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SMLE 11 (medicine) Flashcards

1
Q
  1. hematemesis with abdominal pain first time no previous symptoms no medical hx no medication , all lab normal, dx?
    A. Gastritis ,
    B. peptic ulcer,
    C. immune hepatitis,
    D. mallory weiss
A

B. peptic ulcer

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2
Q
  1. 36 male presented with hypertension (high blood pressure reading given) he have a family history of hypertension and both his sisters have hypertension
    He have high ceriatinin and protein in urin
    How will you manage?
    A. ACEI
    B. alpha blocker
    C. beta blocker
    D. ?
A

A. ACEI

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3
Q
  1. pf after PE stared on heparin ..labs show prolong PT and PTTT
    A. stop and give …?!(i forget the drug name but start with L!)
    B. continue
    C. switch to theraputic dose of enoxaprin
    D. stop and !!!
    Better recall: Case of P.E and recieve heparin after days give labs All normal except
    platelet 80 PTT elevate Wts next?
    A. Stop heparin and give Lepirudin
    B. Give LMW
    C. Increse heparin
A

A. Stop heparin and give Lepirudin

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4
Q
  1. a case of child after brain surgery
    Na177 i forget the exact lab for urin
    A. central DI
    B. SIADH
    C. ?
A

A. central DI

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5
Q
  1. diabatic pt and obese (i think bmi was 41 )failed to reduse weight
    A. diabetic drug for reducing weight
    B. bariatric surgery
A

B. bariatric surgery

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6
Q
  1. female presented with left knee pain for 3 days there is swelling and fever
    Labs showed slighty high wbc and ESR high
    Joint aspiration showed leukocytosis i think 200
    X ray left knee showed decreased joint space and osteophyte
    Diagnosis
    A. septic arthritis
    B. osteoarthritis
    C. gout
    D. rheumatoid arthritis
A

A. septic arthritis

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7
Q
  1. 60somthing female presentes after long travel with car for 5 hours with SOB
    A. pericarditis
    B. PE
    C. -?
A

B. PE

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8
Q
  1. 7yrs old with rash on her cheeks and joints pain and anima what the most
    specific test regarding her disease activity
    A- anti ccp
    B- bnp
    C- ANA
    D- Anti dna ds
A

D- Anti dna ds

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9
Q
  1. Old man says he sometimes forgets his friends’ names or celebrities in his
    community. His wife is worried he has Alzheimer’s.?
    Other recall: old man with tender joints, forgets his friends’ names, his wife is
    worried , what diagnosis ?
    A- Alzheimer’s
    B- Benign-forgetfulness
A

B- Benign-forgetfulness

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10
Q
  1. Young male had pharyngitis, then cough and fever, what is the most
    likely organism?
    a) Staph aureus
    b) Streptococcus pneumonia
A

Group A streptococcus (streptococcus pyogenes) is the most common
causative organism.

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11
Q
  1. DM obese on life modifications his A1c 8 what to add
    A-dulaglutide is also GLP
    B-DPP-4 inhibitors;
    C-GLP-1 receptor agonists
    D-SGLT2 inhibitors;
A

A-dulaglutide is also GLP

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12
Q
  1. Patient with hyperthyroidism and palpitations, heat intolerance.tmt
    A. Propriouracil
    B. Methimazole????
    C. Carbimaxole
    D. Propranolol?????
A

D. Propranolol?????

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13
Q
  1. unilateral neck swelling in the RT side by investigations : hot thyroid nodule
    remaining of the gland cold TSH is low, T3, T4 high No LN enlargement (dx
    hyperthyroidism toxic nodule) What is the initial Treatment?
    A- antithyroid drug
    B- RT thyroidectomy
    C- Hemithyroidectomy
    D- radioactive iodine
A

A- antithyroid drug
D- radioactive iodine صح

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14
Q
  1. Hypothyroidism clear Hx and labs with low Na (it was 129) normal 134
    What to do next ?
  2. Levothyroxine
  3. treat the hyponatremia with hyper Na fluid
A
  1. Levothyroxine
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15
Q
  1. A patient with renal failure presents with low calcium, high alkaline
    phosphatase, and high PTH. What is the best form of vitamin D to give this patient?
    A- Calcitriol
    B- Vitamin D2
A

A- Calcitriol

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16
Q
  1. Most effective method to decrease stone formation in pt with hypercalcemia
    ?
    A. decrease ptn
    B. thiazide
    C. allopurinol
    D. decrease calcium intake
A

