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Mixed Clinical Cases Review MCQs
MBBS Professional Review: Medicine · MBBS / Medicine · 25 practice questions
- Developmental dysplasia of the hip - clinical and imaging signs
- Urothelial tumour management
- Postpartum haemorrhage management
- Postpartum haemorrhage - management sequence
- Addisonian crisis in adolescence
- Colorectal cancer screening - HNPCC vs FAP
- Colorectal cancer screening - risk stratification
- Colorectal cancer screening - hereditary syndromes
1. A urothelial tumour is suspected in a worker with a history of occupational exposure. Which occupational group has an increased frequency of these histologically papillary tumours, supporting the use of surveillance urine cytology to facilitate early diagnosis?
- AAsbestos insulation workers
- BCoal miners
- CDye factory workers
- DAgricultural pesticide handlers
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C. Dye factory workers The excerpt states that these histologically papillary tumours occur with greater frequency in workers in dye-related industries, and urine cytology can be used in risk-prone individuals to facilitate early diagnosis.
2. A 15-year-old girl presents with a three-day history of persistent severe vomiting associated with an intercurrent viral infection, plus several months of tiredness and lack of energy. Examination reveals BP 80/50mmHg, pulse 130/min, and increased pigmentation of her buccal mucosa and nipples. Her serum sodium is 118mmol/L and serum chloride is 76mmol/L. Which of the following is the most likely cause for her presentation?
- ASalt-losing congenital adrenal hyperplasia
- BChronic reflux nephropathy
- CAddison disease
- D'Chronic fatigue syndrome' (CFS)
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C. Addison disease The combination of chronic fatigue, hypotension, tachycardia, hyperpigmentation of mucosa and nipples, hyponatraemia, and hypochloraemia in an adolescent, precipitated by an intercurrent illness, is characteristic of an adrenal (Addisonian) crisis.
3. A 55-year-old dye factory worker presents with painless haematuria. A contrast CT shows a filling defect arising from the renal pelvis, suggestive of a urothelial tumour. Which of the following is the most appropriate treatment?
- AExternal irradiation therapy
- BNephroureterectomy
- COpen fulguration
- DNephrectomy
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B. Nephroureterectomy Urothelial tumours of the renal pelvis are treated with nephroureterectomy, removing the kidney along with the entire ureter, because of the risk of recurrent tumour developing along the length of the urothelium-lined ureter and tumour seeding.
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