M2015A-51-91.pdf Past Paper - Multiple Choice Questions PDF

## Multiple Choice Questions ### 111 Which one of the following treatments has been shown to improve outcomes for a 2 year old with mild to moderate croup? - Humidified air - Nebulized albuterol - Oral azithromycin - Oral dexamethasone - Oxygen therapy ### 112 Which one of the following therapeu...

## Multiple Choice Questions ### 111 Which one of the following treatments has been shown to improve outcomes for a 2 year old with mild to moderate croup? - Humidified air - Nebulized albuterol - Oral azithromycin - Oral dexamethasone - Oxygen therapy ### 112 Which one of the following therapeutic interventions improves outcomes in adults with acute respiratory distress syndrome (ARDS)? - Early initiation of antibiotics - Surfactant therapy - Pulmonary artery catheterization - Aggressive intravenous fluid resuscitation - Starting mechanical ventilation with lower tidal volumes ### 113 The most common root cause of serious medical errors is a deficiency of - nursing support - staffing - communication - leadership - knowledge ### 114 A 32-year-old primigravida at 36 weeks gestation is diagnosed with severe preeclampsia, complains of headaches. Her blood pressure is 155/100 mm Hg and a urinalysis shows 4+ protein. Her blood tests are normal. Which one of the following is the most appropriate management for this patient? - Start labetalol and discharge home on bed rest with close follow-up - Start magnesium sulfate and induce labor now - Start magnesium sulfate, administer corticosteroids, and induce labor in 48 hours - Start magnesium sulfate, lower blood pressure to 140/90 mm Hg, and induce labor at 37 weeks gestation - Arrange for urgent cesarean section ### 115 A 75-year-old otherwise healthy woman states that she has passed out three times in the last month during her daily brisk walk. Which one of the following is the most likely cause of her syncope? - Vasovagal syncope - Transient ischemic attack - Orthostatic hypotension - Atrial myxoma - Aortic stenosis ### 116 Which one of the following would support a diagnosis of subacute granulomatous thyroiditis? - Pretibial myxedema - Exophthalmos - Multiple nodules on ultrasonography - Low radioactive iodine uptake (<5%) ### 117 Which one of the following strategies for preventing the spread of Clostridium difficile infection has been shown to be most effective? - Use of alcohol-based hand sanitizer - Handwashing with soap and water - Screening health care providers for the carrier state - Administration of probiotics to at-risk patients - Use of masks and negative-pressure rooms ### 118 Which one of the following medications would be most appropriate for treating symptoms of delirium in a hospitalized 85 year old? - Haloperidol - Nortriptyline - Pentobarbital - Lorazepam - Mirtazapine ### 119 When assessing the nutritional status and growth of a full-term infant, it is useful to know that birth weight is expected to double between - 2 & 3 months - 3 & 4 months - 4 & 5 months - 5 & 6 months ### 120 In a patient presenting with unstable angina, which one of the following findings would denote the highest risk for death or myocardial infarction? - New-onset angina beginning 2 weeks to 2 months before presentation - Angina with hypotension - Angina provoked at a lower threshold than in the past - Increased anginal frequency ### 121 A 4-year-old infant is diagnosed with a symptomatic choledochal cyst. What is the most appropriate treatment? - Cyst gastrostomy - Cyst jejunostomy - Excision with Roux-en-Y hepaticojejunostomy - Primary excision of the lesion - Surveillance (endoscopic) ### 122 A 65-year-old man presents with left iliac fossa pain, pyrexia and raised white cell count 20x100 per mm³ and C-reactive protein of 200mg/L. What is the most appropriate investigation? - Abdominal X-ray - Barium enema - Colonoscopy - CT of abdomen and pelvis - Flexible sigmoidoscopy ### 123 A 23-year-old woman is referred by the gastroenterology team with tachycardia, hypotension and generalized colonic tenderness. She has had a 5 days of intravenous (IV) steroids and her bowel movements have decreased from 12 to 6 bloody stools per day. What is the most appropriate management? - Colonoscopy and biopsies - Continue IV steroids - Cyclosporine - Infliximab - Subtotal colectomy and ileostomy ### 124 A 