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INTERNAL MEDICINE MCQs

I. CHOOSE THE BEST ANSWER:

1. A 50-year-old female presented with multiple erythematous


scaly papules on trunk and extremities. The following differential
diagnosis may be considered:
A. Pityriasis rosea
B. Psoriasis
C. Pityriasis lichenoides chronica
D. Small plaque parapsoriasis
E. All of the above

2. On further examination, similar lesions appear on sites of even


trivial injuries give one diagnosis.
A. Pityriasis rosea
B. Psoriasis
C. Pityriasis lichenoides chronica
D. Small plaque parapsoriasis
E. All of the above

3. The patient was treated with oral steroids with resolution of lesions. The steroid was
discontinued. Three days later, the patient became febrile followed by
appearance of erythematous patches on trunk and extremities with pinpoint
pustules on the patches. What is your diagnosis?
A. Mycosis Fungoides
B. Drug reaction
C. Von Zumbusch
D. Folliculitis

4. The following drugs may be given in this patient except:


A. Retinoids
B. Methotrexate
C. Steroids
D. Dapsone

5. Clinical clues to look for in patients with exfoliative dermatitis secondary to stasis
dermatitis:
A. Varicosities, edema,ulcers at the ankle
B. Persistence of islands of normal skin within diffusely involved areas
C. Prominent white dermographism
D. Onycholysis and pterygium of the nails

6. Characteristic lesion of Mucha-Habermann disease:


A. Lichenoid papules
B. Macules with collarette scales
C. Papulonecrotic papules
D. Silvery white scales
E. Purplish polygonal papules

7. One of the following is due to suprapapillary thinning of the


epidermis:
A. Koebner phenomenon
B. Woronoff ring
C. Wickham’s striae
D. Auspitz sign

8. One of the following is due to focal epidermal thickening:


A. Koebner phenomenon
B. Woronoff ring
C. Wickham’s striae
D. Buttonhole sign

9 The following diseases have unknown etiology except:


A. Psoriasis
B. Pityriasis rosea
C. Lichen planus
D. Parapsoriasis
E. None of the above

10. Unusual distribution of lesions in patients with pityriasis rosea


include the following sites except:
A. Trunk
B. Face and head
C. Scalp
D. Distal extremities

Reference: Andrews’ Diseases of the Skin 9th edition

11. The mechanism of hypoxemia in patients with an increased carbon dioxide and a
normal alveolar to arterial oxygen gradient is:
a. hypoventilation
b. diffusion impairment
c. ventilation perfusion mismatch
d. shunt

Harrison’s Principles of Internal Medicine, 15 th Edition, p.1452

12. According to the Philippine Clinical Practice Guidelines on CAP, the basis for the
diagnosis of pneumonia is established by:
a. when cough has been present for two weeks
b. clinical findings alone
c. radiologic diagnosis to confirm the diagnosis
d. by sputum G/S and C/S done routinely

Philippine Consensus Guidelines on Diagnosis and Management of


Pneumonia

13. In the Gina (Global Initiative Against Asthma) Guidelines the addition of a long
acting beta agonist as controller medication is recommended in which category:
a. mild intermittent
b. mild persistent
c. moderate persistent
d. status asthmaticus

Global Initiative Against Asthma

14. A physiologic feature most suggestive of chronic bronchitis:


a. decreased DLCo
b. increased residual volume
c. increased airway resistance
d. decreased compliance

Harrison’s Principles of Internal Medicine, 15 th Edition

15. A clinical feature typical of emphysema:


a. cyanosis
b. bipedal edema
c. cachexia
d. recurrent exacerbations

Harrison’s Principles of Internal Medicine, 15 th Edition


16. Localized bronchiectasis is a feature of:
a. panhypogammaglobulinemia
b. primary ciliary dyskinesia
c. endobronchial obstruction
d. cystic fibrosis

Harrison’s Principles of Internal Medicine, 15 th Edition, p. 1486

17. Modality which has largely replaced bronchography for the diagnosis of
bronchiectasis:
a. PET (positron emission tomography)
b. fiberoptic bronchoscopy
c. HRCT (high-resolution computed tomography)
d. gallium Scan

