I n t e r n a L medicine questions Bank

ribaverin

Vitamin e

Beta carotene

19. 
    All of the following medciations are being used in chronic hepatitis B, except:
    
    1. 
       Lamividine
       
    2. 
       Ribavirine
       
    3. 
       Pregyled interferon
       
    4. 
       Adefovel dig
       
    5. 
       Entovavir
       
       
       
20. 
    All of the following micro-organisms can cause infectious diarrhea with positive fecal leucocytes, except:
    

1. 
   Shigella
   
2. 
   Yersinia
   
3. 
   Giardia
   
4. 
   Campylobacet
   
5. 
   Salmonella
   

19. 
    All of the following are protective from colo-rectal cancers, except:
    
    1. 
       Aspirn
       
    2. 
       Folic acd
       
    3. 
       Fier diet
       
    4. 
       calcium
       
    5. 
       moderate use of alcohol
       

19. 
    The most common cause of GI bleeding is:
    
    1. 
       Peptic ulcer disease
       

19. 
    Regarding achalasia, all of the following are tue, except:
    
    1. 
       There is increase of intramural inhibitory signals
       

19. 
    Regarding Crohn’s disease, all of the following are true, except:
    
    1. 
       The rectum is often spared
       
    2. 
       Fistual fissures and absesscess can occur in patietns with colo-rectal Crohns
       
    3. 
       The disease is limited to the mucosa
       
    4. 
       The mucosa can appear as cobble stone
       
20. 
    All of the following are true regarding ulcerative colitis, except:
    
    1. 
       Azathioripne can be sued in treatment
       
    2. 
       Maybe associated with Pyoderma gangreonusum
       
    3. 
       Patients may be P-ANCA positive
       
    4. 
       The rectum is never involved
       

19. 
    Regarding IBD, all of the following are rue, except:
    

1. 
   UC patients usually smokes more than Crohn’s patients (Unlike Crohn's disease, ulcerative colitis has a lesser prevalence in smokers than non-smokers.)
   
2. 
   Incidencei s about 7/100,000
   
3. 
   Jweish affected more often than asians
   
4. 
   Iliocecal area is frequenly involved in Crohn’s disease
   

19. 
    The most common cause of portal hypertension is:
    
    1. 
       Liver cirrhosis
       

19. 
    All of the following are true regarding inflammatory acute diarrhea, except:
    
    1. 
       Can be caused by shigella  Correct
       
    2. 
       There is polymorphonuclear cells in the stool sample
       
    3. 
       There may be blood in the stool sample
       
    4. 
       Usually affects the small bowel in the infected type inflammatory acute diarrhea
       

19. 
    5 year-old girl came to ER because of fatigue and shortness of breath. She was taking amoxacililn for acute otitis medica. Laboratory testing showed Hb 5.5 gm/dL with normal WBC and platelet count. The smear showed numerous nucleated RBCs and spherocytes. Both direct and indirect test Coomb’s test were positive. The patient has:
    

a. Warm autoimmune hemolytic anemia

19. 
    All of the following can cause peptic ulcer, except:
    
    1. 
       Paracetamol
       

19. 
    All of the following help differentiate between inflammatory and non- inflammatory arthritis, except:
    

1. 
   Favorable response to NSAIDS
   
2. 
   Mornign stiffness for 2 hours
   
3. 
   Pain improves with continued ambulation
   
4. 
   Presence of extra-articular features
   
5. 
   Hottness and rednes of the affected joint
   

19. 
    All of the following are features of osteoarthritis, ecept:
    
    1. 
       Morning stiffness for more than an hour
       
    2. 
       Normal ESR
       
    3. 
       Pain in affected joint is increased with ambulation
       
    4. 
       Swelling of the affected joint but without hotness or redness
       
    5. 
       Lack of systemic extra-articular symptoms
       
20. 
    All of the following are consistent with the diagnosis of rheumoatoid arthritis, ecept:
    

1. 
   Symmetrical involvemtn of the small joints of the hands?
   
2. 
   Elevated ESR
   
3. 
   Wan neck deformities in the fingers
   
4. 
   Nodes of the distal interphalangeal Heberden’s joint
   
5. 
   Erosive changes othe MCP joints on x-ray Answer: D (osteoarthritis)
   

19. 
    A positive rheumatoid factor can be seen in all of the following conditions, ecept:
    
    1. 
       RA
       
    2. 
       TB
       
    3. 
       Hepatitc C
       
    4. 
       Malignancies
       
    5. 
       Combined immune deficiency syndrome → Correct
       
       
       
20. 
    All of the following are extra-articular features of rheumatoid arthritis, except:
    
    1. 
       Posterior uveitis
       
    2. 
       Cutaneous vasculitis
       
    3. 
       Pulmonary fibrosis
       
    4. 
       Sicca syndrome (secondary sjogren’s)
       
    5. 
       Pericarditis
       

Answer: A (Eyes: Scleristis, episcleritis, scleromalacia perforans, and Sicca syndrome)

