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Reviewer Finals

Reviewer Finals

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Published by: 2013SecB on Mar 17, 2011
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02/03/2013

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MEDICINE I 
1.
 
Patient presents with critical ischemia, rest pain and tissue loss on thelower extremities because of arterial occlusion. What is the most probable ankle-brachial index of the patient?a.
 
> 1 c. < 0.9b.
 
< 0.6 d. < 0.32.
 
The following are true in examining the Jugular venous pulse except:a.
 
Right Jugular vein is used best b.
 
Simultaneous palpation of the left carotid artery aids in relatingthe venous pulsation to their timing in cardiac cyclec.
 
In decreased venous pressure, it may be necessary to elevatetrunk further to as much as 90 degreesd.
 
Tangential lighting is used to expose the pulsations3.
 
Positive wave produced by the bulging of the tricuspid valve into the RAduring RV isovolumetric systole and by the impact of the carotid artery adjacent to the jugular vein?a.
 
A wave c. v waveb.
 
C wave d. x descent 4.
 
Results from the increasing volume of blood in the RA duringventricular systole when the tricuspid valve is closed?a.
 
A wave c. v waveb.
 
C wave d. x descent 5.
 
Positive presystolic wave produced by venous distention due to RAcontraction?a.
 
A wave c. v waveC wave d. x descent 6.
 
All are true in estimating CVP except:a.
 
Right internal jugular vein is the best vein used b.
 
Right external jugular vein is the best vein used c.
 
Sternal angle is used as reference point d.
 
Normally it measures less than 3 cm7.
 
Most common cause of positive abdominojugular reflux test?a.
 
Right sided HF c. Left side HF b.
 
Cardiac tamponade d. pulmonary edema8.
 
The following produce accentuated S1 except:a.
 
Tachycardia c. short PR interval b.
 
High cardiac output d. long PR interval 9.
 
S2 normally splits into audibly distinct A2 and P2 components during:a.
 
Inspiration c. left decubitus positionb.
 
Expiration d. valsalvamaneuver 10.
 
Best heard with bell of the stethoscope:a.
 
S1 & S2 c. S3 & S4b.
 
Mitral regurgitation d. friction rubs11.
 
What is the effect of Valsalvamaneuver in the length and intensity of heart murmurs of patients with HCM or MVP?a.
 
Increase c. no effect b.
 
Decrease d. variable12.
 
What is the effect of squatting in the intensity of heart murmurs of patients with HCM or MVP?a.
 
Increase c. no effect b.
 
Decrease d. variable13.
 
In valvular aortic stenosis, the murmur may disappear over the sternumand reappear at the apex leaving a false impression that mitral regurgitation is present. What is this phenomenon?a.
 
Mammary soufflé c. Gallavardin effect b.
 
Carvallo Sign d. Still¶s murmur 14.
 
Which of the following will produce a continuous murmur?a.
 
PDA c. ventricular septal defect b.
 
Mitral stenosis d. left atrial myxoma15.
 
Retrosternal pain which lasts 10-20 mins perceived as heaviness,pressure or squeezing over the chest, often associated withdiaphoresis, dyspnea and nausea, which occurs even at rest and isunrelieved by nitroglycerin?a.
 
Stable angina c. esophageal spasmb.
 
Unstable angina d. pulmonary embolism16.
 
Sharp, knifelike pain, aggravated by inspiration or coughing whichresult from lung disease that damage and cause inflammation of thepleura of the lungs?a.
 
Pneumonia c. pericarditisb.
 
Pneumothorax d.pulmonary embolism17.
 
Sudden onset of pleuritic chest pain and respiratory distress which may occur without a precipitating event in persons without lung disease or as a consequence of underlying lung disorder?a.
 
Pneumonia c. pericarditisb.
 
Pneumothorax d.pulmonary embolism18.
 
Abrupt onset of unrelenting, tearing or ripping sensation, sometimesknifelike, often radiating to the back?a.
 
Pericarditis c. aortic dissectionb.
 
Herpes zoster d. pulmonary embolism19.
 
Sharp or burning chest pain that has a dermatomal distribution?a.
 
Pericarditis c. chicken pox b.
 
Herpes zoster d. syphilis20.
 
Retrosternal pain lasting more than 30 mins perceived as heaviness or pressure over the cheast and unrelieved by nitroglycerin?a.
 
Stable angina c. acute MI b.
 
Aortic stenosis d. pulmonary embolism21.
 
Type of syncope occurring during cough, micturition, deglutition and defecation?a.
 
Glossopharyngeal neuralgia c. neurocardiogenic syncopeb.
 
Reflex syncope d. situational syncope22.
 
