All about UoNSDA Medics
Who among the following has NEVER served specifically as a Medical School church elder?
A. Oliver Abade
B. Gideon Ong'era
C. Kenson Kipchumba
D. Jared Okwany
E. Briane Odongo
A. Oliver Abade
What is the only metallic element that is liquid at standard temperature and pressure ($25^\circ\text{C}$ and $1\text{ atm}$)?
a) Gallium
b) Cesium
c) Francium
d) Bromine
e) Mercury
Answer: e) Mercury
A truck leaves Nakuru heading towards Nairobi at 70km/h. One hour later, a car leaves Nairobi towards Nakuru at 90km/h. If the distance between Nakuru and Nairobi is 160km. After how many hours from when the car leaves will they meet?
Step 1: Truck's Head Start
The truck travels for 1 hour at 70 km/h, covering 70 km. Remaining distance = 160 km - 70 km = 90 km.
Step 2: Relative Speed & Time
Towards each other, add their speeds: 70 km/h + 90 km/h = 160 km/h.
Time to meet = Distance ÷ Relative Speed = 90 km ÷ 160 km/h = 0.5625 hours.
Step 3: Conversion 0.5625 hours × 60 = 33.75 minutes. 0.75 minutes × 60 = 45 seconds.
ANSWER: 33 mins 45 seconds
The primary theological firestorm between older traditionalists and young reformers centered on whether the "law in Galatians" was:
a) The civil code vs. the Levitical dietary rules
b) The ceremonial law vs. the moral law (Ten Commandments)
c) The Abrahamic covenant vs. the Davidic covenant
d) Circumcision vs. baptism
e) Natural law vs. revealed scripture
Answer: b) The ceremonial law vs. the moral law (Ten Commandments)
A 65-year-old male is on post-operative day 4 following an elective sigmoid colectomy with primary anastomosis for recurrent diverticulitis. The nursing staff calls you because he has become acutely confused and lethargic.
His vital signs are: Temperature: 39.2°C (102.5°F) [Normal: 36.5–37.5°C]
Heart Rate: 130 bpm [Normal: 60–100 bpm]
Blood Pressure: 78/45 mmHg [Normal: 90/60–120/80 mmHg]
Respiratory Rate: 26/min [Normal: 12–20/min]
On examination, his abdomen is distended, rigid, and diffusely tender with involuntary guarding. His urine output over the last 4 hours has dropped to 10 mL/hr [Normal: >0.5 mL/kg/hr]. Laboratory parameters reveal: Serum Lactate: 6.4 mmol/L [Normal: 0.5–1.0 mmol/L] WBC count: 24.5 x 10^9/L [Normal: 4.5–11.0 x 10^9/L] Which of the following represents the most comprehensive and appropriate step-by-step approach to managing this patient's condition?
A. Immediately start a Norepinephrine infusion to maintain a Mean Arterial Pressure (MAP) >65 mmHg, draw blood cultures, administer narrow-spectrum antibiotics, and observe in the ICU for 24 hours.
B. Administer 30 mL/kg of IV crystalloid fluids, draw blood cultures, administer broad-spectrum IV antibiotics within 1 hour, and immediately prepare the patient for an emergent exploratory laparotomy.
C. Order an urgent contrast-enhanced MRI of the abdomen to definitively locate the anastomotic leak, followed by broad-spectrum antibiotics and percutaneous drainage of any identified collections.
D. Administer IV hydrocortisone for presumed relative adrenal insufficiency, initiate IV crystalloids at 100 mL/hr, and consult interventional radiology to place an intra-abdominal drain.
B. Administer 30 mL/kg of IV crystalloid fluids, draw blood cultures, administer broad-spectrum IV antibiotics within 1 hour, and immediately prepare the patient for an emergent exploratory laparotomy.
Surviving surgical septic shock requires simultaneous medical resuscitation and physical source control:
Resuscitation: Aggressive IV fluid resuscitation (30 mL/kg) and broad-spectrum antibiotics must be initiated within one hour to stabilize tissue perfusion.
