Test Prep Test Prep Certifications MCQS Questions & Answers

• Question 91:

  A 77-years-old male presents with history of enuresis and change in behavior. Exam: waddling gait.

  What is the most likely diagnosis?

  A. Subdural haemorrhage

  B. Normal pressure hydrocephalus

  C. Phychotic depression

  D. Brain tumor

  Correct Answer: B

• Question 92:

  A 15-year-old boy presented with generalized edema. His urinalysis reveals protein +++, eGFR-110.

  What is most likely diagnosis?

  A. Membranous nephropathy

  B. A-IgA nephropathy

  C. Minimal change disease

  D. Lupus nephritis

  Correct Answer: C

• Question 93:

  A 42-year-old obese woman with 5 children presents with a "gnawing" pain that recently has become severe. She notes the pain right after she finishes a meal and states that it radiates to her right shoulder. Physical exam reveals a cessation of inspiration upon palpation of the right upper quadrant and rebound tenderness. Laboratory analysis shows white cell count of 15,000 and a left shift.

  What is the most likely diagnosis?

  A. Acute diverticulitis

  B. Cholecystitis

  C. Acute appendicitis

  D. Ectopic pregnancy

  E. Acute pancreatitis

  Correct Answer: B

  Acute cholecystitis is a common inflammatory condition that occurs often in obese women in their 40s. A gallstone occludes the lumen of the cystic duct. Patients have peritoneal signs and a positive Murphy sign. A sonographic Murphy sign is the ultrasound probe causing a cessation of breathing when it presses against the abdominal wall. On ultrasound, cholecystitis is characterized by pericholecystic fluid and a thickened gallbladder wall. Diverticulitis would be lower left or right quadrant pain in an elderly person with a history of constipation. Pancreatitis would have deep epigastric.

• Question 94:

  Patient came with pitting edema grade 1, where fluid is will accumulate.

  A. Veniole

  B. Arteriole

  C. Interstitial

  D. Capillary

  Correct Answer: C

• Question 95:

  A man with prostate cancer presents with severe, sudden back pain. His MRI shows cord compression, and he is started on steroids.

  What is the next best step in management?

  A. Flutamide and leuprolide simultaneously

  B. Leuprolide followed by flutamide

  C. Ketoconazole

  D. Flutamide

  Correct Answer: D

  Flutamide should be started first to block the temporary flare up in androgen levels that accompanies GnRH agonist treatments. When cord compression is described, GnRH agonists, if used too soon, can worsen the compression. Ketoconazole, at a high dose, blocks the production of androgens, but it is not as effective as the other therapies.

• Question 96:

  All can cause secondary hyperlipidemia except:

  A. Nephrotic

  B. Hypertension

  C. Estrogen therapy

  Correct Answer: B

  Secondary hyperlipidemia causes: Diabetes mellitus, use of drugs such as diuretics, beta blocker hypothyroidism, renal failure, Nephrotic syndrome, alcohol usage, and some rare endocrine and metabolic.

• Question 97:

  A 65-year woman is found on routine CBC to have a hematocrit of 32 percent (normal 37?2) and an MCV of 70 (normal 80?00). Her stool is heme-negative.

  What should you do next?

  A. Upper endoscopy

  B. Two more stool tests now

  C. Barium enema

  D. Colonoscopy

  Correct Answer: D

  Colonoscopy is indicated in all patients > 50 simply as routine screening. Hence, in this case, the patient needs colonoscopy anyway, regardless of what the stool tests show. Another reason to go straight to colonoscopy is the presence of microcytic anemia. Unexplained microcytic anemia in a patient above 50 is most likely caused by colon cancer. Sigmoidoscopy will do nothing to evaluate the right side of the colon and would miss nearly 40 percent of cancers. No matter what a sigmoidoscopy showed, you would need to inspect the right side of the colon. Capsule endoscopy is done to evaluate bleeding when the upper and lower endoscopy are normal and the source of bleeding is likely to be in the small bowel.

• Question 98:

  A 2-month-old baby who has ambiguous genitalia presents to the Emergency room with vomiting Na+125mmol/L, K+=6mmol/L.

  What is the most likely diagnosis?

  A. Turners syndrome

  B. Noonan syndrome

  C. Fragile X syndrome

  D. Congenital adrenal hyperplasia

  Correct Answer: D

  Congenital adrenal hyperplasia autosomal recessive disorder characterized by the partial or total defect of various synthetic enzyme of the adrenal cortex required for cortisol and aldosterone production Clinical Presentation - Classic presentation: vomiting, dehydration, Hyperkalemia, Hyponatremia, hypoglycemia, and fem has Ambiguous genitalia at birth.

• Question 99:

  At what CD4 count should anti-retroviral treatment commence in asymptomatic HIV patients?

  A. Below 500/mm3

  B. Below 100/mm3

  C. Below 50/mm3

  D. Below 200/mm3

  Correct Answer: A

• Question 100:

  Which of the following is an absolute contraindication to the use of beta blockers?

  A. Emphysema

  B. Diabetes

  C. Asthma

  D. Symptomatic bradycardia

  Correct Answer: D

  Symptomatic bradycardia is an absolute contraindication for the use of beta blockers. The overwhelming with peripheral artery disease can still use beta blockers. In a patient with a myocardial infarction, the more metoprolol far exceeds the risk of its use when asthma, emphysema, or peripheral artery disease is present patients can tolerate beta blockers.