Macrocytic normochromic red cells, leukopenia and thrombocytopenia

  Normochromic normocytic red cells, leukopenia and thrombocytopenia

6

The ESR is not increased in which one of the following conditions?


  systemic lupus erythematosus

  multiple myeloma

  polycythaemia rubra vera

  disseminated malignancy

  bacterial infections

7

Which of the following is the commonest cause of a lump in the neck in a 40 year old female?


  Lymphoma

  Carcinoma in a cervical lymph node

  Thyroid nodule

  Branchial cyst

  Dermoid cyst

8

The drug of choice for the treatment of left lower lobe pneumonia developing after a hemicolectomy is:


  penicillin

  cloxacillin

  ampicillin

  ceftriaxone

  doxycycline

9

A 62 year old pipe smoker has noted a painless white area underneath his tongue, present for 6 months. The lesion is irregular, slightly raised and measures about 1 cm by 3 cm. What is the correct initial action?


  advise the patient to cease smoking

  arrange for a biopsy of the lesion

  prescribe hydrocortisone lozenges

  advise review in 1 month

  refer for radiotherapy to the lesion

10

A 17 year old schoolgirl presents with a one week history of bouts of fever, an erythematous macular rash and polyarthritis. Each of the following diagnoses should be seriously considered EXCEPT:


  Rubella

  Ross River virus infection

  Systemic lupus erythematosis

  Gonococcal infection

  Acute hepatitis C infection

11

A 52 year old alcoholic woman is admitted with a history of fever, cough and purulent sputum for one week. Chest radiographs show an irregular cavity in the superior segment of the right lower lobe, surrounded by pulmonary consolidation with a poorly defined margin. There is an air fluid level within the cavity. The most likely diagnosis is:


  Cavitating pneumococcal pneumonia

  Cavitating pulmonary infarct

  Cavitating bronchial carcinoma

  Lung abscess

  Cystic hamartoma

12

In a dirty thigh wound, the most important measure to prevent gas gangrene is:


  intramuscular gas gangrene antitoxin

  admission to an intensive care ward

  wound debridement

  immediate broad spectrum intravenous antibiotics

  hyperbaric oxygenation