MEDICINE FEEDBACK PRELIMS 1ST SEM
Ans: atherosclerosis
1. A 59 yr old male with a history of lung
cancer was admitted due to dehydration and
mental status changes. What is the ideal
fluid for this patient?
Ans: Plain saline solution
2. A 69 yr old male with no hx of lung CA was
admitted due to hpn and generalized edema.
Upon PE there is a non-healing wound on
the right big toe of around 3 weeks duration.
Treatment includes:
Ans. Glucocorticoids
3. What is the mose common cause of
paraneoplastic syndrome?
Ans: Hypercalcemia
4. A 44 yr old female was seen at the clinic due
to dizziness and palpitations. Upon PE there
was pallor on the palpebral conjunctiva and
palmar crest. The estimated level of
haemoglobin in the clinical parameters is:
Ans: less than 80g/L
5. A 25 yr old female was admitted due to
pallor. Upon PE there was postural
hypotension and tachycardia. What will you
request to assess the adequacy of red cell
fraction?
Ans: reticulocyte count????
6. Hyperproliferativecause of anemia
Ans: bone marrow fibrosis
7. A 55 yr old male, smoker, was admitted due
to vertigo, hpn and cyanosis. Hx reveals
upper Pruritus .What is the most likely
etiology?
Ans. Polycythemia
8. Virchow’s nodes signifies?
Ans: GIT malignancy
9. Petechial rashes signify dysfunction of?
Ans: platelet
10. Major risk factors for …. thrombosis?
11. Which of the following features
favorshumoralhypercalcemia of malignancy
(HHM)?
Ans: No malignancy with very high serum
calcium level
12. Which of the ff malignancies is the most
common cause of ectopic vasopressin?
Ans: small cell and carcinoid
13. True regarding tx of hyponatremia, except?
Ans: should be corrected gradually esp. if
mental status is altered.
14. Which of the following is/are the metabolic
manifestations of ectopic ACTH
production?
Ans: fluid retention
15. Which of the following is/are tumors
producing excessive insulin-like growth
factor 2?
Ans: all of the above (mesenchymaltumors,
hepatocellular tumors, adrenal tumors)
16. The most common thrombotic conditions
with cancer is/are?
Ans: A&C only (deep vein thrombosis,
pulmonary embolism)
17. The following is/are paraneoplastic
hematologic syndrome, except?
Ans: thrombocytopenia
18. Acute back pain with haematuria and
deteriorating renal function in an anaemic
pt. is suggestive of?
Ans: hemolysis
19. Erythrocyte functioning is dependent on the
ff, except?
Ans: availability of folic acid
20. A reliable index of red cell production?
Ans: Reticulocyte count
21. A 50 yr old male smoker complains of
occasional digital cyanosis with pruritus is a
 known case of polycythemia. What is the cut
off to diagnose him with the said condition?
Ans: > 170 grams/liter haemoglobin
22. APTT measures…
Ans: intrinsic and common pathway
23. 79 yr old female smoker was admitted due
to a right femoral fx. 24 hrs after sx she
presented with signs of right…. arterial
thrombosis. This….. for arterial thrombosis
in this patient includes:
Ans: atherosclerosis
24. Metastatic malignancy of the head, neck,
lung, breast and thyroid may present with
lymphadenopathies of the :
Ans: Neck
25. The best diagnostic procedure for
lymphadenopathies is:
Ans: excision biopsy
26. A 59 yr old male diagnosed with colonic CA
presented with karnoffsky performance
index of 70. What is the pt’s functional….?
Ans: cares for self, unable to carry on
normal activities
27. Tumor marker for adenocarcinoma of the
breast, colon, pancreas, lung and ovary?
Ans: CEA
28. Non neoplastic condition related to elevation
of CEA?
Ans: smoking
29. Clinical staging includes:
Ans: physical examination
30. Most common cause of death in the USA
with patients with malignancy
Ans: Lung CA
31. True of Fever of unknown origin, except?
Ans: 3 days incubation of cultures
32. Group? Vesicles…
Ans: HSV
33. Maculo-papular, except:
Ans: Meningococcemia
34. A 55 yr old non diabetic obese male smoker
sought consult to a clinic due to a localized
vesicular pink erythematous skin lesion on
the right anterior …. distal area with no
fever. What should you ask on the past
medical hx of your pt which is related to the
present condition?
Ans: Varicella
35. A 19 year old male complains of
circumscribed elevation of skin along the
dorsum of the right foot with purulent fluid.
Ans: Pustules
36. A 19 year old female student of AUF was
seen at the clinic complaining of macular
rashes which are at the hair line swelling
downward which clear up as lesions preads
downward with accompanying posterior
auricular adenopathy.
Ans: rubella
37. Maculopapular lesions with characteristic
annular papules end up as polycyclic lesions
resolving within hours seen with patients
with rheumatic fever.
Ans: Erythema marginatum
38. Target lesions
Ans: Erythema multiforme
39. 27 yr old female was seen in the ER at 6 in
the morning with fever and cough. Oral
temperature was taken at 37.7. What will
you tell your patient regarding temperature?
Ans: patient has fever
40. A 39 year old male had a thyroid sx under
general anaesthesia 2 hours ago. He is now
manifesting with a temp or 39 degrees
centigrade. Other parts of PE are within
normal.
Ans: Malignant hyperthermia
41. A 33 year old male was admitted due to
hypothermia and changes in sensorium
after…….. On PE there is presence of
hemorrhagic vessels along the lower leg on
the dorsum of the feet. What type of frost
bite does the pt have?
Ans: 3rd degree
42. Fever is defined based on diurnal variation
as………. more than restricted value as:
Ans: 6 am 37.2 degrees centigrade, 6pm
37.7 degrees centigrade
43. A 35 yr old…… found along Clark
complained of dizziness and body malaise at
 12:30p, history reveals that he has been
jogging for the past 3 hours. PE reveals that
he is dehydrated with temperature of 38
degrees centigrade. What is the possible
cause?
Ans: exersional heat stoke
44. The most common cause of classic FUO:
Ans: Extrapulmonary TB
45. The most common multisystem cause of
classic FUO……?
Ans: Giant cell
46. Most common cause of nosocomial FUO:
Ans: Infected IV lines
47. One of the ff statements is true regarding
FUO:
Ans: B. drug fever starts 1-3 weeks after
use.
48. One of the ff statements is false in taking a
patient’s hx:
Ans: ask leading questions
49. AGE questionnaire is used for this sensitive
topic as in:
Ans: Drug abuse
50. One of the ff statements is true regarding
the initial pt. relationship:
Ans: Do PE of the opposite gender with
assistance inside the office.
51. When inviting the patient’s hx:
Ans: Do not interrupt
52. One of the ff is true regarding the chief
complaint:
Ans: Use patient’s own words
53. Objective data:
Ans: Urinalysis
54. Subjective data
Ans: back pain
55. Comprehensive history
Ans: new patients
56. Focused health history:
Ans: Establish patients?
57. Overweight for Filipinos/Asians is……..of
Ans: >23kg/m2
