Prc Medicine

7/26/2019 Prc Medicine

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INTERNAL MEDCINE

1 . Th e t re at men t of ch oi ce fo r a ne mi a of ch ro ni c r en al di sea se :a. Ferrous sulfateb. Folic acidc . E ry th ro po et ind. blood transfusion

An swe r: C P. 16 58

2. A patient was brou ht to the !" in a comatose state. #erum electrol$tes drawn on admission showed the followin : %a& 1'' me()*+ , & 8.- me( l+ Cl /8 me()*+ 0C ' 1' me( *. !C showed absent P wa3es+ widend 4"# and pea ed T wa3es. hich would b the mot appropriate initial step:

a. "epeat electrol$te measurement and obser3eb. Attempt cardio3ersionc. Administer intravenous calcium gluconated. Administer sodium pol$st$rene sulfonate 7,a$e elate9

An swe r: C P. 26 2

' . *ow serum complement le3el would be seen in patients with hematuria+ proteinuria and h$pertension result infrom all of the followin + ! C!PT:

a. ;i ed essential cr$o lobulinemiab. 0epatitis C associated membranoproliferati3e lomerulonephritisc. . ne of th e f ol lo wi n is no t t ru e i n t he as se ss me nt of ac ut e ? le ed in :a. The presence o$ large 'uantities o$ bright red blood per rectum rules out the source be$ore the

ligament o$ Treit(b. ;elena almost alwa$s represents B ?c. ?lac stools can be caused b$ lesions in the colond. A bilous % T return flow in a patient who @ust had hematocheGia rules out an upper source of

hemorrha e

8 . h ic h o f t he fo ll ow in i s t ru e r e ar di n as tr ic ul ce ra. presence of astric acid e cludes mali nanc$b. wei ht loss is distincti3el$ unusual in beni n ulcer c. ulcers alon the reater cur3e fa3or mali nanc$d. coe#isting duodenal ulcers $avor benign nature o$ gastric ulcer

/. A 55 $ear old diabetic patient presents with heartburn and acidic eructation for 2 $ears. !ndoscopic biops$ of a patch of h$peremic mucosa ' cm. abo3e the astroesopha eal @unction showed s(uamous epithelium withinflammator$ cells. The patient most li el$ has:

a. ?arrett s esopha usb. &astroesophageal re$lu# diseasec. Candidal esopha itisd. 0erpes simple esopha itis

1-. hich of the followin statements does % T describe secretor$ diarrheaa.


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1=. hich of the followin r is factors has been direct l$ associated with ?roncho enic Carcinomaa. Asbestos e posureb. Aflato in in estionc. Cigaret te smo+ingd. Chronic ?ronchitis

1 5. T hi s r ou p of d ru s r ed uc e ai rw a$ in fl am ma ti on i n b ro nc hi al a st hm a:a. Catecholaminesb. ;eth$l anthinesc . C lu co co rt ic oi dsd. Anticholiner ics

16. The American Thoracic #ociet$ defines chronic bronchitis as persistence of cou h and e cessi3e mucus productionfor most da$s out of ' months for IIIIIIII successi3e $ears:

a. ,b. 'c. =d. 5

1>. A patient with CAP re(uires hospital iGation when one of the fol lowin is present:a. a e J 65 $ears oldb. C-%D in e#acerbat ionc. temperature of '8.5Cd. unilobar C " infiltrate

18. ne of the followin is % T a useful clue to the microbial etiolo $ of CAP 7Communit$ Ac(uired Pneumonia9a. edentulous persons li+ely to develop pneumonia due to anaerobesb. susceptible people e posed to an infectious aerosol in *e ionellosis

c. patients with se3ere h$po amma lobulinemia at ris of infection with #. pneumoniaed. anaerobic lun abscess occurin in patients prone to aspiration

1/. n a patient suspected of PT!+ presence of this s$mptom heralds the occurence of pulmonar$ infarction:a. une plained d$spneab . he mpt ys isc. sudden onset of cou hd. s$ncope

