Internal Medicine Flashcards
(275 cards)
1
Q
The treatment of choice for anemia of chronic renal disease:
A
Erythropoetin
2
Q
A patient was brought to the ER in a comatose state. Serum electrolytes drawn on admission showed the following: Na+ 133 meq/L, K + 8.0 meq?l, Cl 98 meq/L, HCO3 13 meq?L. ECG showed absent P waves, widend QRS and peaked T waves. Which would b the mot appropriate initial step:
A
Administer intravenous calcium gluconate
3
Q
Low serum complement level would be seen in patients with hematuria, proteinuria and hypertension resulting from all of the following, EXCEPT:
A
a. Mixed essential cryoglobulinemia / b. Hepatitis C associated membranoproliferative glomerulonephritis / c. Diffuse proliferative lupus nephritis / D.Henoch-Schonlein purpura*
4
Q
A 37 y.o. man is admitted with confusion. PE showed a BP of 140/70 with no orthostatic changes, normal jugular venous pressure and no edma. Serum chemistries are notable for Na+ 120 meq/L, K + 4.2 meq/L, HCO3 24 meq/L and a uric acid of 2 mg/L. The most likely diagnosis is:
A
SIADH
5
Q
TRUE statement/s about acute poststreptococcal glomerulonephritis (PSGN) EXCEPT:
A
a. The latent period appears to be longer when PSGN is associated with cutaneous rather than pharyngeal infection / b. Serologic tests for a streptococcal infection may be negative if antimicrobial therapy is begun early/ c. PSGN leads to permanent and progressive renal insufficiency more often in adults than in children/ d.Long-term antistreptococcal prophylaxis is indicated after documented cases of PSGN.*
6
Q
The a wave of the jugular venous pulse (JVP) represents:
A
right atrial contraction
7
Q
One of the following is not true in the assessment of acute GI Bleeding:
A
a. The presence of large quantities of bright red blood per rectum rules out the source before the ligament of Treitz* / b. Melena almost always represents UGIB / c. Black stools can be caused by lesions in the colon/ d. A bilous NGT return flow in a patient who just had hematochezia rules out an upper GI source of hemorrhage
8
Q
Which of the following is true regarding gastric ulcer?
A
coexisting duodenal ulcers favor benign nature of gastric ulcer
9
Q
A 55-year-old diabetic patient presents with heartburn and acidic eructation for 2 years. Endoscopic biopsy of a patch of hyperemic mucosa 3 cm. above the gastroesophageal junction showed squamous epithelium with inflammatory cells. The patient most likely has:
A
Gastroesophageal reflux disease
10
Q
Which of the following statements does NOT describe secretory diarrhea?
A
Stools are scanty and mucoid
11
Q
A 16-year-old male patient presenting with hepatitis syndrome has the following serologic exam findings: (+) HBsAG, (-) Anti-Hbe, (+) HBeAG, (+) Anti-HAVIgm , (-) AntiHBclgG. The patient most likely has
A
Acute Hepatitis A and Acute Hepatitis B simultaneous infection
12
Q
The most common organism isolated from the ascitic fluid of patients with spontaneous bacterial peritonitis is:
A
Escherichia coli
13
Q
True of Ascaris infestation:
A
adult worms reside mostly in the small intestines
14
Q
Which of the following risk factors has been directly associated with Bronchogenic Carcinoma?