58. The cause of obesity secondary to
hypoglycaemia induced CA???
Ans: Insulinoma
59. one of the ff is true of leptin:
Ans: loss of adipose tissue stimulates
appetite.
60. A 21 yr old female band singer was brought
to the clinic due to lack of sleep for 2 weeks.
She has been taking sleeping pills for weight
loss. These pills is chemically related to
amphetamine:
Ans: Phentermine???
61. If a pt. is seated the ff examinations can be
done, except:
Ans: JVP
62. If you are to examine a female patient, what
should you do before examining your
patient?
Ans: secure a female companion to
accompany you during the examination
(don’t know if this is the answer)
63. A 55 yr old male went to the office for a
periodic examination. You took his height
and weight. If his height is 1.77m and he
weighs 105 kgs. What is his BMI?
Ans: 32??? (not sure)
64. The disappearance of korotkoff sounds
indicates:
Ans: auscultatory gap
65. An elderly pt. came into the ER due to
massive bleeding, you were asked to take
the vital signs. The resident asked you to
check for orthostatic hypotension. You
would do the ff, except:
Ans: Measure the respiratory rate
66. Blood pressure can be measured in the
following sites, except:
Ans: Subclavian artery
67. While checking the PR you noticed
that………….
Ans: AOTA (atrial fibrillation, atrial flutter,
ventricular premature beat)
68. A pt with pneumonia was admitted. While
doing the vital signs you noticed the RR
decreases until he suddenly breathes deeply
and then went into an apnoeic phase. What
kind of respiratory phase is this?
Ans: cheyne stokes breathing
69. Patient with Hodgkin’slymphoma,
complained of fever. When interviewed
further, she complained for continuous fever
of several days followed by febrile episodes
that lasts for irregular number of days. Her
fever patter is called:
Ans: Pal Epstein fever
70. A pt was admitted in the ER because of
?chondral pain, intial dx was acute AP.
What type of pain does this pt have?
Ans: nociceptive pain
71. What type of primary efferent nociceptive is
involved in light touch moving stimuli?
Ans: Alpha, beta fibers
72. ??? Painful response to non-painful stimuli?
Ans: Alodynia
73. This is a ……condition where in a pt. will
experience burning retrosternal pressure
lasting for 2-3 mins?
Ans: esophageal spasm
74. Among pts. presenting with chest pain in the
ER, the most common etiology would be?
Ans: gastroesophagealdse
75. A 45 yr old female sought consult bec of
headache. On taking the hx, headach e was
described as dull aching pain aggravated by
change in position, with vomiting preceding
the headache. She has a history of early
amenorrhea. What is the possible etiology?
Ans: Brain tumor
76. An abdl pain in the RUQ with radiation in
the right posterior region of the thorax or the
tip of the scapula takes what organ?
Ans: gallbladder
77. To diagnose migraine headache there should
be repeated??? with patients with normal PE
and no other ???? cause for the headache
and 2 of the following, except:
Ans: nausea and vomiting
78. This type of headache presents with pain
when the pt. is in an upright position and
improves when supine. It can be due to
previous lumbar puncture and
valsalvamaneuver:
Ans: Low CSF volume headache
79. A female pt. complains of severe headache
on examination. The dx of temporal arteritis
was made. This ???? with the following
symptoms, except:
Ans: temporal ???is the diagnostic modality
of choice. (not sure if this is the answer)
80. A 45 yr old female ????with severe low
back pain. She complains of difficulty of
urinating and ???. On PE showed weakness
of the lower extremities. You diagnosis is:
Ans: CaudaEquina syndrome (??? Not sure)
MEDICINE MIDTERMS 1st SEMESTER
1. Dysphagia caused by impaired deglutative
inhibition- MOTOR DYSPHAGIA
2. Most common cause of death in patient with
oropharyngeal dysphagia- PULMONARY
COMPLICATION
3. Misdirection of food is a hallmark of what
type of dysphagia- OROPHARYNGEAL
DYSPHAGIA
4. Which of the ff. dysphagia is associated with
GERD- ESOPHAGEAL DYSPHAGIA
5. Which of the ff. procedure is/are useful in
investigating esophageal mechanical
dysphagia or esophageal motor dysphagia-
BARIUM SWALLOW
6. In your ? Miller that mediates induction of
vomiting from your gastroduodenal vagal
afferent- M1
7. The following statement is/are true
regarding anti emetic medication except-
GASTRO INTESTINAL MOTOR
STIMULANTS ARE FOR FUNCTIONAL
VOMITING
8. Regarding heartburns, endoscopy is
recommended in the following situation-
MORE THAN 50 YRS. OF AGE
9. Regarding GERD, further evaluation is
recommended if the following symptoms
is/are present- ALL OF THE ABOVE
(choices not given in the recording)
10. GERD pts who are young and may require
life-long therapy and have frequent
 heartburns and regurgitations who are 18. Hallmark of oropharyngeal dysphagia-
responsive to proton pump inhibitors NASOREGURGITATION AND
recommended treatment is/are- LARYNGO ASPIRATION
FUNDOPLICATION 19. ??? is indicative of- PYLRIC
11. A 34 y/o male was seen in the clinic due to OBSTRUCTION
onset of fever,nausea, abdl pain, watery 20. Duration of chronic diarrhea- ATLEAST 4
diarrhea of 4 episodes in the last 16hours, he WEEKS
denied presence of blood in the stools, stool 21. Constipation is decrease frequency of-
amount is estimated to be half cup per HAPSIS???
episode he denies episode of pancit, 22. Lactase def. is an osmotic type diarrhea
spaghetti, fried rice, eggs and cheese. He ate 23. Foreign body sensation localized in the neck
in a breakfast buffet during his Asian Cruise doesn’t interfere with swallowing and
2 days ago, consisting mostly of sometimes relieved by swallowing-
salads,toasted breads, fruits and cereals, his GLOBUS PHARYNGUS
two other companion consulted also for the 24. Dysphagia caused by an oversized bolus or
same problem, one day prior to his narrowed lumen- STRUCTURAL
consultation, stool examination done 3times DYSPHAGIA
revealed absence pus cells,RBCs, parasites 25. Solid food dysphagia becomes common
and fat globules, he was informed that said when the lumen is narrowed to- <1.3cm
results are all normal, what is the most 26. Stenosis of the crycopharyngus that causes
probable cause of his diarrhea ( Takte neto diminished opening of the upper esophageal
ang haba)- ROTAVIRUS sphincter and results increase
12. The common cause of acute persistent hypopharyngeal pressure during swallowing
infectious diarrhea is secondary to- with development of pulsion diverticulum
GIARDIA immediately above the crycopharyngus in a
13. A 19 y/o male student of AUF consulted due region of potential weakness known as
to bloody diarrhea, and fever of two days of ????dehiscence- ZENKERS
duration, stool less than half cup per DIVERTICULUM
episode, hx. revealed onset of bloatedness 27. Prominent indentation behind the lower