22-year-old woman has marked lymphoedema in her right leg? what is the most appropriate management? - Diuretic therapy - Elevation and elastic support stocking - Excision of scarred skin and fibrotic subcutaneous tissue - Lymphatic bypass - Massage therapy or mechanical compression ### 125 Match the following syndrome with the appropriate tumor: - **gynecomastia** : cancer du poumon qui n'est pas à petites cellules - **Non small cell lung cancer** : testicular cancer - **Testicular cancer:** small cell lung cancer - **Small cell lung cancer:** breast cancer - **Breast cancer:** pancreatic cancer - **Pancreatic cancer:** gynecomastia ### 126 A 54 year-old obese woman has chronic gastroesophageal reflux. Which of the following drugs are known to exacerbate her reflux esophagitis: - Chlorpropamide - Theophylline - Omeprazole - Acetaminophen - Metoclopramide ### 127 A 30 year-old man has had difficulty swallowing for both solids and liquids over the past 6 months. What is the most likely diagnosis: - Barrett's esophagus - Benign esophageal stricture - Schatzki's rings - Esophageal carcinoma - Achalasia ### 128 A 17-year-old girl presents to the emergency department with a 2-day history of a painful and swollen right big toe. She also has had a fever, with temperatures up to 38.9 C at home for 2 days. On physical examination, her temperature is 38.8 C. Her first metatarsal joint of the right foot is markedly swollen and very painful to touch. An aspirated fluid from the joint reveals a white blood count of 55,000/mm3. Which of the following is the most likely diagnosis? - Juvenile rheumatoid arthritis - Gout - Lyme disease - Pseudogout - Septic arthritis ### 129 In the setting of acute trauma, fracture of which bone has the highest associated mortality? - Lumbar vertebra - Femur - Rib - Pelvis - Humerus ### 130 In acute glomerulonephritis, all of the following are present except one: - Arterial hypertension - Water retention - Hematuria - Polyuria-polydipsia - Uremia ### 131 A 37-year-old woman is brought to the emergency department because of intermittent chest pain for 3 days. The pain is worse with inspiration, and she feels she cannot take deep breaths. She has not had shortness of breath, palpitations, or nausea. She had an upper respiratory tract infection 10 days ago and took an over-the-counter cough suppressant and decongestant and acetaminophen. Her temperature is 37.2°C (98.9°F), pulse is 90/min, and blood pressure is 122/70 mm Hg. The lungs are clear to auscultation. S1 and S2 are normal. A rub is heard during systole. There is no peripheral edema. An ECG shows normal sinus rhythm and diffuse, upwardly concave ST-segment elevation and PR-segment depression in leads II, III, and aVF. Which of the following is the most likely diagnosis? - Acute pericarditis - Aortic dissection - Gastroesophageal reflux disease - Peptic ulcer disease - Unstable angina pectoris ### 132 A previously healthy 42-year-old man is brought to the emergency department 1 day after the sudden onset of shortness of breath and chest pain at rest; the pain is exacerbated by deep inspiration. His pulse is 100/min, respirations are 22/min, and blood pressure is 140/90mmHg. Breath sounds are normal. The remainder of the examination shows no abnormalities. Arterial blood gas analysis on room air shows: - pH 7.49 - PCO2 30 mm Hg - PO2 64 mm Hg - O2 saturation 91% An x-ray of the chest shows no abnormalities. Which of the following is the most likely mechanism of these findings? - Carbon monoxide poisoning - Congenital heart disease - Interstitial edema - Interstitial fibrosis - Ventilation-perfusion mismatch ### 133 A 36-year-old nulligravid woman with primary infertility comes for a follow-up examination. She has been unable to conceive for 10 years; analysis of her husband's semen during this period has shown normal sperm counts. Menses occur at regular 28-day intervals and last 5 to 6 days. She is asymptomatic except for severe dysmenorrhea. An endometrial biopsy specimen 5 days before menses shows secretory endometrium. Hysterosalpingography 1 year ago showed normal findings. Pelvic examination shows a normal vagina and cervix. Bimanual examination shows a normal-sized uterus and no palpable adnexal masses. Rectal examination is unremarkable. Which of the following is the most likely diagnosis? - Anovulation - Endometriosis - Intrauterine synechiae - Male factor - Tubal obstruction ### 134 A 22-year-old man with a seizure disorder has had increasing cough and shortness of breath for 3 days and fever for 1 day. He has foul-smelling sputum. He had a generalized tonic-clonic seizure 1 week ago. His temperature is 39.4°C (103°F). Crackles are heard on auscultation of the chest. An x-ray of the chest shows a right upper-lobe infiltrate of the lung. Which of the following is the most likely cause? - Chemical pneumonitis - Pneumonia secondary to anaerobes - Pneumonia secondary to gram-negative aerobes - Pneumonia secondary to gram-positive aerobes - Pneumonia secondary to Mycoplasma pneumonia ### 135 A 37-year-old woman is brought to the emergency department 45 minutes after she was found unconscious on her apartment floor. Her coworkers became concerned when she did not arrive for work. On arrival, she is unable to provide a history. Her pulse is 96/min, respirations are 12/min, and blood pressure is 124/58 mm Hg. Examination shows erythema, warmth, and induration of the upper back, buttocks, and posterior thighs. Her serum creatine kinase activity is 10,300 U/L. Urine toxicology screening is positive for opiates and cocaine. Urine dipstick is strongly positive for blood. Microscopic examination of the urine shows pigmented granular casts and rare erythrocytes. This patient is at increased risk for which of the following conditions over the next 24 hours? - Acute respiratory distress syndrome - Acute tubular necrosis - Cerebral edema - Cerebral hemorrhage - Cocaine-induced cardiomyopathy ### 136 A 27-year-old woman comes to the physician for a follow-up examination. She has a 10-week history of persistent nonproductive cough that is worse at night and a 1-month history of a hoarse voice. She otherwise feels well. She has not had loss of appetite or change in exercise tolerance. She has never smoked. Empiric treatment with an oral decongestant and albuterol inhaler has not improved her symptoms. She has no history of serious illness. Her temperature is 37°C (98.6°F), pulse is 68/min, respirations are 12/min, and blood pressure is 110/76 mm Hg. Cardiopulmonary examination and an x-ray of the chest show no abnormalities. Her FEV1 is normal. Which of the following is the most appropriate next step in management? - 24-Hour monitoring of esophageal pH - Echocardiography - CT scan of the chest - Inhaled corticosteroid therapy - Nitroglycerin therapy ### 137 A 22-year-old man is brought to the emergency department 30 minutes after he sustained a gunshot wound to the abdomen. His pulse is 120/min, respirations are 28/min, and blood pressure is 70/40 mm Hg. Breath sounds are normal on the right and decreased on the left. Abdominal examination shows an entrance wound in the left upper quadrant at the midclavicular line below the left costal margin. There is an exit wound laterally in the left axillary line at the 4th rib. Intravenous fluid resuscitation is begun. Which of the following is the most appropriate next step in management? - Upright x-ray of the chest - CT scan of the chest - Intubation and mechanical ventilation - Peritoneal lavage - Left tube thoracostomy ### 138 A 20-year-old man has had frequent upper respiratory tract infections over the past 4 years. He has daily purulent sputum and has noted decreased exercise tolerance over the past 2 years. He and his wife have been unable to conceive because of his low sperm count. Scattered expiratory wheezing and ronchi are heard throughout both lung fields. An x-ray of the chest shows hyperinflation. Spirometry shows a decreased FEV1/FVC ratio. Which of the following is most likely to confirm the diagnosis? - Arterial blood gas analysis - Examination of sputum for eosinophils - Sweat chloride test - Sputum cytology - Bronchoscopy ### 139 A previously healthy 17-year-old girl comes to the physician because of a 1-week history of itching and progressive rash. She has no history of skin problems or associated symptoms. She takes no medications. Her sister with whom she shares a room had similar symptoms during the previous week. The patient's temperature is 36.8°C (98.2°F). There are multiple 2- to 5-mm erythematous papules over the trunk, especially at the waistline, and over the forearms, hands, and fingers. There is no lymphadenopathy or