Source Control: Antibiotics cannot cure a continuous anatomical leak. Generalized peritonitis (a rigid abdomen) mandates immediate emergent exploratory laparotomy to wash out the abdomen and stop the contamination.
Delaying surgery for imaging, or starting vasopressors before the "vascular tank" is filled with fluids, significantly increases mortality.
After its inception, where did the members of the Medical school church first go for their sabbath fellowship?
A. Lecture Theatre 1
B. Lecture Theatre 3
C. Lecture Theatre 2
D. Room 400 Soweto
E. Ladies' TV Room
C. Lecture Theatre 2
Which of the big cats has the strongest bite force relative to its body size, capable of biting directly through turtle shells and piercing the temporal bones of mammalian skulls?
a) Lion
b) Tiger
c) Jaguar
d) Leopard
e) Snow leopard
Answer: c) Jaguar
What cognitive bias describes the psychological tendency of individuals with low competence or limited knowledge in a specific domain to grossly overestimate their own ability and intelligence?
a) Impostor syndrome
b) Confirmation bias
c) Dunning–Kruger effect
d) Hindsight bias
e) Anchoring effect
Answer: c) Dunning–Kruger effect
Voted by the General Conference Executive Committee in November 2026 to succeed the retiring Pastor Blasious Ruguri, who was elected as the new president of the East-Central Africa Division (ECD) of the Seventh-day Adventist Church?
a) Dr. Tom Ogal
b) Dr. Moses Ndimukika Maka
c) Pastor Joel Rutebuka
d) Pastor Fidelis Kyuma
e) Dr. Paul Mwangi
Answer: b) Dr. Moses Ndimukika Maka
A 35-year-old male is brought to the trauma bay after being struck by a car at high speed. He is pale, diaphoretic, and lethargic.
His vital signs are:
BP: 70/40 mmHg [Normal: 90/60–120/80 mmHg]
Heart Rate: 140 bpm [Normal: 60–100 bpm]
Respiratory Rate: 24/min [Normal: 12–20/min]
During the primary survey, his airway is patent and breath sounds are equal. His pelvis is clinically unstable to gentle compression. A pelvic binder is immediately applied centered over the greater trochanters. A FAST (Focused Assessment with Sonography for Trauma) scan is negative for free intraperitoneal fluid.
Despite the binder and the rapid transfusion of 2 units of uncrossmatched O-negative packed red blood cells, his blood pressure remains 75/45 mmHg. An anterior-posterior (AP) pelvic radiograph reveals a pubic symphysis diastasis of 4.5 cm with widening of both sacroiliac joints (an APC-III "open book" fracture).
According to standard trauma principles (as outlined in Apley & Solomon's System of Orthopaedics and Trauma), what is the most appropriate next step in managing this patient's shock?
A. Perform an emergent exploratory laparotomy to identify and ligate the bleeding vessels.
B. Remove the pelvic binder to properly apply an anterior external skeletal fixator in the trauma bay.
C. Perform urgent pelvic angiography with embolization or preperitoneal pelvic packing.
D. Perform a Diagnostic Peritoneal Lavage (DPL) to definitively rule out a hollow viscus injury.
E. Administer IV Tranexamic Acid (TXA) and transfer immediately to the ICU for permissive hypotension.
C. Perform urgent pelvic angiography with embolization or preperitoneal pelvic packing.
Rationale: This case tests the classic algorithm for a hemodynamically unstable pelvic fracture, a major cause of preventable trauma mortality. Pelvic hemorrhage is primarily venous (80% from the presacral venous plexus and bleeding cancellous bone) and arterial (20% from branches of the internal iliac artery).
The Initial Step: A pelvic binder (placed over the greater trochanters, not the iliac crests) physically reduces the pelvic volume, creating a tamponade effect that controls venous and bone bleeding.
The Decision Fork (The FAST Scan): The patient is still in shock despite the binder and blood. The negative FAST scan means he is not bleeding into his abdominal cavity; he is bleeding into his retroperitoneal space from the pelvic fracture.