B. thiazide

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17
Q
  1. Pt with diffuse thyroid enlargement on exam there is 1 nodule in each lobe,
    labs showed hyperthyroidism what will you do?
    A. Thyroid scan.
    B. FNA from both nodule
A

A. Thyroid scan.

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18
Q
  1. 32 year old pregnant lady in 3rd trimester was complaining of palpitations
    and sweating and heat intolerance along being restless she have notice a large
    goiter but no dyspnea or difficult swallowing and change in both orbits that
    became more prominent. ECG - sinus tachycardia. CBC -LFT - RFT within normal.
    TSH 0.1 ( low ) , T4 10 ( high ). Thyroid Scan showed diffuse homogenous uptake.
    Anti-Thyroid Stimulating Antibody is pending. what is your next step for
    management ?*
    A. Thyroidectomy
    B. Radio-active Iodine Therapy
    C. Methimazole
    D. Propylthiouracil
A

C. Methimazole

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19
Q
  1. A 72 year old man presented with an episode of right sided weakness that
    lasted 10 minutes and fully resolved and he is clinically stable, he has no other
    medical illness. On examination: BP 110/70, HR 95, T 36.6 Which of the following is
    the most appropriate next step in the management?
    A.Aspirin.
    B. Warfarin, INR 3-4
    C. Warfarin, INR 2-3
    D. No additional drug treatment
A

A.Aspirin.

20
Q
  1. A 67 year old male is brought to the ED by his wife saying that he developed
    weakness and dysarthria after he woke up. She says that he went to sleep having
    no complaints, then woke up 2 hours later with symptoms of weakness and slurred
    speach. O/E power 2/5 in left side and 5/5 on the right side. CT picture included
    and shows hypodensity in the right hemisphere. What is the management?
    A. clopidogrel
    B. Aspirin
    C. Thrombolytic
A

C. Thrombolytic

21
Q
  1. 65 year-old male patient k/c of DM, HTN and PAD, presented with severe
    claudication, admitted to the hospital as a case of acute limb ischemia and received
    thrombolytic therapy. Which of the following is a cause of death during hospital
    admission?
    A. Bleeding
    B. Hemorrhagic stroke
    C. Pulmonary embolism
    D. Myocardial infarction
A

B. Hemorrhagic stroke

22
Q
  1. patient complaining of chest pain, diaphoresis and other symptoms of Ml that
    started 2 hours ago. He has a history of ischemic stroke (2 months ago). what would
    you give him next? ]
    A. Thrombolytic Therapy
    B. Aspirin
    C. PCI
    D. Statin
A

B. Aspirin

23
Q
  1. 50 years male returned from vacation ,drowsy, poor concentration,difficult
    awaking from sleep ,he described multuple fulls but all labs and brain images are
    free
    A. Post concussion syndrome
    B. Chronic subdural hemorrhage
A

A. Post concussion syndrome

24
Q
  1. 9-month Hx of MI came to clinic for smoking cessation he was in respiratory
    distress raised JVP nicotine tear in his hand what is the most appropriate drug?
    A. Nicotine replacement therapy
    B. Varenicline
    C. Bupropion
A

B. Varenicline

25
Q
  1. 9-month Hx of MI came to clinic for smoking cessation he was in respiratory
    distress raised JVP nicotine tear in his hand what is the most appropriate drug?
    A. Nicotine replacement therapy
    B. Varenicline
    C. Bupropion
A

B. Varenicline

26
Q
  1. Pt with systemic sclerosis ..comes with fatigue and dizziness Bp188/90 Renal
    impairment. What medications to add?
    A.Lisinopril
    B.Amilodipin
    C. BB
A

A.Lisinopril

27
Q
  1. 70 old male with forgetfulness, progressive gradually for 2 years.. devolop
    signs of aggression and violence after he was calm ,caring ,and kind:
    A. Lewi body
    B. Alzheimer’s
    C. Vascular dementia
A

B. Alzheimer’s

28
Q
  1. 78y/o male presented with change level of consciousness and fever , lumber
    puncture was doe show CSF gram +ve bacilli , hem catalase +ve , how will you
    treat ?
    A-ceftriaxone + vancomycin + steroid
    B- ceftriaxone + ampicillin + vancomycin
    C- ceftriaxone + vancomycin + ampicillin
    D- ampicillin
A