hepatosplenomegaly. Which of the following is the most likely causal organism? - Epstein-Barr virus - Group A streptococcus - Measles virus - Sarcoptes scabiei - Varicella-zoster virus ### 140 A 3-year-old girl is brought to the physician because of fever and left ear pain for 3 days. She has been treated with amoxicillin for the past 5 days for left otitis media. Her temperature is 38.5°C (101.3°F), pulse is 100/min, respirations are 20/min, and blood pressure is 80/60 mm Hg. Examination shows the left ear displaced forward and laterally from the head. There is edema and tenderness behind the left ear. Otoscopic examination shows a red, dull, left tympanic membrane that does not move. Which of the following is the most likely diagnosis? - Acoustic neuroma - Labyrinthitis - Lateral sinus thrombosis - Mastoiditis - Rhabdomyosarcoma ### 141 A 42-year-old woman comes to the physician because of an 8-week history of intermittent nausea and abdominal pain that occurs 20 to 30 minutes after eating. The pain extends from the epigastrium to the right upper quadrant and is sometimes felt in the right scapula; it lasts about 30 minutes and is not relieved by antacids. The last episode occurred after she ate a hamburger and French fries. She has not had vomiting. She is currently asymptomatic. She is 165 cm tall and weighs 104 kg; BMI is 38 kg/m2. Examination shows no other abnormalities. Which of the following is the most appropriate next step in management? - Abdominal ultrasonography of the right upper quadrant - Upper gastrointestinal series with small bowel follow-through - CT scan of the abdomen - Endoscopic retrograde cholangiopancreatography - Immediate cholecystectomy ### 142 A 67-year-old woman comes to the physician because of easy bruising for 4 months. She has a history of lung cancer treated with radiation therapy 6 months ago. She has a 2-year history of hypertension treated with a thiazide diuretic and an angiotensin-converting enzyme (ACE) inhibitor. Examination, including neurologic examination, shows no abnormalities except for multiple ecchymoses. Her hemoglobin concentration is 13 g/dL, leukocyte count is 5000/mm3, and platelet count is 35,000/mm3. A serum antiplatelet antibody assay is negative. Which of the following is the most appropriate next step in diagnosis? - Bone scan - CT scan of the abdomen - CT scan of the chest - Bronchoscopy - Bone marrow aspiration ### 143 A 37-year-old man comes to the physician because of non-radiating low back pain for 3 days. The pain began after he worked in his yard. He has not had any change in bowel movements or urination. He had one similar episode 3 years ago that resolved spontaneously. Vital signs are within normal limits. Examination of the back shows bilateral paravertebral muscle spasm. Range of motion is limited by pain. Straight-leg raising is negative. In addition to analgesia, which of the following is the most appropriate next step in management? - Bed rest - Regular activity - X-rays of the spine - MRI of the spine - Lumbar spine traction ### 144 A 62-year-old man comes to the physician because of a 2-month history of progressive fatigue and ankle swelling. He had an anterior myocardial infarction 3 years ago and has had shortness of breath with mild exertion since then. Current medications include labetalol and daily aspirin. He has smoked one-half pack of cigarettes daily for 30 years. His pulse is 100/min and regular, respirations are 20/min, and blood pressure is 130/75 mm Hg. There are jugular venous pulsations 5 cm above the sternal angle. Crackles are heard at both lung bases. Cardiac examination shows an S3 gallop. There is edema from the mid tibia to the ankle bilaterally. Further evaluation of this patient is most likely to show which of the following findings? - Decreased pulmonary capillary wedge pressure - Impaired contractility of the left ventricle - Prolapse of the mitral valve - Thrombosis of the superior vena cava - Ventricular septal defect ### 145 A 77-year-old man is brought to the physician because of a 12-hour history of word-finding difficulty and weakness and sensory loss of the right arm and leg. He has no history of similar symptoms. He has type 2 diabetes mellitus, hypertension, and atrial fibrillation. Current medications include metformin, lisinopril, and aspirin. He is alert. His pulse is 80/min and