a

Subject Pearls
Internal Medicine Topnotch Board Prep July 2011

Cardiology a
Which of the following are part of preload? a a. b. c. d. e. Atrial contraction Venous tone Elasticity of the arterial tree Resistance of systemic vasculature Pumping of the skeletal muscles

Cardiology a
Which of the following are part of preload? a a. b. c. d. e. Atrial contraction Venous tone Elasticity of the arterial tree Resistance of systemic vasculature Pumping of the skeletal muscles

Cardiology a
a Preload: Atrium PrOVideS Blood Atrial contraction Distribution of Blood Volume Intrathoracic/Intrapericardial pressure Orthostasis Venous Tone Skeletal muscle pumping Amount of Blood Volume

Cardiology a
a Afterload: VenTRicles ReSeiVE Blood Ventricular Wall Tension Ventricular radius

Cardiology a
a Which of the following is a state of HighOutput failure? a. b. c. d. Selenium deficiency Orthostasis Anemia Diabetes Mellitus

Cardiology a
a Which of the following is a state of HighOutput failure? a. b. c. d. Selenium deficiency Orthostasis Anemia Diabetes Mellitus

Cardiology a
What is the initiating event in heart failure? a a. b. c. d. LV dysfunction Decreased output Activation of RAAS Release of Anti-Diuretic Hormone

Cardiology a
What is the initiating event in heart failure? a a. b. c. d. LV dysfunction sine qua non Decreased output Activation of RAAS Release of Anti-Diuretic Hormone

Cardiology a
a Heart failure patients who are warm and wet should receive which treatment? a. b. c. d. Diuretics and vasodilators Inotropes and vasodilators Cautious fluid repletion None, search for causes other than heart failure

Cardiology a
a Heart failure patients who are warm and wet should receive what treatment? a. b. c. d. Diuretics and vasodilators Inotropes and vasodilators Cautious fluid repletion None, search for causes other than heart failure

Cardiology a
a The following are part of the nonpharmacologic management of heart failure EXCEPT? a. Exercise up to functional class III b. Sodium restriction < 2-3 grams daily c. Fluid restriction in hyponatremic patients (Na < 130) d. Vitamin supplementation

Cardiology a
a The following are part of the nonpharmacologic management of heart failure EXCEPT? a. Exercise up to functional class III b. Sodium restriction < 2-3 grams daily c. Fluid restriction in hyponatremic patients (Na < 130) d. Vitamin supplementation

Cardiology a
a 3 Rules of 3 in Heart Failure

1st rule of 3s: LV DySfunction 2nd rule of 3s: Retics, RAAS blockers, Rate controllers 3rd rule of 3s: Excess Salty Fluid

Cardiology a
a regurgitant aortic valve would produce A which of the following murmurs?

a. b. c. d.

Systolic murmur, 2nd ICS Right PSB Diastolic murmur, 2nd ICS Right PSB Systolic murmur, 2nd ICS Left PSB Diastolic murmur, 2nd ICS Left PSB

Cardiology a
a regurgitant aortic valve would produce A which of the following murmurs?

a. b. c. d.

Systolic murmur, 2nd ICS Right PSB Diastolic murmur, 2nd ICS Right PSB Systolic murmur, 2nd ICS Left PSB Diastolic murmur, 2nd ICS Left PSB

Cardiology a
a Which of the following patients should receive prophylaxis against infective endocarditis?

a. Patients with Cyanotic Congenital Heart Disease b. Patients with Prosthetic Heart Valves c. Patients with prior Endocarditis d. All of the above

Cardiology a
a Which of the following patients should receive prophylaxis against infective endocarditis?

a. Patients with Cyanotic Congenital Heart Disease b. Patients with Prosthetic Heart Valves c. Patients with prior Endocarditis d. All of the above

Cardiology a
Hypertrophic cardiomyopathy is present in a which of the following?

a. b. c. d.

Keshans Disease Fabry disease Carcinoid Disease Sarcoidosis

Cardiology a
Hypertrophic cardiomyopathy is present in a which of the following?

a. b. c. d.

Keshans Disease Dilated CMP Fabry disease Carcinoid Disease Restrictive CMP Sarcoidosis Restrictive CMP

Cardiology a
A 54 year-old male diabetic presents to the a emergency room with chest tightness. What is the first diagnostic test that should be done? a. b. c. d. Treadmill exercise Test 2D-Echo 12-L ECG Coronary angiography

Cardiology a
A 54 year-old male diabetic presents to the a emergency room with chest tightness. What is the first diagnostic test that should be done? a. b. c. d. Treadmill exercise Test 2D-Echo 12-L ECG (followed by Cardiac Enzymes) Coronary angiography

Cardiology a
The previous patients chest pain may be a classified as unstable if it has following characteristics EXCEPT a. The pain occurs at rest b. The pain lasts for > 10 minutes c. The pain occurred for the first time 5 months ago d. The pain is more prolonged and frequent

Cardiology a
The previous patients chest pain may be a classified as unstable if it has following characteristics EXCEPT a. The pain occurs at rest b. The pain lasts for > 10 minutes c. The pain occurred for the first time 5 months ago within 4 to 6 weeks d. The pain is more prolonged and frequent

Pulmonology a
a Obstructive respiratory disease will have what particular lung volume pattern?

a. Decreased Vital Capacity b. Same residual volume c. Decreased vital capacity and residual volume d. Increased vital capacity and residual volume

Pulmonology a
a Obstructive respiratory disease will have what particular lung volume pattern?

a. Decreased Vital Capacity b. Same residual volume c. Decreased both vital capacity and residual volume d. Increased both vital capacity and residual volume

Pulmonology a
a What is the mechanism of hypoxia in Atelectasis?

a. b. c. d.

Hypoventilation Low inspired FiO2 Shunt V/Q mismatch

Pulmonology a
a What is the mechanism of hypoxia in Atelectasis?

a. b. c. d.

Hypoventilation Low inspired FiO2 Shunt V/Q mismatch

Pulmonology a
What is the most common allergen that can a trigger an asthma exacerbation?

a. b. c. d.

