Test Prep Test Prep Certifications MCQS Questions & Answers

• Question 121:

  A 28-year-old female presents with 1-week history of jaundice and 2days history of altered sleep pattern

  and moods. She was diagnosed with hypothyroidism for which she is receiving thyroxine. Thyroid function

  showed increased TSH.

  PT=70s.

  What is the most probable diagnosis?

  A. Hyper-acute liver failure

  B. Acute liver failure

  C. Acute on chronic liver failure

  D. Autoimmune hepatitis

  Correct Answer: D

• Question 122:

  An elderly man comes to the emergency department with fever, headache, a stiff neck, and photophobia. He is HIV positive with < 50 CD4 cells and a history of pneumocystis pneumonia. His head CT is normal. CSF shows 2,500 white cells that are all neutrophils; Gram stain is normal.

  What is the best initial therapy?

  A. Cefoxitin and mefloquine

  B. Fluconazole

  C. Ceftriaxone, ampicillin, and vancomycin

  Correct Answer: C

  Listeria monocytogenes is a cause of meningitis that is not adequately treated by any form of cephalosporin. Ampicillin is added to the usual regimen of ceftriaxone and vancomycin to cover Listeria. This cannot be fungal meningitis, because the CSF is characterized exclusively by a high number of neutrophils; neutrophils are not consistent with fungal meningitis.

• Question 123:

  The tumor, which may occur in the residual breast or overlying skin following wide local excision and radiotherapy for mammary carcinoma, is:

  A. Squamous cell carcinoma

  B. Leiomyosarcoma

  C. Angiosarcoma

  D. Basal cell carcinoma

  Correct Answer: C

• Question 124:

  To prevent tetanus in neonate:

  A. Give penicillin to child to kill tetanus bacilli

  B. Give immunoglobulin to mother

  C. Give tetanus toxoid to mother

  D. Give antibiotics to mother

  Correct Answer: C

  Antitetanus vaccination in multiple doses (2?) is up to 98% effective in preventing neonatal tetanus and neonatal tetanus deaths in under-resourced settings. Single doses of the tetanus vaccine are not enough to prevent neonatal tetanus deaths. In addition to administration of antitetanus vaccines, efforts should be made to ensure that women receive obstetric care to ensure clean deliveries.

• Question 125:

  A 11-year-old boy comes with decreased appetite and abdominal pain around his umbilicus. His parents think he doesn't want to go to school, and while in math class he begins to have sharp pain in his right lower abdomen. He is rushed to the ED and laboratory analysis shows a WBC of 12,500.

  What is the most likely diagnosis?

  A. Acute appendicitis

  B. Acute pancreatitis

  C. Cholecystitis

  D. Acute diverticulitis

  Correct Answer: A

  Acute appendicitis presents with pain that originates in the umbilical region and later begins to localize to the right lower quadrant. The patient will then develop signs of peritonitis. This patient is too young for diverticulitis. Diverticultitis also gives pain in the left lower quadrant. Cholecystitis would present with right upper quadrant pain. Pancreatitis would have midepigastric pain that radiates to the back with high amylase and lipase levels. The number one consideration is the location of the pain. It gives away 95% of the diagnosis.

• Question 126:

  A 42-year-old man presents with a target shaped rash that has developed over the last several days. He was on a camping trip in the woods last week in Maine.

  What is the next best step in management?

  A. Western blot

  B. Doxycycline E-Ceftriaxone

  C. ELISA

  D. Serology for IgM

  Correct Answer: B

  A rash suggestive of Lyme is enough to indicate treatment. A 5-cm-wide targetshaped rash, particularly with a history of camping/hiking, is enough to indicate the need for antibiotic treatment with doxycycline. A characteristic rash is more specific than serology.

• Question 127:

  A 35-year-old car driver crashed into a concrete block without a safety belt on. Thirty minutes after and on the way by ambulance to the hospital he begins to become breathless. On administration of 100% oxygen there is not much improvement in this condition. On arrival at the Emergency Department he has lost consciousness and appears cyanosed with markedly distended jugular veins. Blood pressure 80/40 mmHg Heart rate 120 /min Respiratory rate 34 /min Temperature 36.6 癈. Oxygen saturation 60% on room air.

  What's immediate action should be taken?

  A. Rapid infusion of crystalloid

  B. IV 0.2 mg adrenaline

  C. Intubation and 100% oxygen

  D. Needle decompression

  Correct Answer: D

• Question 128:

  A pregnant lady comes at 37 weeks with 3+ proteinuria, confusion and Blood pressure 170/110 mmhg.

  What is the best step in her management?

  A. Admit and monitor / mgso4 E-Send home

  B. Hydralazine

  C. Deliver the baby immediately

  D. C-section

  Correct Answer: C

• Question 129:

  Hypogammaglobulinemia is often present at the time of the diagnosis.

  Which one of the following clinical findings is NOT characteristic of chronic lymphatic leukaemia?

  A. Coombs test is positive in 10-20% of cases

  B. Bone marrow examination is essential to confirm the diagnosis

  C. B-lymphocytes are the leukaemia cell line in the majority of cases

  D. It converts to lymphoma

  Correct Answer: A

  Bone marrow examination is essential to confirm the diagnosis Chronic lymphatic leukaemia (CLL) is characterized by accumulation of small mature lymphocytes in the bone marrow and peripheral blood. The presenting features are persistent lymphocytosis, lymphadenopathy and hepatosplenomegaly. Hypogammaglobulinemia is often present at the time of the diagnosis. Autoimmune hemolytic anemia occurs in 25% of cases. The diagnosis is usually confirmed on peripheral blood examination; bone marrow examination is rarely needed. Evolution in to a more aggressive disease such as diffuse large cell lymphoma (Richter's syndrome) can occur.

• Question 130:

  A man develops erectile dysfunction after an infarction. What is the most common cause?

  A. ACE inhibitors

  B. Anxiety

  C. Aspirin

  D. Nitrates

  Correct Answer: B

  Anxiety is the most common cause of erectile dysfunction postinfarction. Although beta blockers may be the most common medication associated with erectile dysfunction, anxiety is still a more common cause of erectile dysfunction than beta blockers.