|
63 |
Julie Morris. Basic Medical Statistics. |
|
64 |
EMQ. Noonan syndrome. |
|
65 |
EMQ. Stilboestrol. |
|
66 |
SBA. Flu and pregnancy. |
63. Julie
Morris. Basic Medical Statistics.
You will need the questions and flowchart which I have sent.
64. EMQ. Noonan’s syndrome.
Abbreviations.
NS: Noonan syndrome.
TS: Turner syndrome.
Question
1.
Why
‘Noonan’?
Option
list.
|
A |
the first case was diagnosed in the Noonan family in Wichita,
Kansa in 1953. |
|
B |
the first case was described by Jacqueline A. Noonan. |
|
C |
it is named after Dr Theodore X. Dalry who had the condition. He
was a preacher on USA TV in the 1950s and particularly railed against
onanism, acquiring the soubriquet ‘Dr. Noonan’. |
|
D |
none of the above. |
Question
2.
Which,
if any, of the following have been used as names for the condition?
Option
list.
|
A |
familial Turner syndrome |
|
B |
female pseudo-Turner syndrome |
|
C |
male Turner syndrome |
|
D |
Noonan-Ehmke syndrome |
|
E |
Noonan's syndrome |
|
F |
NS |
|
G |
pseudo-Ullrich-Turner syndrome |
|
H |
Turner phenotype with normal karyotype |
|
I |
Turner syndrome in female with X chromosome |
|
J |
Turner-like syndrome |
|
K |
Ullrich-Noonan syndrome |
|
L |
all of the above |
|
M |
none of A-K |
Question
3.
What
is the approximate incidence of NS in newborns?
Option
list.
|
A |
1 in 2,000 |
|
B |
1 in 5,000 |
|
C |
1 in 10,000 |
|
D |
1 in 50,000 |
|
E |
1 in 100,000 |
Question
4.
Which,
if any, of the following is true of NS?
Option
list.
|
A |
it is an autosomal dominant condition |
|
B |
it is an autosomal recessive condition |
|
C |
it is an X-linked dominant condition |
|
D |
it is an X-linked recessive condition |
|
E |
it is due to loss of part of an X chromosome |
|
F |
it is due to loss of part of chromosome 5 |
|
G |
none of the above |
Question
5.
Which
if any of the following are features of NS?
Option
list.
|
A |
bicuspid aortic valve |
|
B |
bleeding disorders |
|
C |
coarctation oi the aorta |
|
D |
cryptorchidism |
|
E |
furrowed philtrum |
|
F |
hypertelorism, epicanthic folds, ptosis |
|
G |
hypertrophic cardiomyopathy |
|
H |
leukaemia |
|
I |
low occipital hairline |
|
J |
low-set, retro-rotated ears |
|
K |
micrognathia |
|
L |
obesity |
|
M |
pectus excavatum
or carinatum (Latin: ‘keel-shaped’) |
|
N |
pulmonary stenosis |
|
O |
scoliosis |
|
P |
‘shield’ chest |
|
Q |
short stature |
|
R |
significant intellectual impairment |
|
S |
streak gonads |
|
T |
‘striking’ blue or blue/green eyes |
|
U |
tall stature |
|
V |
thin philtrum |
|
W |
thrombophilia |
|
X |
webbed neck |
Question
6.
Which,
if any, of the following are common in NS and TS?
Option
list.
|
A |
bicuspid aortic valve |
|
B |
bleeding disorders |
|
C |
coarctation of the aorta |
|
D |
coeliac disease |
|
E |
cryptorchidism, |
|
F |
cubitus valgus |
|
G |
diabetes |
|
H |
epicanthic folds |
|
I |
gonadal dysgenesis |
|
J |
hypertelorism |
|
K |
hypothyroidism |
|
L |
hypertrophic cardiomyopathy |
|
M |
increased risk of leukaemia |
|
N |
low occipital hairline |
|
O |
pectus excavatum or carinatum (Latin: ‘keel-shaped’) |
|
P |
pulmonary stenosis |
|
Q |
red-green colour blindness |
|
R |
short stature |
|
S |
short, webbed neck |
65.
EMQ. Stilboestrol.
Abbreviations.
CSM: Committee on Safety of Medicines – now part of MHRA.
DES: diethylstilboestrol / stilboestrol.
WSIP: women given DES in pregnancy.
DOS: ‘daughter(s)
of stilboestrol’. Women exposed to DES in-utero.
SOS: ‘son(s)
of stilboestrol’. Men exposed to DES in-utero.
GDOS: ‘granddaughter(s)
of stilboestrol’’. Granddaughters of women exposed to DES in-utero.