2-. old standard in the dia nosis of PT!:a. 3entilation perfusion scanb. pulmonary angiographyc. 0elical)#piral CT #cand. transesopha eal echocardio raph$

21. ne of the disorders below does % T ha3e 3esicles or bul la as presentin lesions:a. mpeti ob. Chic en poc. 0erpes #impled. %soriasis

22. Annular lesions with raised er$thematous border and clear centers+ distributed o3er the trun area:a. Tinea un lumb. Psoriasisc. Tinea 3ersicolor d . Tin ea co rp or is

2 '. rouped 3esicles arran ed in a se mental pat tern o3er the ri ht side of the t run + T> 8

le3el:

a. 0erpes #imple

b. Chic en poc. Eerruca 3ul arisd . er pe s os te r

2=. A pre nant woman with brown macules with irre ular borders+ s$mmetric pattern on her chee s+ forehead+ upperlips+ nose and chin most li el$ has:

a. #*!b. melasmac. Addison s diseased. Psoriasis

2 5. ne of th e f ol lo wi n st at em en ts is % T t ru e o f t $p ho id fe 3e r:a. #almonella t$phi has no nown hosts other than humans.b. ;ost cases result from in estion of contaminated food or water.c. ncubation period ran es from ' to 21 da$s.d. "tool culture is best done during the $irst *ee+ o$ $ever.

26. n t$phoid fe3er+ which of the followin specimen will ha3e the best sensiti3it$ for culture if a patient has beeni3en antibiotics

a. bloodb. b on e ma rro*c. stoold. urine

2>.


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'-. The most li el$ or anism)s causin secondar$ bacteremia followin manipulation of a furuncle is)are:a. anaerobes and m 7 9 bacillib. anaerobes and #taph aureusc. #taph aureus and m 7 9 bacillid . "ta ph au reu s

'1. hich of the fol lowin 3accines is especiall$ indicated in a splenectomiGed pat ient:a . p ne umo co cc alb. hepatitis ?c. tetanusd. polio

'2. A pat ient with ?el l s Pals$ has a patholo $ in3ol3in which cranial ner3ea.b. Ec. /IId. and E

''. A patient suspected to ha3e menin itis under oes spinal tap. Bpon insertion of the spinal needle+ the openin pressure is recorded to be mar edl$ ele3ated. Kou should:

a. continue drainin the C#F to decrease the pressureb. *ithdra* the needle and run I/ mannitolc. continue drainin the C#F while runnin E mannitold. withdraw the needle and reinsert at a lower site

' =. T he f ir st d ru o f ch oi ce i n a pa ti en t pr es en ti n wi th f ra n s ei Gu re s is :a.


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b. acute blood lossc. hemol$tic anemiad. treatment of iron deficienc$

=>. All of the followin anemias e cept one are chronic de3elopin o3er wee s. hich anemia ma$ de3elop acutel$a. aplasticb. perniciousc. hemolyticd. iron deficienc$

= 8. n th e t um or c el l c$c le + th e ce ll s re fr ac to r$ to c he mo th er ap $ ar e th e:a. Cells in the 2

phase

b. Cells in the ; phasec . Ce lls in the &

0 phase

d. Cells in the acti3e # phase

=/. ;ul tiple osteol$t ic lesions+ h$percalcemia and neurolo ic abnormali t ies are most often seen in:a. Prostatic CAb. %on 0od in s l$mphomac. %lasma cel l myelomad. C%# tumors

5-. Thr omboc$topen ia is not e pec ted in:a. #*!b. & 1%D de$iciency

c. Acute *eu emiad.