Harrison’s Principles of Internal Medicine, 15 th Edition, p. 1486

18. The initial recommended procedure for the diagnosis of pulmonary


thromboembolism:
a. ventilation perfusion scan
b. leg ultrasound
c. d-dimer assay
d. pulmonary angiogram

Harrison’s Principles of Internal Medicine, 15 th Edition, p.1511

19. Antimicrobials for suspected atypical pathogens causing pneumonia EXCEPT:


a. macrolide or azalide
b. antipneumococcal fluroquinolone
c. tetracycline
d. beta lactam

Harrison’s Principles of Internal Medicine, 15 th Edition

20. The most common etiologic agent of pneumonia in HIV-infected patients with
CD4+ counts of <200/µL:
a. Mycobacterium avium-intracellulare
b. Cytomegalovirus
c. Pneumocystis carinii
d. Nocardia

Harrison’s Principles of Internal Medicine, 15 th Edition, p.1477

21. The single useful measurement for thyroid function in a suspect hypothyroid
patient is:
A. T3
B. T4
C. TSH
D. Thyroglobulin

Harrison’s Principle of Internal Medicine Vol. 2 15 th Edition page 2068


22. In large retrosternal goiter, when the arms are raised above the head, this cause
the thyroid mass to impinge on the blood vessels causing suffusion of the face,
giddiness and syncope. This is known as:
a. Basedow sign
b. Pembertons sign
c. Curtis sign
d. Reidel’s sign
Harrison’s Principle of Internal Medicine Vol. 2 15 th Edition page 2064

23. One of the following is a long glucocorticoid preparation.


a. Hydrocortisone
b. Prednisone
c. Bethamethasone
d. Triamcinolone

Harrison’s Principle of Internal Medicine Vol. 2 15 th Edition page 2104

24. The first to rise up among the lipoproteins in diabetes mellitus is:
a. Total cholesterol
b. LDL
c. HDL
d. Triglycerides

Harrison’s Principle of Internal Medicine Vol. 2 15 th Edition page 2124

25. The principal undesirable side effect of anti-thyroid drugs:


a. Wolf-Chaikoff effect
b. Agranulocytosis
c. Thyroid acropatchy
d. Fulminant hepatitis

Harrison’s Principle of Internal Medicine Vol. 2 15 th Edition page 2072

26. The single-thyroid drug which can be safely use in pregnant women:
a. Neomercazole
b. Thiamazole
c. Propylthiouracil
d. Tapazole

Harrison’s Principle of Internal Medicine Vol. 2 15 th Edition page 2073

27. The shortest acting oral hypoglycemics:


a. Glipizide
b. Glibenclamide
c. Gliclazide
d. Glimeperide

Harrison’s Principle of Internal Medicine Vol. 2 15 th Edition page 2133

28. Secondary hyperaldosterone has all of the following, EXCEPT:


a. Acidosis
b. Hypokalemia
c. Hypertension
d. Edema

Harrison’s Principle of Internal Medicine Vol. 2 15 th Edition page 2097

29. The other name of Multiple Neoplasia Type I is:


a. Lub syndrome
b. Stenon’s disease
c. Parry’s disease
d. Wermer’s syndrome

Harrison’s Principle of Internal Medicine Vol. 2 15 th Edition page 2184

30. The other term for Subacute thyroiditis are the following, EXCEPT:
a. Painless thyroiditis
b. Granulomatous thyroiditis
c. Giant cell thyroiditis
d. De Quervan’s thyroiditis

Harrison’s Principle of Internal Medicine Vol. 2 15 th Edition page 2074

31. One of these cardiac anti-arrythmic drugs contains 37% iodine and can induce
thyrotoxicosis:
a. Flecainide
b. Verapamil
c. Amiodarone
d. Propranolol

Harrison’s Principle of Internal Medicine Vol. 2 15 th Edition page 2076

32. Conns’ syndrome commonly present with the following signs and symptoms,
EXCEPT:
a. Hyperkalemia
b. Hypernatremia
c. Alkalosis
d. hypertension

Harrison’s Principle of Internal Medicine Vol. 2 15 th Edition page 2096

33. The effort less appearance of gastric or esophageal contents in the mouth is
called:
a. Heartburn
b. Pyrosis
c. Vomiting
d. Regurgitation

Harrison’s Principle of Internal Medicine Vol. 2 13 th Edition page 1356 Chap 251