A
Cigarette smoking
15
Q
This group of drugs reduce airway inflammation in bronchial asthma:
A
Clucocorticoids
16
Q
The American Thoracic Society defines chronic bronchitis as persistence of cough and excessive mucus production for most days out of 3 months for ________ successive years:
A
2
17
Q
A patient with CAP requires hospitalization when one of the following is present:
A
COPD in exacerbation
18
Q
One of the following is NOT a useful clue to the microbial etiology of CAP (Community Acquired Pneumonia)
A
edentulous persons likely to develop pneumonia due to anaerobes
19
Q
In a patient suspected of PTE, presence of this symptom heralds the occurence of pulmonary infarction:
A
hemptysis
20
Q
Gold standard in the diagnosis of PTE:
A
pulmonary angiography
21
Q
One of the disorders below does NOT have vesicles or bulla as presenting lesions:
A
Psoriasis
22
Q
Annular lesions with raised erythematous border and clear centers, distributed over the trunk area:
A
Tinea corporis
23
Q
Grouped vesicles arranged in a segmental pattern over the right side of the trunk, T7-8 level:
A
Herpes Zoster
24
Q
A pregnant woman with brown macules with irregular borders, symmetric pattern on her cheeks, forehead, upper lips, nose and chin most likely has:
A
melasma
25
One of the following statements is NOT true of typhoid fever:
Stool culture is best done during the first week of fever.
26
In typhoid fever, which of the following specimen will have the best sensitivity for culture if a patient has been given antibiotics?
bone marrow
27
Drug of choice for Schistosomiasis:
Praziquantel
28
The fungus which is a normal inhabitant of the human mucocutaneous body surfaces and is a frequent cause of fungemia is:
Candida
29
An 18-year-old boy had sex with an HIV+ prostitute a week ago. He is frightened and wants assurance he has not been infected. You should:
tell him you regret that there is no way at this time to tell if he has been infected or not
30
The most likely organism/s causing secondary bacteremia following manipulation of a furuncle is/are:
Staph aureus
31
Which of the following vaccines is especially indicated in a splenectomized patient:
pneumococcal
32
A patient with Bell’s Palsy has a pathology involving which cranial nerve?
VII
33
A patient suspected to have meningitis undergoes spinal tap. Upon insertion of the spinal needle, the opening pressure is recorded to be markedly elevated. You should:
withdraw the needle and run IV mannitol
34
The first drug of choice in a patient presenting with frank seizures is:
Diazepam IV
35
Lower motor neuron type of paralysis is characterized by:
hypotonia
36
A Cavernous sinus lesion could involve several cranial nerves. Which of the following is least likely to be affected?
facial nerve
37
Bitemporal hemianopsia means involvement of the
optic chiasm
38
Elevated urea in patients with chronic renal disease occurs because of
decreased urea excretion
39
Asymptomatic bacteriuria should always be treated in:
pregnant women
40
What is the most conservative management for chronic renal failure?
dietary proteins of 0.6 g/kg/day
41
One of the following is NOT a pathophysiologic mechanism of DM nephropathy:
Ig G deposits along GBM resulting in immune complex mediated glomerulonephritis
42
Not a characteristic laboratory feature of hepatorenal syndrome:
Proteinuria
43
The single most important parameter of renal function is:
Creatinine clearance
44
A 50-year-old male with ESRD 20 diabetic nephropathy was brought to the emergency room because of weakness and light headedness. He has just completed his first dialysis, and was observed to be somewhat confused. BP = 90/40, CR = 80/min., RR = 20/min. The most likely explanation for his condition is:
Dialysis disequilibrium syndrome
45
In the presence of anemia, the ability to produce adequate circulating red cells is best measured by:
Reticulocyte count
46
Reticulocytosis is NOT seen in:
aplastic anemia
47
All of the following anemias except one are chronic developing over weeks. Which anemia may develop acutely?
