Test Prep Test Prep Certifications MCQS Questions & Answers

• Question 151:

  A pregnant woman comes with weakness and elevated liver function tests. She is in her 35th week of pregnancy. The prothrombin time is normal. The smear of blood shows fragmented red cells. Platelet count is low.

  What is the treatment?

  A. Delivery of the baby

  B. Fresh frozen plasma

  C. Prednisone

  Correct Answer: A

  Deliver the baby with the HELLP syndrome. HELLP syndrome stands for hemolysis, elevated liver function tests, and low platelets. This disorder is idiopathic and can be distinguished from DIC by the normal coagulation studies, such as the prothrombin time and aPTT.

• Question 152:

  A 47-year old man comes to the emergency department with fever, headache, photophobia, and a stiff neck.

  What is the next best step in the management of this patient?

  A. Head Ct scan

  B. Lumbar puncture

  C. Ceftriaxone and vancomycin

  Correct Answer: B

  When you suspect bacterial meningitis, administer antibiotics quickly. Further, do blood cultures stat simultaneously with a lumbar puncture (LP), or immediately prior. Penicillin can never be used as empiric therapy for meningitis; it is not sufficiently broad in coverage to be effective empiric therapy. In this case, perform the LP.

• Question 153:

  A 24-year-old male with a history of gang violence presents to the emergency room with 3 stab wounds to the abdomen. He was intubated in the field for airway protection and is barely conscious. Blood pressure is 70/30 mm Hg and pulse is 140/min. On exam, 3 penetrating wounds covered by abdominal pressure pads are noted.

  Which of the following is the best next step in management of this patient?

  A. IV fluids

  B. Abdominal x-ray

  C. Obtain consent for surgery

  D. IV antibiotics

  Correct Answer: A

  This patient is in hemorrhagic shock and requires immediate resuscitation. Of the choices listed, the best next step in management is IV fluids after obtaining venous access. The best form of venous access is 2 large-bore IVs in the periphery and/or central venous access. Applying direct pressure to the abdomen (a) does not treat the underlying cause. Getting an abdominal x-ray (b) will take too long for a patient with this rate of blood loss. IV antibiotics (c) may be needed later in the care of this patient, but stabilizing blood pressure is now the more urgent need. Surgical consent (e) is implied in a life-threatening emergency in which a patient cannot communicate his wishes.

• Question 154:

  A child with a small head, minor anomalies of the face including a thin upper lip, growth delay, and developmental disability can have all of the following, except:

  A. A polygenic syndrome

  B. Teratogenic syndrome

  C. A mendelian syndrome

  Correct Answer: A

  The features given can occur as a part of a chromosomal / teratogenic / mendelian syndrome. Polygenic in answer of exclusion. In a polygenic inheritance, multiple genes are involved in the phenotypic expression. of polygenic inheritance are hypertension and diabetes.

• Question 155:

  A 78-year-old woman is admitted to the intensive care unit for acute pulmonary edema. She has rales to the apices and Jugular vein distention. Her EKG shows ventricular tachycardia.

  Which of the following is the best therapy?

  A. Synchronized cardioversion

  B. Amiodarone

  C. Lidocaine

  D. Unsynchronized cardioversion

  E. Procainamide

  Correct Answer: A

  Synchronized cardioversion is used when ventricular tachycardia is associated with acute pulmonary edema. Unsynchronized cardioversion is used for ventricular fibrillation or ventricular tachycardia without a pulse. Medical therapy, such as lidocaine, amiodarone, or procainamide, can be used for sustained ventricular tachycardia that is hemodynamically stable.

• Question 156:

  A homeless lady presents with cough and fever. She complains of night sweats and weight loss. CXR has opacity.

  What is the next appropriate management?

  A. IFN gamma testing

  B. Mantoux

  C. Bronchoscopy

  D. AFB

  E. CT chest

  Correct Answer: D

  Cough and fever and night sweat and weight loss are very suggestive of TB. She should do AF investigation.

• Question 157:

  A 75 year's lady who had mitral valve replacement 13 years ago has developed recurrent breathlessness. There is a prominent pulsation in her neck. She complains of abdominal pain and ankle swelling.

  What is the most probably diagnosis?

  A. Aortic regurgitation

  B. Mitral stenosis

  C. Tricuspid regurgitation

  D. Mitral regurgitation

  E. Pulmonary stenosis

  Correct Answer: C

• Question 158:

  A 30 years' woman presents with acute headache. She complains of seeing halos especially at night.

  What is likely defect?

  A. Mono-ocular field loss

  B. Central scotoma

  C. Paracentral scotoma

  D. Cortical blindness

  E. Tunnel vision

  Correct Answer: E

  The diagnosis is glaucoma (headache and haloes especially at night). In glaucoma the vision.

• Question 159:

  An asymptomatic 56years man who has never consumed alcohol came for a routine checkup. Exam:

  increase spider angioma, Cardiomegaly, S3 gallop, liver firm with 8cm span, no ascites.

  He is in the risk of which condition?

  A. Werniecke's encephalopathy

  B. Hepatoma

  C. Renal failure

  D. cerebellar degeneration

  E. Hepatic vein thrombosis

  Correct Answer: B

• Question 160:

  A 75-yearold man has been attending the clinic for lower urinary tract symptoms. His mood is very low and he is unhappy, anxious and unable to sleep. He has been diagnosed with moderate depression.

  What treatment would you use for this patient?

  A. Amitryptaline

  B. CBT

  C. Citalopram

  D. Dosulepin

  E. Diasepam

  Correct Answer: C

  Mild depression = CBT, Moderate depression = Antidepressant, Severe depression and Ps = ECT,

  Amitriptyline and Dosulepine causes urinary retention (which is comparatively less in citalopram) so no a

  patient with lower urinary symptoms.

  Hence Citalopram is the preferred option.