34. Nutcracker esophagus is associated with:


a. Achalasia
b. Scleroderma
c. Diffuse esophageal spasm
d. Esophageal CA

Harrison’s Principle of Internal Medicine Vol. 2 13 th Edition page 1358 Chap 251

35. The most common complication of Gastric Ulcer is:


a. Perforation
b. Penetration
c. Obstruction
d. Hemorrhage

Harrison’s Principle of Internal Medicine Vol. 2 13 th Edition page 1371 Chap 252

36. A 40-year-old patient with a history of peptic ulcer surgery due to massive upper
GI bleeding came in because of lightheadedness, diaphoresis confusion 90 min
after eating. Your diagnosis is:
a. Dumping syndrome
b. Bile reflux gastritis
c. Afferent loop syndrome
d. Postvagomtomy diarrhea

Harrison’s Principle of Internal Medicine Vol. 2 13 th Edition page 1374 Chap 252
37. A 39-year-old seaman showed you the following hepatitis serologic profile:
HbsAg (+), IgM anti-HAV (+), IgM anti-HBc (+), anti-HCV (-). Your diagnostic
interpretations are:
a. Acute Hep A superimposed on Chronic Hep B
b. Acute Hep A and B
c. Acute Hep A
d. Acute Hep B

Harrison’s Principle of Internal Medicine Vol. 2 13 th Edition page 1470 Chap 266

38. Stage II hepatic Encephalopathy is characterized by:


a. Coma
b. Marked confusion, incoherent speech
c. Lethargy
d. Euphoria or depression

Harrison’s Principle of Internal Medicine Vol. 2 13 th Edition page 1494 Chap 269

39. A collection of tissue, fluid, debris, pancreatic enzymes and blood which develop
over a period of 1-4 weeks after the onset of acute pancreatitis is:
a. Phlegmon
b. Pseudocyst
c. Abscess
d. Pseudoaneurysm

Harrison’s Principle of Internal Medicine Vol. 2 13 th Edition page 1525 Chap 274

40. A sudden and severe loss of vision in patient with acute pancreatitis is:
a. Diabetic retinopathy
b. Glaucoma
c. Purstcher’s retinopathy
d. Retinal detachment

Harrison’s Principle of Internal Medicine Vol. 2 13 th Edition page 1356 Chap 274

41. The most consistently observed risk factor for development of pancreatic cancer
is:
a. Chronic alcoholism
b. Diabetes mellitus
c. Cigarette smoking
d. Acute pancreatitis

Harrison’s Principle of Internal Medicine Vol. 2 13 th Edition page 1352 Chap 275

42. The following frequent signs and symptoms of pancreatic cancer, EXCEPT:
a. Abdominal pain
b. Weight loss
c. Jaundice
d. Splenomegaly

Harrison’s Principle of Internal Medicine Vol. 2 13 th Edition page 1532 Chap 275

43. A serum creatinine level starts to increase when the glomerular filtration rate is:
a. 75ml/min
b. 50ml/min
c. 25ml/min
d. 10mml/min

Harrison’s Textbook of Internal Medicine, 15 th edition

44. Metabolic acidosis in moderate to severe renal failure is due to:


a. Increase acid production
b. Decreased acid excretion
c. Increase serum potassium
d. Nephron loss

Harrison’s Textbook of Internal Medicine, 15 th edition

45. A source of endogenous toxin which can cause acute renal failure is:
a. Rhabdomyolysis
b. Sepsis
c. Radiocontrast agents
d. Antibiotics

Harrison’s Textbook of Internal Medicine, 15 th edition

46. The most common complication of end stage renal disease is:
a. Congestive health failure
b. Hypertension
c. Recurrent infections
d. Gastrointestinal bleeding

Harrison’s Textbook of Internal Medicine, 15 th edition

47. An absolute contraindications of kidney transplantation is:


a. Active glomerulonephritis
b. Presence of vesical or urethral abnormality
c. Iliofemoral occlusive disease
d. Psychiatric problem

Harrison’s Textbook of Internal Medicine, 15 th edition

48. The major cause of death in end stage disease patients receiving dialysis is:
a. Bleeding
b. Infection
c. Uremia
d. Cardiovascular disease