and abd’l discomfort 4days prior to third of cricoid cartilage –
consultation, he denies intake of medication, CRYCOPHARYNGEAL BAR
what should not be given to this patient- 28. Cause of structural oropharyngeal dysphagia
ANTI-MOTILITY AGENT except- SCHIATZI RING
14. The most cost effective diagnostic procedure 29. Cause of neurogenic propulsive
for a patient presenting with weight loss, oropharyngeal dysphagia except-Myesthenia
rectal bleeding, anemia, and constipation, in Gravis
a 50 y/o patient- COLONOSCOPY 30. Can cause both solid and liquid esophageal
15. Minimum esophageal lumen distention dysphagia except-NEOPLASM
diameter wherein dysphagia to solid food 31. Causes of variable structural esophageal
occurs- 2.5CM dysplasia except-SCHIATZI RING
16. Disorder of inhibitory inhibition except- 32. GERD stands for-GASTRO
MYESTHENIA GRAVIS ESOPHAGEAL REFLUX DSE
17. A hx of insidious onset of dysphagia from 33. Refers to absence of overt bleeding via fecal
solid to liquid is unlikely, for one or more of occult blood test or the presence of iron def-
the following- ACHALASIA OCCULT BLEEDING
34. Most common cause of upper GI bleed- 52. SAAG <1.1g/dl is usually caused by-IVC
PUD OBSTRUCTION
35. Classic hx of vomiting retching or coughing 53. Scleral icteresia indicates
preceding hematemesis especially on hyperbilirubinemia of atleast- 3MG/DL
alcoholic patients- MALLORY TEST 54. Characteristic of unjugated bilirubin –
36. Endoscopic therapy of choice for esophageal USUALLY ALBUMIN BOUND
varices-LIGATION 55. Isolated indirect hyperbilirubinemia except-
37. Common cause of erosive gastropathy ROTOR
except- COFFEE 56. Absence billurubin UBPGT activity-
38. Most common cause of significant LGIB in CRIGLER NAEGER TYPE 1
children- MECKELS DIVERTICULUM 57. Impaired conjugation except-ROTOR
39. Most common cause of LGIB- SYNDROME
HEMORRHOIDS 58. Anti-mitochondrial antibody is usually seen-
40. Abrupt painless sometimes massive LGIB is PRIMARY BILIARY CIRRHOSIS
usually caused by-DIVERTICULAR 59. What is the most appropriate physical
BLEEDING examination in determining presence of
41. The landmark which is often used to ascites-SHIFTING DULLNESS
separate LGIB to UGIB- LIGAMENT of 60. What is the normal volume of air in the
TREITZ intestines of which an increase would result
42. An increase in abdl size is first noted in abdominal distention- 200
what week/s of pregnancy- 12-14WEEKS 61. Most common cause of ascites- AGAIN
43. Signs of Chronic liver dse except- LIVER CIRRHOSIS
VIRCHOWS NODES 62. A 56 y/o alcoholic male complaint of vague
44. Procedure of choice in patient admitted with right upper quadrant pain, on inspection you
LGIB unless bleeding is massive or unless noted a slightly icteric pain on the skin eyes,
sigmoidoscopy has disclosed an obvious pedal edema and the presence of
acute bleeding-COLONOSCOPY gynecomastia-LIVER CIRRHOSIS
45. Most Common cause of ascites- 63. Lab computation used in differentiating
CIRRHOSIS whether the cause of ascites due to portal
46. Causes of abdl swelling except-FLAT HTN- SAAG
FOOTED***BONUS 64. Procedure to determine the cause of ascites-
47. All of the ff. increase hepatic resistance PARACENTESIS
except-DECREASE CIRCULATING 65. Upon determination of SAAG you obtain a
LEVELS OF NITRIC OXIDE value of >1.1, however, the acidic protein is
48. Consider as the hallmark of chylus ascites- <2.5, the ff. differentials maybe considered
WHITE MILKY FLUID INDICATING except- CONSTRICTIVE PERICARDITIS
PRESENCE OF TRGLYS 66. In differentiating cirrhosis from CHF, the
49. Ascites in the absence of cirrhosis generally use of acidic would be helpful in that it
result in the ff. except- PORTAL HTN usually >2.5 and is usually <2.5 in patients
50. ??? Distinguishing ascites caused by portal with liver cirrhosis-BOTH ARE CORRECT
HTN- (SAAG) SERUM ASCITES 67. A 63 y/o man complaining gradual abdl
ALBUMIN GRADIENT enlargement with diffuse abld pain cachexia
51. Acidic protein >2.5g/dl is usually caused by- and edema, presence of fluid waves, shifting
LATE ???? SYNDROME dullness and advised paracentesis, on
 tapping, you noted presence of blackish loss for the past 2mos. You are entertaining
fluid- A METASTATIC CONDITION steatorrhea secondary to pancreatic
68. In treating ascites apart from low salt diet, insufficiency, the amount of stool fat should
judicious use of diuretics is indicated for pts be- MORE THAN 32 GRAMS
ascites secondary to liver cirrhosis the ff. 80. A 66 y.o male was seen at the ER due to
guidelines for the use to liver cirrhosis easy fatigability muscle wasting, body
except-NONE OF THE ABOVE malaise and ascites, what is the significant
69. A 23 y.o. female came for consultation AST to ALT ratio- MORE THAN 2
complaining of constipation when ask over
hx, she complaints of regular bowel *****END*****
movements every 3 days, what should you 2nd SEMESTER MEDICINE PRELIMS
do- NONE
70. A 45 y.o male alcoholic complains of non
bloody loose diarrhea that persisted for a
ans: diastolic dysfunction(number?)
month, occurring even with fasting, has
already signs of dehydration and weight
loss, no other PE findings of note,what is the
possible dx- ENTEROCYTE INJURY DUE dyspnea cause by low cardiac output
TO ETHANOL
choices: obesity
71. A pt chronic constipation arrives at the
clinic, she 64 y.o female with 8 children via anemia
NSD, you suspect a pelvic floor dysfunction,
what is a positive test- ALL OF THE constrictive pericarditis(ans)(explanation from
ABOVE doctora, imagine a heart being
72. What psychiatric condition would strangulated(sinasakal) caused by the pericardium,
predispose a patient to develop constipation that cause restriction and reduction of the cardiac
except- MUNCHAUSEN SYNDROME output
73. Type of chronic diarrhea, characterized by diastolic dysfunction
greasy fowl smelling stool , presence of fats
in the stool and mark signs of nutritional
def- CELIAC DSE
condition that is......(incomprehensible)
74. Condition that require evaluation for pt with
acute diarrhea manifesting the ff. except- choices: pregnancy
MILD RESTRICTION IN ACTIVITIES
75. Institutionalized individual usually develop pneumonia(ans)
diarrhea due to this organism- C.DIFICILE
anemia
76. Diarrhea of 2-4 weeks is termed-
PERSISTENT myocardial ischemia
77. You went to Russia for convention and
develop diarrhea- GIARDIA
78. The ff. are antibiotic prophylaxis except- disorders of the airways that leads to increase in
METRONIDAZOLE airway resistance and work of breathing, except
79. 16 y.o male student was seen in the clinic
due to chronic diarrhea of greasy fowl choice: asthma
smelling stool and a 15 to 25 percent weight
emphysema choices: shifting of oncotic forces from the vessel to
the surrounding lung tissue(ans)
bronchiectasis

