Give one correct answer for each question

1. Regarding ALCAPA, which one of the following statements is false?

A. The acronym ALCAPA stands for 'anomalous left coronary artery originating from the pulmonary artery'.

B. It is not usually associated with a high infant mortality rate.

C. It presents with myocardial ischaemia and/or cardiac failure in infants.

D. The treatment of choice is surgical correction to re-establish a two-coronary artery perfusion system.

2. Which one of the following is true concerning the diagnosis of pulmonary tuberculosis (PTB) in children?

A. The diagnosis of pulmonary tuberculosis in children presents no challenge.

B. Lateral chest radiographs are infrequently utilised to assist with the diagnosis of PTB in children.

C. Most attention should be paid to the area anterior to a line extended from the anterior tracheal wall and below the right upper lobe bronchus when assessing the CXR for lymphadenopathy in children with suspected PTB.

D. The precarinal zone on CXR has a low sensitivity and specificity.

3. Which one of the following statements is false?

A. Alexander disease was originally described by Alexander in 1949.

B. It typically presents with parieto-occipital preponderance of white matter abnormalities and microencephaly.

C. It is a rare, fatal, nonfamilial leucoencephalopathy.

D. Alexander disease is caused by astrocyte dysfunction characterised by missense mutation in the genes coding for glial fibrillary acidic protein (GFAP).

4. Identify one false statement.

A. Aortic stenosis is the most commonly encountered valvular disease in developed countries.

B. Patients unfit for surgical valve replacement may require transcatheter aortic valve implantation (TAVI).

C. TAVI involves the delivery of a prosthetic valve, through the femoral artery, by means of a Retroflex delivery system.

D. TAVI is no longer a popular treatment for symptomatic aortic stenosis in patients unfit for conventional surgery.

5. Which of the following statements is false?

A. Glioblastoma multiforme (GBM) is a class of highly aggressive central nervous system tumours.

B. Gliomas are subdivided into astrocytomas and oligodendrogliomas.

C. Surgery, chemotherapy and radiation therapy achieve great success in the management of glioblastoma.

D. Glioblastoma multiforme demonstrates a high degree of heterogeneity in both its pathological and radiological appearance.

6. Identify the one correct statement among the following choices.

A. Ankylosing spondylitis is a debilitating disease, affecting mostly white men,

with a male:female ratio of about 6:1, within the age group of 15 - 35 years of age.

B. Early lumbar axial ankylosis and spinal involvement is less marked in male patients with early radiographic signs of hip involvement.

C. Ankylosing spondylitis is not associated with diseases such as ulcerative colitis, iritis and aortic insufficiency.

D. The prognosis is not affected by age at first presentation, or the radiological grade, as defined by either the Bath Ankylosing Spondylitis Radiology Index (BASRI) - for cervical-, lumbar spine and hips - or the Modified New York Criteria for the extent of sacro-iliitis.

7. Regarding ankylosing spondylitis, all the following are true except:

A. Classic joint involvement includes: bilateral sacro-iliac, thoraco-lumbar and lumbo-sacral joints (early) and cervical spine (late).

B. Cardiac manifestations, such as aortic valve and root abnormalities, together with conduction and rhythm abnormalities, are unheard of.

C. Genetic susceptibility is a causative factor, with 96% of these patients, testing positive for the HLA-B27 gene.

D. Apical fibrosis of the lung is only reported in 1% of patients.

8. Identify the one false statement among the following.

A. Isolated unilateral axillary adenopathy is not an uncommon finding.

B. Axillary adenopathy can be caused by either locoregional or systemic pathology.

C. The breast, thoracic wall and arm have direct lymphatic drainage to the axilla. Local infection, inflammation or malignancy in these regions may lead to unilateral axillary adenopathy.

D. Auto-immune diseases such as rheumatoid arthritis, lupus, Sjögren's syndrome and dermatomyositis are unheard of as causes of isolated axillary lymphadenopathy.

9. Regarding pulmonary tuberculosis, identify the single false statement.

A. The Western Cape in South Africa had an incidence of 468 cases per 100 000 people in 1998, which is among the highest in the world.

B. Diagnosing the disease in children is a challenge, as 56 - 65% of children are asymptomatic at the time of diagnosis.

C. The Mantoux test reaction lags behind radiological findings.

D. Mycobacterium tuberculosis is isolated in more than 70% of paediatric cases.

10. Identify one false statement.

A. Functional magnetic resonance imaging (fMRI) is an MRI technique capable of estimating regional brain activity during a predefined cognitive task.

B. Currently, the most promising direct clinical application is in pre-surgical planning, where fMRI is used to identify the spatial relationship between important functional areas in the brain and the area to be resected.

C. Functional MRI works on the principle that deoxygenated blood is magnetic whereas oxygenated blood is not.

D. The presence of deoxyhaemoglobin in the tissue being imaged has no effect on the local magnetic field.

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2. Read the articles in the journal to find the answers to the questions.

3. After completing the questionnaire, you can check the answers and print your own CPD certificate.

4. Please contact Gertude Fani on 021 681 7200 or gertrude@hmpg.co.za in the event of queries.

Accreditation number: MDB 001/027/10/2011