Harrison’s Textbook of Internal Medicine, 15 th edition

For nos. 49 – 52: A 68-year-old female was admitted because of LBM. Her condition
started 3 days PTA as abdominal pain, followed by LBM characterized as watery, non-
bloody, and occurring 4-5 times per day. LBM became more persistent and profuse,
hence, the admission.
Her past history included mild hypertension of 2 years, which was treated
irregularly, and joint pains of 10 years.
On admission, vital signs were the following: BP = 90/60; HR = 100/min; RR =
24/min; T = 38.5 C. She was weak looking but conscious. He r skin and tongue were
dry. The heart had a gr 2/6 systolic aortic murmur. The abdomen was soft, tympanitic,
and slightly tender all over, with hyperactive bowel sounds.
Lab result revealed the following: CBC: Hb = 132g/l, WBC ct = 10.2, Seq. = 0.85,
Ly = 0.15. Urinalysis: pH = 5.0, SG = 1.030, protein = +, sugar = trace, pus cells = 1-
3/hpf, rbc = 5-10/hpf, hyaline cast = 5-10/hpf. FBS = 6.4 m mol/I; serum creatinine = 330
mmol/l; serum Na+ = 136 mmol/l; serum K+ = 3.4 mmol/l. Stool exam: pus cell = 5-
10/hpf; rbc = 3-5/hpf. ECG = sinus tachycardia.

49. What is the cause of the abnormal serum creatinine?


a. Acute renal failure
b. Chronic renal failure
c. Nephrosclerosis
d. Rapidly progressive renal failure

Harrison’s Textbook of Internal Medicine, 15 th edition


50. What is the possible etiology?
a. Hypertension
b. Dehydration
c. Nephrotoxicity
d. Diabetic nephropathy

Harrison’s Textbook of Internal Medicine, 15 th edition

51. If this is an uncomplicated acute renal failure, when would you expect the
kidneys to recover?
a. 1-2 weeks
b. 2-3 weeks
c. 3-4 weeks
d. 2-3 months

Harrison’s Textbook of Internal Medicine, 15 th edition

52. If this patient had chronic renal failure secondary to diabetic nephropathy when
would you expect end stage renal disease to set in?
a. 3-5 years
b. 5-10 years
c. 10-15 years
d. 15-20 years

Harrison’s Textbook of Internal Medicine, 15 th edition

53. The primary factor that regulates erythropoietic activity is:


a. The kidney
b. Erythropoietin
c. Bone marrow
d. Oxygen

Harrison’s Textbook of Internal Medicine, 15 th edition

54. Maximal iron absorption occurs in the:


a. Stomach
b. Duodenum and upper jejunum
c. Terminal ileum
d. Colon

Harrison’s Textbook of Internal Medicine, 15 th edition

55. Phagocytosis is a primary function of:


a. Lymphocytes
b. Eosinophils
c. Neutrophils
d. Basophils

Harrison’s Textbook of Internal Medicine, 15 th edition

56. The like hood that a daughter of a patient with severe hemophilia A will be a
carried of hemophilia is:
a. 0%
b. 25%
c. 50%
d. 100%

Harrison’s Textbook of Internal Medicine, 15 th edition

57. Aspirin affects the platelets by:


a. Shortens platelets life span
b. Promotes platelets aggregation
c. Decreases platelet production
d. Prolongs the bleeding

Harrison’s Textbook of Internal Medicine, 15 th edition

58. Which of the following hematopoietic growth factors is non-lineage specific and
would induce formation of progenitor cells.
a. Granulocyte colony stimulating factors
b. Macrophage colony stimulating factor
c. Granulocyte-macrophage colony stimulating factor
d. Erythropoietin

Harrison’s Textbook of Internal Medicine, 15 th edition

59. One of the following is true in patients with New York Heart Association functional
class IV:
a. Symptoms occur with ordinary activity
b. Asymptomatic at rest
c. Symptoms occur even at rest
d. None of the above

Harrison’s Textbook of Internal Medicine, 15 th edition

60. Pulsus paradoxus may be seen in:


a. Pericardial tamponade
b. COPD
c. Superior vena cava obstruction
d. All of the above

Harrison’s Textbook of Internal Medicine, 15 th edition

61. One or some of the following is/are true regarding jugular venous pulse (JVP),
EXCEPT:
a. The left internal jugular vein is the best to use in JVP measurement
b. Cannon a wave may be seen in complete heart block
c. It reflects phasic pressure changes in the left atrium
d. A and C

