Q1        Which of the following blood gases can be seen in a person with acute pulmonary embolism?

  • Scenario A  pH – 7.21; PO2 – 12.4; PCO2 – 2.3; Base excess (- 12.3)
  • Scenario B    pH – 7.24; PO2 – 7.8; PCO2 – 12.3; Base excess (- 1.2)
  • Scenario C    pH – 7.52; PO2 – 8.7; PCO2 – 2.3; Base excess (- 1.5)
  • Scenario D    pH – 7.35; PO2 – 7.8; PCO2 – 2.5; Base excess (- 9.3)
  • Scenario E    pH – 7.35; PO2 – 7.8; PCO2 – 7.8; Base excess (+ 12.3)

Q 2   Which of the following is a feature of Diabetic kidney disease? ( 2 correct answers)

  • A) Microalbuminuria
  • B) Haematuria
  • C) Ketonuria
  • D) Bilateral Small shrunken kidney o ultrasound
  • E) Kimmelstein Wilson Nodules

Q3 Which of the following is true in people with type 1 diabetes (3 correct answers)

  • A) There is a biphasic peak of presentation with a second peak in middle age
  • B) The majority of type 1 diabetes in the younger age group present with diabetic ketoacidosis
  • C) The risk of Type 1 diabetes is 25% in a child of an affected parent
  • D) C- peptide may be present at diagnosis of type 1 diabetes indicating endogenous insulin secretion
  • E) Antibodies to GAD and islet cells are present in 15% of people with type 1 diabetes

Q4 Which of the following is true in people with type 1 diabetes? (2 correct answers)

  • A) The dose of insulin required to prevent ketosis is 1 unit per kg body weight
  • B) There is a linear relationship between carbohydrate consumption and mealtime insulin
  • C) There is an absolute deficiency of insulin
  • D) People with Type 1 diabetes do not have insulin resistance
  • E) adolescents who present with diabetes should be treated as type 1 diabetes

Q 5 What are the underlying fundamental  pathologies that underlie the progression to diabetes (2 correct answers)

  • A) obesity
  • B) decline in beta cell function]
  • C) sedentary lifestyle
  • D) insulin resistance
  • E) low grade inflammation in fat cells

Q 6 Which of the following are true about sleep? (3 correct answers)

  • A) Caffeine predominantly blocks melatonin receptors inducing wakefulness
  • B) Sleep spindles in stage 2 sleep and may relate to memory consolidation
  • C) Sleep pressure occurs due build up of adenosine in the brain
  • D) Melatonin induces stage 4 sleep within 1 hour of administration
  • E)  Duration of Deep sleep time (Stage 4 ) becomes less out as we age.

Which of the following is true about diabetic ketoacidosis? (2 correct answers)

  • Long acting subcutaneous insulin should be stopped when starting IV insulin
  • Ketones are the product of protein metabolism
  • The fluid deficit tends to be around 100 ml/kg
  • IV bicarbonate is used to rapidly correct metabolic acidosis
  • DKA usually is a presenting feature in young onset type 1 diabetes but not in LADA (Latent Autoimmune diabetes in Adults)

Q 8 Which is true about Diabetes ketoacidosis? ( 2 correct answers)

  • IV insulin is the first step in the treatment of diabetic ketoacidosis in A and E
  • Electrolytes need to measured every 4 hours in the first 24 hours
  • broad spectrum IV antibiotics are started in all patients with Diabetic Ketoacidosis to treat any possible infection
  • In pregnancy patients with DKA need to have emergency induction of labour or caesarian section
  • Blood ketones tend to be a better measure of ketoacidosis compared to urine ketones

Q 9 Which of the following is true about pituitary gland (3 correct answers)

  • Pituitary tumours can be functional ( secrete hormones) and non functional ( no hormone secretion)
  • The commonest functional pituitary adenoma secretes prolactin which causes galactorrhoea and oligomenorrhoea
  • Expanding Pituitary adenoma causes compression of the optic chiasm causing bi nasal hemianopia
  • Anterior Pituitary gland secretes oxytocin and antidiuretic hormone
  • The pituitary fossa sits in the midline just above the sphenoid air sinus

Q 10 A 35 year old lady presents with progressive weight gain over the past 5 years. She had a difficult labour and caesarian section at the age of 30. Her weight gain has been predominantly around the abdomen and hips. Over the last 2 years she has noticed whitish abdominal striae and a dorsal fat pad. Her periods became irregular and over the past year, her periods became irregular and have stopped completely. In clinic her weight was 104 kg height 164 cm BMI 38 kg/m2.

Which of the following point to  a clinical diagnosis of Primary Obesity compared to Cushing’s syndrome?

  • Obstetric history and detailed history of weight gain reveals weigh gain over 10 years
  • History of muscle weakness and difficulty climbing stairs
  • Medications including antidepressants and the contraceptive pill
  • History of headaches migraine and visual disturbance
  • Family history of obesity and type 2 diabetes