hemolytic
48
In the tumor cell cycle, the cells refractory to chemotherapy are the:
Cells in the G0 phase
49
Multiple osteolytic lesions, hypercalcemia and neurologic abnormalities are most often seen in:
Plasma cell myeloma
50
Thrombocytopenia is not expected in:
G6PD deficiency
51
This finding in Chronic Myelogenous Leukemia can differentiate it from leukemoid reaction:
decreased leukocyte alkaline phosphatase
52
Lung cancer that is associated with significant progressive dyspnea and increasing hypoxemia
Bronchoalveolar CA
53
The most common form of arthritis characterized by progressive deterioration and loss of articular cartilage:
Osteoarthritis
54
The characteristic feature of Rheumatoid arthritis is:
persistent inflammatory synovitis
55
Heberden’s nodes are found in
Osteoarthritis
56
Loss of hair at the lateral part of eyebrows, thickening of speech, coarse hair and dry skin, dulling of intellect, sluggish movements. Most likely diagnosis is:
Hypothyroidism
57
Psamomma bodies are characteristic of:
Papillary Thyroid CA
58
Jodbasedow phenomenon is:
iodide-induced hyperthyroidism
59
A 50-year-old obese woman with hypertriglyceridemia without hypercholesterolemia. The most appropriate first management step would be
weight reduction
60
The diagnosis of diabetes mellitus is certain in which of the following situations?
successive fasting plasma glucose of 147, 165, 152 mg/dL in an otherwise healthy 40-year-old female
61
Which of the following medications can cause hyperprolactinemia?
metoclopramide
62
Obese persons are at increased risk for
Cholelithiasis
63
Dietary deficiency of thiamine produces which of the following clinical syndromes?
peripheral neuropathy
64
A 24/M who took megadoses of vitamins develops severe headache and papilledema. The cause for this is intoxication of
Vitamin A
65
In using Serum albumin as gauge for malnutrition, which statement is correct?
the half-life of albumin in 21 days, so it cannot be used to assess acute malnutrition
66
Prolonged fasting causes the intestinal villi to
atrophy
67
A person with known allergy to penicillins should not be given
cefalexin
68
Lymphokines are secreted by
lymphocytes
69
A 30-year-old female has severe perennial allergic rhinitis. Her house is frequently flooded. She has a dog and sleeps on kepok pillow. As part of management of her allergy, you should advice her to
replace the kapok pillow with foam rubber, cover the pillow and mattress with allergen proof encasings
70
IgE has high affinity for which type of cells?
mast cells
71
A 65/M is brought to the ER due to chest pain. He suddenly becomes unresponsive and pulseless and cardiac monitor reveals ventricular fibrillation. You should immediately:
begin CPR, then defibrillation at 200 J, 300 J then 360 J
72
If despite defibrillation, a pulseless patient has persistent ventricular fibrillation, the use of which drug would be most appropriate?
epinephrine
73
If only one person is present to provide basic life support, chest compressions should be performed at a rate of ______ per minute, and breaths twice in succession every 15 seconds
80
74
One of the following is associated with an increased risk of sudden cardiac death:
frequent PVC’s (>30/min)
75
Elevation of Serum Potassium is toxic to the:
heart
76
Anti – Tuberculosis drug that can cause hyperuricemia:
Pyrazinamide
77
Which of the following tests is required to diagnose Chronic Obstructive Pulmonary Disease:
Spirometry
78
Marantic endocarditis is commonly associated with this lung cancer:
Small cell
79
This is considered as the most frequent cause of Acute Respiratory Distress Syndrome
Severe sepsis
80
The most common form of Lung cancer arising in lifetime of a non smoker young women
Adenocarcinoma
81
The most common cause of acute renal failure
Pre renal acute renal failure
82
The most significant risk factor for cancer is:
Sex
83
DNA synthesis phase
S
84
This is the most common local manifestation of lung cancer at presentation
Cough
85
Painless myocardial infarction is greater in patients with
hypertension
86
In typoid fever this diagnostic exam is not affected by prior antibiotic use:
