I n t e r n a L medicine questions Bank

35. The treatment of choice for thrombotic events in the antiphospholipid antibody syndrome is ?

1. 
   Intravenous steroid
   
2. 
   High dose oral steroids with a rapid taper
   
3. 
   Penicillamine
   
4. 
   Aspirin
   
5. 
   Warfarin
   

36. A patient is given aspirin 300 mg after developing an acute coronary syndrome, what is the mechanism of action of aspirin to achieve an antiplatelet effect?

1. 
   Inhibit the production of thromboxane A2ia
   
2. 
   Inhibit ADP binding to its platelet receptor ia
   
3. 
   Inhibit the production of prostaglandin H2ia
   
4. 
   Glycoprotein IIb/IIIa receptor antagonist ia
   
5. 
   Inhibit the production of prostacyclin (PGI2)ia
   

37. Which of the following studies is most sensitive for detecting early diabetic nephropathy?

1. 
   serum creatinine level
   
2. 
   creatinine clearance
   
3. 
   urine albumin
   
4. 
   glucose tolerance teat
   
5. 
   Ultrasonography
   

38. Radiofemoral delay present in one of the following ?

1. 
   Angina pectoris
   
2. 
   Coarctation of the aorta
   
3. 
   Renal artery stenosis
   
4. 
   Heart failure
   
5. 
   COPD
   

39. Warfarin is an oral?

1. 
   Anticoagulant which inhibits the reduction of vitamin K to its active form
   
2. 
   Anticoagulant which acts as a direct antithrombin III inhibitor
   
3. 
   Anticoagulant which inhibits the activated factor X
   
4. 
   Antiplatelet which acts as an ADP receptor inhibitor
   
5. 
   Antiplatelet which inhibit GPIIbIIIa
   

40. A 30 year old man presented with a history of transient loss of consciousness and palpitation . his ECG showed ventricular tachycardia , which one of the following treatment should be avoided?

1. 
   Adenosine
   
2. 
   Amiodarone
   
3. 
   DC cardioversion
   
4. 
   Flecainide
   
5. 
   Verapamil
   

41. A 65 year old women who is currently recurving chemotherapy for myeloid leukemia is found on blood testing to have urea of 10.1 mmol/l ( n3.4-4.5), creatinine of 190 micro mol/l ( n 70-133), potassium of 6.1 mmol/l, (n 3.5-5), phosphate of 805 mg/dl ( n 3.4-4.5) and corrected calcium of 2.00 mmol/l ( n 2.15-2.55), the patient is asymptomatic, her electrolyte levels were normal prior to the start of treatment, what is the most likely single cause of this electrolyte disturbance?

1.