QUESTION: 117

An infant boy is born at 39 weeks' gestation by way of spontaneous vaginal delivery to a healthy, 32-year-old primigravid women. Prenatal care was appropriate and there were no problems at the time of delivery. Physical examination by the staff pediatrician is normal, with the exception of the genital examination. She observes that the urethral meatus is located on the ventral aspect of the penile shaft.
Which of the following is the most correct statement about this condition?

The infant may have a circumcision now
Voiding cystourethrogram should be ordered
A-Circumcision should be delayed
The infant may never have a circumcision

Answer(s): C

Explanation:

This infant has hypospadias. This condition occurs when there is incomplete invagination of ectoderm that is located at the glans penis where the normally located urethral meatus should be. When this occurs, the urethral opening is located on the ventral side of the penis, somewhere between the tip and the base of the shaft. Circumcision should never be performed directly after an infant is born with this condition (choice B). Rather, it should be delayed until approximately 6 months of age when the infant can better tolerate anesthesia. The reason to delay circumcision is because the prepuce will be needed for the plastic reconstruction that will need to be done. At the time of reconstruction, the infant will also undergo a circumcision (choice C). These patients do not have an increased risk for urinary tract infections. Therefore, a urine culture is not necessary (choice D). A voiding cystourethrogram (VCUG) allows for evaluation of the bladder, urinary reflux, and the presence or absence of posterior urethral valves. None of these conditions are associated with hypospadias

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QUESTION: 118

Ophthalmoplegic migraine is best characterised as?

Headache associated with irreversible palsy of 3 nerve rd
Headache with optic neuritis
Recurrent headache with transient palsy of 3, 4 and / or 6 cranial nerves th

Answer(s): C

Explanation:

Recurrent headache with transient palsy of 3, 4 and / or 6th cranial nerves OPHTHALMOPLEGIC MIGRAINE It is a rare condition which was previously considered as a type of migraine. Recent studies suggest that is it likely to be an inflammatory cranial neuropathy. The International Headache Classification has reclassified ophthalmoplegic migraine as a type of neur earlier classification as a type of migraine.It is characterised by transient migraine like headache asso paresis of oculomotor, trochlear and/or abducens nerves.To arrive at a diagnosis of ophthalmoplegic m causes should be ruled out by appropriate investigations
(like digital subtraction angiography / magne angiography of the brain).

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QUESTION: 119

12 years old girl with malaise, fatigue, sore throat and fever. On examination there were petechial rash on palate, large tonsils with follicles, cervical lymphadenopathy and hepatosplenomegaly.
All are complications except:

Chronic active hepatitis
Splenic rupture
Transverse myelitis
Encephalitis
Aplastic anemia

Answer(s): A

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QUESTION: 120

A man develops erectile dysfunction after an infarction. What is the most common cause?

ACE inhibitors
Anxiety
Aspirin
Nitrates

Answer(s): B

Explanation:

Anxiety is the most common cause of erectile dysfunction postinfarction. Although beta blockers may be the most common medication associated with erectile dysfunction, anxiety is still a more common cause of erectile dysfunction than beta blockers.

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QUESTION: 117

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