Bone marrow culture
87
British Thoracic Society major category for diagnosis of severe pneumonia
Need for mechanical ventilation
88
This anti-TB drug may cause “barrel vision”
a. Rifampicin / b. Isoniazid/ c. Pyrazinamide / d. Streptomycin
89
Most common cause of pneumonia in ambulatory patients:
Streptococcus pneumoniae
90
Most common etiologic agent in uncomplicated cystitis:
Escherichia coli
91
The best parameter to differentiate chronic bronchitis from emphysema
DLCO
92
The duration of treatment for acute cystitis in pregnant patient :
7 days
93
Diagnosis of Diabetes Mellitus is defined as:
A random plasma glucose concentration =11.1 mmol/L (200 mg/dL) accompanied by classic symptoms of DM (polyuria, polydipsia, weight loss) is sufficient for the diagnosis of DM
94
Type 2 DM is characterized by one of the pathophysiologic abnormalities:
peripheral insulin resistance
95
Acute complication of Type 2 Diabetes Mellitus :
Hyperosmolar Hyperglycemic State
96
Target blood pressure in Diabetes Mellitus
130/80
97
Risk factor for adverse prognosis in hypertension:
smoking
98
The most common form of suppurative intracranial infection:
bacterial meningitis
99
Precipitating cause of heart failure:
infection
100
Underlying cause of heart failure:
cardiomyopathy
101
Minor criteria of congestive heart failure:
tachycardia
102
Levine’s sign:
clenching of the fist in front of the sternum
103
An important factor predisposing to bacteriuria in men is urethral obstruction due to:
prostatic hypertrophy
104
The most common finding on physical examination in leptospirosis aside from fever:
conjunctival suffusion
105
The most common cause of partial or generalized epilepsy in the elderly is :
stroke
106
Definition of severe pneumonia by American Thoracic Society:
need for mechanical ventilation
107
Cause of transudative pleural effusion:
cirrhosis
108
Hallmark of COPD:
airflow obstruction
109
Most commonly involved in extrapulmonary TB:
lymph nodes
110
Primary Pulmonary TB frequently involved the:
middle and lower lung zones
111
The most common complication of measles:
subacute sclerosing panencephalitis
112
The drug of choice for primary generalized seizures is:
phenytoin
113
Type of anemia in Malaria:
normochromic normocytic
114
Cerebral Malaria is caused by:
P. falciparum
115
The most common presentation of amoebic infection is:
asymptomatic cyst passage
116
Duodenal ulcer occur 90% located within:
3cm of the pylorus
117
The most common type of gallstone:
cholesterol
118
Gold standard in diagnosing gallstone:
ultrasound
119
The most common risk factor of stroke :
hypertension
120
The most specific and characteristic symptom of gallstone disease:
biliary colic
121
Local complication of acute pancreatitis:
pancreatic abscess
122
85% of Pancreatic pseudocyst are located at the :
body and tail
123
The most common serious complication of chicken pox:
pneumonia
124
Incubation period of chicken pox:
7-10 days
125
The person recommended to receive influenza vaccine:
person > 65 years of age
126
Most serious complication of influenza B virus:
reye’s syndrome
127
Metabolic complication of nephritic syndrome
hypoalbuminemia
128
Primary Glomerulopathy which is highly steroid responsive:
minimal change disease
129
Most common cause of idiopathic nephrotic syndrome in adult:
membranous
130
Hallmark of nephrotic syndrome:
heavy protenuria
131
Most common glomerulopathy worldwide:
IgA nephropathy
132
Most common cause of Iron deficiency in adult:
chronic blood loss
133
Virus serotype associated greatest risk for DHF:
DEN-2
134
Most important laboratory test for DHF monitoring:
Hemoglobin
135
Which of the following is the earliest rabies specific clinical manifestation:
tingling sensation at the bite site
136
The diagnostic laboratory method of choice for typhoid fever in the first week of illness:
blood culture
137
The most important predictor of multi-drug resistant M. tuberculosis organism in all studies is:
history of treatment tuberculosis
138
Most discriminating symptom of duodenal ulcer:
pain occur 90 min to 3 hours after a meal
139
Liver cirrhosis is best diagnosed by:
Liver biopsy
140