GSOS: ‘grandson(s)
of stilboestrol’’. Grandsons of women exposed to DES in-utero.
MHRA: The
Medicines and Healthcare Products Regulatory Agency.
Question
7.
When
was stilboestrol first described?
Option
list.
|
A |
1938 |
|
B |
1940 |
|
C |
1950 |
|
D |
1961 |
|
E |
1970 |
|
F |
1971 |
|
G |
1973 |
|
H |
1984 |
|
I |
2005 |
|
J |
2019 |
Question
8.
When
did Herbst describe the risk of cancer for DOS?
Option
list. Use the list for question 1.
Question
9.
Which
cancer did he refer to?
Option
list. Use the list for question 7.
Question
10.
When
did the FDA and CSM issue warnings about the use of DES in pregnancy?
Option
list. Use the list for question 1.
Question
11.
The Kefauver-Harris Amendments to the 1938
Food, Drug, and Cosmetic Act were a response to the thalidomide tragedy /
scandal in the USA. When were they enacted?
Option
list. Use the list for question 1.
Question
12.
When was
the US National Cancer Institute’s “DES
Third Generation Study” published?
Option
list. Use the list for question 1.
Question
13.
Which,
if any, of the following are more common in DOS?
Option
list.
|
A |
amenorrhoea |
|
B |
menstrual irregularity |
|
C |
infertility |
|
D |
polycystic ovary syndrome |
|
E |
breast cancer |
|
F |
cervical cancer |
|
G |
ovarian cancer |
|
H |
miscarriage |
|
I |
ectopic pregnancy |
|
J |
pre-eclampsia |
|
K |
premature delivery |
|
L |
IUGR |
|
M |
neural tube defect |
|
N |
uterine malformation |
|
O |
cervical malformation |
|
P |
abnormal cervical cytology |
|
Q |
vaginal adenosis |
|
R |
vaginal adenocarcinoma |
|
S |
vaginal squamous carcinoma |
|
T |
vaginal melanoma |
|
U |
ADHD |
|
V |
depression |
Question
14.
Which,
if any, of the following are more common in GDOS?
Option
list. Use the list for question 7.
Question
15.
Which,
if any, of the following have been described as risks for SOS?
Option
list.
|
A |
ADHD |
|
B |
cryptorchidism |
|
C |
depression |
|
D |
hypospadias |
|
E |
infertility |
|
F |
prostate cancer |
|
G |
suicide |
Question
16.
Which,
if any, of the following have been described as risks for GSOS?
Option
list. Use the list for question 9.
66.
SBA. Flu and pregnancy.
Lead-in
What did MBRRACE say about flu & pregnancy in its
first report in 2014?
Option List
Pick the best option from the following list.
|
A. |
1 in 11 women died from flu |
|
B. |
1 in 11 women
died from flu and flu vaccination could have prevented ½ of the deaths |
|
C. |
1 in 21 women
died from flu |
|
D. |
1 in 21 women
died from flu and flu vaccination could have prevented ½ of the deaths |
|
E. |
1 in 51 women
died from flu |
|
F. |
1 in 51 women
died from flu and flu vaccination could have prevented ½ of the deaths |
Question 2.
Lead-in
How many types of flu virus are recognised?
Pick the best option from the following list.
Option List
|
A. |
3 |
|
B. |
5 |
|
C. |
10 |
|
D. |
15 |
|
E. |
>100 |
Question 3.
Lead-in
Why can’t we have a universal flu vaccine?
Pick the statements from the following list that are true.
List of statements.
|
A. |
The main surface antigens are haemagglutinin and
neuraminidase |
|
B. |
The main
surface antigens are haemolysin and neuroxidase |
|
C. |
The main
surface antigens frequently |
|
D. |
The main core
antigens change frequently, rendering existing vaccines impotent |
|
E. |
The big drug
companies avoid making a universal vaccine for financial reasons. |
Option List
|
1. |
A + C + D + E |
|
2. |
A + C |
|
3. |
A + D + E |
|
4. |
B + C |
|
5. |
B + D + E |
Question 4.
Lead-in
When is flu’ most often a problem in the UK?
Pick the best option from the following list.
Option List
|
A. |
Spring |
|
B. |
Summer |
|
C. |
Autumn |
|
D. |
Winter |
|
E. |
None of the
above. |
Question 5.
Lead-in
How is flu spread?
Pick the best option from the following list.
Option List
|
A. |
via aerosol or droplets from respiratory tract of an
infected person |
|
B. |
via aerosol or
droplets from respiratory tract or direct contact with respiratory secretions
of an infected person |
|
C. |
from getting
drenched in cold winter showers |
|
D. |
from thinking
lascivious thoughts |
|
E. |
from toilet
seats |
Question 6.