The Definitive Step: Because the mechanical binder did not stop the bleeding, you must achieve direct hemostasis. The standard of care is urgent pelvic angiography (to embolize arterial bleeders) or preperitoneal pelvic packing (to physically pack the retroperitoneal space).
How many elders from Medical School church have ever served at the pastorate of UoNSDA church since the nomination held after its inception in 2018? (Overall head elders, deputies and pastor)
A. 6
B. 8
C. 5
D. 7
B. 8
When two pieces of the exact same pure metal touch each other in the vacuum of outer space, they permanently fuse into a single solid piece without melting, a phenomenon known as what?
a) Cold welding
b) Sintering
c) Vacuum annealing
d) Galvanic bonding
e) Capillary fusion
Answer: a) Cold welding
Despite its name translating to "snow-covered" in Spanish, this U.S. state's highest recorded temperature is a scorching 125 degrees Fahrenheit. Which State is this?
Nevada
Which of the following biblical figures did not have their name changed by God or a royal authority ?
a) Abram
b) Jacob
c) Saul of Tarsus
d) Sarai
e) Mattaniah
Answer: c) Saul of Tarsus.
Saul ,contrary to common belief had dual names due to his dual citizenship as a Roman and a Jew. Paul - Greco-Roman name, Saul - Jewish name.
Acts 13:9 "Then Saul, (who also is called Paul,) filled with the Holy Ghost, set his eyes on him," (KJV)
A 24-year-old female presents to the emergency department with a 24-hour history of abdominal pain that began around her umbilicus and has now localized to the right lower quadrant (RLQ). She reports nausea, one episode of vomiting, and loss of appetite.
Her vital signs are: Temperature: 37.6°C (99.7°F) [Normal: 36.5–37.5°C]
Heart Rate: 95 bpm [Normal: 60–100 bpm]
On examination, she has localized tenderness at McBurney's point with mild rebound tenderness. Her laboratory parameters reveal:
WBC count: 12.0 x 10^9/L [Normal: 4.5–11.0 x 10^9/L]
CRP: 35 mg/L [Normal: < 10 mg/L]
Urine β-hCG: Negative
Because her clinical presentation is highly suggestive but not definitive, a CT scan of the abdomen and pelvis is ordered. The CT reveals a 9 mm diameter fluid-filled tubular structure in the RLQ with wall thickening and surrounding fat stranding. There is a small, calcified radiopacity noted within the lumen of the structure.
Based on the clinical presentation and imaging findings, what is the most likely diagnosis and the most appropriate definitive management?
A. Ruptured ovarian cyst; supportive care with NSAIDs and outpatient gynecology follow-up.
B. Acute appendicitis secondary to a fecalith; immediate surgical consultation for appendectomy.
C. Crohn's disease exacerbation (terminal ileitis); initiate intravenous corticosteroids and antibiotics.
D. Uncomplicated acute appendicitis; admit for a 3-day course of intravenous antibiotics only.
E. Complicated acute appendicitis with localized perforation; consult interventional radiology for immediate percutaneous drainage and plan for an interval appendectomy in 6–8 weeks.
B. Acute appendicitis secondary to a fecalith; immediate surgical consultation for appendectomy.
Rationale: This case represents a classic presentation of acute appendicitis with definitive imaging findings.
The Diagnosis: The patient has classic symptoms and signs. The CT scan findings are the hallmark of acute appendicitis:
Enlarged appendix: > 6 mm in diameter.
Fat stranding: Indicates surrounding inflammation (periappendicitis).
The Calcified Radiopacity: This is a fecalith—the most common cause of acute appendicitis in adults.
The Management: The presence of an appendicolith (fecalith) is a major risk factor for failure of medical therapy and subsequent perforation. Therefore, the gold standard and most appropriate definitive management is a surgical appendectomy.
Calculate the number of days from the date of inception of UoNSDA Medical School church to 7th November 2026.