Drug of choice for Schistosomiasis:
praziquantel
141
Spasm that is observed first in Tetanus:
risus sardonicus
142
Gold standard in the treatment of typhoid fever:
chloramphenicol
143
The most common opportunistic fungal infection:
candida
144
Source of cholera infection:
contaminated water supply
145
Classical malarial paroxysms suggest infection with:
P. vivax
146
Most common cause of pneumonia in ambulatory patients:
S. pneumoniae
147
The single most useful clinical sign of the severity of pneumonia:
Respiratory rate of > 30/min
148
The most common route for bacterial pneumonia :
microaspiration of oropharyngeal secretions
149
Most common site of spinal tuberculosis in adult:
lower thoracic spine
150
The most common site of gastrointestinal TB:
terminal ileum
151
Most common site of pancreatic cancer:
tail
152
Most consistent risk factor in pancreatic cancer:
cigarette smoking
153
Hereditable gastrointestinal syndromes that has least malignant potential:
juvenile polyposis
154
The most common infectious complication of varicella is
bacterial superinfection of the skin
155
The most common extracutaneous site of involvement in children
CNS
156
A deficiency of this protease inhibitor is a proven genetic risk factor for COPD
alpha 1 anti trypsin
157
Glucose goal in patients with DKA:
150 – 250 mg/dl
158
Heart failure with development of symptoms in less than an ordinary activity:
Class III
159
Heart failure with warm and flushed extremities and with widened pulse pressure
High output
160
Cardiomyopathy with primary myocardial involvement
Idiopathic
161
Reversible form of dilated cardiomyopathy
Alcohol abuse
162
Systolic Hypertension with wide pulse pressure
Arteriosclerosis
163
Framingham major criteria for Diagnosis of CHF :
Positive hepatojugular reflux
164
Characteristic appearance of stools in patients with cholera:
non-bilious,non-bloody, gray, sl. cloudy with flecks of mucus
165
Primary pulmonary TB is characterized as:
involves the middle and lower lobes in most cases
166
Class I recommendations for use of an Early invasive strategy in Myocardial Infarction:
Recurrent angina at rest/ low level activity despite Rx
167
The most common presenting complaint in patients with ST elevation MI:
Pain
168
De bakey classification of Aortic dissection in which dissection is limited to the ascending aorta:
Type II
169
Cardiomyopathy with primary myocardial involvement
Idiopathic
170
This form of respiratory failure occurs when alveolar flooding and subsequent intrapulmonary shunt physiology occur:
Type 1 respiratory failure
171
Heavy drinkers (i.e., those consuming 100 g of ethanol per day for the preceding 2 years) have a higher incidence of acquiring what type of organism in Community acquired Pneumonia?
gram negative organisms
172
Associated with pandemics and are restricted to influenza A viruses
antigenic shift
173
Most common pathogen in intensive care unit:
S. pneumoniae
174
The only known reservoir for Varicella zoster virus is
humans
175
The most common infectious complication of varicella is
bacterial superinfection of the skin
176
The most common site of hypertensive intraparenchymal hemorrhage is:
Putamen
177
The most common cause of ischemic stroke is
Artery to artery embolism from carotid bifurcation atherosclerosis
178
Currently considered the best initial treatment for primarily generalized tonic clonic seizures is:
Valproic acid
179
Adverse effects such as gum hyperplasia, hirsutism and coarsening of facies is associated with long term use of:
Phenytoin
180
The pathognomonic sign of meningitis is:
Presence of fever, headache and nuchal rigidity
181
The most common cause of community acquired bacterial meningitis in adults >20 years of age
Strep. Pneumoniae
182
Which of the following systemic disease is NOT associated with polyneuropathy:
Carpal Tunnel Syndrome
183
Compressive Metastatic Myelopathies most commonly involve which level of the spinal cord
Thoracic
184
Which of the following is true of Trigeminal Neuralgia
Objective sign of sensory loss in the face cannot be demonstrated on examination
185
Which of the following disorders causes irreversable dementia?