Viral Upper respiratory tract infection Dermatophagoides spp Aspirin Food additives

Pulmonology a
What is the most common allergen that can a trigger an asthma exacerbation?

a. b. c. d.

Viral Upper respiratory tract infection Dermatophagoides spp dust mite Aspirin Food additives

Pulmonology a
Tap water lung is caused by which agent? a

a. b. c. d.

Thermophilic actinomycetes Mycobacteria spp Aspergillus spp Penicillium casei

Pulmonology a
Tap water lung is caused by which agent? a

a. b. c. d.

Thermophilic actinomycetes Mycobacteria spp Aspergillus spp Penicillium casei

Pulmonology a
a A 32 year-old male alcoholic develops pneumonia. What is the most likely etiology?

a. b. c. d.

Legionella Pseudomonas aeruginosa Streptococcus pneumoniae Oral anaerobes

Pulmonology a
a A 32 year-old male alcoholic develops pneumonia. What is the most likely etiology?

a. b. c. d.

Legionella Pseudomonas aeruginosa Streptococcus pneumoniae Oral anaerobes

Pulmonology a
a Risk factors for Pseudomonas in the Philippine CAP 2010 guidelines EXCEPT

a. b. c. d.

COPD Malnutrition Chronic steroid use of at least 5 mg/day Previous antibiotic use for 7 days in the past month

Pulmonology a
a Risk factors for Pseudomonas in the Philippine CAP 2010 guidelines EXCEPT

a. b. c. d.

COPD Malnutrition Chronic steroid use of at least 5 mg/day Previous antibiotic use for 7 days in the past month

Pulmonology a
aWhich imaging study provides the best assessment of extent and distribution of interstitial lung disease?

a. b. c. d.

Biopsy Chest X-ray Chest CT Scan Spirometry

Pulmonology a
aWhich imaging study provides the best assessment of extent and distribution of interstitial lung disease?

a. b. c. d.

Biopsy Chest X-ray Chest CT Scan Spirometry

Pulmonology a
a Among the following interstitial lung diseases, which one has the worst prognosis?

a. b. c. d.

Idiopathic Pulmonary Fibrosis Non-specific Interstitial Pneumonia Acute Interstitial Pneumonia Desquamative Interstitial Lung Disease

Pulmonology a
a Among the following interstitial lung diseases, which one has the worst prognosis?

a. b. c. d.

Idiopathic Pulmonary Fibrosis Non-specific Interstitial Pneumonia Acute Interstitial Pneumonia Hamman-Rich Syndrome Desquamative Interstitial Lung Disease

Pulmonology a
The following are mainly caused by trauma, a EXCEPT

a. b. c. d.

Chylothorax Hemothorax Subcutaneous emphysema Primary spontaneous Pneumothorax

Pulmonology a
The following are mainly caused by trauma, a EXCEPT

a. b. c. d.

Chylothorax Hemothorax Subcutaneous emphysema Primary spontaneous Pneumothorax

Pulmonology a
a What is the most common ECG abnormality in patients with pulmonary embolism?

a. b. c. d.

Right axis deviation S1Q3T3 T-wave inversion V1-4 Sinus tachycardia

Pulmonology a
a What is the most common ECG abnormality in patients with pulmonary embolism?

a. b. c. d.

Right axis deviation S1Q3T3 T-wave inversion V1-4 Sinus tachycardia

Pulmonology a
a The presence of a Graham-Steell murmur in a patient with Cor Pulmonale indicates a defect in which valve?

a. b. c. d.

Tricuspid Pulmonary Mitral Aortic

Pulmonology a
a The presence of a Graham-Steell murmur in a patient with Cor Pulmonale indicates a defect in which valve?

a. b. c. d.

Tricuspid Carvallos sign Pulmonary Mitral Aortic Austin-Flint murmur

Pulmonology a
a is the only grade A recommendation in What the management of Acute Respiratory Distress Syndrome?

a. b. c. d.

Low Tidal Volume Minimization of LA Filling Pressure Prone Positioning Aspiration Precautions

Pulmonology a
a is the only grade A recommendation in What the management of Acute Respiratory Distress Syndrome?

a. b. c. d.

Low Tidal Volume Minimization of LA Filling Pressure (B) Prone Positioning Aspiration Precautions

Pulmonology a
In patients with Acute Respiratory Distress a Syndrome, weaning from ventilation is expected earliest by when?

a. b. c. d.

After 1 week After 2 weeks After 3 weeks After 4 weeks

Pulmonology a
In patients with Acute Respiratory Distress a Syndrome, weaning from ventilation is expected earliest by when?

a. b. c. d.

After 1 week After 2 weeks After 3 weeks After 4 weeks

Allergy, Immunology and Rheumatology a

a A patient consults at the Emergency Room for wheals, swelling of the face and difficulty breathing. What is the hallmark of the patients condition?

a. b. c. d.

Urticaria Angioedema Response to Epinephrine Onset of symptoms within seconds to minutes of exposure

Allergy, Immunology and Rheumatology a

a A patient consults at the Emergency Room for wheals, swelling of the face and difficulty breathing. What is the hallmark of the patients condition?

a. b. c. d.

Urticaria Angioedema Response to Epinephrine Onset of symptoms within seconds to minutes of exposure (History is gold std)

Allergy, Immunology and Rheumatology a

a Which of the following is the LEAST priority in treating urticaria?

a. b. c. d.

Loratadine Ranitidine Mometasone Diphenhydramine

Allergy, Immunology and Rheumatology a

a Which of the following is the LEAST priority in treating urticaria?

a. b. c. d.