anatomical problem of kyphoscoliosis(ans)

true of the cardiogenic pulmonary edema

choices: hydrostatic pressure are normal

nocturnal dyspnea(difficulty of breathing at night)
suggest chest xray findings in non-cardiogenic pulmonary
edema
choices: occupational lung disease
presence of perihilar alvolar infiltrates
myocardial ischemia
(ab)normal heart signs (with/or) interstitial
embolism thickening(ans)(incomprehensible)
asthma(ans)(explanation, due to environmental
changes, presence of some allergens at night, and
house dust mites) recommended diagnostic procedures to differentiate
pulmonary dyspnea from cardiac dyspnea

choices: cardiopulmonary exercise test(ans)

which of the following causes orthopnea(dyspnea
upon lying down)

choices: emphysema chronic cough with a normal xray(discarded

question)
asthma
choices: upper respiratory infection......
obesity

congestive heart failure(ans)(explanation, due to the

presence of fluid in the lungs(alveoli) common cause of acute cough

choice: ashtma

platypnea is defined as postnasal drip

choices: increase work of breathing gastroesophageal reflux

development of effusion pulmonary embolism(ans)

dyspnea in the supine position relived in the upright

postiion
subacute cough is caused by
dyspnea in the upright position relived in the supine
position(ans) choices: congestive heart failure

aspiration

effects of cardiac abnormality that lead to an non-toxic syndrome?(ans)

increase in pulmonary venous pressure, except
among the following agents, this agent inhibits the 59 year old male admitted due to hemoptysis, blood
efferent limb of .....(incomprehensible) coming from the lungs would be characterized with
a

choice: bright red color

a physical exam finding due to a large airway
narrowing is

choices: stridor(ans) the exception for diagnostic for examination of

hemoptysis(incomprehensible)

choice: chest xray

complication of cough
lipid profile(ans)
choices: orthopneas
coagulation profile
congestive heart failure