Harrison’s Textbook of Internal Medicine, 15 th edition

62. Prominent waves of the JVP waves are seen in the following, EXCEPT:
a. Severe mitral stenosis with atrial fibrillation
b. Severe tricuspid stenosis in sinus rhythm
c. Ventricular tachycardia
d. A and B only

Harrison’s Textbook of Internal Medicine, 15 th edition

63. The following are true regarding cardiac activation, EXCEPT:


a. At the rest the cardiac cell are polarized
b. The polarized state is brought about by the Na+-K-+ inhibiting pump
c. During phase 2 of the action potential there is slow inward current through
the L-type calcium channel
d. A and C only

Harrison’s Textbook of Internal Medicine, 15 th edition

64. The following are components of Wolf-Parkinsons-White syndrome, EXCEPT:


a. Short PR interval
b. Delta wave
c. Paroxysmal ventricular tachycardia
d. All of the above

Harrison’s Textbook of Internal Medicine, 15 th edition

65. The following are true regarding digitalis in heart failure, EXCEPT:
a. It is now obsolete since the discovery of ACE inhibitors which block
the RAA axis
b. It is particularly effective in patient with systolic heart failure by stimulating
myocardial contraction
c. It improves ventricular emptying by improving myocardial contractility
d. It has little or no value in heart failure patients in sinus rhythm and diastolic
dysfunction

Harrison’s Textbook of Internal Medicine, 15 th edition

66. The following are true regarding murmurs, EXCEPT:


a. Tricuspid regurgitation murmurs are louder during expiration
b. With valsalva maneuver, the murmur of hypertrophic obstructive
cardiomyopathy increases.
c. With standing mitral regurgitation murmur decreases
d. A and C

Harrison’s Textbook of Internal Medicine, 15 th edition

67. The following are true regarding contractile process of the cardiac muscle,
EXCEPT:
a. During activation, the A band remains constant in length, whereas the I
band shortens and the Z lines move towards one another
b. The interactions between the actin and myosin is inhibited by the
tropomyosin during relaxed stage
c. Troponic I, accelerates cardiac contraction
d. A and B

Harrison’s Textbook of Internal Medicine, 15 th edition

68. Continuous murmurs are heard in the following, EXCEPT:


a. Coarctation of the aorta
b. Ruptured coronary sinus of valsalva into the left ventricle
c. PDA with normal PA
d. Pregnant woman with mammary soufflé

Harrison’s Textbook of Internal Medicine, 15 th edition

69. Which of the following exposures is most likely to result in transmission of HIV to
an uninfected person?
a. One use of injected drugs with a needle previously used by an HIV
infected person
b. Once instance unprotected sexual intercourse with an HIV infected partner
c. being born to a woman with symptomatic HIV disease
d. sustaining a needle stick injury with a needle used to draw blood from a
patient with AIDS

Harrison’s Textbook of Internal Medicine, 15 th edition

70. An HIV man presents with Pneumocystic pneumonia, oral hairy leukoplakia, oral
candidiasis. Select the stage of HIV disease.
a. Acute retroviral syndrome
b. Early disease (CD4 count greater than 500/ul)
c. Intermediate disease (CD4 count 200 to 500/ul)
d. Late disease (CD4 count 50 to 200/ul)
Harrison’s Textbook of Internal Medicine, 15 th edition

71. A 26 year old female prostitute with recently diagnosed HIV infection has
odynophagia and vaginal discharge without fever. Select the most likely
pathogen.
a. Candida
b. Cytomegalovirus
c. Hepatitis C
d. Microsporidia

Harrison’s Textbook of Internal Medicine, 15 th edition

72. True statements about MDR (multidrug-resistant) tuberculosis:


a. It is more likely to cause extra pulmonary disease than is drug-susceptible
TB
b. It is likely to present with cavitary pulmonary disease than is drug-
susceptible TB
c. HIV-infected injection drug users have the highest risk of MDR-TB of all
HIV (+) patient
d. Noncompliance with treatment for drug-susceptible TB is the most
important cause of this disease