Loratadine Ranitidine adjunct to H1-blockers Mometasone Diphenhydramine

Allergy, Immunology and Rheumatology a

Which is NOT a criterion of Systemic Lupus a Erythematosus?

a. Fixed malar erythema with nasolabial fold sparing, and does not cross the nasal bridge b. Arthritis in the presence of a normal joint Xray c. Leukopenia < 4,000 d. Proteinuria of 0.5 g/d

Allergy, Immunology and Rheumatology a

Which is NOT a criterion of Systemic Lupus a Erythematosus?

a. Fixed malar erythema with nasolabial fold sparing, and does not cross the nasal bridge b. Arthritis in the presence of a normal joint Xray c. Leukopenia < 4,000 d. Proteinuria of 0.5 g/d

Allergy, Immunology and Rheumatology a

a Which of the following must be present for at least 6 weeks to qualify as a criterion for Rheumatoid Arthritis? a. Rheumatoid nodules b. Rheumatoid factor c. Radiologic changes d. Arthritis of the hand joints

Allergy, Immunology and Rheumatology a

a Which of the following must be present for at least 6 weeks to qualify as a criterion for Rheumatoid Arthritis? a. Rheumatoid nodules b. Rheumatoid factor c. Radiologic changes d. Arthritis of the hand joints

Allergy, Immunology and Rheumatology a

a Which of the following is a major criterion for Acute Rheumatic Fever?

a. b. c. d.

Polyarthritis Fever Prolonged PR interval Positive ASO

Allergy, Immunology and Rheumatology a

a Which of the following is a major criterion for Acute Rheumatic Fever?

a. b. c. d.

Polyarthritis Fever Prolonged PR interval Positive ASO

Allergy, Immunology and Rheumatology a

a Systemic sclerosis affects all parts of the body. Involvement of which organ system is the leading cause of death in this disease? a. b. c. d. Lungs Heart Kidneys Brain

Allergy, Immunology and Rheumatology a

a Systemic sclerosis affects all parts of the body. Involvement of which organ system is the leading cause of death in this disease? a. b. c. d. Lungs Heart Kidneys Brain

Allergy, Immunology and Rheumatology a

aWhat is the sine qua non of ankylosing spondylitis?

a. b. c. d.

Sacroiliitis Bamboo spine Positive Schober test Limitation of chest expansion

Allergy, Immunology and Rheumatology a

aWhat is the sine qua non of ankylosing spondylitis?

a. b. c. d.

Sacroiliitis Bamboo spine Positive Schober test Limitation of chest expansion

Allergy, Immunology and Rheumatology a

A 24 year-old male was diagnosed to have a Reactive Arthritis. Which of the following is not among its common causative agents? a. b. c. d. Shigella Campylobacter Chlamydia Gonorrhea

Allergy, Immunology and Rheumatology a

A 24 year-old male was diagnosed to have a Reactive Arthritis. Which of the following is not among its common causative agents? a. b. c. d. Shigella Campylobacter Chlamydia Gonorrhea

Allergy, Immunology and Rheumatology a

A 32 year-old sales lady complains of foot a pain. On examination and biopsy, several arteries, veins and venules have inflammation. Which condition has been ruled out?

a. b. c. d.

Churg-Strauss Syndrome Polyarteritis Nodosa Behcets Syndrome Wegeners Granulomatosis

Allergy, Immunology and Rheumatology a

A 32 year-old sales lady complains of foot a pain. On examination and biopsy, several arteries, veins and venules have inflammation. Which condition has been ruled out?

a. b. c. d.

Churg-Strauss Syndrome Polyarteritis Nodosa Behcets Syndrome Wegeners Granulomatosis

Allergy, Immunology and Rheumatology a

a Which organ is spared in amyloidosis? a. b. c. d. Skin Kidney Heart Brain

Allergy, Immunology and Rheumatology a

a Which organ is spared in amyloidosis? a. b. c. d. Skin Kidney Heart Brain

Allergy, Immunology and Rheumatology a

a Blue sclerae is associated with which disease? a. b. c. d. Amyloidosis Osteogenesis Imperfecta Ehler-Danlos Disease Marfan Syndrome

Allergy, Immunology and Rheumatology a

a Blue sclerae is associated with which disease? a. b. c. d. Amyloidosis Osteogenesis Imperfecta Sillence classification Ehler-Danlos Disease Marfan Syndrome Ghent criteria

Allergy, Immunology and Rheumatology a

a What is the most potent risk factor for Osteoarthritis? a. b. c. d. Age Injury Estrogen Loss Family History

Allergy, Immunology and Rheumatology a

a What is the most potent risk factor for Osteoarthritis? a. b. c. d. Age Injury Estrogen Loss Family History

Allergy, Immunology and Rheumatology a

aA 44 year-old male presents at the outpatient
department complaining of pain, erythema, and swelling of the knee but no fever. Aspiration revealed the abundance of envelope-shaped crystals. What is the diagnosis?

a. b. c. d.

Gout CPPD Deposition Disease Calcium Apatite Deposition Disease Calcium Oxalate Deposition Disease

Allergy, Immunology and Rheumatology a

aA 44 year-old male presents at the outpatient
department complaining of pain, erythema, and swelling of the knee but no fever. Aspiration revealed the abundance of envelope-shaped crystals. What is the diagnosis?

a. b. c. d.

Gout needle CPPD Deposition Disease rhomboid/rod Calcium Apatite Deposition Disease Calcium Oxalate Deposition Disease

Allergy, Immunology and Rheumatology a

a What is the most common causative agent for acute infectious arthritis? a. b. c. d. Gonorrhea Chlamydia Streptococcus Staphylococcus

Allergy, Immunology and Rheumatology a

a What is the most common causative agent for acute infectious arthritis? a. b. c. d. Gonorrhea Chlamydia Streptococcus Staphylococcus 2nd most common

Allergy, Immunology and Rheumatology a

Which structure is affected among patients a with Tennis Elbow? a. b. c. d. Lateral epicondyle Medial epicondyle Rotator cuff Knee

Allergy, Immunology and Rheumatology a

Which structure is affected among patients a with Tennis Elbow? a. b. c. d. Lateral epicondyle Medial epicondyle golfers/pitchers Rotator cuff Knee jumpers

Hematology a
Which of the following does not present with a microcytic hypochromic anemia? a. b. c. d. Anemia of Iron deficiency Anemia of Inflammation Thalassemia Anemia of Hypometabolic States