paroxysmal nocturnal dyspnea

65 year old male smoker with cough of 2 months
exhaustion(ans) duration no Hx of angina, heart disease, nausea
vomiting and bloatedness, what is the least likely
cause of this cough
massive hemoptysis
choices: copd
ans: more than 100-(600?) in 24
hours?(incomprehensible) bronchogenic CA

embolism(ans)

a 58 year old male, with history of hemoptysis of 12 eosinophilic bronchitis

episodes....(incomprehensible) which among the
following is the most common cause of massive
hemoptysis the best diagnostic procedure to document presence
of bronchiectasis and interstitial lung disease
choices: bronchogenic cancer
choice: high resolution CTscan(ans), ( not CTscan
TB(ans) only, it should be high resolution CTscan)
bleeding disorders

lung abscess sudden onset of hemoptysis, chest pain and cough,

in a 49 y/o female , with auscultation of .... friction
rub
the best treatment modality to avoid asphyxation in
patients presenting with massive hemoptysis is choice: pneumonia

choice: mechanical ventilation(ans) bronchitis

foreign body

pulmonary embolism(ans)

sound in auscultation can be reduced with intake of
this medication on patients with asthma
choices: ACE inhibitors
calcium channel blockers
diuretics
betablockers(ans)
which of the following type of hypoxia is caused by
unattainable oxygen transport
choice: anemic hypoxia(ans)
which of the following is/are .... operating in
decrease oxygen demand(incomprehensible)
choice: decrease ventiltion and decrease cardiac
output
which of the following is the effect of hypoxemia
choice: (incomprehensible)
the following is/are concepts of hypoventilation
hypoxia, except
choice: airway disease(ans)
decrease repiratory drive
which of the following is/are true with cyanosis
choice: (incomprehensible)
which of the following .... favors
cyanosis?(incomprehensible)
choice: COPD with chronic hypoxemia(ans)
polycythemia(ans)
thalasemia
A and B(ans)
which of the following will no display cyanosis
choice: exercise?(ans)
methemoglobin
the following is/are causes of .... cyanosis
except(discarded question)
clubbing with cyanosis is common in the following,
except
choices: congenital heart disease
lung abscess
AV fistuta?
infective endocarditis(ans)
....the following are differential diagnosis for
patients with acute chest discomfort, except
choices: pulmonary regurgitation?(ans)
GERD
ischemic heart disease
45 y/o male complaining with on and off chest pain
of about 10mins described as tightness and
heavyness, stess test?(incomprehensible) show st
segment shift? during peak exercise, coronary
artery..... which is the most possible diagnosis
choice: cardiac.....(incomprehensible)
36 y/o male apparently healthy suddenly complain
of pleuritic chest pain more on the right ....
acompanied by dyspnea?(incomprehensible)
choice: spontaneous pneumothorax(ans)
a 30 y/o female complain burning pain located
substernal and epigastric, she noted that the pain
experienced after a large meal and during
recumbent position, ecg shows st segment
depression of less than 1mm, exercise stress test are
normal, what is the most posible cause of this?
choice: GERD(ans)
38y/o male... complaining blurring of vision and
was rush to the ER due to sudden intense sharp
pain? at the anterior chest wall radiating to the back,
what is the probable cause of this chest pain?
choice: embolism
myocardial infarction
aortic dissection(ans)
45 y/o female complain of episodic chest pain for 2
days, described sharp, constricting, retrosternal with
radiation to the left shoulder, aggravated with
coughing and change in position, ecg shows
extensive st segment elevation, the most probable
diagnosis would be
choice: unstable angina
pneumonia
pleuritis?
pericarditis(ans)
52 y/o female complaining of chest pain lasting for
>10mins decrribed as heavyness and tightness,
patient is still in pain in the ER, ecg reveal non
specific st wave changes, which of the following
best test for coronary artery disease
choice: cardiac perfusion scan(ans)
exercise stress test
xray
65 y/o male bedridden, complain of pleuritic chest
pain more on the right side of the chest,
accompanied with difficulty of breathing and
hemoptysis, what is the most common cause of this
choice:aortic dissection
pneumonia
embolism(ans)
pneumothorax
a 38 y/o female complain of burning pain located
substernal and epigastric area non-radiating in
character, pain occurs during large meals and
recumbent position,(discarded question, repeated
question)
the following sign and symptoms increases the
likelyhood of acute MI, except
choice: sharp pain(ans)
radiation to both arms
nausea vomiting
according to JNC7,...chronic blood pressure
monitoring is recomended to the following, except
choice: symptomatic hypertention(ans)
which of the following is true, with extra the following are vascular mechanism of
intervention?? in treatment of hypertension hypertension, except

choice: limiting of daily sodium intake by 4.4 to choice: letter C, (ans)

7.4grams per day(ans)

according to JNC7 blood pressure classification, a

the following effects of angiotensin II when it binds patient with blood pressure of 150/100 is classified
to the integral receptor? located in the cell as
membrane, except
choice: stage 2(ans)
choice: venoconstriction(ans)

in treating malignant hypertension the ... is to know

true with the epidemiology of hypertension, except the hypertension at a range of(discarded question)

choice: incidence of hypertension is higher in men choice: 160/100/ to 160/110(ans)

than in women

older individuals.....(incomprehensible)
the effects of decrease in renal function includes the
among individuals >60/yo hypertension is higher in following, except
women than in men
choice: decrease in calcitriol? levels(ans)
among adults systolic blood pressure is
progressively decrease?.....(incomprehensible)(ans)
effects of progressive renal dysfunction is

which of the following is true regarding choice: sodium retention(ans)

hypertension(discarded question)

choice: mechanism of .....except(incomprehensible)

choice: letter A, increase in glomerular .... ateriol

the following.... present with systolic hypertension vasoconstriction(ans)
with wide pulse pressure except

