اسئلة الباطنية 2018 (2)
1) A 52 year old man comes to the emergency department because he has had vomiting, nausea, and abdominal pain for the past 12 hours . He says he attempted suicide . 3 days ago by taking everything in the medicine cabinet . He was stuporous for approximately 12 hours after the overdose . But felt better the following day . At this time , he has jaundice and pain in the RUQ . Which of the following drugs is most likely to have caused the pain , vomiting and jaundice ?
A . Acetaminophen
B . Aspirin
C . Cimetidine
D . Diphenhydramine
E . Triazolam
2) A patient present with weakness , nausea , vomiting , weight loss and new skin pigmentation . Labs show Hyponatremia and Hyperkalemia , most likely diagnosis is ?
A . Tinea versicolor
B . SIADH
C . Addison disease
D . Leprosy
E . Phenylketonuria
3) A 70 year old man who is presented with 2 weeks history of abdominal pain that has worsened over the last few days , on examination the patient is jaundice with tenderness over the epigastric area , with smooth hepatomegaly and shifting dullness , which of the following is the cause of hepatomegaly ?
A . IDA
B . Budd Chiari syndrome
C . Ulcerative colitis
D . Crohn disease
E . Left sided heart failure
4) In patient with microscopic Hematuria , which of the following favours a glomerular source ?
A . Red cell cast and protein in urine
B . Blood at the beginning of voiding
C . Blood at the end of voiding
D . Suprapubic pain
E . WBC in urine
5) A 25 year old man present to a rheumatologist with complaints of joint pain involving the large joints of the legs . On questioning the patient indicates that exacerbations in the joint pain are frequently accompanied by diarrhea . Which of the following most likely diagnosis ?
A . Amebic colitis
B . Chronic appendicitis
C . Diverticulosis
D . Pseudomembranous colitis
E . Ulcerative colitis
6) A 38 year old man has pulmonary tuberculosis , treatment with isoniazid , rifampin , ethambutol and pyrazinamide is started, which of the following should be added to the medication regimen to prevent neurologic toxicity in this patient ?
A . Vitamin B9
B . Vitamin B3
C . Vitamin B12
D . Vitamin B6
E . Vitamin C
7) Major criteria of rheumatic fever are all except ?
A . Carditis
B .subcutaneous nodules
C . Arthralgia
D . Erythema marginatum
E . Sydenham Chorea
8) ) A 30 year old female is started on Carbimazole 20 mg following a diagnosis of Graves disease . What is the best biochemical marker to assess her response to treatment ?
A . Total T4
B . TSH
C . Free T4
D . ESR
E . Free T3
9) A 75 years old woman has increasing shortness of breath on exertion . Findings on physical examination are unremarkable . X_Ray of the chest show no abnormalities of the hear or lungs . Labs show HCT 28% , Hb 9 g/dl , MCV 70 . Which of the following is most likely diagnosis ?
A . Acquired Hemolytic anemia
B . Chronic blood loss
C . Folic acid deficiency
D . B _ thalassemia minor
E . Pernicious anemia
10) What is the most common cause of bacterial UTI ?
A . Staphylococcus
B . Neisseria
C . E coli
D . Streptococcus
E . Pseudomonas
11) Which of the following is an appropriate initial treatment for pulmonary tuberculosis ?
A . INH
B . INH and rifampin
C . INH , rifampin and ethambutol
D . INH, rifampin , ethambutol and pyrazinamide
E . INH , rifampin , ethambutol and streptomycin
12) The treatment of choice for recurrent transient ischemic attack in patient on aspirin with new onest atrial fibrillation is ?
A . Anticoagulation
B . Carotid endarterectomy
C . Clopidogrel
D . Corticosteroids
E . Carotid stent
13) Chronic renal dialysis patient is brought to the emergency department in cardiac arrest , the most likely cause is ?
A . Pericardial effusion
B . Hyperkalemia
C . Hypocalcemia
D . Malignant HTN
E . Post dialysis hypotension
14) All of the following are contraindications to passing a nasogastric tube except ?