Hematology a
Which of the following does not present with a microcytic hypochromic anemia? a. b. c. d. Anemia of Iron deficiency Anemia of Inflammation Thalassemia Anemia of Hypometabolic States

Hematology a
a a. b. c. d. True about Sickle Cell Anemia It is a change in the 6th amino acid There is a shift from valine to glutamic acid Sticky cells cause arterial occlusion Hemolytic anemia is the most common manifestation

Hematology a
a a. b. c. d. True about Sickle Cell Anemia It is a change in the 6th amino acid There is a shift from valine to glutamic acid Sticky cells cause arterial occlusion Hemolytic anemia is the most common manifestation

Hematology a
a What is the treatment for alpha-thalassemia? a. b. c. d. Chronic hypertransfusions Splenectomy Pneumococcal vaccines Genetic counseling

Hematology a
a What is the treatment for alpha-thalassemia? a. b. c. d. Chronic hypertransfusions Splenectomy Pneumococcal vaccines Genetic counseling

Hematology a
a What is the only hematologic condition with an increased MCHC? a. b. c. d. Methemoglobinemia Megaloblastic anemia Hereditary Spherocytosis G6PD Deficiency

Hematology a
a What is the only hematologic condition with an increased MCHC? a. b. c. d. Methemoglobinemia Megaloblastic anemia Hereditary Spherocytosis G6PD Deficiency

Hematology a
a A patient presents with sudden-onset jaundice, tea-colored urine and anemia. On peripheral blood smear, you would expect to see the following EXCEPT a. b. c. d. Pyknocyte Bite cells Heinz bodies Auer rods

Hematology a
a A patient presents with sudden-onset jaundice, tea-colored urine and anemia. On peripheral blood smear, you would expect to see the following EXCEPT a. b. c. d. Pyknocyte Bite cells Heinz bodies Auer rods

Hematology a
a What is the gold standard for the diagnosis of Paroxysmal Nocturnal Hemoglobinuria?

a. b. c. d.

Peripheral Blood Smear Urine Hemoglobin Flow Cytometry Karyotyping

Hematology a
a What is the gold standard for the diagnosis of Paroxysmal Nocturnal Hemoglobinuria?

a. b. c. d.

Peripheral Blood Smear Urine Hemoglobin Flow Cytometry CD 55-, CD 59- cells Karyotyping

Hematology a
a What is the most common presenting symptom in a patient with aplastic anemia?

a. b. c. d.

Easy fatigability Dizziness Bleeding Infection

Hematology a
a What is the most common presenting symptom in a patient with aplastic anemia?

a. b. c. d.

Easy fatigability Dizziness Bleeding thrombocytopenia Infection

Hematology a
a In a 29 year-old male with anemia, the presence of Auer rods and elevated WBC, you also note high amounts of platelets. What is his FAB classification?

a. b. c. d.

M4 M5 M6 M7

Hematology a
a In a 29 year-old male with anemia, the presence of Auer rods and elevated WBC, you also note high amounts of platelets. What is his FAB classification?

a. b. c. d.

M4 M5 M6 M7

Hematology a
a Starry sky appearance Flower-shaped Nucleus Epstein-Barr virus HIV Skin involvement Reed-Sternberg Cell Burkitts Lymphoma Adult T-cell lymphoma Burkitts Lymphoma Burkitts Lymphoma Mycosis Fungoides Hodgkins Lymphoma

Hematology a
a Which of the following diseases is treated with DDAVP?

a. b. c. d.

Hemophilia A Hemophilia B Factor XI deficiency Von Willebrand Disease

Hematology a
a Which of the following diseases is treated with DDAVP?

a. b. c. d.

Hemophilia A Factor VIII Hemophilia B Factor IX Factor XI deficiency Von Willebrand Disease

Infectious Disease a
Which genera of influenza is responsible for a most major flu pandemics?

a. b. c. d.

A B C D

Infectious Disease a
Which genera of influenza is responsible for a most major flu pandemics?

a. b. c. d.

A (e.g H1N1 swine flu, H5N1 avian flu) B C D

Infectious Disease a
a What is the maximum length of quarantine for influenza-infected patients starting from the day of first symptoms?

a. b. c. d.

4 days 5 days 6 days 7 days

Infectious Disease a
a What is the maximum length of quarantine for influenza-infected patients starting from the day of first symptoms?

a. b. c. d.

4 days 5 days 6 days 7 days

Infectious Disease a
a What is NOT part of the treatment of tetanus? a. b. c. d. Penicillin Metronidazole Anti-toxin Brain biopsy

Infectious Disease a
a What is NOT part of the treatment of tetanus? a. b. c. d. Penicillin Metronidazole Anti-toxin Brain biopsy

Infectious Disease a
Which illness has the highest case-fatality a rate? Which causes the most rapidly lethal form of shock in humans? a. b. c. d. Meningococcemia Leptospirosis Malaria Rabies

Infectious Disease a
Which illness has the highest case-fatality a rate? Which causes the most rapidly lethal form of shock in humans? a. b. c. d. Meningococcemia Leptospirosis Malaria Rabies

Infectious Disease a
aWhat is the hepatic stage of falciparum malaria? a. b. c. d. Sporozoites Schizogony Merozoites Hypnozoites

Infectious Disease a
aWhat is the hepatic stage of falciparum malaria? a. b. c. d. Sporozoites infective stage Schizogony Merozoites Hypnozoites vivax and ovale

Infectious Disease a
a Which test is unreliable in diagnosing cases of Typhoid Fever? a. b. c. d. Blood culture Urine culture Stool culture Typhidot

Infectious Disease a
a Which test is unreliable in diagnosing cases of Typhoid Fever? a. b. c. d. Blood culture Urine culture Stool culture Typhidot

Headache is the most common presenting sign Rose spots are pathognomonic

Infectious Disease a
a What is the component of the cell wall of Mycobacterium Tuberculosis that is responsible for most of its antibiotic-resisting and tissue-damaging effects?

a. b. c. d.