irregular, respirations are 16/min, and blood pressure is 170/90 mm Hg. He follows commands but has nonfluent aphasia. There is moderate weakness and decreased sensation of the right upper and lower extremities. Deep tendon reflexes are 2+ bilaterally. Babinski sign is present on the right. His serum glucose concentration is 162 mg/dL. Which of the following is the most appropriate next step in diagnosis? - Carotid duplex ultrasonography - CT scan of the head - EEG - Lumbar puncture - Cerebral angiography ### 146 A 70-year-old man comes to the physician because of fever, productive cough, and pleuritic chest pain for 1 day. Over the past 2 years, he has had two similar episodes. He also has had persistent pain in the thoracic spine for 1 month. His temperature is 39.2°C, pulse is 94/min, respirations are 22/min, and blood pressure is 110/60 mm Hg. There is dullness to percussion and decreased breath sounds over the right base. Examination shows tenderness of the midthoracic spine. Laboratory studies show: Hematocrit 34% Leukocyte count 15,000/mm3 Segmented neutrophils 81% Bands 4% Lymphocytes 15% Serum calcium 10.9 mg/dL X-rays of the chest show consolidation of the right lower lobe, lytic lesions at T8 and T10, and diffuse osteopenia. Which of the following is the most likely diagnosis of this patient's back condition? - HIV infection - Multiple myeloma - Prostate cancer - Staphylococcal osteomyelitis - Tuberculosis osteomyelitis ### 147 A 52-year-old man comes to the physician with his wife because of a 1-year history of excessive daytime sleepiness. He does not think the symptoms are problematic, but his wife is concerned because he sometimes falls asleep on the sofa early in the evening when guests are present. He also once fell asleep while driving at night and drove off the road, narrowly avoiding injury. His wife says that he has always snored loudly, and over the past year, he has had episodes of choking or gasping for breath while sleeping. He is 178 cm tall and weighs 105 kg; BMI is 33 kg/m2. His pulse is 76/min, respirations are 14/min, and blood pressure is 150/76 mm Hg. Physical and neurologic examinations show no other abnormalities. Which of the following is most likely to confirm the diagnosis? - 24-Hour ambulatory ECG monitoring - Multiple sleep latency test - Polysomnography - CT scan of the head - Laryngoscopy ### 148 A 67-year-old woman has had fatigue, dry skin, brittle hair, swelling of the ankles, and cold intolerance for 1 year; she has gained 9 kg during this period. Her pulse is 55/min, and blood pressure is 150/90 mm Hg. She appears lethargic. Examination shows dry skin and a nontender thyroid gland that is enlarged to two times its normal size. There is mild edema of the ankles bilaterally. The relaxation phase of the Achilles reflex is greatly prolonged. Which of the following is the most likely diagnosis? - Chronic lymphocytic thyroiditis (Hashimoto disease) - Graves disease - Multinodular goiter - Thyroid cyst - Thyroiditis ### 149 A 19-year-old man has had fever, headache, sore throat, and swelling of the cervical lymph nodes for 5 days. His temperature is 40°C, pulse is 120/min, respirations are 20/min, and blood pressure is 125/85 mm Hg. The pharynx is red and swollen with enlarged tonsils and exudate. There is tender cervical adenopathy and palpable lymph nodes in the axillary and inguinal areas. The spleen tip is palpable. Leukocyte count is 14,000/mm3 (25% segmented neutrophils, 60% atypical lymphocytes, and 15% monocytes). A throat culture is obtained. Which of the following is the most likely pathogen? - Adenovirus - Cytomegalovirus - Epstein-Barr virus - Group A streptococcus - Toxoplasma gondii ### 150 A healthy 16-year-old boy comes to the physician for an examination prior to participation in school sports. He is at the 90th percentile for height and 75th percentile for weight. His temperature is 37°C (98.6°F), pulse is 66/min, respirations are 16/min, and blood pressure is 145/95 mmHg Examination shows no other abnormalities. Which of the following is the most appropriate next step in management? - Repeat blood pressure measurement in 2 weeks - Recommend a low-sodium diet - Recommend a weight loss program - Begin diuretic therapy - No further intervention indicated ### 151 A 15-month-old girl is brought to the emergency department after a