I n t e r n a L medicine questions Bank

Wrong about ulcerative colitis complications:

1. 
   Renal stones and gallstones
   
2. 
   Malignancy
   
3. 
   Amyloidosis
   
4. 
   Ascending cholangitis
   

12. 
    Wrong about FAP:
    

1. 
   Unlikely to present with cancer before the age of 40
   
2. 
   Autosomal recessive
   
3. 
   Clinically apparent before age 20
   
4. 
   Associated with osteomas and mucous fibromas
   

13. 
    History of a man with retrosternal chest pain. ECG reveals ST segment depression in I and aVL, diagnosis:
    

1. 
   Posterior MI
   
2. 
   Inferior MI
   
3. 
   Lateral MI
   

14. 
    Not part of child purgh score in liver cirrhosis:
    

1. 
   Encephalopathy
   
2. 
   Partial thromboplastin time
   
3. 
   Ascites
   
4. 
   Albumin
   

15. 
    Anti-TB drugs and side effect, correct answer is:
    

1. 
   streptomycin and renal failure
   
2. 
   Pyrazinamide and hepatitis
   
3. 
   Optic neuritis and…
   
4. 
   Vesitbular neuritis and ethambutol
   

16. 
    Not a cause of atrial fibrillation:
    

1. 
   Core pulmonale
   
2. 
   Alcoholic cardiomyopathy
   
3. 
   Hypertension
   
4. 
   Acute rheumatic fever
   
5. 
   Rheumatic heart diseases
   

17. 
    All are causes of chronic interstitial nephritis, except:
    

1. 
   Sickle cell
   
2. 
   Wilson’s disease
   
3. 
   NSAIDs
   

18. 
    RA, patient in pain, he takes indomethacin, next step:
    

1. 
   Methotrexate
   
2. 
   Corticosteroid therapy
   

19. 
    All are causes of upper zone infiltrate, except:
    

1. 
   RA
   
2. 
   Ankylosing spondylitis
   
3. 
   TB
   
4. 
   Sarcoidosis
   

20. 
    All cause cavitation in lungs, except:
    

1. 
   Pneumocystic carini
   
2. 
   Aspiration pneumonia
   
3. 
   Invasive Aspergillosis
   
4. 
   Septic emboli
   

21. 
    Young male, 20 years, fever, weight loss 10 kg, x-ray show anterior mediastinal mass , diagnosis is:
    

1. 
   Lymphoma
   
2. 
   Coccidiomycoma
   
3. 
   Histoplasmosis
   

22. 
    All are risk factors for legionella pneumonia, except:
    

1. 
   Surgery
   
2. 
   Tobacco use
   
3. 
   Hospital stay
   
4. 
   HIV
   
5. 
   Steroids
   

23. 
    One is true about COPD:
    

1. 
   Prophylactic antibiotics reduce the incidence of exacerbations
   
2. 
   A patient with PaO2 <60 who want to air travel, must have O₂ therapy
   

24. 
    A joint deformity that is not present in RA:
    

1. 
   Heberden
   
2. 
   Botnunnier
   
3. 
   Z-deformity
   

25. 
    A patient who presented with typical signs and symptoms of PMR, next step in management:
    

1. 
   Low dose steroids
   
2. 
   High dose steroids
   

26. 
    Correct about PAN:
    

1. 
   Association with hepatitis C
   
2. 
   Pathology in small and medium arteries at site of bifurcation
   
3. 
   Associated with leukocytoclastic necrosis
   

27. 
    Not causes by fungus:
    

a. Leprosy

28. 
    Defect in C5-C8 predispose to infection with which of the following organisms:
    

1. 
   Nisseria meningitides
   
2. 
   Streptococcus pneumonia
   
3. 
   Salmonella
   

d. ????

29. 
    MRSA treated by 
    

Vancomycin

30. 
    Not in management of bronchiectasis:
    

1. 
   Surgery
   
2. 
   Postural drainage and CPT
   
3. 
   Maintenance of normal BP
   
4. 
   Prophylactic antibiotics
   

31. 
    Not a complication of HIV:
    

1. 
   Idiopathic pulmonary fibrosis
   
2. 
   Lymphoid interstitial pneumonia
   

32. 
    Wrong about IBS:
    

1. 
   All need barium enema and meal
   
2. 
   Patient with diarrhea-prominent disease can be treated by leperulide
   

33. 
    Not indication for renal biospy 
    

isolated proteinuria and normal shaped RBCs

34. 
    A cause of respiratory failure I:
    

1. 
   Guillain bare
   
2. 
   ARDS
   
3. 
   Kyphosis
   
4. 
   Foreign body in a major brochus
   

35. 
    Correct about psoriasis:
    

1. 
   Can cause sacroilitis
   
2. 
   Psoriatic arthritis present in 60% of patients
   

36. 
    Not part of criteria to diagnose Behcet:
    

1. 
   Arterial aneurysms
   
2. 
   Uveitis
   
3. 
   Pethargy test positive
   

37. 
    Correct about Cushing syndrome:
    

1. 
   Loss of diurnal variation is a reliable sign for diagnosis
   
2. 
   ACTH level elevated
   

38. 
    Correct about hypothyroisim:
    

1. 
   T4 and T3 can be normal while TSH is the first to be elevated
   
2. 
   Weight gain is not a sensitive parameter
   

39. 
    Wrong about hypothyroidism:
    

a. Antibodies are positive only in 70% of patients with Hashimotoo thyroidits.