Mycolic Acid Lipoarabinomannan Arabinoglycan Surface glycolipids

Infectious Disease a
a What is the component of the cell wall of Mycobacterium Tuberculosis that is responsible for most of its antibiotic-resisting and tissue-damaging effects?

a. b. c. d.

Mycolic Acid Lipoarabinomannan Arabinoglycan Surface glycolipids

Infectious Disease a
a Which of the following is a bacteriostatic antiTB medication?

a. b. c. d.

Isoniazid Rifampicin Streptomycin Pyrazinamide

Infectious Disease a
a Which of the following is a bacteriostatic antiTB medication?

a. b. c. d.

Isoniazid Rifampicin Streptomycin Pyrazinamide

Infectious Disease a
a When the level of CD4+ cells drops below this value, HIV-infected individuals have a steep rise in opportunistic infections. a. 100 b. 200 c. 300 d. 400

Infectious Disease a
a When the level of CD4+ cells drops below this value, HIV-infected individuals have a steep rise in opportunistic infections. a. 100 b. 200 c. 300 d. 400

a
a End of Part 1

a
a

Subject Pearls
Internal Medicine Topnotch Board Prep July 2011

Nephrology a
Thiazides act on which part of the nephron? a

a. b. c. d.

Proximal convoluted tubule Loop of Henle Distal convoluted tubule Collecting duct

Nephrology a
Thiazides act on which part of the nephron? a

a. b. c. d.

Proximal convoluted tubule Loop of Henle Distal convoluted tubule Collecting duct

Nephrology a
a Uremia develops during which phase of acute tubular necrosis?

a. b. c. d.

Initiation Extension Maintenance Recovery

Nephrology a
a Uremia develops during which phase of acute tubular necrosis?

a. b. c. d.

Initiation Extension Maintenance Recovery

Nephrology a
Which of the following is NOT a correct goal a for patients with chronic kidney disease?

a. Protein restriction of 0.6-0.75 for CKD stage II b. BP < 125/75 c. FBS 90-130 mg/dL d. Hemoglobin > 90 g/L

Nephrology a
Which of the following is NOT a correct goal a for patients with chronic kidney disease?

a. Protein restriction of 0.6-0.75 for CKD stage II b. BP < 125/75 c. FBS 90-130 mg/dL d. Hemoglobin > 90 g/L

Nephrology a
a What is the stage of lupus nephritis if mesangial proliferation is seen on kidney biopsy? a. I b. II c. III d. IV

Nephrology a
a What is the stage of lupus nephritis if mesangial proliferation is seen on kidney biopsy? a. I b. II c. III d. IV

Nephrology a
Which of the following is NOT a pulmonarya renal syndrome?

a. b. c. d.

Churg-Strauss Vasculitis Goodpastures Syndrome Henoch-Schonlein Purpura Polyarteritis Nodosa

Nephrology a
Which of the following is NOT a pulmonarya renal syndrome?

a. b. c. d.

Churg-Strauss Vasculitis Goodpastures Syndrome Henoch-Schonlein Purpura Polyarteritis Nodosa

Nephrology a
What is the most common cause of chronic a renal insufficiency in adults?

a. b. c. d.

Diabetic Nephropathy Hypertensive Nephrosclerosis Membranous glomerulonephritis Minimal Change Disease

Nephrology a
What is the most common cause of chronic a renal insufficiency in adults?

a. b. c. d.

Diabetic Nephropathy Hypertensive Nephrosclerosis Membranous glomerulonephritis - elderly Minimal Change Disease - children

Nephrology a
a Hypertension, cysts, SAH Nephrocystin and Inversin Hamartin and Tuberin Paintbrush features on IVP Polycystic Kidney Nephronophthisis Tuberous Sclerosis Med Sponge Kidney

Nephrology a
a Bartters Syndrome Thick Ascending Limb Gitelmans Syndrome Distal Convoluted Tub+Mg Liddles Syndrome Cortical Collecting Duct

Nephrology a
a Which is not a feature of Type II renal tubular acidosis?

a. b. c. d.

Impaired bicarbonate reabsorption Nephrolithiasis Hypercalciuria Hyperaminoaciduria

Nephrology a
a Which is not a feature of Type II renal tubular acidosis?

a. b. c. d.

Impaired bicarbonate reabsorption Nephrolithiasis Hypercalciuria Hyperaminoaciduria

Nephrology a
a is an expected finding on biopsy of the What kidney of a patient with essential hypertension? a. b. c. d. Hyaline deposits Fibrinoid necrosis Onion-skin lesions Crescentic destruction

Nephrology a
a is an expected finding on biopsy of the What kidney of a patient with essential hypertension? a. b. c. d. Hyaline deposits Fibrinoid necrosis malignant HPN Onion-skin lesions malignant HPN Crescentic destruction RPGN

Nephrology a
a What is the treatment for cystine stones? a. b. c. d. Low Na diet Allopurinol High fluid intake Antibiotics

Nephrology a
a What is the treatment for cystine stones? a. b. c. d. Low Na diet Allopurinol High fluid intake Antibiotics

Nephrology a
a is the pathognomonic urinalysis finding What of acute pyelonephritis? a. Positive urine culture b. Low specific gravity c. WBC casts d. Hyaline casts

Nephrology a
a is the pathognomonic urinalysis finding What of acute pyelonephritis? a. Positive urine culture b. Low specific gravity c. WBC casts d. Hyaline casts

Nephrology a
When should candiduria NOT be treated? a a. b. c. d. Symptomatic patient Immunocompromised patient Patient with positive culture for Candida None of the above

Nephrology a
When should candiduria NOT be treated? a a. b. c. d. Symptomatic patient Immunocompromised patient Patient with positive culture for Candida None of the above

Gastroenterology a
a Which anti-hypertensive medication exacerbate gastroesophageal reflux disease? a. b. c. d. Calcium channel blockers Beta-adrenergic blockers Alpha-adrenergic blockers Diuretics

Gastroenterology a
a Which anti-hypertensive medication exacerbate gastroesophageal reflux disease? a. b. c. d. Calcium channel blockers Beta-adrenergic blockers Alpha-adrenergic blockers Diuretics

