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FEB 2019 YEAR I Flashcards

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1
Q
  1. Based on the Philippine CPG on Community-Acquired Pneumonia in the Immunocompromised Adults, what is the drug of choice for low-risk pneumonia without co-morbid illness?

A. Amoxicillin

B. Azithromycin

C. Cefuroxime

D. Sultamicillin

A

A. Amoxicillin

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2
Q
  1. A 67/M, diabetic, presents with a 4-day history of cough, productive of greenish phlegm, fever, and back pain. PE: BP of 100/70, RR 27, HR of 125/min, temp of 38.5C, CBG of 267 mg/dL, and crackles from mid-to-base at the right posterior hemithorax. What is the patient’s pneumonia risk stratification?

A. Low risk

B. Moderate risk

C. High risk

D. Severe risk

A

B. Moderate risk

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3
Q
  1. Which drug is helpful for severe cases of amphetamine abuse?

A. Lidocaine

B. Cyproheptadine

C. Barbiturates

D. Pyridoxine

A

B. Cyproheptadine

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4
Q
  1. Which disease condition causes low level of Blood Urea Nitrogen?

A. Anabolic state

B. Gastrointestinal hemorrhage

C. Severe liver disease

D. Syndrome of Inappropriate Anti-Diuretic Hormone

A

A. Anabolic state

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5
Q
  1. What is the triceps skinfold in marasmus?

A. 8mm

B. 6-7mm

C. 4-5mm

D. <3mm

A

D. <3mm

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6
Q
  1. In specific nutrition support (SNS), what is the recommended percentage of carbohydrate intake for protein energy malnutrition?

A. 40-50%

B. 30-39%

C. 21-29%

D. 10-20%

A

D. 10-20%

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7
Q
  1. A 48/F hypertensive, presents with a 2-month history of productive cough with scanty sputum. She intermittently took over-the-counter decongestants to no avail. Except for 5 lbs weight loss during this period, chest x-ray and basic lab tests are normal. Which test will you request next?

A. Pulmonary function test

B. Sputum cytology

C. Chest ultrasound

D. Sputum AFB

A

B. Sputum cytology

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8
Q
  1. Which condition will most likely present as diffuse alveolar lesions on chest x-ray?

A. Pulmonary infarction

B. Radiation pneumonitis

C. Hypersensitivity pneumonitis

D. Acute respiratory distress syndrome

A

D. Acute respiratory distress syndrome

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9
Q
  1. A 62/F, presents with a 4-day history of fever, cough and right-sided pleuritic chest pain. Chest x-ray shows right lower and middle lobe infiltrates with effusion. Which pleural fluid result would indicate a complicated effusion that may require chest tube thoracostomy?

A. pH > 7.20

B. Glucose >60mg/dL

C. (+) gram stain/culture

D. Protein 1gm

A

C. (+) gram stain/culture

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10
Q
  1. Which procedure has replaced the lateral decubitus x-ray in the evaluation of suspected pleural effusions and as a guide to thoracentesis?

A. Chest CT scan

B. Chest ultrasound

C. Chest MRI

D. Thoracoscopy

A

B. Chest ultrasound

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11
Q
  1. What size of the space between the lungs and chest wall is therapeutic thoracentesis indicated?

A. 1-3mm

B. 4-5mm

C. 7-9mm

D. >10mm

A

D. >10mm

*** the answer applies for CXR done in lateral decubitus position

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12
Q
  1. What is the standard test to detect and confirm diagnosis of bronchiectasis?

A. Chest MRI

B. Chest CT scan

C. Chest x-ray

D. Chest ultrasound

A

B. Chest CT scan

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13
Q
  1. How often should periodic contrasted chest CT scan be done in patients’ resected non-small cell lung carcinoma?

A. Every 3 months

B. Every 6 months

C. Every 9 months

D. Once a year

A

B. Every 6 months

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14
Q
  1. A 45/M comes to ER because of an acute exacerbation of severe asthma attack. He becomes agitated, confused and develop progressive respiratory distress and cyanosis. What would be his expected ABG?

A. pH: 7.45, pCO2: 30mmHg, pO2: 88mmHg

B. pH: 7.28, pCO2: 55mmHg, pO2: 60mmHg

C. pH: 7.40, pCO2: 33mmHg, pO2: 80mmHg

D. pH: 7.35, pCO2: 40mmHg, pO2: 75mmHg

A

B. pH: 7.28, pCO2: 55mmHg, pO2: 60mmHg

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15
Q
  1. 62/M, diabetic, presents with voluminous watery diarrhea occurring for >10 episodes accompanied by vomiting. He is clinically dry with brownish urine on foley catheter. What is the expected urinary sediments?

A. RBC casts

B. WBC casts

C. Granular casts

D. Crystalluria

A

C. Granular casts

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16
Q
  1. What is the most compatible Gram stain finding for gonococcal urethral discharge?

A. Gram +, extracellular, coccobacilli

B. Gram +, intracellular, diplococci

C. Gram -, extracellular, coccobacilli

D. Gram -, intracellular, diplococci ​

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A

D. Gram -, intracellular, diplococci ​

17
Q
  1. A 25/M consulted due to morning stiffness and pain from the neck down to the lumbar area. An x-ray of the lumbo-sacral spine showed “body fusion”. What is the most likely diagnosis?

A. Osteoarthritis

B. Ankylosing spondylitis

C. Rheumatoid Arthritis

D. Gouty Arthritis

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A

B. Ankylosing spondylitis

18
Q
  1. A patient who has been coughing for 3 weeks underwent work-up for tuberculosis. The chest x-ray revealed an apical scar, the sputum AFB is negative, and the sputum GeneXpert showed MTB positive, Rif negative. What regimen should be given for this patient?