40. 
    Not side effects of interferon TT hepatitis B:
    

1. 
   Irreverislbe hair loss
   
2. 
   Depression
   
3. 
   ?
   

Answer: A (it is a reversible hair loss)

41. 
    Wrong about management of upper GI bleeding:
    

1. 
   Ligation and sclerotherapy is more effective than medical therapy
   
2. 
   Most bleeding stop temporarily
   
3. 
   Somatostatins and terlipressin reduce portal pressure
   
4. 
   Ballon tamponade after upper GI Endoscopy
   

42. 
    Not biological agent in ??:
    

1. 
   IL 6
   
2. 
   Infliximab
   
3. 
   Etanrecpt
   
   
   

43. 
    Wrong about hemochromatosis:
    

1. 
   Has a male predominance
   
2. 
   Autosomal recessive
   
3. 
   Congestive cardiomyopathy
   
4. 
   Patients have gray skin pigmentation from iron deposition
   

44. 
    Not a cause of thrombocytosis:
    

1. 
   Iron defeciency anemia
   
2. 
   Myelodysplasia
   
3. 
   Pernicious anemia
   

45. 
    Another marker that is used to diagnose vitamin B12 defeciency:
    

1. 
   Elevated methylmalonic acid level
   
2. 
   Decrease methylmalonic acid level
   
3. 
   Elevated homocysteine level
   
4. 
   Decrease homocysteine level
   

46. 
    A typical cause of anemia with normal RDW:
    

1. 
   Thalssemia
   
2. 
   Iron defeciency anemia
   

47. 
    The definitive treatment of B-thalassemia major:
    

1. 
   BMT (Bone marrow transfusion)
   
2. 
   Blood transfusion
   
3. 
   Iron therapy
   

48. 
    Which leukemia typically is associated with DIC:
    

1. 
   M1
   
2. 
   M2
   
3. 
   M3
   
4. 
   M4
   
5. 
   M5
   

49. 
    Not a typical feature of elevated ICP:
    

1. 
   Tachycardia and hypotension
   
2. 
   Morning headache
   
3. 
   Headahce that increase with straining and bending forward
   

50. 
    Patient present with Hb of 8… Blood film shows polychromasia. Best next step in management . patient is on hydoxychloroquine therapy for SLE :
    

1. 
   IV corticosteroids
   
2. 
   Plasmapharesis
   

Ans: A (She has Evan’s syndrome)

51. 
    All are correct about the mortality in ARF, except:
    

1. 
   Mortality depend on the cause
   
2. 
   Prognosis is generally good with reversible causes like drugs and blood loss
   
3. 
   Mortality in complicated ARF reaches 15-30%
   

52. 
    History: A female with history of long travel, then develops unilateral lower limb swelling with redness and hotness. She was diagnosed with DVT. She was started on Unfractionated heparin. 10 days later, she was found to have a platelet count of 60,000. Next step in management:
    

1. 
   Stop unfractionated heparin and no longer anticoagulation
   
2. 
   Stop unfractionated heparin and start low-molecular heparin.
   
3. 
   Stop unfractionated heparin and start her on leperudine
   

53. 
    Alcoholic patient was found to have macrocytic anemia, the most likely cause:
    

a. Vitmain B12 defeciency

54. 
    30 year old male patient, presented with chest pain one week after an URTI, most likely diagnosis:
    

1. 
   Pericarditis
   
2. 
   Tension pneumothorax
   

55. 
    3 weeks after MI, a patient presented with chest pain. ECG showed elevated ST segment in anterior chest leads, diagnosis is:
    

1. 
   Re-infarction
   
2. 
   Pericarditis
   
3. 
   Ventricular aneurysm with superimposed VT
   

Answer: C (Cause of persistent ST segment elevation is ventricular aneurysm)

56. 
    A 22 year old male patient, with central chest pain, radiating to back, he is found to have murmur on exam. Also, he is 2m tall. Most likely diagnosis:
    

1. 
   MI
   
2. 
   Pericarditis
   
3. 
   Aortic dissection
   

Answer: C (tall  Marfan syndrome. Plus, he is too young for an MI. Also, chest pain
that radiates to back is characteristic of aortic dissection)

57. 
    Wrong statement about T wave:
    

1. 
   Can be inverted in all leads in pericarditis
   
2. 
   Always abnormal if inverted in V2
   
3. 
   Always abnormal if inverted in V5
   
4. 
   Can be normally inverted in V1 in 20% of population.
   
5. 
   Can be found in NSTEMI
   

58.