A . Hx of esophageal varices
B . Basal skull fracture
C . Suspected perforation of the esophagus
D . Complete intestinal obstruction
E . Presence of esophageal foreign body
15) All of the following are side effects of steroid except ?
A . Elevated blood pressure
B . Acne
C . Skin bruises
D . Hypoglycemia
E . Cataract
16) All of the following can cause acute renal failure except ?
A . Rhabdomyolysis
B . NSAIDs
C . Ethylene glycol
D . Penicillin
E . Iron
17) Which of the following is the most common cause of Duodenal ulcer ?
A . NSAIDs
B . H pylori
C . Alcohol abuse
D . Chronic corticosteroids
E . Zollinger Ellison syndrome
18) All of the following forms of vaccine except ?
A . Killed vaccine
B . Attenuated vaccine
C . Toxoid
D . Serum
E . Subunit
19. A 19 year old female presents with sudden sever right sided chest pain that develops shortly after she had been placing heavy boxes on shelves in her garage physical examination reveals an a febrile female in mild respiratory distress . Breath sounds are markedly decreased on the right , and the right lung is hyperresonant to percussion . Which of the following is most likely present in this individual ?
A . Pneumoconiosis
B . Pneumocystis infection
C . Bacterial pneumonia
D . Viral pneumonia
E . Pneumothorax
20) Tertiary prevention consist of ?
A . Crisis preparation
B . Elimination of specific disease
C . Early diagnosis
D . Rehabilitation after disability
E . Environmental sanitation
21) Which of the following statement about Polyvalent anti_snake venom serum is true ?
A . It is to be given subcutaneously
B . It is an example of passive immunization
C . It is usually obtained from human's donor's
D . Should be stored at 0 Sep Celsius
E . It gives life long immunity
22) All are true about CPR quality in advanced cardiac life support except ?
A . Push hard less than 2 inches and allow complete chest recoil .
B . Push fast more than 100 and less than 120 compressions per minute .
C . Minimize interruptions in compressions and give shock as soon as possible .
D . Compressions to ventilation ratio 30 : 2 .
E . Target of CPR quality are ETco2 > 10 mmhg and diastolic BP > 20 mmhg .
23) All of the following are common causes of chest pain except ?
A . Angina
B . Pericarditis
C . PE
D . Tension pneumothorax
E . Esophageal reflux
24) All of the following are true matching about drugs and side effects except ?
A . Sulfa drugs _ Steven Johnson syndrome .
B . Aminoglycosides _ nephrotoxicity .
C . Acetaminophen _ GI upset and bleeding .
D . Opiates _ constipation .
E . Atenolol _ Bradycardia.
25) All of the following are causes of DM except ?
A . Thyroid hormone
B . Thiazides
C . Pancreatic cancer
D . Addison disease
E . Hemochromatosis
26) All of the following are differential diagnosis of ST segment elevation except ?
A . Acute Pericarditis
B . Early repolarization
C . Hyperthermia
D . Prinzmetal angina
E . Left ventricular aneurysm
27) All of the following are rapid or short acting prandial bolus insulin except ?
A . Insulin glargine
B . Insulin regular
C . Insulin lispro
D . Insulin glulisine
E . Insulin aspart
28) Adverse consequences of obesity include all of the following except ?
A . Coronary artery disease
B . Hypertension pulmonary
C . DM type one
D . Osteoarthritis
E . Colorectal cancer
29) NT_PRO BNP elevation is caused by all of the following except ?
A . MI
B . CHF
C . Atrial fibrillation
D . PE
E . COPD exacerbation
30) All are true about Hyperosmolar hyperglycemic state except ?
A . Partial or relative insulin deficiency .
B . Characterized by hyperglycemia , hyperosmolarity , dehydration and ketosis .
C . Occurs in DM type two .
D . Lower insulin requirement compared to DKA .
E . Overall mortality higher compared to DKA .
31) All are causes of Acute bloody diarrhea except ?
A . Shigella
B . Campylobacter
C . Bacillus cereus
D . Yersinia
E . Entamoeba histolytica
32) All of the following are indications for Enalapril administration except ?