19. 
    All of the following are true for myofibril, except:
    
    1. 
       Each myofibril is made up of a serious of sacromeres
       
    2. 
       The basic unit of contraction is intercalated disc
       
    3. 
       A scromere is bounded by two tran??? Z lines
       
    4. 
       The actin filamne overaly with thicker protein filament called myocin
       

19. 
    In conductive system of the heart muscle, all of the following are ture, except:
    

1. 
   Conduction started in SA node. AV node, bundle of His, left and right bundle branch- purkinjee fibers.
   
2. 
   Left bundle branch is shorter than right bundle
   
3. 
   Right bundle supplies right ventricle and left bundle supplied left ventricle and spetum
   
4. 
   Action potential in the ventricle is rapid and generated by rapid transmembrane K diffusion.
   

19. 
    Cause of syncope include all of the following, except:
    
    1. 
       Arrhythmias, atrial and ventricular.
       
    2. 
       Obstruction to cardiac output like artic stenosi
       
    3. 
       Vasovagal, neurogenic
       
    4. 
       CVA
       
    5. 
       SBE
       
20. 
    The least common ause of AF is? Or: The commonest cause of AF?
    
    1. 
       WPW syndrome
       
    2. 
       Mitral valve disease
       
    3. 
       Hypertension
       
    4. 
       Pericarditis
       
    5. 
       Thyrotoxicosis
       

Most common cause: Mitral valve disease
Least common cause: Either WPW syndrome or pericarditis (The common arrhythmia that occurs in WPW syndrome is a paroxysmal (intermittent) supraventricular tachycardia (PSVT). Other arrhythmias that can also occur include atrial fibrillation, atrial flutter and atrioventricular re-entrant tachycardia (AVRT). Rarely, another arrhythmia called ventricular fibrillation can develop)

19. 
    Compensatory physiologic changes in HF include which one of the following:
    

Thyrotoxicosis\ infection and infective endocarditis, poor compliance in therapy, renin angiotensin system, pregnancy ??? Question not clear  Probably answer is Renin- angiotensin-system.

19. 
    All of the following are true in atrial fibrillation, except:
    
    1. 
       Presence of A wave in front of QRS in EKG
       
    2. 
       Presence of pulse deficit between apical rate and radial rate ≪< Wrong
       
    3. 
       It’s a type of arrhythmia called irregular irregularly
       
    4. 
       It is treated medically by digoxin and surgicall by Maixe operations?
       

19. 
    Myocardial ischemia is an imbalance between O2 supply and myocardial demand, all of the following are true except:
    

1. 
   Obstruction of coronary arteries by atherosclerosi
   
2. 
   Coronary artery spasm
   
3. 
   Anemia
   
4. 
   Thyrotoxicosis
   
5. 
   Pericarditis
   

Answer: E Conditions that may cause myocardial ischemia include Coronary artery disease (atherosclerosis). Atherosclerosis occurs when plaques made of cholesterol and other cellular waste products build up on your artery walls and restrict blood flow. Atherosclerosis of the heart arteries is called coronary artery disease and is the most common cause of myocardial ischemia.
Blood clot. The plaques that develop in atherosclerosis can rupture, causing a blood clot, which may lead to sudden, severe myocardial ischemia, resulting in a heart attack.
Coronary artery spasm. A coronary artery spasm is a brief, temporary tightening (contraction) of the muscles in the artery wall. This can narrow and briefly decrease or even prevent blood flow to part of the heart muscle. Coronary artery spasms are more common in people with risk factors for heart disease, such as high cholesterol and high blood pressure, but the spasms can happen in people who have no risk factors, too. Coronary artery spasms can also occur in people who have conditions that affect their immune systems, such as lupus.
Severe illnesses. Myocardial ischemia can occur when the metabolic demands of your heart increase or when blood pressure is very low due to infection, bleeding or other severe illness. Source: http://www.mayoclinic.com/health/myocardial-ischemia/DS01179/DSECTION=causes

19. 
    In acute MI< all of the following are true, except:
    
    1. 
       Inf MI, St elevation in 1, 2, AVF
       
    2. 
       Anteroseptal MI – ST segment elevation in V1-V2-V3
       
    3. 
       In acute MI, thrombolytic therapy achieve 100% reperfusion arate.
       
    4. 
       Treatment of MI include morphine, coronary vasodilation, aspirin.
       
    5. 
       Cardiac markers in acute MI, serial cardiac enzymes, like CPK, troponin. Answer: C (reperfusion rate 100%? Fee eshee bel6eb 100%)…
       

19. 
    Clinical features in infective endocarditis include all of the following, except:
    
    1. 
       Appearnace of new murmur or change in the quantiy of eisting murmur
       
    2. 
       Fever
       
    3. 
       CHF
       
    4. 
       Skin and eye lesions
       
    5. 
       No splenomegaly