Harrison’s Textbook of Internal Medicine, 15 th edition

73. Which of the following statements is true about the bactericidal activity of
antibiotics?
a. B lactam antibiotics are bactericidal in vivo at all concentrations
b. Only bactericidal antibiotics are effective in sterilizing abscesses
c. Relapse rates of endocarditis are higher when bacteriostatic
antibiotics are used in place of bactericidal drugs
d. The MIC of the antibiotic predicts its bactericidal activity

Harrison’s Textbook of Internal Medicine, 15 th edition

74. Antibiotics prophylaxis is advised for prevention of endocarditis in all of the


following conditions, EXCEPT:
a. Previous episode of infectious endocarditis
b. Mitral valve prolapse with an audible murmur
c. Hypertrophiccardiomyopathy
d. Coronary artery disease after coronary bypass graft

Harrison’s Textbook of Internal Medicine, 15 th edition

75. All of the following STD facilitate transmission of HIV, EXCEPT:


a. Human papilloma virus
b. Chancroid
c. Syphillic ulcers
d. Herpes simplex virus

Harrison’s Textbook of Internal Medicine, 15 th edition

76. All of the following statements are true about human papilloma virus, EXCEPT:
a. An abnormal Pap test requires consideration of human papilloma virus
b. Women with some serotypes of human papilloma virus should be routinely
screened for cervical neoplasia
c. Cervical neoplasia in a 23 year old woman suggest HIV disease
d. Interferon alfa eliminates human papilloma infection

Harrison’s Textbook of Internal Medicine, 15 th edition


77. No clinical evidence for “true” bacteremia. Select the most likely blood culture.
a. E.coli
b. Epidermidis
c. Clostridium welchi
d. S. Aureus

Harrison’s Textbook of Internal Medicine, 15 th edition

78. Rheumatic heart disease. Select the organism most likely to cause endocarditis.
a. A. aureus
b. S. bovis
c. E.faecalis
d. Viridans streptococci

Harrison’s Textbook of Internal Medicine, 15 th edition

79. A 63 year old man with diabetes and peripheral vascular disease. Select the
most appropriate prophylaxis.
a. Rabies vaccine
b. Pneumococcal vaccine
c. Hepatitis B vaccine
d. Meningococcal vaccine

Harrison’s Textbook of Internal Medicine, 15 th edition

80. Approximately one third of patient infected with this virus may respond to
treatment with interferon alfa.
a. Norwalk virus
b. Rotavirus
c. Human herpesvirus 6
d. Hepatitis C virus

Harrison’s Textbook of Internal Medicine, 15 th edition

81. The following are risk factor for the increasing prevalence of drug resistant TB,
EXCEPT:
a. HIV-1 infection
b. Addition of a single new drug to a failing anti-TB regimen
c. Failure to complete treatment of active TB
d. Increased age

Harrison’s Textbook of Internal Medicine, 15 th edition

82. True about granulocyte-colony stimulating factor, EXCEPT:


a. It reduces the number of febrile days and the frequency of infection in
patients receiving cytotoxic therapy for lung carcinoma
b. It stimulates the proliferation of neutrophils in the bone marrow
c. Its principal side effects is bone pain
d. Its use should be avoided in patient receiving treatment for myeloid
leukemia

Harrison’s Textbook of Internal Medicine, 15 th edition

83. True about coagulase-negative staphylococci (CNS), EXCEPT:


a. Most CNS are resistant to B lactam and therefore require a glycopeptide
antibiotic in initial, empiric, or definitive antibiotic regimens
b. CNS often cause true bacteremias, even in the absence of a foreign
body
c. CNS strains frequently cause foreign body infections
d. Definitive therapy of CNS central nervous system shunt infections usually
requires shunt removal.
Harrison’s Textbook of Internal Medicine, 15 th edition

84. This is characterized by an inability to recall important personal information,


usually of a traumatic or stressful nature:
a. Dissociative Amnesia
b. Dissociative Fugue
c. Depersonalization Disorder
d. Dissociative Identity Disorder

Kaplan & Saddock’s Synopsis of Psychiatry - page 678

85. Characterized by the presence of two or more distinct personality states:


a. Depersonalization Disorder
b. Dissociative Identity Disorder
c. Dissociative Amnesia
d. Dissociative Fugue

Kaplan & Saddock’s Synopsis of Psychiatry - page 681

86. The following are features seen in Kleptomania, except:


a. Increasing sense of tension immediately before committing the theft
b. Pleasure or relief at the time of committing the theft
c. Stealing is committed to express anger
d. Recurrent failure to resist impulses to steal objects