Nephrology a
Iron deficiency, hypopharyngeal web, middle a aged women Plummer-Vinson Syndrome Diverticulum in the posterior hypopharyngeal wall Zenkers Diverticulum Lower esophageal ring Schatzkis Ring Tear from retching/Rupture from retching Mallory-Weiss Tears/Boerhaaves Syndrome

Gastroenterology a
a Which of the following is NOT a risk factor for H. pylori infection? a. Unclean food b. Exposure to the gastric contents of an infected individual c. Poor economic status d. Increased meat intake

Gastroenterology a
a Which of the following is NOT a risk factor for H. pylori infection? a. Unclean food b. Exposure to the gastric contents of an infected individual c. Poor economic status d. Increased meat intake

Gastroenterology a
a Of the disorders of malabsorption, which one will require only dietary restriction? a. b. c. d. Short Bowel Syndrome Celiac Sprue Whipples Disease Bacterial Overgrowth Syndrome

Gastroenterology a
a Of the disorders of malabsorption, which one will require only dietary restriction? a. b. c. d. Short Bowel Syndrome Celiac Sprue Whipples Disease T. whipplei, Cotrimoxazole Bacterial Overgrowth Syndrome

Gastroenterology a
a Which of the following is a feature of Ulcerative Colitis? a. b. c. d. Crypt abscesses Granulomas Segmental involvement Tendency to spare the rectum

Gastroenterology a
a Which of the following is a feature of Ulcerative Colitis? a. b. c. d. Crypt abscesses Granulomas Segmental involvement Tendency to spare the rectum

Gastroenterology a
What is the sine qua non of irritable bowel a syndrome? a. b. c. d. Changes in the appearance of stool Changes in the frequency of stool Recurrent abdominal pain CNS dysmodulation

Gastroenterology a
What is the sine qua non of irritable bowel a syndrome? a. b. c. d. Changes in the appearance of stool Changes in the frequency of stool Recurrent abdominal pain CNS dysmodulation

Gastroenterology a
a Which areas of the colon are predisposed to mesenteric vascular insufficiency? a. Junction of the ileum and the cecum b. Junction of the cecum and the ascending colon c. Junction of the ascending colon and the transverse colon d. Junction of the transverse colon and the descending colon

Gastroenterology a
Griffiths a Which areas of the colon are predisposed to Point mesenteric vascular insufficiency?

a. Junction of the ileum and the cecum b. Junction of the cecum and the ascending colon Sudecks c. Junction of the ascending colon and the Point transverse colon d. Junction of the transverse colon and the descending colon Griffiths point

Gastroenterology a
Which of the following is lowest in Crigglera Najar I as compared to the rest of the unconjugated hyperbilirubinemias? a. b. c. d. Levels of unconjugated bilirubin Incidence of kernicterus Pigmentation of the liver Response to phenobarbital

Gastroenterology a
Which of the following is lowest in Crigglera Najar I as compared to the rest of the unconjugated hyperbilirubinemias? a. b. c. d. Levels of unconjugated bilirubin Incidence of kernicterus Pigmentation of the liver Response to phenobarbital

Gastroenterology a
In patients with Chronic Hepatitis B, what a finding will prompt you to start treatment? a. b. c. d. Positive HBsAg Positive HBeAg HBV DNA level > 105 All of the above

Gastroenterology a
In patients with Chronic Hepatitis B, what a finding will prompt you to start treatment? a. b. c. d. Positive HBsAg all cases are positive Positive HBeAg negative cases are tx HBV DNA level > 105 All of the above

Gastroenterology a
a Which of the following is a risk factor for Alcoholic Liver Disease? a. b. c. d. Male sex Hepatitis B infection Underweight Alcohol Intake > 40-60 g/d

Gastroenterology a
a Which of the following is a risk factor for Alcoholic Liver Disease? a. b. c. d. Male sex Hepatitis B infection Underweight Alcohol Intake > 40-60 g/d

Gastroenterology a
which of the following cases would you opt In a for immediate drainage of the hepatic abscess? a. b. c. d. 2 cm abscess in the right lobe 4 cm abscess in the right lobe 5 cm abscess in the right lobe 5 cm abscess in the left lobe

Gastroenterology a
which of the following cases would you opt In a for immediate drainage of the hepatic abscess? a. b. c. d. 2 cm abscess in the right lobe 4 cm abscess in the right lobe 5 cm abscess in the right lobe 5 cm abscess in the left lobe

Gastroenterology a
a Which of the following antibiotics is NOT used as prophylaxis against spontaneous bacterial peritonitis? a. b. c. d. Azithromycin Ciprofloxacin Norfloxacin Cotrimoxazole

Gastroenterology a
a Which of the following antibiotics is NOT used as prophylaxis against spontaneous bacterial peritonitis? a. b. c. d. Azithromycin Ciprofloxacin Norfloxacin Cotrimoxazole

Gastroenterology a
aWhat is the most important therapeutic maneuver in Acute Pancreatitis? a. b. c. d. NGT Insertion Meperidine Antibiotics NPO

Gastroenterology a
aWhat is the most important therapeutic maneuver in Acute Pancreatitis? a. b. c. d. NGT Insertion Meperidine Antibiotics NPO

Endocrinology a
a The following are functions of FollicleStimulating Hormone EXCEPT a. b. c. d. Estrogen secretion Seminiferous tubule development Spermatogenesis Testosterone secretion

Endocrinology a
a The following are functions of FollicleStimulating Hormone EXCEPT a. b. c. d. Estrogen secretion Seminiferous tubule development Spermatogenesis Testosterone secretion

Endocrinology a
a Which of the following peaks at night? a. b. c. d. ACTH GH TSH Prolactin

Endocrinology a
a Which of the following peaks at night? a. b. c. d. ACTH GH TSH Prolactin

Hormone ACTH GH TSH Prolactin

Peak Secretion 6 AM Night (sleep) Pulsed 4-6 AM

Endocrinology a
Hypersecretion syndromes of the following a hormones are correctly matched with their temporizing agents EXCEPT a. b. c. d. ACTH Ketoconazole GH Somatostatin TSH Methimazole Prolactin Cabergoline