A . HTN
B . MI
C . CHF
D . DM
E . Aortic stenosis
33) All are risk factors for Barrett esophagus except ?
A . Old age
B . Female
C . Smokers
D . Obesity
E . Hiatus hernia
34) All are true about Crohn disease except ?
A . Usually affect terminal ileum .
B . Fever is very common .
C . Palpable mass is rare compared to ulcerative colitis .
D . Diarrhea less prevalent than ulcerative colitis .
E . Cobblestone mucosal appearance .
35) All of the following are true about irritable bowel syndrome except ?
A . Onest of symptoms usually in young adults .
B . Signs and symptoms relived with defecation , increased by stress .
C . Bloody diarrhea .
D . Inflammatory markers are negative .
E . 80% improve over time .
36) All of the following are matching about hepatitis B serology except ?
A . Acute infection _ HBsAg , HBeAg , anti HBc IgG are positive .
B . Chronic inactive infection _ HBsAg , HBeAg , anti HBc IgG are positive .
C . Chronic active infection _ HBsAg , anti HBe , anti HBc IgG are positive .
D . Resolved infection _ anti HBs , anti HBe , anti HBc IgG are positive .
E . Immunized person _anti HBs positive .
37) Auer rod white blood cell on blood film is characteristic for ?
A . AML
B . CML
C . ALL
D . CLL
E . Hodgkin lymphoma
38) Mode of transmission for all of the following by food_water borne except ?
A . MRSA
B . Cholera
C . Salmonella
D . HAV
E . HEV
39) Red currant jelly sputum is characteristic for ?
A . Streptococcal pneumonia
B . Staphylococcal pneumonia
C . Klebsiella pneumonia
D . Mycoplasma pneumonia
E . Legionella pneumonia
40) All of the following are causes of Reticulocytosis except ?
A . SCA
B . Chronic blood loss
C . HUS
D . DIC
E . Malaria
41) All of the following are causes of cavitating lung nodule on CXR except ?
A . Wegener disease
B . Allergic alveolitis
C . Sarcoidosis
D . Tuberculosis
E . Metastasis
42) All of the following are true matching about the interpretation of urinary casts except ?
A . Fatty casts _ nephritic syndrome .
B . Pigmented epithelial granular cast _ ATN .
C . White blood cell casts _ interstitial nephritis .
D . Red blood cell casts _ glomerulonephritis .
E . Hyaline casts _ physiological during exercise or fever
43) All of the following are true matching about RBC inclusions except ?
A . Erythroblasts _ Hemolytic anemia .
B . Heinz bodies _ IDA
C . Howell jolly bodies _ post splenectomy
D . Basophilic stippling _ lead poisoning .
E . Sideroblasts _ hypothyroidism
44) Westermark sign , Hamptons hump , enlarged right ventricle and right atrium and atelectasis on CXR is characteristic for ?
A . Pulmonary edema
B . Pulmonary embolism
C . Sarcoidosis
D . COPD
E . Pulmonary fibrosis
45) All of the following are causes of Hyponatremia except ?
A . Nephrotic syndrome
B . Hyperthyroidism
C . SIADH
D . Furosemide
E . CHF
46) Signs and symptoms of third cranial nerve palsy include all of the following except ?
A . Absent of light reflexes
B . Ptosis
C . Eye deviated downward
D . Eye deviated outward
E . Mydriasis
47) Paresthesia , sensory ataxia , myopathy , subacute combined degeneration of spinal cord , optic neuropathy are characteristic of ?
A . Vitamin B12 deficiency
B . Vitamin B6 deficiency
C . Vitamin B1 deficiency
D . Folate deficiency
E . Niacin deficiency
48) All are causes of Hypokalemia except ?
A . Bartter syndrome
B . Angelman syndrome
C . Hypomagnesemia
D . Conn syndrome
E . Cushing syndrome
49) One is true about Petit mal seizures ?
A . Muscle rigidity
B . Tongue biting
C . Arrest of activity for 5 _ 10 seconds .
D . Flaccid limbs
E . Loss of muscle tone
50) The goal of tertiary level of prevention is ?