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6'. . A p er so n w it h no wn al le r $ t o p en ic il li ns sh ou ld no t b e i3 ena. cotrimo aGoleb. tetrac$clinec. er$throm$cind. ce$ale#in

68. *$mpho ines are secreted b$a. pol$morphonuclear cellsb. monoc$tesc . ly mp ho cy te sd. l$mphoma cells

6/. A '- $ear old female has se3ere perennial aller ic rhinitis. 0er house is fre(uentl$ flooded. #he has a do andsleeps on epo pillow. As part of mana ement of her aller $+ $ou should ad3ice her to

a. et a new apo pillow and launder it fre(uentl$b. tr$ to scoop out the flooded water as soon as the rain poursc. eep the do out or et a cat insteadd. replace the +apo+ pillo* *ith $oam rubber6 cover the pillo* and mattress *ith allergen proo$

encasings

> -. ! h as h i h a ff in it $ f or wh ic h t $p e o f c el lsa. eosinophilsb. mast cellsc. platelets

d. macropha es

>1. A 65); is brou ht to the !" due to chest pain. 0e suddenl$ becomes unresponsi3e and pulseless and cardiacmonitor re3eals 3entricular fibrillation. Kou should immediatel$:

a. be in CP"+ followed b$ intubation+ then defibrillation with 1-- D 2-- D '6- Db. be in CP"+ followed b$ intubation+ then defibrillation startin at 2--Dc. begin C%R6 then de$ibrillation at ,00 86 900 8 then 910 8d. be in CP"+ defibrillate at 2-- D+ then intubate

>2. f despite defibrillation+ a pulseless patient has persistent 3entricular fibrillation+ the use of which dru would bemost appropriate

a. lidocaineb. procainamidec. amiodaroned. e pin ep hr in e

>'. f onl$ one person is present to pro3ide basic life support+ chest compressions should be performed at a rate of IIIIII per minute+ and breaths twice in succession e3er$ 15 seconds

a. 5-b. :0c. 6-d. =-

>=. ne of the fol lowin is associated with an increased r is of sudden cardiac death:a. $re'uent %/C;s b. h$ponatremiac. smo ind. h$perlipidemia

> 5. ! le3 at io n of # er um P ot as si um i s t o ic t o t he:a. idne$sb. brainc. heartd. li3er

>6. Anti O Tuberculosis dru that can cause h$peruricemia:a. soniaGidb . % yr a( in am id ec. "if ampi cind . # tr ep to m$c in;P*: -.25 p:/6=

>>. hich of the followin tests is re(uired to dia nose Chronic bstructi3e Pulmonar$


6/19

d . "ma ll ce ll;P*: -.25 p: 5-/

>/. This is considered as the most fre(uent cause of Acute "espirator$


7/19

b. Fastin is defined as no caloric inta e for at least 12 h.c. The test should be performed usin a lucose load containin the e(ui3alent of 5- anh$drous

lucose dissol3ed in waterH not recommended for routine clinical use.d. A random plasma glucose concentration ?33.3 mmol2L accompanied by classic

symptoms o$ DM is su$$icient $or the diagnosis o$ DM ;P*: -.''' p: 215'

/=. T$pe 2 1

1-2. *e3ine s si n:a. tenderness on palpationb. slowl$ pro ressi3e d$spneac. clenching o$ the $ist in $ront o$ the sternumd. difficult$ of breathin;P*: -.25 p: 1='5

1-' . An important factor predisposin to bacter iuria in men is urethral obstruct ion due to:A. prostatic hypertrophy?. catheter insert ionC. i nf ect ion16

1-=. The most common f indin on ph$sical e amination in leptospirosis aside from fe3er:A. calf tenderness). con@unctival su$$usion

C. @ aundice


8/19

1-8. 0allmar of C P

11- . P ri ma r$ Pu lm on ar $ T? fr e( ue nt l$ i n3 ol 3ed t he :A. m id dl e l ob e?. lower lob eC. middle and lo*er lung (ones=

11'. T$pe of anemia in ;alaria:A. normochromic normocytic?. h$pochromic normoc$ticC. h$pochromic microc$tic=/