generalized tonic-clonic seizure at home. The seizure stopped spontaneously after 2 minutes, and she seemed sleepy afterward. Her temperature prior to arrival was 39.6°C, and paramedics administered rectal acetaminophen. Her parents state that yesterday she had a mild runny nose but otherwise has been well. There is no personal or family history of serious medical illness or seizures. Development has been appropriate for age. On arrival, she is afebrile, alert, and interactive. Physical examination shows a supple neck. Neurologic examination shows no focal findings. Which of the following is the most appropriate next step in management? - Reassurance - CT scan of the head - Oral administration of Phenobarbital - EEG - Lumbar puncture ### 152 A 3-month-old boy is brought to the emergency department because of a 3-day history of vomiting and diarrhea. He has a low-pitched cry and responds only to painful stimuli. His temperature is 35.2°C, pulse is 203/min, respirations are 48/min, and blood pressure is 52/35 mm Hg. Peripheral pulses are barely palpable. Capillary refill time is delayed. Administration of 100% oxygen by nasal cannula is begun. Multiple attempts at establishing peripheral intravenous access are unsuccessful. Which of the following is the most appropriate next step in management? - Oral rehydration - Intramuscular injections of antibiotics - Intubation and mechanical ventilation - Placement of a nasogastric tube - Placement of an intraosseous catheter ### 153 A 72-year-old female presents with a 6-week history of "carrot colored skin. "She denies fever, malaise, or abdominal pain. Her only medications are hydrochlorothiazide and a baby aspirin daily. On examination she has icteric sclera and a single enlarged left supraclavicular lymph node which is nontender. Which one of the following is the most likely diagnosis? - Biliary cirrhosis - Ascending cholangitis - Obstructing pancreatic pseudocyst - Carcinoma of the head of the pancreas - Hepatocellular carcinoma ### 154 Hyperbaric oxygen treatment has been shown to be beneficial for which one of the following conditions? - Tinnitus - Malignant otitis externa - Crush injury wounds - Nonunion of bone fractures - Vascular dementia ### 155 Which one of the following medications should be discontinued in pregnancy? - Atenolol - Bupropion - Fluoxetine - Glargine - Metformin ### 156 A 25-year-old female reports the absence of menses for the past 6 months. She has an elevated prolactin level and all her other labs and exams are normal. Which one of the following would be most appropriate at this point to further evaluate her pituitary gland? - A follow-up serum prolactin level in 4 weeks - A prolactin-stimulating hormone level - MRI of the pituitary - Head CT with intravenous contrast ### 157 Which one of the following EKG abnormalities would dictate the use of a pharmacologic stress test as opposed to an exercise stress test? - First degree atrioventricular block - Left bundle branch block - Poor R-wave progression in leads V1 through V3 - Q-waves in the inferior leads - Ventricular trigeminy ### 158 An elderly immunosuppressed woman has not been feeling well for the last week. She is hospitalized and noted to have an increased respiratory rate. She has no fever or cough. A chest radiograph reveals diffuse bilateral interstitial infiltrates. Which one of the following is the most likely diagnosis? - Pneumococcal pneumonia - Staphylococcal pneumonia - Pneumocystis pneumonia - Pulmonary tuberculosis - Pneumothorax ### 159 Which one of the following medications is most likely cause of viamin B12 deficiency? - Hydrochlorothiazide - Lisinopril - Amlodipine - Simvastatin - Omeprazole ### 160 Tramadol should be avoided in patients with a history of which one of the following? - Seizures - Heart failure - Ventricular dysrhythmias - Hypertension ### 161 For patients on lithium monotherapy for bipolar disease, monitoring should include periodic blood levels of lithium, creatinine, and - calcium - hemoglobin A1C - lipids - testosterone - TSH ### 162 A 35-year-old otherwise healthy male who is not on any medications complains of 3-4 episodes of watery diarrhea that started 2 days earlier. The diarrhea is accompanied by some nausea and abdominal cramping. He denies fever, dehydration, and bloody stool. Which one of the following is indicated