Associated with both sympathetic withdrawal (vasodilatation) and increased parasympathetic activity (bradycardia)?a.
 
Vasovagal syncope c. pure autonomic syncopeb.
 
Vasodepressor syncope d. orthostatic syncope23.
 
Syncope that is gradual in onset, precipitated by hot environment,extreme fatigue, pain, hunger or stress where sphincter control ismaintained and relieved by lying down?a.
 
Neurocardiogenic c. carotid sinus hypersensitivity b.
 
Psychogenic d. situational syncope24.
 
Syncope that is not accompanied by facial pallor and not relieved by recumbency but can be reproduced by hyperventilation?a.
 
Hysterical fainting c. Anxiety attacksb.
 
Stokes-Adams Syndrome d. Wolff-Parkinson-White syndrome25.
 
The following results from ventilatory pump dysfunction except:a.
 
Kyphoscoliosis c. anemiab.
 
GBS d. asthma26.
 
The following results from controller dysfunction except:a.
 
Pregnancy c. high altitudeb.
 
Pneumonia d. drug induced 27.
 
The following are low cardiac output dyspnea except:a.
 
Anemia c. nonischemic cardiomyopathiesb.
 
Coronary artery dse d. myocardial ischemia28.
 
Which of the following results in normal cardiac output dyspnea?a.
 
CAD c. cardiovascular deconditioningb.
 
L
R intracardiac shunt d. systolic dysfunction29.
 
A type of pulmonary edema with normal hydrostatic pressures, and results from damage to pulmonary capillary lining?a.
 
Cardiogenic c. physiologic b.
 
Noncardiogenic d. hydropericardium
 
30.
 
In a non-smoker who has normal chest readiograph and is not takingACE inhibitor, the most common causes of chronic cough are thefollowing except:a.
 
Infection c. postnasal dripb.
 
Asthma d. GERD31.
 
Acute cough lasts for about:a.
 
<4 weeks c. <2 weeksb.
 
<3 weeks d. <1 week 32.
 
Chronic cough lasts for about:a.
 
>5 weeks c. >7 weeksb.
 
>6 weeks d. >8 weeks33.
 
Massive hemoptysis involves expectoration of how much blood over a24 hour period?a.
 
> 25 mL c. >75 mLb.
 
> 50 mL d. >100 mL34.
 
Most common cause of respiratory hypoxia?a.
 
V/Q mismatch c. L
R shuntingb.
 
anemia d. asthma35.
 
For cyanosis to occur, reduced Hb should be elevated to how much?a.
 
> 2 g/dL c. > 8 g/dLb.
 
>5 g/dL d. >10 g/dL36.
 
Results from arterial desaturation?a.
 
Central cyanosis c. clubbingb.
 
Peripheral cyanosis d. hypoxia37.
 
Selective bulbous enlargement of the distal segments of the fingers dueto proliferation of connective tissues, particularly on the dorsal surface?a.
 
Callous formation c. Reynaud¶s phenomenonb.
 
Clubbing d. arthritis38.
 
Unusual awareness of heartbeat that may be intermittent thumping,pounding or fluttering sensation?a.
 
Palpitation c. skip beatsb.
 
Angina d. panic attack 39.
 
Most common cause of palpitation?a.
 
Cardiac c. miscellaneousb.
 
Psychiatric d. unknown40.
 
Gross or generalized edema?a.
 
Ascites c. myxedemab.
 
Hydrothorax d.anasarca41.
 
Which of the following promotes movement of fluid from the vascular tothe extravascular space?a.
 
Capillary hydrostatic pressureb.
 
Capillary colloid oncotic pressurec.
 
Interstitial hydrostatic pressured.
 
B & C 42.
 
Multiple peripheral arteriovenous fistulae result in reduced effectivesystemic perfusion and effective arterial blood volume thereby enhancing edema formation?a.
 
Beriberi heart disease c. Edema of Nephrotic syndromeb.
 
Refeedingedema d. Edema of Cirrhosis43.
 
Apical impulse is normally found where?a.
 
th
RICS, 7-9cm lateral to midaxillary lineb.
 
th
LICS, 7-9cm lateral to midsternal linec.
 
th
LICS, midclavicular lined.
 
th
LICS, anterior axillary line44.
 
LV hypertrophy has a PMI measuring:a.
 
> 1.5 cm c. > 2.5 cmb.
 
> 2.0 cm d. > 3.0 cm45.
 
Most prominent palpable impulse at xiphoid or epigastric area?a.
 
LV hypertrophy c. pulmonary HPN b.
 
RV hypertrophy d. cardiac tamponade46.
 
Which of the following is closed during diastole?a.
 
Mitral valve c. semilunar valveb.
 