choice: hypothyroidism(ans) factors promoting compensatory renal hypertrophy

is, except

the following are primary stimuli for renin secretion choice: renin(ans)

choice: decrease sodium chloride transport in the angiotensin II

thick ascending loop of henle(ans) PgF
components of.... glomerular filtration regulation?, plasma bicarbonate in normal acid base homeostasis
except is controlled by what organ

choice: natric? ..... peptide(incomprehensible)(ans) choice: kidyney(ans)

true of serum calcium in renal which among this is metabolic acidosis'

function?(disfunction?)
choice: letter B, pH 7.3, pCO2 34, HCO3 15(ans)
choice: tends to go down(decrease in serum
levels)(ans)
amonium production and excretion increases in

true of serum potassium in renal dysfunction, except choice: metabolic acidosis(ans)

choice: increased by aldosterone(ans)

in which acid base disorder when the pH is normal,
an elevated anion gap denotes the presence of
effects of hyperkalemia in the kidney
choice: metabolic acidosis(ans)
choice: all of the above(ans)

inhibits tubular bicarbonate reabsorption

what compound is found in wine? that causes
extracellular volume expansion allergic reaction

and increase parathyroid hormone? choice: tyramine(ans)

recommended low? protein? diet per day is diphenhydramine is give to this route vasodilation
and hypotension
choice: 0.6-0.75? grams/kg(ans)
choice: intramuscular(ans)

(a)typical? urinalysis findings in patient with acute

GN the 2nd gen antihistamine that stimulates appetite is

choice: RBC choice: buclicine(ans)

dysmorphic RBC

presence of RBC cast this antihistamine was removed from the market
due to side effect of ventricular tachycardia
proteinuria
choice: terfenadine(ans)
all of the above?(ans)

