I n t e r n a L medicine questions Bank

20. A30 years old lady hive history of weight gain and hoarseness of voice . On examination her pulse 60 beat per minute and pale, dry skin. The most important investigation is?

1. 
   ACTH
   
2. 
   Cortisol level
   
3. 
   Gonadotropin levels
   
4. 
   Insulin like growth factor
   
5. 
   Thyroid function test
   

21. A 27 year old women present with sudden onset of SOB. Pleuritic pain and haemoptysis. With past history of 3 miscarriage and DVT most likely diagnosis is?

1. 
   SLE
   
2. 
   Antiphospholibid syndrome
   
3. 
   Raynauds disease
   
4. 
   Systemic sclerosis
   
5. 
   Bechet disease
   
   

22. A 55 year old women, with past history of rheumatoid arthritis , presents with progressive shortness of breath and dry cough a few months ago , on examination bilateral fine inspiratory crackles . whats the Dx ?

1. 
   Pulmonary odema
   
2. 
   Consolidation
   
3. 
   Pleural effusion
   
4. 
   Pulmonary fibrosis
   
5. 
   Lung cancer
   

23. In the management of dilated cardiomyopathy all are true except ?

1. 
   Salt and water retention
   
2. 
   ACE inhibitors
   
3. 
   Diuretics
   
4. 
   Beta blockers
   
5. 
   Complete bed rest
   

24. A 40 year old women who has never had significant respiratory disease is hospitalized for hemoptysis. urinary reveals proteinuria and microscopic hematuria, serological findings include normal complement level and negative assay for fluorescent antinuclear antibodies, renal biopsy reveals granulomatous necrotizing vasculitis with scattered immunoglobulin and complement deposits, the most likely diagnosis in this case is ?

1. 
   Mesangial lupus glomerulonephritis
   
2. 
   Henoch schonlein purpura
   
3. 
   Microscopic polyarteritis
   
4.