Alzheimer’s disease
186
The most powerful risk factor for osteoarthritis is:
Age
187
Disabilility of patient with knee osteoarthritis is strongly associated with:
Obesity
188
Which of the following is the characteristic physical examination finding of patient with osteoarthritis?
Bony Crepitus
189
Which of the following is considered as the most common form of idiopathic osteoarthritis
Heberden’s nodes
190
A 30 y/o female with SLE is noted to have a prolonged partial thromboplastin time. This abnormality is associated with:
Deep venous thrombosis
191
The best screening test for the detection of SLE is:
Antinuclear antibodies
192
Diagnosis of gouty arthritis is base on the finding of crystals in the synovial fluid and which of the following crystals is diagnostic of gout?
Birefringent needle-shaped crystals
193
The preferred treatment of acute gouty attack in elderly patient is:
Intraarticular steroid infection
194
Joint pain among patient with Rheumatoid arthritis is cause mainly by which of the following mechanism?
Distention of joint capsule
195
Axial (vertebra) joints involvement in Rheumatoid arthritis is usually limited to the:
Cervical vertebrae
196
Evidence suggests that early aggressive treatment of rheumatoid arthritic patient with Disease-Modifying Antirheumatic Drugs (DMARD) maybe effective at slowing the appearance of bone erosions. Which of the DMARD is currently considered the best initial choice?
Methotrexate
197
Which of the following Vitamins is capable of eliciting systemic anaphylactic reaction?
Thiamine
198
Which of the following medicine or drug is NOT effective in the treatment of the acute event of systemic anaphylactic reaction?
IV Glucocorticoids
199
Majority of acute diarrheas are due to
infectious agents
200
Clostridium deficile causes acute diarrhea by
cytotoxin production
201
Majority (>50%) of all esophageal cancers are of which cell type?
adenocarcinoma
202
Not considered as risk factor for the development of Pancreatic cancer?
cholelithiasis
203
Which of the following is a protective antibody against Hepatitis B infection?
Anti HBs
204
Drug that is contraindicated in the treatment of chronic Hepatitis B infection with decompensated liver is: disease
Interferon
205
Minimum amount of ascetic fluid which can be detected by shifting dullness is:
500 cc
206
Secretion of water and bicarbonate rich solution from the pancreas is stimulated by:
secretin
207
Most common complication of Peptic Ulcer Disease is:
bleeding
208
Which of the following isconnsidered as a non-pharmacologic management of Gastroesophageal Reflux Disease?
Decreased amount of fluids at night
209
Who among the following is considered to be diabetic?
a 34 y/o male who complained of excessive thirst, weight loss and casual blood sugar of 120mg%
210
The best way to assess blood sugar control is to monitor the:
Glycosalated Hemoglobin
211
A patient who is Hypertensive and Hypokalemic, should make one consider which of the ff. as the most likely cause of the hypertension?
Conn’s Syndrome
212
What is the most common cell type of Thyroid Carcinoma?
Papillary carcinoma
213
Which of the following physiologic condition can stimulate prolactin secretion by the pituitary gland?
Stress
214
Which of the following is NOT consistent with Diabetic Ketoacidosis?
Blood sugar of 240mg%
215
What is the expected laboratory findings in Grave’s Hyperthyroidism?
elevated thyroid hormones with low TSH
216
Which of the following is NOT a feature of Hypocalcemia?
diarrhea
217
Which of the following test is recommended as the initial screening for Cushing’s Sydrome?
overnight dexamethasone test
218
Which of the following have the most potent glucocorticoid effect?