example? of CD4 T-helper 1 reaction is

choice: leprosy(ans)
a holosystolic murmur at the left lower sternal
border radiating to the right lower sternal border
which becomes louder in inhalation/inspiration is
choice: .......tricuspid regurgitation(ans)
the austin flint murmur is heard along the cardiac
apex, a diastolic murmur seen in patient with
choice: severe aortic insufficiency (ans)
#78- (discarded)
67 y/o man come to the clinic for insurance as
requirements for physical examination, during
blood pressure measurement the systolic sounds are
heard until the cuff is deflated(no disappearance of
korotkoff sounds) blood pressure 180/60, PE
revealed..... high pitch blowing diastolic murmur
along the left sternal border, the most likely
diagnosis is
choice: aortic regurgitation(ans)
30 y/o woman reports to her physician due to
progressive dyspnea, there is a history of
excertional shortness of breath that has worsen even
mild amounts of activity, episode of hemoptysis, no
fever, chills and sputum production...... fine lung
crackle is auscultated in the lung base, the most
likely diagnosis is
choice: mitral stenosis(ans)
....fainting... ecg revealed arrythmia,
echocardiogram reveals a mass in the left atrium,
which of the following is likely be seen on the
microscopic resected mass
choice: myxoma(ans)
72 y/o female was admitted ..... passes out while
exercising, intermitent exertional chest pain and
dyspnea on inpiration, PE revealed cresendo-
decresendo murmur at the right upper sternal border
and a 3/6 holo systolic murmur at the apex, s2 heart
sound is soft and the carotid upstroke is weak and
delayed, this is most probably due to a
choice: aortic valve stenosis(ans)
18 year old male no significant past medical Hx
come to the clinic for routine PE, BP of 150/85, HR
80 RR 12, afebrile, PE revealed normal heart
sounds but there is a 5/6 holosystolic murmur with a
thrill at the left lower sternal border, no change in
intensity in inpiration, no extra heart sound, normal
JVP, ECG normal, most likely diagnosis would be
Choice: ventricular septal defect(ans)
this murmur is produce by post dynamic LV
outflow tract obstruction and mitral regurgitation.....
choice: hypertrophic obstructive
cardiomyopathy(ans)
impalpable apex beat is due to the following causes,
except
choice: ventricular septal defect(ans)
which of the following is true,
choice: the bell of the stetoscope is best in
evaluating high pitch sound
the bell and diagpharm of the stestoscope, are used
alternately for evaluating of murmur(ans)
one of the following is true about evaluation of
heart sound
choice: apex=mitral valve, 2nd right intercostal
space=aortic valve(ans)
39 y/o female was seen due to palpitations, an
auscultation a faint murmur was heard upon
listening, what is the grade of this murmur
choice: grade 2(ans)
this characteristic feature.... should be included in
the evaluation....
choice: site, radiation, effect of respiration......(ans)
which of the following is true regarding JVP
choice: an elevated JVP is evident of raised heart
ventricular pressure(ans)
paroxysmal nocturnal dyspnea as a sign of cardiac
disease described as
choice: awakening of the patient from sleep in the
supine position with severe shortness of breath(ans)
one of the following is true regarding s1 and s2
choice: s2 is louder than s1(ans)
one of the following is true regarding s3 and s4
choice: can be appreciated with the bell of the
stetoscope(ans)
mucoid sputum is described as
choice: transluscent white(ans)
elevated jugular venous pressure is
choice: more than 4cm above the sternal
angle?(ans)
hyperresonance (discarded question)
instructed to say 99
choice: bronchophony(ans)
characteristic of this breath sound in a normal
airfilled lung is described as
choice: predominantly vesicular(ans)
.....over the sternal area..... with bronchial breath
sound, respiratory crackles and increase tacktile
fremitus over the involved area is due to
choice: consolidation
shifting of the trachea over the affected side is
choice: atelectasis, or consolidation(ans)(2 answers)
2nd SEMESTER MEDICINE MIDTERMS
1. 65 year old diabetic woman weighs 65 kg with a
blood crea of 2.5 mg/dl, compute for cockcroft
gault, parameters included are: ALL OF THE
ABOVE (age, sex and weight).
2. Her GFR: 23 ml/min
3. Based on her GFR, you classify her as: CKD 4
4. This component is a freely filtered solute that is
derived from muscle metabolism and is oftenly
used commercially: CREATININE.
5. The following condition will predispose the
patient to develop PRERENAL azotemia,
EXCEPT: PROSTATIC HYPERTROPHY (this
is post-renal). Hepatorenal syndrome, Sepsis,
Rhabdomyolysis are all pre-renal.
6. This urine sediment’s presence in routine
urinalysis among renal transplant patients might
suggest transplant rejection: WBC CAST
7. Diabetic patient…. You are not sure if the
azotemia is pre-renal or renal. Based on the
following laboratory results, azotemia is pre-
renal rather than acute renal failure: THE
URINE OSMOLALITY WAS MORE THAN
500 mOsm.
8. Patient with ischemic GN will present with the
ffg manifestations, EXCEPT: NONE OF THE
ABOVE. It would present with ----, hematuria
and proteinuria.
9. Discarded.
10. Proteinuria level of 30-300 may be seen in:
EARLY DIABETES
11. Urine output of more than 3L/day: POLYURIA
12. Proximate volume composition of intracellular
fluid: 60% MALE, 40% FEMALE
13. Composition of the extracellular fluid,
EXCEPT: BLOOD. Interstitial, transcellular and
lymph are extracellular fluids.
14. Majority of the water intake in our body comes
from: WATER IN BEVERAGES
15. Proximately how much water is lost through
skin and lungs: 28%
16. Homeostasis is maintained by, EXCEPT:
RESPIRATORY EXCHANGE
17. ADH release is triggered by, EXCEPT:
DECREASED AMOUNT OF SODIUM IN
THE BODY
18. ADH and aldosterone both exert their effect on
what part of the glomerulus: COLLECTING
DUCTS
19. A major ECF cation is: SODIUM
20. About 1/3 of our body water is in the:
EXTRCELLULAR SPACE
21. True of obligate water loss: THE URINE HAS
TO EXCRETE A MINIMUM AMOUNT OF
500 ML/DAY FOR ---- TO BE BALANCED.
22. Effective osmolytes, EXCEPT: UREA
23. A least likely trigger of hypercalcemia:
MUSCLE CRAMPS
24. The most prominent feature of increased serum
magnesium level is: VASODILATION
25. The earliest signs or symptoms of hypovolemia:
THIRST
26. The symptom of hyponatremia:
OBTUNDATION
27. The most common cause of hypernatremia:
RENAL WATER LOSS
28. Hypernatremia is seen in this case: POOR
WATER INTAKE
29. Nephrogenic DI with hypernatremia is most
probably due to: OSMOTIC DIURESIS
30. Treatment for hypernatremia: D5 WATER
31. One of the ffg statements is TRUE regarding
fluid and electrolyte imbalance: SERUM
SODIUM CORRECTION SOULD NOT
EXCEED 12 MMOL/L DURING THE FIRST
24 HOURS
32. One of the ffg statements is true regarding fluid
and electrolytes imbalance: CALCIUM
GLUCONATE DECREASE MEMBRANE