D- ampicillin

29
Q
  1. In a patient with suspected transient Ischemic attack full recovery should take
    place within:
    A. 6 Hours
    B. 12 Hours
    C. 18 Hours
    D. 24 Hours
    E. 48 Hours
A

D. 24 Hours

30
Q
  1. What is the AB that use in ICU patient have pneumonia:
    A. Vancomycin
    B. Azithromycin
    C. Ceftoxime
    D. Amoxicillin
A

B. Azithromycin
C. Ceftoxime

31
Q
  1. A case of interstitial pneumonitis most commonly associated with?
    A-Viral pneumonia
    B- Lobar pneumonia
    C- Bronchopneumonia
    D-Secondary tuberculosis
A

VIRAL OR ATYPICAL

32
Q
  1. 80 year old smoker for 40 years , all labs normal except high Ca , Dx ?
    A. paget dis
    B. hyperparathyroidism
    C. lung cancer
A

C. lung cancer

33
Q
  1. 32 non smoker presented with lung nodule 7 mm otherwise normal except
    for ca 4 mmol :
    A. Repeat CT scan within 3-6 months
    B.Pulmonary funtion test
    C. Biopsy of the lesion
    D. PET scan
A

A. Repeat CT scan within 3-6 months

34
Q
  1. Copd patient his FEV1% is 39 he is on inhaled salbutamole (SABA) and
    ipratropiam and still not controlled What to add ?
    A. Inhaled salmeterol
    B. Inhaled slameterol + Inhaled corticosteroid Long o2 therapy
A

B. Inhaled slameterol + Inhaled corticosteroid Long o2 therapy

35
Q
  1. COPD pt on high flow o2 3 L with O2 saturation 93% , develop acidosis and
    hypercapnia, what will you do ? ]
    A. Decrease O2 flow
    B. Mechanical ventilation
    C. Increase O2 flow
    D. CPAP
A

A. Decrease O2 flow

36
Q
  1. Chronic kidney disease picture of iron def anemia and and high ferritin what is
    the treatment ?
    A Oral iron
    B erythropoietin
    C IV iron
A

B erythropoietin

37
Q
  1. Plt were low, PT&PTT&INR all normal, high bilirubin and reticulocytes and low
    Hb (indicates hemolysis), creatinine was normal, your management:
    A.Steroids and IVIG
    B. Exchanged transfusion
    C. Platelet transfusion
A

B. Exchanged transfusion

38
Q
  1. 81 yo woman DM, HTN on medications at risk or known to have DVT asking
    about prophylactic for DVT?
    A. Aspirin 81 mg oral
    B. Enoxaparin 40mg SC
A

B. Enoxaparin 40mg SC

39
Q
  1. Female c/o urine leakage with cough, sneezing, exercise and with urgency.
    What type of incontinence does she have?
    A. Urge incontinence
    B. Stress incontinence
    C. Mixed incontinence
    D. Overflow incontinence
A

C. Mixed incontinence

40
Q
  1. 80 yr old male c/o inability to urinate with Abd. Pain and severe need of
    urination What to do?
    A. Cystoscopy
    B. Emergency TURP
    C. Foley cath + culture
A

C. Foley cath + culture

41
Q
  1. Female patient came to ER complaining of RUQ pain from 8h, the patient has
    jaundice with fever of 37.9
    Elevated WBC.
    A. pancreatitis
    B. cholangitis
    C. Cholecystitis
A

….

42
Q
  1. RTA one lung dull to percussion
    A- tension pneumothorax
    B- massive hemothorax
    C- pulmonary contusion
A

….

43
Q
  1. Patient with hyperthyroidism on anti thyroid medications for 10 months, still
    symptomatic. TSH: 0.1 and T4 was 27 I think. Best next step?
    A. Continue anti thyroid
    B. Subtotal thyroidectomy
    C. Near total thyroidectomy
    D. RAI or increase the dose of drug
A

…. D. RAI or increase the dose of drug

44
Q
  1. Elderly had cough with white sputum that turned yellowish with
    diffused infiltration bilaterally and more dense in right lung . Dx?
    A. Atypical pneumonia
    B. pneumococcal pneumonia
    C. Viral pneumonia
A

….

45
Q
  1. What causes interstitial pneumonia / Interstitial pneumonitis?
    A-Viruses
    B- tuberculosis
    C- bacteria (Atypical pneumonia)
A

….

safety (15 decks)

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