Tricuspid valve d. fossa ovale47.
 
Borders of Precordiuma.
 
nd 
to 5 
th
ICS from right border of sternum to left midclavicular line
th
to 6 
th
ICS b.
 
nd 
to 5 
th
ICS from right border of sternum to left midclavicular line
th
to 7 
th
ICS c.
 
3
rd 
to 5 
th
ICS from right border of sternum to left midclavicular line
th
to 6 
th
ICS d.
 
3
rd 
to 5 
th
ICS from right border of sternum to left midclavicular line
th
to 7 
th
ICS 48.
 
At HR < 100 bpm, what is the relationship of diastole with regards tosystole?a.
 
Greater c. equal b.
 
Lesser d. no relationship49.
 
At HR > 100 bpm, what is the relationship of diastole with regards tosystole?a.
 
Greater c. equal b.
 
Lesser d. no relationship50.
 
Occurs at the onset of systole, during which a contraction is occurringin the ventricles but there is no emptying?a.
 
rapid filling c. ejectionb.
 
isovolumetric contraction d. isovolumetric relaxation51.
 
At the end of systole, ventricular relaxation begins suddenly and theelevated pressures in the large arteries snaps the semilunar closed.The ventricular muscles continues to relax even though ventricular volume does not change?a.
 
Rapid filling c. ejectionb.
 
Isovolumetric contraction d. isovolumetric relaxation52.
 
The following increases the preload except:a.
 
Inspiration c. exerciseb.
 
Exhalation d. increase venous return53.
 
Blood pressure is the product of?a.
 
CO & TPR c. SV & TPRb.
 
CO & SV d. CO, SV & TPR54.
 
The following are true except:a.
 
Internal jugular pulsation is rarely palpableb.
 
Height of carotid pulsation is not affected by inspirationc.
 
Internal jugular pulsation is eliminated by light pressured.
 
Carotid pulsation are soft, biphasic, undulating quality with 2 elevations and 2 troughs per heart beat 55.
 
Increased arterial pulse with a double systolic peak a.
 
Bisferiens pulse c. bigeminal pulseb.
 
Pulsusalternans d. paradoxical pulse56.
 
Palpable decrease in the pulse amplitude on quiet respiration, SBP decreases by >10 mmHg during inspirationa.
 
Bisferiens pulse c. bigeminal pulseb.
 
Pulsusalternans d. paradoxical pulse57.
 
Humming vibration that feel like the throat of a purring cat a.
 
Bruit c. heavesb.
 
Lift d. thrill 58.
 
Soft decreascendo diastolic murmurs of aortic insufficiency isaccentuated in which of the following maneuver?a.
 
Supine c. standingb.
 
Left lateral decubitus d. leaning forward after exhalation59.
 
Opening snap, S3 and diastolic rumble of mitral stenosis areaccentuated in which of the following maneuver?a.
 
Supine c. standingb.
 
Left lateral decubitus d. leaning forward after exhalation
 
60.
 
Decreased P2 intensity a.
 
Pulmonary hypertension c. calcific aortic stenosisb.
 
Pulmonic stenosis d. systemic hypertension61.
 
Increase A2 intensity a.
 
Pulmonary hypertension c. calcific aortic stenosisb.
 
Pulmonic stenosis d. systemic hypertension62.
 
Occur shortly after S1 coincident with opening of the aortic and pulmonic valves. Usually high pitch, sharp and with clicking quality a.
 
Early systolic ejection sound c. systolic clicksb.
 
Opening snap d. Atrial Gallop63.
 
Very early diastolic sound produced by opening of stenotic mitral valvea.
 
Early systolic ejection sound c. systolic clicksb.
 
Opening snap d. atrial gallop64.
 
Occurs just before S1, dull and low in pitch which is due to increased resistance to ventricular filling following atrial contractiona.
 
Ventricular gallop c. summation gallopb.
 
Opening snap d. atrial gallop65.
 
Holosystolic murmur at the apex, medium to high pitch that is soft toloud in intensity with apical thrill.a.
 
Mitral regurgitation c. ventricular septal defect b.
 
Tricuspid regurgitation d. aortic regugitation66.
 
Pansystolic murmur heard over the 3
rd 
, 4
th
and 5 
th
LICS, that is oftenloud and high pitch.a.
 
Mitral regurgitation c. ventricular septal defect b.
 
Tricuspid regurgitation d. aortic regugitation67.
 
Turbulent blood flow generated by ventricular ejection of blood into theaorta with no underlying cardiovascular diseasea.
 
Innocent mumur c. aortic stenosisb.
 
Physiologic murmur d. aortic regugitation68.
 