Hint: There have been only 2 leap years since.
WORKING: (The inception date being 13th October 2018)
1. Days remaining in 2018 (Oct 13 to Dec 31) = 18 days
-November: 30 days + December: 31 days
-Total for 2018: 18+31+30 = 79 days
2. Full calendar years (2019 to 2025) - 7 full years in this span, which includes the 2 leap years (2020 and 2024).
-5 standard years (365 days × 5) = 1,825 days
-2 leap years (366 days × 2) = 732 days
-Total: 1,825 + 732 = 2,557 days
3. Days elapsed in 2026 (Jan 1 to Nov 7)
January to October: 304 days (31 + 28 + 31 + 30 + 31 + 30 + 31 + 31 + 30 + 31)
November: 7 days
Total for 2026: 311 days
Final Calculation: 79 + 2,557 + 311 = 2,947.
Which method is most suitable for separating a mixture of ammonium chloride and sodium chloride?
a) Fractional crystallization
b) Simple distillation
c) Sublimation
d) Solvent extraction
e) Paper chromatography
Answer: c) Sublimation
Who holds the record as Kenya’s shortest-serving Vice President, holding the office for only 104 days in 1969 before resigning following political fallout with President Jomo Kenyatta?
a) Joseph Murumbi
b) Jaramogi Oginga Odinga
c) Daniel arap Moi
d) Mwai Kibaki
e) Josephat Karanja
Answer: a) Joseph Murumbi
Which king of Judah was struck with leprosy in the forehead after unlawfully entering the temple to burn incense?
a) Amaziah
b) Uzziah (Azariah)
c) Jotham
d) Ahaz
e) Asa
Answer: b) Uzziah (Azariah)
A 19-year-old college student with Type 1 Diabetes complains of waking up drenched in sweat with a pounding headache. His fasting capillary blood glucose at 07:00AM is consistently around 14.4 mmol/L [Normal: 3.9–5.6 mmol/L]. Frustrated, he tells you he has been independently increasing his evening basal insulin dose for the past three days, but his morning sugars are only getting higher.
You ask him to set an alarm and check his blood sugar at 03:00 AM. He reports a 03:00 AM glucose of 2.5 mmol/L [Normal: 3.9–5.6 mmol/L].
Which of the following correctly identifies the phenomenon occurring and the most appropriate next step in management?
A. Dawn phenomenon; further increase the evening basal insulin.
B. Dawn phenomenon; decrease the evening basal insulin.
C. Somogyi effect; decrease the evening basal insulin or add a bedtime snack.
D. Somogyi effect; further increase the evening basal insulin to suppress morning glucose production.
E. Insulin waning; switch evening basal insulin to a short-acting bolus at 03:00 AM.
Correct Answer: C
Rationale: This patient is experiencing the Somogyi effect (rebound hyperglycemia).
The Trap: Because the patient only sees the high morning glucose, their instinct is to take more evening insulin.
The Pathophysiology: The excessive evening insulin causes unrecognized nocturnal hypoglycemia (the 03:00 AM low, causing the night sweats and morning headaches). The body panics and releases counter-regulatory hormones (glucagon, epinephrine, cortisol, growth hormone), which flood the liver and trigger massive gluconeogenesis and glycogenolysis, resulting in high blood sugar by morning.
The Fix: You must decrease the evening basal insulin (or add a bedtime snack) to prevent the 03:00 AM low.
Who among the following KNH elders came up with the first concept note for the Purchase of Medical School Church piano?
A. Teddy Allan
B. Griffins Omondi
C. Ibsen Ong'idi
D. Markfinley Ogweno
E. Stephen Nyabuto
B. Griffins Omondi
While most domestic cats avoid water, which two of these big cats are famous for being exceptional swimmers that actively hunt and bathe in rivers?
a) Lion and Jaguar
b) Tiger and Jaguar
c) Lion and Tiger
d) Leopard and Lion
e) Cheetah and Tiger
Answer: b) Tiger and Jaguar
A 34-year-old healthcare worker in Uganda presents with high fever, diarrhea, and intractable hiccups 9 days after a needlestick exposure to Sudan ebolavirus. Labs show platelets 42,000/μL [Normal: 150,000–450,000/μL], AST 950 U/L [Normal: 10–40 U/L], and ALT 210 U/L [Normal: 7–56 U/L].
