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Internal Medicine board questions

Internal Medicine board questions

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Published by: Romberg's sign on Oct 26, 2011
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01/12/2014

 
INTERNAL MEDCINE
1.
The treatment of choice for anemia of chronic renal disease:a.Ferrous sulfateb.Folic acid
c.Erythropoetin
d.blood transfusionAnswer: CP. 1658
2.
A patient was brought to the ER in a comatose state. Serumelectrolytes drawn on admission showed the following: Na+ 133 meq/L,K + 8.0 meq?l, Cl 98 meq/L, HCO3 13 meq?L. ECG showed absent Pwaves, widend QRS and peaked T waves. Which would b the motappropriate initial step:a.Repeat electrolyte measurement and observeb.Attempt cardioversion
c.Administer intravenous calcium gluconate
d.Administer sodium polystyrene sulfonate (Kayexelate)Answer: CP. 262
3.
Low serum complement level would be seen in patients withhematuria, proteinuria and hypertension resulting from all of thefollowing, EXCEPT:a.Mixed essential cryoglobulinemiab.Hepatitis C associated membranoproliferativeglomerulonephritisc.Diffuse proliferative lupus nephritis
d.Henoch-Schonlein purpura
Answer: D P. 16804.A 37 y.o. man is admitted with confusion. PE showed a BP of 140/70with no orthostatic changes, normal jugular venous pressure and noedma. Serum chemistries are notable for Na+ 120 meq/L, K + 4.2meq/L, HCO3 24 meq/L and a uric acid of 2 mg/L. The most likelydiagnosis is:a.Hepatic cirrhosis
b.SIADH
c.Addison’s diseased.Severe vomiting and diarrhesAnswer: Bp. 2565.TRUE statement/s about acute poststreptococcal glomerulonephritis(PSGN) EXCEPT:a.The latent period appears to be longer when PSGN isassociated with cutaneous rather than pharyngeal infectionb.Serologic tests for a streptococcal infection may be negative iantimicrobial therapy is begun earlyc.PSGN leads to permanent and progressive renal insufficiencymore often in adults than in children
d.Long-term antistreptococcal prophylaxis is indicated after documented cases of PSGN.
Answer: Dp. 1680-1681
1
 
6.
The
a
wave of the jugular venous pulse (JVP) represents:a.right ventricular contraction
b.right atrial contraction
c.ventricular septal defectd.atrial septal defect7.One of the following is not true in the assessment of acute GI Bleeding:
a.The presence of large quantities of bright red blood per rectum rules out the source before the ligament of Treitz
b.Melena almost always represents UGIBc.Black stools can be caused by lesions in the colond.A bilous NGT return flow in a patient who just had hematocheziarules out an upper GI source of hemorrhage8.Which of the following is true regarding gastric ulcer?a.presence of gastric acid excludes malignancyb.weight loss is distinctively unusual in benign ulcer c.ulcers along the greater curve favor malignancy
d.coexisting duodenal ulcers favor benign nature of gastriculcer 
9.A 55-year-old diabetic patient presents with heartburn and acidiceructation for 2 years. Endoscopic biopsy of a patch of hyperemicmucosa 3 cm. above the gastroesophageal junction showed squamousepithelium with inflammatory cells. The patient most likely has:a.Barrett’s esophagus
 b.
Gastroesophageal reflux disease
c.Candidal esophagitisd.Herpes simplex esophagitis10.Which of the following statements does NOT describe secretorydiarrhea?a.Diarrhea continues during fasting
b.Stools are scanty and mucoid
c.Fecal fat is lowd.Cholera can cause it11.A 16-year-old male patient presenting with hepatitis syndrome has thefollowing serologic exam findings:(+) HBsAG(-) Anti-HBe(+) HBeAG(+) Anti-HAVIgm(+) Anti HBclgM(-) AntiHBclgGThe patient most likely has
a.Acute Hepatitis A and Acute Hepatitis B simultaneousinfection
b.Acute Hepatitis A superimposed on Chronic Hepatitis B in thereplicative phasesc.Acute Hepatitis A superimposed on Chronic Hepatitis B in thenon-replicative phased.Acute Hepatitis A; a previous immunization to Hepatitis B12.The most common organism isolated from the ascitic fluid of patientswith spontaneousbacterial peritonitis is:a.Streptococcus pneumoniaeb.Staphylococcus aureus
c.Escherichia coli
d.Bacteroides fragilis
2
 
13.True of Ascaris infestation:a.may cause ground itchb.Loeffler’s pneumonitis results from allergy to ascaris eggs
c.adult worms reside mostly in the small intestines
d.the drug of choice in biliary ascariasis is Mebendazole becauseit paralyzes the worms and prevents their further migration14.Which of the following risk factors has been directly associated withBronchogenic Carcinoma?a.Asbestos exposureb.Aflatoxin ingestion
c.Cigarette smoking
d.Chronic Bronchitis15.This group of drugs reduce airway inflammation in bronchial asthma:a.Catecholaminesb.Methylxanthines
c.Clucocorticoids
d.Anticholinergics16.The American Thoracic Society defines chronic bronchitis aspersistence of cough and excessive mucus production for most daysout of 3 months for ________ successive years:
a.2
b.3c.4d.517.A patient with CAP requires hospitalization when one of the following ispresent:a.age < 65 years old
b.COPD in exacerbation
c.temperature of 38.5Cd.unilobar CXR infiltrate18.One of the following is NOT a useful clue to the microbial etiology of CAP (Community Acquired Pneumonia)
a.edentulous persons likely to develop pneumonia due toanaerobes
b.susceptible people exposed to an infectious aerosol inLegionellosisc.patients with severe hypogammaglobulinemia at risk of infectionwith S. pneumoniaed.anaerobic lung abscess occuring in patients prone to aspiration
19.
In a patient suspected of PTE, presence of this symptom heralds theoccurence of pulmonary infarction:a.unexplained dyspnea
b.hemptysis
c.sudden onset of coughd.syncope
3

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