IM 4 ANSWERS By Irina Israt

1. E
Clubbing and hypertropic osteoarthropathy of joints toward the diagnosis of lung
cancer, the next step should be Chest Xray
2. C
3. (A)
Correct in online test, the murmur (ejection click) matches with bicuspid aortic
valve that calcified leading to aortic stenosis
4. D
5. E
Symptoms of shoulder impingement syndrome (SIS) are similar to those of
rotator cuff (RC) tendinopathy. Patients complain of pain with overhead activity.
The pain may localize to the deltoid area or lateral arm and often occurs at night
or when lying on the affected shoulder.
6. D
7. A. Autoinfection

TINEA CRURIS Tinea cruris (also known as jock itch) is a dermatophyte infection
involving the crural fold.

Etiology The most common cause is T. rubrum. Other frequent causes include E.
floccosum and T. interdigitale (formerly T. mentagrophytes).

Tinea cruris is far more common in men than women. Often, infection results from the
spread of the dermatophyte infection from concomitant tinea pedis. Predisposing factors
include copious sweating, obesity, diabetes, and immunodeficiency.

8. E.
9. D
10. C
11. B
12. A
13. F
since already had a stroke,hypertension should be treated with drugs, weight
loss is suggested but will not be definitive in this case to reduce recurrence of
stroke
14. A
15. D
16. A
17. A
end expiratory wheezes indicating copd, early onset so alpha1antitrypsin
deficiency
18. A
19. C
20. D

21. C
22. A
23. I
24. E
25. D
26. A (confirmed) is suggested current answer but HIV treatment guideline changes
so check before your exam
27. B
28. E
29. A
30. G
31. D

32. D
33. D
34. B
35. A
STAGE FOUR cancer without treatment life expectancy motnhs. Indication for
hospice care.
36. D
37. B
38. I
39. E
40. G
41. C
42. B
HYPOGLYCEMIA DOESNT Resolve spontaneously and all the other options can
be ruled out, paroxysmal episode so ecg now cant catch it
43. C
44. E
45. F
46. E
diagnosis acute epiglottis
47. B
Diagnosis isolated systolic hypertension
48. E
49. B
Resulting from rhabdomyolysis
50. E