Endocrinology a
Hypersecretion syndromes of the following a hormones are correctly matched with their temporizing agents EXCEPT a. b. c. d. ACTH Ketoconazole GH Somatostatin TSH Methimazole Prolactin Cabergoline

Endocrinology a
a

Hypersecretion
ACTH
(Cushings Syndrome)

Temporizing Agent Ketoconazole, Metyrapone Somatostatin

GH
(Acromegaly)

TSH
Prolactin

Somatostatin Cabergoline, Bromocriptine

Endocrinology a
a Which of the following is the correct treatment modality for Pituitary Diabetes Insipidus? a. b. c. d. Thiazides Amiloride Low Na Diet Desmopressin

Endocrinology a
a Which of the following is the correct treatment modality for Pituitary Diabetes Insipidus? a. b. c. d. Thiazides - Nephrogenic Amiloride - Nephrogenic Low Na Diet - Nephrogenic Desmopressin

Endocrinology a
a What is the most important finding that would confirm the presence of hyperthyroidism? a. b. c. d. Low TSH High T4 Positive anti-TPO Clinical findings

Endocrinology a
a What is the most important finding that would confirm the presence of hyperthyroidism? a. b. c. d. Low TSH High T4 confirms thyrotoxicosis Positive anti-TPO for autoimmune thyroiditis Clinical findings there are cases of subclinical hyperthyroidism

Endocrinology a
a What is the most common cause of Cushings Syndrome? a. b. c. d. ACTH secretion Exogenous steroid use Adrenal neoplasm Bilateral adrenal hyperplasia

Endocrinology a
a What is the most common cause of Cushings Syndrome? a. b. c. d. ACTH secretion Exogenous steroid use Adrenal neoplasm Bilateral adrenal hyperplasia

Endocrinology a
Which of the following is present in primary a adrenocortical deficiency as opposed to secondary deficiency (ACTH deficiency)? a. b. c. d. Weakness Hypotension Hyperkalemia Hyperpigmentation

Endocrinology a
Which of the following is present in primary a adrenocortical deficiency as opposed to secondary deficiency (ACTH deficiency)? a. b. c. d. Weakness Hypotension Hyperkalemia Hyperpigmentation

Endocrinology a
a Which of the following is not a part of the classic triad of Pheochromocytoma? a. b. c. d. Sweating Hypertension Headaches Palpitations

Endocrinology a
a Which of the following is not a part of the classic triad of Pheochromocytoma? a. b. c. d. Sweating Hypertension Headaches Palpitations

Endocrinology a
Which of the following does NOT qualify as a Diabetes Mellitus? a. b. c. d. FBS of 126 mg/dL alone 2-hour PPBS of 200 mg/dL alone RBS of 200 mg/dL alone HBa1c of 7% alone

Endocrinology a
Which of the following does NOT qualify as a Diabetes Mellitus? a. b. c. d. FBS of 126 mg/dL alone 2-hour PPBS of 200 mg/dL alone RBS of 200 mg/dL alone HBa1c of 7% alone

Endocrinology a
Patients in a hyperglycemic hyperosmolar a state have higher laboratory findings in the following parameters compared to DKA, EXCEPT

a. b. c. d.

Serum Sodium Serum HCO3 Serum pCO2 Anion Gap

Endocrinology a
Patients in a hyperglycemic hyperosmolar a state have higher laboratory findings in the following parameters compared to DKA, EXCEPT

a. b. c. d.

Serum Sodium Serum HCO3 Serum pCO2 Anion Gap

Endocrinology a
a Which of the following is a correct target for a 45 year-old diabetic female with no signs of chronic kidney disease? a. b. c. d. HDL > 40 mg/dL LDL < 150 mg/dL Post-prandial glucose < 180 mg/dL BP < 130/80

Endocrinology a
a Which of the following is a correct target for a 45 year-old diabetic female with no signs of chronic kidney disease? a. b. c. d. HDL > 40 mg/dL LDL < 150 mg/dL Post-prandial glucose < 180 mg/dL BP < 130/80

Endocrinology a
a Which of the following is the correct temporizing agent for Verner-Morrison Syndrome? a. b. c. d. Somatostatin Octreotide Diazoxide Omeprazole

Endocrinology a
a Which of the following is the correct temporizing agent for Verner-Morrison Syndrome? a. b. c. d. Somatostatin Octreotide Diazoxide Omeprazole

Endocrinology a
a
Hypersecretion 5-HT
(Carcinoid Syndrome)

Temporizing Agent Somatostatin PPI, H2-Blockers Diazoxide Somatostatin Octreotide Octreoride

Gastrin
(Zollinger-Ellison Syndrome)

Insulin Glucagon Somatostatin VIP

(Verner-Morrison syndrome, WDHA syndrome, Pancreatic cholera)

Endocrinology a
a Which of the following is NOT present in Multiple Endocrine Neoplasia Type I?

a. b. c. d.

Prolactinoma Hyperparathyroidism Gastrinoma Medullary Thyroid CA

Endocrinology a
a Which of the following is NOT present in Multiple Endocrine Neoplasia Type I?

a. b. c. d.

Prolactinoma Hyperparathyroidism Gastrinoma Medullary Thyroid CA

Endocrinology a
a What is the most common cause of Hypercalcemia?

a. b. c. d.

Bone lysis Exogenous Vitamin D intake PTHrP secretion Calcitonin hypersecretion

Endocrinology a
a What is the most common cause of Hypercalcemia?

a. b. c. d.

Bone lysis 2nd most common Exogenous Vitamin D intake rare PTHrP secretion by malignancies Calcitonin hypersecretion calcitonin has little physiologic significance in humans

Endocrinology a
a What is the first-line management of hypercalcemia?

a. b. c. d.

Witholding of Vitamin D Diuresis Dialysis Fluid repletion

Endocrinology a
a What is the first-line management of hypercalcemia?

a. b. c. d.