Which of the following is the most accurate management principle?
A. Administer the rVSV-ZEBOV (Ervebo) vaccine immediately as post-exposure prophylaxis.
B. Give targeted monoclonal antibodies (e.g., Inmazeb) based on the classic AST > ALT ratio.
C. Rule out Ebolavirus definitively if the initial day-4 RT-PCR is negative.
D. Counsel that prolonged barrier contraception is required post-recovery due to viral persistence in immunologically privileged sites.
E. Perform an immediate lumbar puncture, as hiccups indicate viral meningoencephalitis.
D. Hiccups are a classic presentation of Ebolavirus Disease (EVD). Filoviruses evade complete immune clearance by hiding in immunologically privileged sites (like the testes), necessitating barrier contraception for 12 to 18 months post-recovery.
Which prophet lay on his left side for 390 days and then on his right side for 40 days to bear the punishment of Israel and Judah?
a) Jeremiah
b) Ezekiel
c) Isaiah
d) Daniel
e) Zechariah
Answer: b) Ezekiel
A 34-year-old male with newly diagnosed HIV (CD4 count = 28 cells/μL) presents with a 2-week history of progressively worsening headache, nausea, and lethargy. A lumbar puncture reveals an opening pressure of 340 mm H₂O. CSF analysis shows a mild mononuclear pleocytosis and is strongly positive for Cryptococcal antigen (CrAg).
Which of the following represents the most comprehensive and accurate step-by-step approach to managing this patient's condition?
A. Induction: Liposomal Amphotericin B (3-4 mg/kg/day IV) + Flucytosine (100 mg/kg/day PO) for 2 weeks. ICP Management: Administer IV Dexamethasone or Mannitol to rapidly reduce cerebral edema and lower intracranial pressure. ART Timing: Initiate Antiretroviral Therapy (ART) immediately within the first 7 days to rapidly restore cellular immunity and clear the infection.
B. Induction: High-dose Fluconazole (1200 mg/day PO) monotherapy for 2 weeks to safely penetrate the blood-brain barrier. ICP Management: Administer Acetazolamide to decrease CSF production, avoiding invasive procedures. ART Timing: Delay ART initiation for 4 to 6 weeks to prevent Immune Reconstitution Inflammatory Syndrome (IRIS).
C. Induction: Liposomal Amphotericin B (3-4 mg/kg/day IV) + Flucytosine (100 mg/kg/day PO) for 2 weeks, followed by Fluconazole consolidation. ICP Management: Perform daily serial therapeutic lumbar punctures (draining 20-30 mL) until the opening pressure is consistently <200 mm H₂O. ART Timing: Delay ART initiation for 4 to 6 weeks to prevent fatal Immune Reconstitution Inflammatory Syndrome (IRIS).
D. Induction: Liposomal Amphotericin B (3-4 mg/kg/day IV) + Flucytosine (100 mg/kg/day PO) for 2 weeks. ICP Management: Consult neurosurgery immediately for the placement of a ventriculoperitoneal (VP) shunt to permanently relieve the 340 mm H₂O pressure. ART Timing: Delay ART initiation for 6 months until the CD4 count naturally recovers to >100 cells/μL.
C. Induction: Liposomal Amphotericin B (3-4 mg/kg/day IV) + Flucytosine (100 mg/kg/day PO) for 2 weeks, followed by Fluconazole consolidation. ICP Management: Perform daily serial therapeutic lumbar punctures (draining 20-30 mL) until the opening pressure is consistently <200 mm H₂O. ART Timing: Delay ART initiation for 4 to 6 weeks to prevent fatal Immune Reconstitution Inflammatory Syndrome (IRIS).