A . Protect health and lifestyle
B . Prevention of disease Onest
C . Early detection of disease
D . Treat and rehabilitate of disease to prevent progression , and disability .
E . Stop of smoking .
A . Acetaminophen
B . Aspirin
C . Cimetidine
D . Diphenhydramine
E . Triazolam
2) A patient present with weakness , nausea , vomiting , weight loss and new skin pigmentation . Labs show Hyponatremia and Hyperkalemia , most likely diagnosis is ?
A . Tinea versicolor
B . SIADH
C . Addison disease
D . Leprosy
E . Phenylketonuria
3) A 70 year old man who is presented with 2 weeks history of abdominal pain that has worsened over the last few days , on examination the patient is jaundice with tenderness over the epigastric area , with smooth hepatomegaly and shifting dullness , which of the following is the cause of hepatomegaly ?
A . IDA
B . Budd Chiari syndrome
C . Ulcerative colitis
D . Crohn disease
E . Left sided heart failure
4) In patient with microscopic Hematuria , which of the following favours a glomerular source ?
A . Red cell cast and protein in urine
B . Blood at the beginning of voiding
C . Blood at the end of voiding
D . Suprapubic pain
E . WBC in urine
5) A 25 year old man present to a rheumatologist with complaints of joint pain involving the large joints of the legs . On questioning the patient indicates that exacerbations in the joint pain are frequently accompanied by diarrhea . Which of the following most likely diagnosis ?
A . Amebic colitis
B . Chronic appendicitis
C . Diverticulosis
D . Pseudomembranous colitis
E . Ulcerative colitis
6) A 38 year old man has pulmonary tuberculosis , treatment with isoniazid , rifampin , ethambutol and pyrazinamide is started, which of the following should be added to the medication regimen to prevent neurologic toxicity in this patient ?
A . Vitamin B9
B . Vitamin B3
C . Vitamin B12
D . Vitamin B6
E . Vitamin C
7) Major criteria of rheumatic fever are all except ?
A . Carditis
B .subcutaneous nodules
C . Arthralgia
D . Erythema marginatum
E . Sydenham Chorea
8) ) A 30 year old female is started on Carbimazole 20 mg following a diagnosis of Graves disease . What is the best biochemical marker to assess her response to treatment ?
A . Total T4
B . TSH
C . Free T4
D . ESR
E . Free T3
9) A 75 years old woman has increasing shortness of breath on exertion . Findings on physical examination are unremarkable . X_Ray of the chest show no abnormalities of the hear or lungs . Labs show HCT 28% , Hb 9 g/dl , MCV 70 . Which of the following is most likely diagnosis ?
A . Acquired Hemolytic anemia
B . Chronic blood loss
C . Folic acid deficiency
D . B _ thalassemia minor
E . Pernicious anemia
10) What is the most common cause of bacterial UTI ?
A . Staphylococcus
B . Neisseria
C . E coli
D . Streptococcus
E . Pseudomonas
11) Which of the following is an appropriate initial treatment for pulmonary tuberculosis ?
A . INH
B . INH and rifampin
C . INH , rifampin and ethambutol
D . INH, rifampin , ethambutol and pyrazinamide
E . INH , rifampin , ethambutol and streptomycin
12) The treatment of choice for recurrent transient ischemic attack in patient on aspirin with new onest atrial fibrillation is ?
A . Anticoagulation
B . Carotid endarterectomy
C . Clopidogrel
D . Corticosteroids
E . Carotid stent
13) Chronic renal dialysis patient is brought to the emergency department in cardiac arrest , the most likely cause is ?
A . Pericardial effusion
B . Hyperkalemia
C . Hypocalcemia
D . Malignant HTN
E . Post dialysis hypotension
14) All of the following are contraindications to passing a nasogastric tube except ?
A . Hx of esophageal varices
B . Basal skull fracture
C . Suspected perforation of the esophagus
D . Complete intestinal obstruction
E . Presence of esophageal foreign body
15) All of the following are side effects of steroid except ?