at this time? - Testing for fecal leukocytes - A stool culture - A stool examination for ova and parasites - A stool test for Clostridium difficile toxin - No testing ### 163 A 6-year-old boy has right anterior cervical chain lymph node that was noted a week ago after he had recovered from an upper respiratory infection. It measures 2 cm in diameter and is somewhat firm, mobile, and nontender. The remainder of the examination is normal. Which one of the following would be most appropriate at this point? - Ultrasound evaluation of the lymph node - A fine-needle biopsy of the node - An excisional biopsy of the node - A 10-day course of antibiotics - Follow-up examination in 1 month ### 164 Which one of the following is the treatment of choice for Campylobacter resistant to quinolones? - Amoxicillin - Azithromycin - Metronidazole - Rifaximin ### 165 Diabetic retinopathy can be distinguished from hypertensive retinopathy by which one of the following? - Retinal "exudates". - Macular "stars". - Flame-shaped hemorrhages. - Microaneurysms. ### 166 Post-thyroidectomy high dose radio-iodine therapy improves long-term survival in: - Papillary thyroid carcinoma - Colloid thyroid carcinoma - Medullary thyroid carcinoma - Anaplastic thyroid carcinoma ### 167 Absolute indications for dialysis include: - Metabolic acid with PH 7.2 - Hyperkalemia with K 6.5 mEq/L - Uremic pericarditis - Volume overload with good urinary output. ### 168 A 30 years old woman with subacute Streptococcus viridans endocarditis, has penicillin allergy. Which of the following would be the most appropriate alternative? - Intravenous piperacillin - Intravenous cefazolin - Intravenous gentamicin - Intravenous vancomycin - Intravenous azithromycin ### 169 A low-risk patient is discharged from hospital after an acute coronary syndrome. His condition is stable. When can he resume driving for short distances? - 6 months. - Immediately after discharge. - In 4 to 6 weeks. - In about 1 week. - Not until undergoing a postdischarge exercise stress test to confirm adequate exercise capacity. ### 170 For most patients, which one of the following modalities is the safest to confirm cirrhosis diagnosis? - Computed tomography scan. - Liver biopsy. - Magnetic resonance imaging study. - Radionuclide imaging. - Ultrasound. ### 171 High intake of which one of the following foods has been most strongly linked to the development of colorectal cancer? - Eggs. - Red meat. - Roasted sesame seeds. - Spicy fetta cheese. - Tuna from Japan. ### 172 Which one of the following is most sensitive for detecting alcohol use disorders? - Carbohydrate-deficient transferrin. - Elevated gamma-glutamyl transferase. - Macrocytosis on hemogram. - Screening questionnaires. ### 173 Which one of the following psychiatric conditions is associated with acquired long QT interval? - Agoraphobia. - Anorexia nervosa. - Bipolar disorder. - Munchausen syndrome. - Schizophrenia. ### 174 In chronic subdural hematoma, one is wrong: - more frequent at extreme ages - can mimic any neurological disease - increase by osmosis - increase by bleeding between the membranes ### 175 In case of acute headache presenting to the emergency room. The first thing to do: - CT Brain - Brain MRI - Assessment for nucchal rigidity - Fundoscopy ### 176 All the following are features of salicylates intoxication except one: - Convulsions - Hyperventilation - Respiratory alkalosis - Aciduria - Dehydration ### 177 All the following are critical features in accidental drug poisoning except one: - Decreased consciousness and respiration - Convulsions - Cardiac arrhythmia - Hyperthermia - Vomiting ### 178 Which of the following tests has a high positive predictive value for Juvenile Rheumatoid Arthritis? - Erythrocyte sedimentation rate - C-reactive protein - HLA-B27 - Antinuclear antibody - None of the above ### 179 When is adenoidectomy recommended? - Upper airway obstruction - Recurrent otitis media - Sleep apnea - All of the above - None of the above ### 180 Which of the following are the most important and clinically useful risk factors for breast cancer? - Fibrocystic disease, age and gender - Cysts, family history in immediate relatives and gender - Age, gender and family history in immediate relatives - Obesity, nulliparity and alcohol use The document or image contains 180 Multiple Choice Questions.