11>. The most com mon t$pe of alls tone:A . c ho le st er ol?. blac pi ment s toneC. brown pi ment s tone2

12-. The most specific and characteris tic s$mptom of allstone disease:A . b il ia ry c ol ic?. 3omiti nC . c on st ip at io n


9/19

1 2' . T he mo st co mm on se ri ou s c om pl ic at io n o f c hi c en po :A. pn eu mo nia?. hepatit isC. m en in i ti s< . p er ic ar di ti s;P*: -.5- p: 1-='

12=. ncuba tion peri od of chic en po :a. 1- 21 da$s

b. 5!30 daysc. 5 1- da$sd. 21 '-da$s

;P*: -.''' p: 1-='

1 25 . T he pe rs on re co mm en de d t o r ec ei 3e in fl ue nG a 3 ac ci ne :A. person = 17 years o$ age?. women in first trimester of pre nanc$C. h$pertensi3e pat ients

1'5. hich of the followin is the earliest rabies specific cl inical manifestation:A . h $d ro ph ob ia?. a er op hob iaC. tingling sensation at the bite site


10/19

;P*: -.5 p: /58

1 '8. ; os t di sc ri mi na ti n s $m pt om o f du od en al u lc er :A. nausea and 3omitin). pain occur 0 min to 9 hours a$ter a mealC. rel ie3ed b$ food inta e 51

1'/. *i 3er ci rrhos is is best di a nosed b$:A. Bl tr as ou nd) . L iv er b io ps yC. CT scan


11/19

A . h $p er te ns io n?. a lc oh ol is mC. cigaret te smo+ing1

1 6= . C ha ra ct er is ti c ap pe ar an ce o f st oo ls i n p at ie nt s wi th c ho le ra :A. non mucoid+ non bilious stools?. mucoid and water$ stoolsC. sour and offensi3e odor which is non bilious and non blood$D. non!bilious6non!bloody6 gray6 sl. cloudy *ith $lec+s o$ mucus;P*: -.25 p: /11

1 65 . P ri ma r$ pu lm ona r$ T? i s c ha ra ct er iG ed as :A. t$picall$ in3ol3es the apices of the lun s?. causes rupture of "asmussen s aneur$smC. involves the middle and lo*er lobes in most cases


12/19

;P*: -.''' p: 1=>>

16>. The most common presentin complaint in pat ients with #T ele3at ion ; :A. 2. Associated with pandemics and are restr icted to influenGa A 3irusesA. antigenic shi$t? . a nt i en ic d r if tC. anti enic transformation'. ; os t c om mon pa th o e n i n i nt en si 3e ca re un it :A. ". pneumoniae?. C. pneumoniaeC. ;. pneumoniae


13/19

Page 2471

>. hich of the followin s$stemic disease is % T associated with pol$neuropath$:A. 0 E infection?. .


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15/19

Page 2138

'>. hat is the most common cell t$pe of Th$roid CarcinomaA. Follicular carcinoma?. Papillar$ carcinomaC. ;edullar$ carcinoma


16/19

A. c$toadherence in capillar$ and 3enular endothelium?. rosette formation b$ non parasitiGed "?C sC. a lutination of parasitiGed "?C s9?. t7/H229C. in3 16


17/19

?. nfluenGa 3irusC. #treptococcus1. "ecurrent pneumonia in the same location is most li el$ due to the presence of:

A. mmunodeficienc$?. ?ronchial obstructionC. *un h$poplasia2. The presence of pus in the pleural space is termed as:A. Parapneumonic effusion?. Ch$lothoraC. !mp$ema'. #udden se3ere d$spnea+ and P.!. findin of unilateral absent breath sounds and h$pertesonance in a C P< patientwithout antecedent in@ur$ should ma e one suspect:A. Primar$ spontaneous pneumothora?. #econdar$ spontaneous pneumothoraC. Traumatic pneumothora=. #ubcutaneous emph$sema and 0amman s si n is seen in:A. C P

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