Triamcinolone
219
The most potent risk factor for development of active TB disease is:
HIV co-infection
220
Tuberculosis treatment failure is suspected when appropriate regimen is prescribed but:
A. sputum cultures remain positive after 3 months / B. AFB sputum smears remain positive after 5 months / C. Either* / D. Neither
221
The most important impediment to cure Tuberculosis is:
non-compliance
222
A 58 years old male presented with 4 days fever and lately weakness and dizziness whenever he sits or stands up; disorientation. Upon PE: BP=90/60mmHg, PR=112/min., RR=28/min., T=39.8ºC. The only remarkable finding is an ulcerated skin lesions in the lower leg with black discoloration. Lab tests: WBC=2,500cells/m3; gram negative bacilli from smears of the skin lesion. This patient has
severe sepsis
223
The most probable organism that has causes severe febrile illness with changes in sensorium and associated with ulceration and black discoloration of the skin is:
P. aeruginosa
224
The following anti microbial agent is effective for the treatment of Pseudomonas infection:
Ceftazidime
225
The major anatomic site for the establishment and propagation of HIV infection is:
Lymphoid organs
226
Central to the pathogenesis of severe falciparum malaria is/are:
A. cytoadherence in capillary and venular endothelium / B. rosette formation by non parasitized RBC’s / C. agglutination of parasitized RBC’s / D. all of the above*
227
Sequestration and microcirculatory arrest occur in which of the following Plasmodium?
P. falciparum
228
Hypoglycemia in severe malaria is associated with poor prognosis and it may result from
A. failure of hepatic gluconeogenesis / B. increased glucose consumption by host and parasite / C. increased insulin secretion in treatment with Quinine / D. all of the above*
229
The diagnostic test of malaria that is also used to monitor response to treatment is:
Stained blood film
230
Dengue Hemorrhagic fever can occur following:
Second infection with a serotype different from that involved in primary infection
231
Diagnosis of Dengue fever is made in a clinically Compatible disease manifestation by
IgM ELISA
232
The main clinical manifestations of Chronic Schistosomiasis are dependent on
A. Species / B. site of egg deposition in the host’s tissues / C. Both*
233
The following are effects of tetanospasmin EXCEPT
A. blood release of inhibitory neurotransmitters / B. increased circulating catecholamine levels / C. block neurotransmitter release at the neuromuscular junction / D. all of the above*
234
The following laboratory findings are suggestive of Iron Deficiency Anemia EXCEPT
A. koilonychias / B. decreased serum ferritin* / C. decreased total iron binding capacity / D. low reticulocyte response
235
Which of the following statement regarding Polycythemia Vera is correct?
an elevated plasma erythropoietin level excludes the diagnosis
236
Diagnosis of Acute Myeloid Leukemia is established by the presence of:
≥ 20% myeloblasts in the bone marrow
237
Which of the following syndrome have autoimmune hemolytic anemia with immune thrombocytopenia?
Evans syndrome
238
Which of the following is the cytogenetic hallmark of Chronic Myelogenous Leukemia?
t(8;21)
239
What is the most common symptom of patient with Myeloma?
Bone pain
240
Cryoprecipitate is produced by centrifugation after thawing of this particular blood component
Fresh frozen plasma
241
Asthma is a disorder characterized by:
Persistent subacute airway inflammation
242
Major infectious cause of asthma exacerbation in adults is:
Influenza virus
243
The hallmark of COPD is airflow obstruction as evidenced by
Decreased FEV1/FVC
244
Paradoxical inspiratory inward movement of the rib cage seen in patients with severe COPD is called the:
Hoover’s sign
245
The single most useful clinical sign of severe pneumonia among patient without underlying lung disease is:
RR>30/min
246
Recurrent pneumonia in the same location is most likely due to the presence of:
Bronchial obstruction
247
The presence of pus in the pleural space is termed as:
Empyema
248
Sudden severe dyspnea, and P.E. finding of unilateral absent breath sounds and hypertesonance in a COPD patient without antecedent injury should make one suspect:
Secondary spontaneous pneumothorax
249
Subcutaneous emphysema and Hamman’s sign is seen in:
Pneumomediastinum
250
Hospital acquired pneumonia (HAP) is consider if pneumonia occur:
Occurs 48 hours after hospital admission
251
A 56 y/o female admitted for Acute Pyelonephritis was started on Amikacin 500 mg IV every 6 hours. After 7 days repeat serum creatinine=5.7 mg/dL (Initial was 1.3 mg/dL). Urinalysis at this time will reveal:
muddy brown granular casts
252
A 65 y/o male with poorly controlled diabetes had renal colic and underwent an IVP. He develop oliguria 1 day after the procedure. Repeat serum creatinine=6.9 mg/dL (Initial=2.9 mg/dL). The risks factors on this patient that predispose him to develop contrast dye nephropathy are the following, EXCEPT:
A. Diabetes / B. Renal Insufficiency / C. Infection* / D. Elderly
253
The findings of eosinophiluria in patient with acute Renal Failure is suggestive of:
Acute Allergic Insterstitial Nepritis
254
Which of the following statement is true regarding the measurement of GFR?