Kaplan & Saddock’s Synopsis of Psychiatry - page 786

87. Trichotillomania is associated with:


a. Fire setting
b. Gambling
c. Stealing
d. Pulling of hair

Kaplan & Saddock’s Synopsis of Psychiatry - page 790

88. The following are impulses control disorders, except:


a. Generalized anxiety disorder
b. Pathological gambling
c. Kleptomania
d. Intermittent explosive disorder

Kaplan & Saddock’s Synopsis of Psychiatry - page 783

89. The following are features of Anorexia Nervosa, except:


a. Refusal to maintain body weight at or above a minimally weight for age
b. Intense fear of gaining weight
c. Awareness of the seriousness of the current low body weight
d. Amenorrhea

Kaplan & Saddock’s Synopsis of Psychiatry - page 741

90. Features of Bulimia Nervosa, except:


a. Normal weight to slightly overweight or underweight
b. Poor sexual adjustments
c. Increased frequency of depressive symptoms
d. Binge eating

Kaplan & Saddock’s Synopsis of Psychiatry - page 748


91. A 60 year old male was brought to the emergency room when he was found to be
wandering in the vicinity, apparently lost and distressed. He was able to state his name,
his daughter’s name, but could not recall how he came to be lost. When his daughter
arrived, she provided information that his father has been increasingly forgetful for the
last 12 months. Initially, he would forget where he placed his keys, glasses. He would
ask questions repeatedly, would forget names of friends and relatives. This has
progressed to difficulty finding his way even in familiar places. Neurologic exam shows
an awake, alert, elderly male who insists that he was just on his way to the mall. There
were no moto-sensory deficits. These manifestations are consistent with
A. Dementia
B. Delirium
C. Either dementia or delirium
D. None of the above

Kaplan 9th ed page 334-335

92. Which component of the neurologic exam would be most important in the diagnosis
of this case
A. mental status exam
B. cranial nerve exam
C. motor exam
D. sensory exam

Kaplan 9th ed page 334-335

93. On further exam the patient was noted to be rigid with tremors and bradykinesia.
What is your consideration?
A. Cortical dementia
B. Subcortical dementia
C. Binswanger’s disease
D. Normal pressure hydrocephalus

Kaplan 9th ed page 334

94. What is the most common type of dementia


A. Alzheimer’s disease
B. Pick’s disease
C. Huntington’s disease
D. Vascular dementia

Kaplan 9th ed page 330

95. A 54 year old alcoholic was brought to the ER confused and disoriented with
fluctuating consciousness and perception. What is your diagnosis?
A. Alzheimer’s disease
B. Alcohol intoxication
C. Alcohol delirium
D. none of the above

Kaplan 9th ed page 405 - 406

96. A few months later the patient mentioned above came back because of memory
impairment and confabulation. What is your diagnosis?
A. Alzheimer’s disease
B. Korsakoff’s syndrome
C. Wernicke’s encephalopathy
D. None of the above

Kaplan 9th ed page 347

97. The following are reversible causes of dementia EXCEPT


A. hypothyroidism
B. vit b deficiency
C. normal presuure hydrocephalus
D. Creuztdfeldt-Jakob disease

Kaplan 9th ed page 364

98. Triad of Normal Pressure Hydrocephalus


A. gait disturbance,aphasia, memory disturbance
B. cerebellar signs, sensory signs, ocular signs
C. gait disturbance, urinary incontinence and dementia
D. memory impairment, ataxia and urinary incontinence

Kaplan 9th ed page 254

99. A 50 year old man was brought to the ER because of worsening confusion and
distractibility. The wife can’t pinpoint the exact onset of symptoms but remembers her
husband to be acting different some 2 months ago. Lately the patient has been
complaining of headache.What’s the least likely possibility?
A. Dementia
B. Delirium
C. Mood disorder
D. Primary psychotic disorder

Kaplan 9th ed page 360 - 361

100. On further exam the patient has lapses in memory and mild right facial weakness.
What diagnostic tool will you employ?
A. lumbar puncture
B. electroencephalograph
C. Ct scan of the head with contrast
D. None of the above

Kaplan 9th ed page 360 - 361

***END***

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