Witholding of Vitamin D Diuresis Dialysis Fluid repletion

Endocrinology a
a Hexosaminidase deficiency Alpha-galactosidase Beta-galactosidase Sphingomyelinase Tay-Sachs Disease Fabry Disease Gauchers Disease Niemann-Pick Dse

Endocrinology a
a Glycogen Storage Diseases

Type I Type II Type III Type IV Type V

G6PD Acid Maltase Glycogen debranching Glycogen branching Muscle phosphorylase

Endocrinology a
a Glycogen Storage Diseases

Phenylalanine Cystathionine -synthase Homogentisic acid oxidase Impaired dibasic amino acid reabsorption Defective neutral amino acid transporter

Phenylketonuria Homocystinuria Alkaptonuria Cystinuria

Hartnup disease

Oncology a
What is the most significant risk factor for a cancer? a. b. c. d. Age Smoking Increased BMI Sun exposure

Oncology a
What is the most significant risk factor for a cancer? a. b. c. d. Age Smoking Increased BMI Sun exposure

Oncology a
What is the most common cause of death in a cancer? a. b. c. d. Infection Respiratory failure Heart failure Renal insufficiency

Oncology a
What is the most common cause of death in a cancer? a. b. c. d. Infection Respiratory failure Heart failure Renal insufficiency

Oncology a
a What is the most specific parameter to determine whether a nevus is neoplastic? a. b. c. d. Asymmetry Border irregularity Color variegation Diameter

Oncology a
a What is the most specific parameter to determine whether a nevus is neoplastic? a. b. c. d. Asymmetry Border irregularity Color variegation Diameter

Oncology a
a What is the most significant risk factor for the development of non-melanoma skin cancer? a. b. c. d. Old age Male sex Fair complexion UV light B

Oncology a
a What is the most significant risk factor for the development of non-melanoma skin cancer? a. b. c. d. Old age Male sex Fair complexion UV light B

Oncology a
What is the most important initial test in the a work-up for Thyroid Cancer? a. b. c. d. TSH Thyroid Ultrasound CT scan of the neck Fine-needle aspiration biopsy

Oncology a
What is the most important initial test in the a work-up for Thyroid Cancer? a. b. c. d. TSH Thyroid Ultrasound CT scan of the neck Fine-needle aspiration biopsy

Frequency: Papillary > Follicular > Medullary > Anaplastic

Oncology a
aWhich of the following is NOT a correct description of Small Cell Lung Cancer? a. b. c. d. It has neuroendocrine properties It is not responsive initially It is likely to relapse It presents as metastatic

Oncology a
aWhich of the following is NOT a correct description of Small Cell Lung Cancer? a. b. c. d. It has neuroendocrine properties It is not responsive initially It is likely to relapse It presents as metastatic

Oncology a
a Which is NOT a risk factor for Breast Cancer? a. b. c. d. Radiation Earlier menarche Increased caloric intake Use of Oral contraceptive pills

Oncology a
a Which is NOT a risk factor for Breast Cancer? a. b. c. d. Radiation Earlier menarche Increased caloric intake Use of Oral contraceptive pills

Oncology a
a Hot tea is a risk factor for malignancy of which part of the Gastrointestinal Tract? a. b. c. d. Head and neck CA Esophageal CA Gastric CA Colon CA

Oncology a
a Hot tea is a risk factor for malignancy of which part of the Gastrointestinal Tract? a. b. c. d. Head and neck CA Esophageal CA Gastric CA Colon CA

Oncology a
a doing a triphasic CT scan for a hepatic Upon mass, a central hypovascular scar was appreciated during the arterial phase. This is most compatible with which of the following? a. b. c. d. Focal Nodular Hyperplasia Hepatocellular CA Hemangioma Adenoma

Oncology a
a doing a triphasic CT scan for a hepatic Upon mass, a central hypovascular scar was appreciated during the arterial phase. This is most compatible with which of the following? a. b. c. d. Focal Nodular Hyperplasia Hepatocellular CA necrosis, heterogenous Hemangioma vascular lesion Adenoma smooth, well defined, enhances on portal venous phase

Oncology a
Coffee is a risk factor for which neoplasm? a a. b. c. d. Pancreatic CA Gallbladder CA Peritoneal CA Cholangiocarcinoma

Oncology a
Coffee is a risk factor for which neoplasm? a a. b. c. d. Pancreatic CA Gallbladder CA Peritoneal CA Cholangiocarcinoma

Oncology a
a Polychronotropism is a characteristic of which neoplasm? a. Uterine CA b. Endometerial CA c. Renal cell CA d. Bladder CA

Oncology a
a Polychronotropism is a characteristic of which neoplasm? a. Uterine CA b. Endometerial CA c. Renal cell CA d. Bladder CA

Oncology a
AFP and HCG are both elevated in which a male germ cell tumor? a. b. c. d. Choriocarcinoma Endodermal sinus tumor Pure embryonal carcinoma Teratoma

Oncology a
AFP and HCG are both elevated in which a male germ cell tumor? a. b. c. d. Choriocarcinoma Endodermal sinus tumor Pure embryonal carcinoma Teratoma

Oncology a
a What is the most common female pelvic malignancy? a. b. c. d. Vulvar CA Uterine CA Ovarian CA Cervical CA

Oncology a
a What is the most common female pelvic malignancy? a. b. c. d. Vulvar CA Uterine CA Ovarian CA Cervical CA

Oncology a
An onion-peel periosteal reaction is seen in a which osteogenic sarcoma? a. b. c. d. Osteosarcoma Chondrosarcoma Ewings sarcoma Histiocytoma

Oncology a
An onion-peel periosteal reaction is seen in a which osteogenic sarcoma? a. b. c. d. Osteosarcoma Codmans triangle, sunburst Chondrosarcoma Lobular/Cauliflower Ewings sarcoma Histiocytoma

Oncology a
a Surgery is required to stage the following cancers EXCEPT a. b. c. d. Colorectal CA Prostate CA Ovarian CA Uterine CA

Oncology a
a Surgery is required to stage the following cancers EXCEPT a. b. c. d. Colorectal CA Prostate CA Ovarian CA Uterine CA