Serum creatinine is ⇑ after ingestion of cooked meat
255
A patient with Chronic Renal Disease and GFR of 40 ml/min has serum K of 6.2 meq/L. the elevated K is due to the following, EXCEPT:
A.⇓ urinary K+ excretion* / B. constipation / C. ⇑ dietary K+ intake / D. drugs that ⇓ K+ secretion in tubules
256
A 36 y/o female with Chronic Renal Disease complains of restless leg syndrome. Screatinine=5.2 mg/dL. You should advice the patient to:
initiation of Dialysis
257
A 46 y/o hypertensive patient serum creatinine=9.8 mg/dL and with marked pallor. The anemia is primarily due to:
⇓ EPO synthesis
258
The most prominent findings in patient with nephritic syndrome is:
proteinuria > 3.5 gm/1.73m2
259
A 20 y/o male, smoker was admitted because of oliguria and hemoptysis. Initial lab: revel serum creatinine=8.6mg/dL. Urinalysis shows rbc casts and dysmorphic rbc. (+) anti GBM Ab’s. The expected histopathologic findings is
crescents formation
260
Duration of treatment of acute uncomplicated cystitis in non pregnant woman is:
3 days
261
Which of the following is a chronic clinical manifestation of Atherosclerosis?
Stable effort induced angina pectoris
262
Atherosclerotic plaque that ate vulnerable to rupture is characterized by which of the ff.?
A. Thick fibrous cap / B. Large lipid cores / C. A high content of lymphocytes / D. Abundance of smooth muscle cells
263
Which of the following risk factors is a coronary heart disease risk equivalent?
Diabetes Mellitus
264
The abnormal lipoprotein profile associated with insulin resistance known as Diabetic dyslipidemia?
High Triglyceride, Low HDL
265
Microvascular angina is a condition caused by:
Abnormal constriction or failure of normal dilatation of the coronary resistance vessels
266
The major sites of atherosclerotic disease are the:
Epicardial arteries
267
CAD manifested as symptoms of dyspnea, fatigue and faintness is known as
Angina equivalent
268
The typical physical examination findings of patients with Stable Angina Pectoris is:
Normal
269
Which of the following is typical of hypertensive crises?
Diastolic blood pressure is > 140 mm Hg
270
Class I drug used in the treatment of symptoms of patients with Chronic stable Angina pectoris include which of the following?
ASA, beta blockers and NTG
271
Stenosis of the left main coronary artery on three vessel disease in patients with Diabetes Mellitus or severe LV dysfunction are best treated with:
CABGS
272
To achieve revascularization of the ischemic myocardium in patients with asymptomatic IHD and suitable stenoses of the epicardial coronary arteries, the best treatment option is:
PCI
273
The most common presenting symptom of patients with STERMI is:
Deep and visceral pain
274
The initial ECG changes in STEMI is:
A. ST segment depression / B. ST segment elevation / C. Deep Q / D. Tall T wave
275
In which of the following pattern of MI will the use of morphine be restricted because of its vagotonic effect?
Postero inferior MI
