Clinical Techniques Adobe Scan 22 Apr 2022 — Past Paper Q...

13 clinical MCQs in Introduction to Clinical Techniques. Full question stem here?. Kenya, Africa and global revision.

Questions, Answers & Explanations

1. Q1. Full question stem here?

   • Angular stomatitis is associated with liver disease.
   • Oral candidiasis is only seen in HIV/AIDS patients.
   • Trauma, vitamin B12 deficiency and folate deficiency are associated with aphthous ulceration.
   • All of the above
   • None of the above ✅ Answer: D

   Answer: Angular stomatitis is associated with liver disease.

   Explanation: This answer implies that all statements A, B, and C are considered true by the paper's marker, despite statement B being factually incorrect with the word "only".

2. Q2. Which of the statements is false on essentials of mental state exam

   • Recent and distant memory
   • Walking/abnormal gait
   • Poor dressing, dirty person
   • Appropriate language and speech
   • Assessment of mood and affect ✅ Answer: B

   Answer: Recent and distant memory

   Explanation: While gait is observed as part of general appearance and behavior, it is often considered a more detailed component of a neurological examination rather than a core "essential" of the mental state exam itself, which focuses more on cognitive and psychological functions.

3. Q3. Which of the following cranial nerves conducts sensory touch information from the skin of the forehead, cheeks and lower jaw and conducts motor signals to the muscles of mastication?

   • Facial nerve
   • Trigeminal
   • Hypoglossal
   • Abducens
   • Vagus nerve ✅ Answer: B

   Answer: Facial nerve

   Explanation: The trigeminal nerve (CN V) is

4. Q4. Causes of bilateral reduction chest wall expansion on palpation include except

   • Bilateral symmetrical pleural effusions.
   • End stage idiopathic pulmonary fibrosis.
   • COPD
   • Pneumothorax.
   • Ankylosing spondylitis. ✅ Answer: D

   Answer: Bilateral symmetrical pleural effusions.

   Explanation: Pneumothorax typically causes unilateral reduction in chest wall expansion.

5. Q5. On pupillary light reflexes, all true except

   • Direct pupillary reflex is constriction of the pupil light is shown into.
   • Constriction of the contralateral pupil is known as consensual light reflex.
   • On accommodation light reflex pupils constrict and converge bilaterally
   • The afferent limb of the pupillary light reflex is via the optic nerve. ✅ Answer: C

   Answer: Direct pupillary reflex is constriction of the pupil light is shown into.

   Explanation: Snellen charts are used to assess visual acuity, not color blindness.

6. Q6. In bronchial breathing, which statement is false

   • Is associated with a clear distinct pause between the inspiratory and expiratory phase.
   • Louder than vesicular sounds.
   • Quiet low pitched rustling.
   • Can be likened to auscultation of the trachea.
   • Is typically heard over consolidated lung tissue. ✅ Answer: C

   Answer: Is associated with a clear distinct pause between the inspiratory and expiratory phase.

   Explanation: Bronchial breathing is loud, high-pitched, and harsh, not quiet low-pitched rustling.

7. Q7. False on vocal resonance

   • Pleural effusion is associated with reduced or absent vocal resonanc
   • Consolidation is associated with increased vocal resonanc

   Answer: Pleural effusion is associated with reduced or absent vocal resonanc

8. Q8. The following statements are true?

   • Bleeding of gums is due to lack of vitamin B12
   • Koplik spots are found on mucous membrane of the mouth
   • Pharyngitis is to inflammation of the throat
   • Smooth tongue is usually due to iron deficiency
   • Polyps are growth found on the surface of the nose. ✅ Answer: B

   Answer: Bleeding of gums is due to lack of vitamin B12

   Explanation: Koplik spots are pathognomonic for measles and appear on the buccal mucosa.

9. Q9. All the following conditions are associated with high output heart failure EXCEPT

   • Iron overload
   • Hyperthyroidism
   • Systemic arteriovenous fistula
   • Thiamine deficiency
   • Paget disease ✅ Answer: A

   Answer: Iron overload

   Explanation: Iron overload (hemochromatosis) typically causes restrictive cardiomyopathy, leading to low-output heart failure, not high-output.

10. Q10. What is the preferred order for the examination of the abdomen?

    • Inspection, auscultation, percussion, palpation?
    • percussion, auscultation, palpation and inspection.
    • auscultation, inspection, palpation, percussion.
    • inspection, auscultation, auscultation, percussion.
    • palpation, percussion, inspection, auscultation. ✅ Answer: A

    Answer: Inspection, auscultation, percussion, palpation?

    Explanation: Auscultation is performed before percussion and palpation to avoid altering bowel sounds.

11. Q11. Which of these features suggest that a pulsation in the neck is arterial?

    • Wagging ear lobe.
    • Positive for hepatojugular reflux.
    • No variation with posture.
    • Pressure in the root of the neck reduces the impulse.
    • Varies with respiration. ✅ Answer: C

    Answer: Wagging ear lobe.

    Explanation: Arterial pulsations do not vary with posture or respiration, and are not obliterated by pressure at the root of the neck, unlike venous pulsations.

12. Q12. A palpable left parasternal impulse suggests which abnormality?

    • Right ventricular hypertrophy.
    • Aortic stenosis.
    • Aortic regurgitation.
    • Left ventricular hypertrophy.
    • Pericardial effusion. ✅ Answer: A

    Answer: Right ventricular hypertrophy.

    Explanation: A palpable left parasternal heave or lift is characteristic of right ventricular hypertrophy.

13. Q13. Which of these is not necessary when examining the jugular venous pulse?

    • Patient's neck muscles should be relaxed.
    • Timing the pulsation with the radial pulse.
    • Good lighting.
    • Patient lying at 45 degree angle.
    • Using a penlight to visualize. ✅ Answer: B

    Answer: Patient's neck muscles should be relaxed.

    Explanation: While timing with a pulse is important, the carotid pulse is typically used for JVP timing to identify 'a' and 'v' waves, making radial pulse timing less directly necessary for JVP assessment.