A. 9HR

B. 6HRZE

C. 2HR/4HRZE

D. No treatment is necessary

19
Q
  1. Which condition commonly occurs in women described as tickle or sensitive throat and is typically “dry” or at most productive of scanty amount of mucoid discharge?

A. Cough-variant asthma

B. Cough hypersensitivity syndrome

C. Chronic eosinophilic bronchitis

D. Gastroesophageal reflux disease

Study These Flashcards
A

B. Cough hypersensitivity syndrome

20
Q
  1. What is the consequence of alveolar hypoventilation syndrome regardless of the cause?

A. Respiratory alkalosis

B. Compensatory decrease in serum bicarbonate

C. Hypoxemia

D. Primary erythrocytosis

21
Q
  1. A 28/M with a 3-day history of productive cough and fever is brought to the ER for difficulty of breathing. PE: BP 100/70 mmHg, HR 108/min, RR 25/min. Chest PE showed decreased breath sounds and dullness over the right mid-base lung field. Chest x-ray: blunted costophrenic angle with shifting of radiodensity on right decubitus film. What is the next appropriate diagnostic procedure?

A. Chest CT scan

B. Bronchoscopy

C. Pleural tap

D. Fluroscopy

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A

C. Pleural tap

22
Q
  1. What is the most common sign/symptom accompanying severe migraine attack?

A. Photophobia

B. Lightheadedness

C. Vomiting

D. Nausea

23
Q
  1. Which feature readily distinguishes syncope from seizure?

A. Variable posture

B. Cyanosis and frothing of mouth

C. Immediate transition to unconsciousness

D. Facial pallor

Study These Flashcards
A

D. Facial pallor

24
Q
  1. A 25/M, person living with HIV, who was recently diagnosed with Kaposi’s sarcoma presents with numbness over the hands and feet. What is the most likely diagnosis?

A. Multiple mononeuropathy

B. Distal Symmetric Polyneuropathy

C. Progressive Polyradiculopathy

D. Demyelinating Polyradiculopathy

Study These Flashcards
A

B. Distal Symmetric Polyneuropathy

25
25. A 52/F, presents with a unilateral, throbbing frontal headache of moderate intensity and aggravated by movement, associated with nausea and vomiting. Her headache is being felt repeatedly and lasting for almost the entire day. PE: normal. A. Tension Headache B. Migraine Headache C. Hypnic Headache D. Cluster Headache
B. Migraine Headache
26
26. What is the leading cause of cancer-related death worldwide? A. Prostate cancer B. Breast cancer C. Colon cancer D. Lung cancer
D. Lung cancer
27
27. What would a chest x-ray finding of a 6-cm nodule with spiculations in the right upper lobe in a chronic smoker means? A. Pulmonary tuberculosis B. Lung cancer C. Pneumonia D. Sarcoidosis
B. Lung cancer
28
28. A 65/M presents with pallor, 20% weight loss in 6 months and hypochromic, microcytic anemia. Which malignancy would you consider in this patient? A. Lung CA B. Colon CA C. Gastric CA D. Pancreatic CA
B. Colon CA
29
29. 50/M, known case of CKD secondary to hypertensive nephrosclerosis not on dialysis complains of dyspnea and body weakness maintained on ACEI and Spironolactone for his CHF. 12L ECG shows loss of P wave and widened QRS complex. Serum K is 8.5mmol/L, Na is 138mEq/L, Creatinine is 2.5mg/dL. What is your immediate intervention? A. Insulin B. 50% Dextrose C. Calcium gluconate D. Bicarbonate
C. Calcium gluconate
30
30. What condition causes metabolic alkalosis with concomitant extracellular fluid volume expansion, hypertension, hypokalemia and high renin? A. Estrogen therapy B. Primary aldosteronism C. Cushing’s syndrome D. Liddle’s syndrome
A. Estrogen therapy
31
31. What diagnostic test would differentiate Syndrome of Inappropriate Antidiuretic Hormone secretion from other causes of euvolemic hyponatremia? A. UNa \> 20 B. UNa \< 20 C. Serum uric acid \> 4mg/dL D. Serum uric acid \< 4mg/dL ​
D. Serum uric acid \< 4mg/dL ​
32
32. Which antibiotic can be used for the treatment of patients with aspiration pneumonia? A. Azithromycin B. Cefuroxime C. Gentamycin D. Moxifloxacin
D. Moxifloxacin
33
33. Which can cause tendon rupture and prolongation of QT interval? A. Azalides B. B-lactams C. Cephalosporins D. Fluoroquinolones ​
D. Fluoroquinolones ​
34
34. A 75/F, with severe CAP is admitted at the ICU with pleural effusion on the lung. CTT insertion is done revealing empyema. Which organism needs to be covered for our empirical therapy pending sputum and/or blood culture results? A. Hemophilus B. Legionella C. MRSA D. Pseudomonas
C. MRSA
35
35. A 50/M, with history of intermittent attacks of arthritis relieved by NSAIDs. He was brought to ER because of severe right knee pain and swelling for 2 days. PE shows swollen and erythematous right knee. CBC reveals mild anemia and decrease creatinine clearance. What is the most appropriate drug to give for this patient? A. Colchicine 0.5mg/tab 1tab BID B. Prednisone 30mg single dose then taper on subsequent days C. Celecoxib 400mg as initial dose followed by 200mg BID D. Indomethacin 50mg QID
B. Prednisone 30mg single dose then taper on subsequent days
36
36. Lifestyle modification to control gout includes low purine diet and limit red meat to how much? A. 2-4 ounces/day B. 4-6 ounces/day C. 6-8 ounces/day D. 8-10 ounces/day
B. 4-6 ounces/day
37

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