Lead-in
What is the incubation period for flu?
Pick the best option from the following list.
Option List
|
A. |
1 – 3 days |
|
B. |
1 – 7 days |
|
C. |
5 – 10 days |
|
D. |
up to 2 weeks |
|
E. |
up to 3 weeks |
Question 7.
Lead-in
Who decides which viruses will be used in the vaccine for
seasonal flu?
Pick the best option from the following list.
Option List
|
|
DOH |
|
|
JCVI |
|
|
the Prime
Minister |
|
|
the vaccine
manufacturers |
|
|
WHO |
Question 8.
Lead-in
How long has flu vaccination been recommended in the UK?
Pick the best option from the following list.
Option List
|
A.
|
since the 1950s |
|
B. |
since the 1960s |
|
C. |
since the 1970s |
|
D. |
since the 1980s |
|
E. |
since the 1990s |
Question 9.
Lead-in
What is the recommendation about when the vaccine should
be given?
Pick the best option from the following list.
Option List
|
A. |
May - July |
|
B. |
June - August |
|
C. |
July -
September |
|
D. |
August -
October |
|
E. |
September -
November |
Question 10.
Lead-in
What advice is given about vaccination in pregnancy?
Pick the best option from the following list.
Option List
|
A.
|
flu vaccine is potentially teratogenic and should be
avoided before 16 weeks |
|
B. |
the vaccine
contains an attenuated virus with no evidence of risk in pregnancy |
|
C. |
the vaccine recommended
for pregnancy has no live viral material and all pregnant women are
encouraged to have the seasonal vaccine |
|
D. |
flu vaccine
contains an attenuated virus with minimal risk, but the anti-viral drug
Tamiflu is given with the vaccine to eliminate any risk of harm |
Question 11.
Lead-in
What is the H1N1 virus?
Pick the best option from the following list.
Option List
|
A.
|
The avian virus which causes outbreaks of “bird flu” |
|
B. |
The virus
associated with “swine” flu, which caused a pandemic in 2009 |
|
C. |
The virus
associate with MERS, currently causing deaths particularly in Saudi Arabia |
|
D. |
The virus
associated with simian flu |
|
E. |
The virus
associated with the pandemic of 1915. |
Question 12.
Lead-in
What advice should be given to pregnant women about
protection against the H1N1 virus?
Pick the best option from the following list.
Option List
|
A. |
to have vaccination against H1N1 in addition to the
seasonal vaccine |
|
B. |
to have vaccination
against H1N1 in preference to the seasonal vaccine |
|
C. |
to await
evidence of epidemic H1N1 flu and then have vaccination against H1N1 |
|
D. |
to have the
seasonal vaccine as it gives good protection against H1N1 |
|
E. |
not to have any
flu vaccination, but to take antiviral drugs if symptoms of flu occur |
Question 13.
Lead-in
Pick the best option from the following list.
Which of the following conditions have been linked to
flu in pregnancy?
Conditions.
|
A.
|
risk of flu complications for
the mother |
|
B.
|
risk of low birthweight |
|
C.
|
risk of maternal death |
|
D.
|
risk of perinatal death |
|
E.
|
risk of prematurity |
Option List
|
1 |
A + C+ D + E |
|
2 |
A + B + C+ D |
|
3 |
A + C + D |
|
4 |
A + C+ D + E |
|
5 |
A + B + C+ D +
E |
Question 14.
Lead-in
What is the estimated uptake of flu vaccination by
pregnant women in the UK?
Pick the best option from the following list.
Option List
|
A. |
20-30% |
|
B. |
30-40% |
|
C. |
40-50% |
|
D. |
50-60% |
|
E. |
> 60% |
Question 15.
Lead-in
How many maternal deaths from flu were reported by
MBRRACE for the years 2012 - 2013?
Pick the best option from the following list.
Option List
|
A. |
0 |
|
B. |
5 |
|
C. |
10 |
|
D. |
15 |
|
E. |
20 |
Question 16.
Lead-in
With regard to the probable explanation for the numbers
of maternal deaths from ‘flu in 2012 and 2013, which of the following
statements is true?
Option List
|
A. |
the numbers reflected increased prevalence of ‘flu |
|
B. |
the numbers
reflected reduced prevalence of ‘flu |
|
C. |
the numbers
reflected improved uptake of ‘flu vaccine in pregnancy |
|
D. |
the numbers
reflected the introduction of Tamiflu for pregnant women with ‘flu |
|
E. |
none of the
above |
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