A . Elevated blood pressure
B . Acne
C . Skin bruises
D . Hypoglycemia
E . Cataract
16) All of the following can cause acute renal failure except ?
A . Rhabdomyolysis
B . NSAIDs
C . Ethylene glycol
D . Penicillin
E . Iron
17) Which of the following is the most common cause of Duodenal ulcer ?
A . NSAIDs
B . H pylori
C . Alcohol abuse
D . Chronic corticosteroids
E . Zollinger Ellison syndrome
18) All of the following forms of vaccine except ?
A . Killed vaccine
B . Attenuated vaccine
C . Toxoid
D . Serum
E . Subunit
19. A 19 year old female presents with sudden sever right sided chest pain that develops shortly after she had been placing heavy boxes on shelves in her garage physical examination reveals an a febrile female in mild respiratory distress . Breath sounds are markedly decreased on the right , and the right lung is hyperresonant to percussion . Which of the following is most likely present in this individual ?
A . Pneumoconiosis
B . Pneumocystis infection
C . Bacterial pneumonia
D . Viral pneumonia
E . Pneumothorax
20) Tertiary prevention consist of ?
A . Crisis preparation
B . Elimination of specific disease
C . Early diagnosis
D . Rehabilitation after disability
E . Environmental sanitation
21) Which of the following statement about Polyvalent anti_snake venom serum is true ?
A . It is to be given subcutaneously
B . It is an example of passive immunization
C . It is usually obtained from human's donor's
D . Should be stored at 0 Sep Celsius
E . It gives life long immunity
22) All are true about CPR quality in advanced cardiac life support except ?
A . Push hard less than 2 inches and allow complete chest recoil .
B . Push fast more than 100 and less than 120 compressions per minute .
C . Minimize interruptions in compressions and give shock as soon as possible .
D . Compressions to ventilation ratio 30 : 2 .
E . Target of CPR quality are ETco2 > 10 mmhg and diastolic BP > 20 mmhg .
23) All of the following are common causes of chest pain except ?
A . Angina
B . Pericarditis
C . PE
D . Tension pneumothorax
E . Esophageal reflux
24) All of the following are true matching about drugs and side effects except ?
A . Sulfa drugs _ Steven Johnson syndrome .
B . Aminoglycosides _ nephrotoxicity .
C . Acetaminophen _ GI upset and bleeding .
D . Opiates _ constipation .
E . Atenolol _ Bradycardia.
25) All of the following are causes of DM except ?
A . Thyroid hormone
B . Thiazides
C . Pancreatic cancer
D . Addison disease
E . Hemochromatosis
26) All of the following are differential diagnosis of ST segment elevation except ?
A . Acute Pericarditis
B . Early repolarization
C . Hyperthermia
D . Prinzmetal angina
E . Left ventricular aneurysm
27) All of the following are rapid or short acting prandial bolus insulin except ?
A . Insulin glargine
B . Insulin regular
C . Insulin lispro
D . Insulin glulisine
E . Insulin aspart
28) Adverse consequences of obesity include all of the following except ?
A . Coronary artery disease
B . Hypertension pulmonary
C . DM type one
D . Osteoarthritis
E . Colorectal cancer
29) NT_PRO BNP elevation is caused by all of the following except ?
A . MI
B . CHF
C . Atrial fibrillation
D . PE
E . COPD exacerbation
30) All are true about Hyperosmolar hyperglycemic state except ?
A . Partial or relative insulin deficiency .
B . Characterized by hyperglycemia , hyperosmolarity , dehydration and ketosis .
C . Occurs in DM type two .
D . Lower insulin requirement compared to DKA .
E . Overall mortality higher compared to DKA .
31) All are causes of Acute bloody diarrhea except ?
A . Shigella
B . Campylobacter
C . Bacillus cereus
D . Yersinia
E . Entamoeba histolytica
32) All of the following are indications for Enalapril administration except ?
A . HTN
B . MI
C . CHF
D . DM
E . Aortic stenosis
33) All are risk factors for Barrett esophagus except ?
A . Old age
B . Female
C . Smokers
D . Obesity
E . Hiatus hernia
34) All are true about Crohn disease except ?