EXCITABILITY
33. One of the ffg statements is true regarding fluid
and electrolytes imbalance:
GLUCOCORTICOID DEFICIENCY IS A
COMMON CAUSE OF HYPOOSMOLAR
HYPONATREMIA
34. Which of the following is/are test/s for level of
alertness: SPELLING SHORT WORD
FORWARD AND BACKWARD.
35. Which of the ffg is/are important factor/s to take
into consideration in applying test and
interpretation of results of neurologic
examination: ALL OF THE ABOVE (cultural,
co-morbidity, ---)
36. True of visual acuity testing: FOR SHORT
SIGHTED PATIENTS, GLASSES SHOULD
 BE WORN, BUT IF NOT AVAILABLE,
READING THROUGH A PIN HOLE WOULD
HELP ------.
37. Which of the ffg is/are test for calculation: ALL
OF THE ABOVE (Identify right and left body
parts, simple addition, identify each digit)
38. True of with visual field defects: LESION IN
OCCIPITAL CORTEX WILL PRESENT
WITH MACULA SRARING
39. True of an oculomotor nerve palsy: PTOSIS OF
THE AFFECTED EYE
40. True of the corneal reflex: MOTOR IS
INNERVATED BY THE FACIAL NERVE
41. The 7th nerve supplies the ffg: ALL OF THE
ABOVE
42. True regarding conductive deafness: WEBER’S
LOUDER IN DEAF EAR
43. True of the isolated 9th nerve palsy: PALATE
MOVES WHEN SAYING “AH”
44. Area 22 is also called: WERNICKE’S AREA
45. Area 312 is also called: POST CENTRAL
GYRUS
46. Infarction of the superior division of the middle
cerebral artery and the posterior angular
branches would produce: RECEPTIVE
APHASIA
47. Massive stroke in the left frontal region will
produce: NON-FLUENT APHASIA
48. A most common language disorder in a head
trauma, metabolic encephalopathy
Alzheimer’s disease: ANOMIC APHASIA
49. Deficit found in goal-directed sequence of
movement is seen in: APRAXIA
50. Responsible for coordination of motion,
motivation, autonomic function and endocrine
function: LIMBIC SYSTEM
51. Frontal disinhibition syndrome, EXCEPT:
LOSS OF INITIATIVE AND CREATIVITY
52. All of the ffg will have hearing loss and tinnitus
associated with vertigo, EXCEPT: BENIGN
POSITIONAL VERTIGO
53. Nystagmus due to peripheral causes has all of
the ffg features, EXCEPT: THEY CAN BE
HORIZONTAL OR VERTICAL
54. One of the ffg statements about nystagmus of
central origin is NOT TRUE: ACCENTUATED
BY HEAD MOVEMENT
55. Dizziness maybe classified into 3 categories,
EXCEPT: GAIT DISTURBANCE
56. Vertigo: IS USUALLY DUE TO
DISTURBANCE IN THE VESTIBULAR
SYSTEM
57. Example of physiologic vertigo: CAR
SICKNESS
58. Most common cause of pathologic vertigo:
VESTIBULAR DYSFUNCTION
59. The most common offending drug is an
aminoglycoside antibiotic: ACUTE
BILATERAL LABYRINTHINE
DYSFUNCTION
60. Associated with sinus symptoms of cochlear
disease: RECURRENT UNILATERAL
LABYRINTHINE DYSFUNCTION
61. Due to lesions in and around the 4th ventricle:
CENTRAL POSITIONAL VERTIGO
62. Acute or episodic hemiparesis: FUNGAL
GRANULOMA
63. The most common responsible for paraparesis:
PARASEPTAL LESIONS
64. True of right-sided hemiparesis: IT RESULTS
FROM AN UPPER MOTOR NEURON
LESION ABOVE THE MIDCERVICAL
SPINAL CORD
and 65. One of the ffg statements is true in left-sided
hemiparesis: THERE IS A TENDENCY TO
TALK EXCESSIVELY
66. The language disturbance occurring after a
right-hemisphere lesion in the right ----- is
called: GLOBAL APHASIA
67. The naming error is, if the patient offers an
incorrect but legitimate word , example, pen for
pencil: SEMANTIC PARAPHASIA
68. What is the retrieval based naming deficit:
WHEN ASKED TO NAME COMMON
OBJECT, THE PATIENT MAY FAIL TO
COME UP WITH THE APPROPRIATE
WORD AND PROVIDE CIRCUMLO…
DESCRIPTION OF THE OBJECT OR MAY
COME UP WITH THE WRONG WORD
69. In assessing repetition, the ffg are true, 81. The ffg findings are indicative of Wernicke’s
EXCEPT: APHASIC PATIENTS MAY HAVE aphasia: A NON-FLUENT LANGUAGE
A HARD TIME REPEATING A STRING OF OUTPUT
FUNCTION WORDS 82. Impaired comprehension and spoken language:
70. The ffg statements are true with Wernicke’s GLOBAL APHASIA
aphasia: LANGUAGE OUTPUT IS FLUENT 83. What is the origin of the ataxia: CEREBELLAR
BUT IS HIGHLY PARAPHASIC AND DYSFUNCTION
CIRCUMLOQUITEOUS?? 84. Cramps are characterized as: LOWER MOTOR
71. Which of the ffg types of aphasia wherein NEURON IN ORIGIN
insight and cognition is preserved: 85. There is minimal sense of environment if the
WERNICKE’S patient arouses only on application of painful
72. A type of aphasia where speech is fluent but stimuli and goes back to unresponsive state after
paraphasic, comprehension of spoken language cessation of said stimuli: OBTUNDATION
is intact and repetition is severely impaired: 86. Gait is described as hyperkinetic, and typically
WERNICKE’S APHASIA (FOR presents with regular rhythmic dance-like
CLARIFICATION) quality: HUNTINGTON’S DISEASE
73. Which of the ffg statements is/are true of 87. Testing for convergence and extraocular
inhibition neglect: CLINICAL EXPERIENCE movement assesses the ffg cranial nerves,
SHOW THAT CONTRALESIONAL EXCEPT: CN V
NEGLECT IS MORE COMMON 88. Abnormality of the lateral rectus muscle is
74. The ffg are true with patients with secondary to: CN VI
prosopagnosia, EXCEPT: PATIENT CANNOT 89. Muscle strength of 3/5 is described as: ACTIVE
RECOGNIZE FAMILIAR FACE BY VISUAL MOVEMENT AGAINST GRAVITY
INSPECTION ALONE AND USES 90. Assessment of gait includes the ffg, EXCEPT:
AUDITORY CUES TO BRIDGE RUNNING
APRROPRIATE RECOGNITION BY 91. Reflex graded as 3+, the response is: BRISKER
ALLOWING TO LISTEN TO PERSONAL THAN AVERAGE
VOICE 92. Asking the patient to determine if they could
75. Damage to this part of the brain impairs mental identify 1 or 2 touches in the finger pads is a test
flexibility, reasoning, hypothesis formation, for: 2-POINT DESCRIMINATION
abstract thinking, foresight?, judgment and ----: 93. Ankle reflex is stimulated by what cord level:
OCCIPITO-TEMPORAL NETWORK S1
76. This neurologic deficit is due to an upper motor 94. Test for meningeal signs include the ffg,
neuron lesion above the midcervical spinal cord EXCEPT: DOLL’S EYE
above the foramen magnum which cause 95. Gait is described as hyperkinetic, and typically
language disorders and cotico-sensory presents with regular rhythmic dance-like
disturbances: HEMIPARESIS quality: HUNTINGTON’S DISEASE
77. Acute hemiparesis maybe caused by the ffg, 96. Proximal extremity weakness will present with:
EXCEPT: MENINGITIS WADDLING GAIT
78. Focal myalgia maybe secondary to: RUPTURE 97. 75 y/o female with disturbance in walking,
OF THE MUSCLE TENDON described as walking on toes: STIFF-LEG
79. The most common finding in aphasic patients: GAIT
ANOMIA 98. This gait abnormality is due to mass? extending
80. Intact comprehension of spoken language and in brainstem or segmental spinal inhibitory
reading: CONDUCTION APHASIA reflexes: STIFF PERSON SYNDROME
 99. Characteristic of hyperkinetic movement
disorder: TREMORS AT REST
100. Parkinson’s disease is characterized by: LOSS
OF DOPAMINERGIC NEURONS IN THE
SUBSTANTIA NIGRA PARS COMPACTA