Medical intern examination

Nocturnal enuresis 'enuresis' is synonymous with bedwetting Enuresis is defined as the repeated voiding of urine into clothes or bed at least twice a week for at least 3 consecutive months in a child who is at least 5 yr of age Children can wet themselves by day or night It is quite common: about 6% of 5-year-olds and 3% of 10-year-olds are not dry at night. Boys outnumber girls by nearly 2 to 1 There is a genetically determined delay in acquiring sphincter competence, with two-thirds of children with enuresis having an affected first-degree relative. Organic causes of enuresis are uncommon but include urinary tract infection faecal retention severe enough to reduce bladder volume and cause bladder neck dysfunction polyuria from osmotic diuresis, e.g. diabetes mellitus, or renal concentrating disorders, e.g. chronic renal failure A urine sample should always be tested for glucose and protein, specific gravity and checked for infection bladder ultrasonograph

1 ) All of the following are indications for induction of labor except ? A . Prolonged pregnancy . B . IUGR . C . Abnormal lie . D . Gestational HTN . E . Term decreased fetal movement .  2 ) The best method to diagnose endometriosis is ? A . Laparotomy . B . CT scan . C . MRI . D . Ultrasound scan . E . Laparoscopy .  3 ) The oxygenated blood is allowed into the fetal body by ? A . Foramen ovale . B . Ductus venosus . C . Right ventricle . D . Umbilical arteries . E . Fetal aorta .  4 ) Apgar score parameters include all of the following except ? A . Respiratory rate . B . Pulse rate . C . Response to stimuli . D . Colour . E . Tone .  5 ) All are causes of regular heavy periods except ? A . Endometrial polyp . B . Endometriosis . C . Hypothyroidism . D . Fibroids . E . OCPs .  6 ) The maximum number of oogonia are formed at what age female life ? A . One month intrauterine . B . Five months intrauterine . C . At birth . D . At puberty . E . At 21 years of age . 7 ) A p

1) The smallest diameter of the true pelvis is ? A . True conjugate B . Obstetric conjugate C . Diagonal conjugate D . Transverse diameter E . Oblique diameter  2) Regarding gestational trophoblastic neoplasia ( GTN) all of the following are correct except ? A . Complete mole associated with presence of fetal and embryonic tissue . B . Incomplete mole associated with focal swelling of chorionic villi . C . Karyotype of partial mole usually triploidy . D . Theca lutein ovarian cysts develop in about half of patients with complete mole . E . Snow storm appearance on ultrasound is characteristic for complete mole .  3) A healthy woman complaining of crying , insomnia , feeling low , mood lability 3 day after normal delivery , the most likely cause is ? A . Postpartum depression B . Postpartum psychosis C . Postpartum psychosis D . Postpartum neurosis E . Postpartum schizophrenia  4) Women with uterine fibroid can present with all of the following except ? A . Menorrhagia B . Increas

Multifactorial inheritance Multifactorial inheritance refers to traits that are caused by a combination of inherited and environmental factors Characteristics 1- The risk of recurrence is related to the incidence of the disease 2- Some disorders have a sex predilection, Pyloric stenosis, for example, is more common in males, whereas congenital dislocation of the hips is more common in females 3-The likelihood that both identical twins will be affected with the same malformation is less than 100% but much greater than the chance that both members of a nonidentical twin pair will be affected. This is in contrast with the pattern seen in mendelian inheritance, in which identical twins almost always share fully penetrant genetic disorders 4- The risk of recurrence is increased when multiple family members are affected. A simple example is that the risk of recurrence for unilateral cleft lip and palate is 4% for a couple with 1 affected child and increases to 9% with 2 affec

Clinical features Down's syndrome is usually suspected at birth because of the baby's facial appearance Typical craniofacial appearance 1. Round face and flat nasal bridge 2. Upslanted palpebral fissures 3. Epicanthic folds (a fold of skin running across the inner edge of the palpebral fissure) 4. Brushfield spots in iris (pigmented spots) 5. Small mouth and protruding tongue Small ears 6. Flat occiput and third fontanelle Other anomalies 1. Short neck 2. Single palmar creases, incurved fifth finger and wide 'sandal' gap between toes 3. Hypotonia 4. Congenital heart defects (40%) 5. Duodenal atresia 6. Hirschsprung's disease Later medical problems 1. Delayed motor milestones 2. Moderate to severe learning difficulties Small stature 3. Increased susceptibility to infections 4. Hearing impairment from secretory otitis media 5. Visual impairment from cataracts, squints, myopia 6. In