A . Usually affect terminal ileum .
B . Fever is very common .
C . Palpable mass is rare compared to ulcerative colitis .
D . Diarrhea less prevalent than ulcerative colitis .
E . Cobblestone mucosal appearance .
35) All of the following are true about irritable bowel syndrome except ?
A . Onest of symptoms usually in young adults .
B . Signs and symptoms relived with defecation , increased by stress .
C . Bloody diarrhea .
D . Inflammatory markers are negative .
E . 80% improve over time .
36) All of the following are matching about hepatitis B serology except ?
A . Acute infection _ HBsAg , HBeAg , anti HBc IgG are positive .
B . Chronic inactive infection _ HBsAg , HBeAg , anti HBc IgG are positive .
C . Chronic active infection _ HBsAg , anti HBe , anti HBc IgG are positive .
D . Resolved infection _ anti HBs , anti HBe , anti HBc IgG are positive .
E . Immunized person _anti HBs positive .
37) Auer rod white blood cell on blood film is characteristic for ?
A . AML
B . CML
C . ALL
D . CLL
E . Hodgkin lymphoma
38) Mode of transmission for all of the following by food_water borne except ?
A . MRSA
B . Cholera
C . Salmonella
D . HAV
E . HEV
39) Red currant jelly sputum is characteristic for ?
A . Streptococcal pneumonia
B . Staphylococcal pneumonia
C . Klebsiella pneumonia
D . Mycoplasma pneumonia
E . Legionella pneumonia
40) All of the following are causes of Reticulocytosis except ?
A . SCA
B . Chronic blood loss
C . HUS
D . DIC
E . Malaria
41) All of the following are causes of cavitating lung nodule on CXR except ?
A . Wegener disease
B . Allergic alveolitis
C . Sarcoidosis
D . Tuberculosis
E . Metastasis
42) All of the following are true matching about the interpretation of urinary casts except ?
A . Fatty casts _ nephritic syndrome .
B . Pigmented epithelial granular cast _ ATN .
C . White blood cell casts _ interstitial nephritis .
D . Red blood cell casts _ glomerulonephritis .
E . Hyaline casts _ physiological during exercise or fever
43) All of the following are true matching about RBC inclusions except ?
A . Erythroblasts _ Hemolytic anemia .
B . Heinz bodies _ IDA
C . Howell jolly bodies _ post splenectomy
D . Basophilic stippling _ lead poisoning .
E . Sideroblasts _ hypothyroidism
44) Westermark sign , Hamptons hump , enlarged right ventricle and right atrium and atelectasis on CXR is characteristic for ?
A . Pulmonary edema
B . Pulmonary embolism
C . Sarcoidosis
D . COPD
E . Pulmonary fibrosis
45) All of the following are causes of Hyponatremia except ?
A . Nephrotic syndrome
B . Hyperthyroidism
C . SIADH
D . Furosemide
E . CHF
46) Signs and symptoms of third cranial nerve palsy include all of the following except ?
A . Absent of light reflexes
B . Ptosis
C . Eye deviated downward
D . Eye deviated outward
E . Mydriasis
47) Paresthesia , sensory ataxia , myopathy , subacute combined degeneration of spinal cord , optic neuropathy are characteristic of ?
A . Vitamin B12 deficiency
B . Vitamin B6 deficiency
C . Vitamin B1 deficiency
D . Folate deficiency
E . Niacin deficiency
48) All are causes of Hypokalemia except ?
A . Bartter syndrome
B . Angelman syndrome
C . Hypomagnesemia
D . Conn syndrome
E . Cushing syndrome
49) One is true about Petit mal seizures ?
A . Muscle rigidity
B . Tongue biting
C . Arrest of activity for 5 _ 10 seconds .
D . Flaccid limbs
E . Loss of muscle tone
50) The goal of tertiary level of prevention is ?
A . Protect health and lifestyle
B . Prevention of disease Onest
C . Early detection of disease
D . Treat and rehabilitate of disease to prevent progression , and disability .
E . Stop of smoking .
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