Midsystolic Murmur heard over the right ICS, medium to high pitch,crescendo decrescendo type.a.
 
Innocent mumur c. aortic stenosisb.
 
Mitral regurgitation d. aortic regurgitation69.
 
Diastolic murmur heard over the 2 
nd 
to 4
th
ICS, high pitch that is blowingdecrescendo type.a.
 
Innocent murmur c. aortic stenosisb.
 
Mitral regurgitation d. aortic regurgitation70.
 
Paradoxical Angina occurring during rest but usually not duringexervise caused by coronary artery spasm.a.
 
Stable Angina c. Pritzmetal Anginab.
 
Atypical angina d. Unstable Angina71.
 
Abdomen with General distented contour with inverted umbilicusa.
 
Chronic ascites c. obesity b.
 
Umbilical hernia d. malnutrition72.
 
Normoactive bowel sound a.
 
<5/min c. <5 / 5 minb.
 
5 ± 34 / min d. 5-34 / 5 min73.
 
Decreased bowel sound a.
 
Diarrhea c. ileusb.
 
Early pyloric obstruction d. early intestinal obstruction74.
 
Frequent bowel sound due to early intestinal obstructiona.
 
Tinkles c. succusion splashb.
 
Rushes d. peritoneal friction rub75.
 
Pain occurring at the site of pressurea.
 
Blumberg¶s sign c. markles¶ signb.
 
Rovsing¶s sign d. cullen¶s sign76.
 
Stand on toes and suddenly relax causing heels to hit the floor and eliciting paina.
 
Blumberg¶s sign c. markles¶ signb.
 
Rovsing¶s sign d. cullen¶s sign77.
 
Place hand above patient¶s knes and raise his thigh to elicit paina.
 
Rebound tenderness c. psoas signb.
 
Jar tenderness d. obturator sign78.
 
Inspiratory arrest seen in acute cholecystitis upon placing right hand onliver border a.
 
Middleton maneuver c. ballotment b.
 
Murphy¶s sign d. markle¶s sign79.
 
Normal liver span (mid clavicular line)a.
 
4-8 cm c. 6 ± 10 cmb.
 
6-12 cm d. 8 -12 cm80.
 
Meatus of penis on ventral surfacea.
 
Hypospadias c. phimosisb.
 
Epispadias d. hydrocele81.
 
Enlargement of spermatic cord that feels like a bag of wormsa.
 
Hypospadias c. phimosisb.
 
Epispadias d. varicocele82.
 
Steady and aching abdominal pain accentuated by pressure changes inthe peritoneuma.
 
Peritonitis c. cholangitisb.
 
Pancreatitis d. colonic obstruction83.
 
Dull suprapubic pain usually low in intensity associated with restless of no specific complaina.
 
Urinary bladder obstruction c. pacreatitisb.
 
Bilary tree obstruction d. peritonitis84.
 
Occur in dieases that injure sensory nerves which is burning incharacter, limited to the distribution of the peripheral nerve and demonstration of irregularly spaced cutaneous pain spotsa.
 
Causalgic pain c. functional causeb.
 
Spinal nerve pain d. metabolic abdominal crisis85.
 
Sensation of lump lodged in the throat with no difficulty encountered whens swallowinga.
 
Aphagia c. phagophobiab.
 
Globus pharyngeus d. odynophagia86.
 
Inhibitory innervation of both esophageal body and LES is impaired a.
 
Aphagia c. achalasiab.
 
Globus pharyngeus d. diffuse esophageal spasm87.
 
Inhibitory innervation only to the esophageal body is impaired a.
 
Aphagia c. achalasiab.
 
Globus pharyngeus d. diffuse esophageal spasm88.
 
Rare disorder of unknown etiology that produces periodic discreteepisodes of relentless nausea and vomiting, common in children.a.
 
Intestinal pseudoobstruction c. functional vomitingb.
 
Chronic idiophatic nausea d. cyclic vomiting syndrome89.
 
Severe form of nausea of pregnancy a.
 
Hyperemesis gravidarum c. hyperemesis neonatarumb.
 
Functional vomiting d. idiopathic nausea90.
 
Cyclical event which characterizes motility of SI during fastinga.
 
MMC c. HAPC b.
 
Phasic contraction d. colonic tone91.
 
Average transit time of the ascending and transverse colona.
 
10 h c. 20 hb.
 
15 h c. 25 h92.
 
Average transit time of descending colona.
 
1 h c. 3 hb.
 
2 h d. 4h93.
 
Causes diarrhea after eating chicken except a.
 
Salmonella c. campylobacter b.
 
Shigella d. citrobacter 94.
 
Causes diarrhea from eating mayonnaisea.
 
Gardia c. rotavirus

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