FREE PANRE MCQ Question and Answers

Question 1

What qualities do an indirect inguinal hernia have?

Accepted Answer

Congenital protrusion through the inguinal ring into inguinal canal

Answer

An indirect inguinal hernia is characterized by a congenital protrusion through the deep (internal) inguinal ring into the inguinal canal. This occurs when the processus vaginalis, a peritoneal outpouching, fails to close completely after testicular descent, creating a pathway for abdominal contents to herniate. It follows the path of the spermatic cord and can extend into the scrotum.

Question 2

What would you expect with a positive obturator sign while performing an exam on a patient with probable appendicitis?

Accepted Answer

Increased pain when passively flexing and internally rotating the right hip

Answer

A positive obturator sign, indicative of probable appendicitis, is characterized by increased pain when passively flexing and internally rotating the right hip. This maneuver stretches the obturator internus muscle, which lies in close proximity to an inflamed appendix. The resulting pain in the right lower quadrant suggests irritation of this muscle by the inflamed appendix.

Question 3

The following x-ray results would all suggest abuse, with the exception of:

Accepted Answer

10-year-old with distal radius fracture

Answer

A distal radius fracture in a 10-year-old is the least likely x-ray result to *alone* suggest abuse. This type of fracture, often called a Colles' fracture, is a common injury resulting from a fall onto an outstretched hand, which is a plausible mechanism for a child of this age. In contrast, rib fractures, skull fractures across suture lines, and spiral fractures of the femur (especially in younger children) are highly suspicious for abuse without a clear, accidental explanation.

Question 4

Which of the following conditions can be diagnosed with certainty with a temporal artery biopsy?

Accepted Answer

Giant cell arteritis

Answer

Giant cell arteritis (GCA), also known as temporal arteritis, is a systemic vasculitis affecting large and medium-sized arteries, most commonly the temporal artery. A temporal artery biopsy is the definitive diagnostic test for GCA, revealing characteristic inflammatory changes within the artery wall. While polymyalgia rheumatica is often associated with GCA, it is a clinical diagnosis, and the biopsy is specific for GCA.

Question 5

At the intensive care unit (ICU), a newborn was being treated for cyanotic episodes and stunted growth. Auscultation reveals a systolic murmur, and an x-ray reveals a heart that resembles a boot. Which diagnosis is more likely?

Accepted Answer

Tetralogy of Fallot

Answer

The combination of cyanotic episodes, stunted growth, a systolic murmur, and a 'boot-shaped heart' on X-ray is classic for Tetralogy of Fallot (TOF). TOF is a congenital heart defect comprising four anomalies: a ventricular septal defect, pulmonary stenosis, an overriding aorta, and right ventricular hypertrophy. The 'boot-shaped heart' appearance is due to right ventricular hypertrophy and pulmonary artery hypoplasia.

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FREE PANRE MCQ Question and Answers