[2] Sample Exams

Question 1

Dyspepsia is described as chronic or recurrent epigastric or diffuse abdominal pain characterized as fullness, gnawing, bloatedness or burning occurring intermittently for at least:

a. 1 week
b. 2 weeks
c. 3 weeks
d. 4 weeks

Answer 1

B

Question 2

54 years old, female, hypertensive controlled, diabetic with poor control s/p CVD without residuals came in for consult because of 3 months history of burning epigastric pain. She had belching, bloatedness, melena. Patient was assessed to have dyspepsia with alarm. The alarm feature/s in this case are:

a. age, DM with poor control, melena
b. Sex, CVD without residuals, duration of sx
c. CVD without residuals, DM with poor control, melena
d. Age and melena only

Answer 2

D

Question 3

[Alarm Features of Dyspepsia]

Answer 3

age of onset>45,
weight loss,
anemia,
hematemesis, melena, hematochezia, dysphagia, odynophagia, persistent vomiting, abdominal mass, jaundice,
chronic NSAID intake, chronic alcohol intake, previous history of ulcer

Question 4

The following are considered alarm features of dyspepsia, except:

a. anemia
b. dysphagia
c. nausea
d. jaundice

Answer 4

C

Question 5

The minimum duration of treatment for dyspepsia

a. 1 week
b. 2 weeks
c. 3 weeks
d. 4 weeks

Answer 5

D

Contested: According to the PowerPoint, it was 2-4 weeks but NICE 2014 guidelines say 4 weeks

Question 6

MR, 30 came to AMBU with intermittent, non-radiating burning epigastric pain, VAS 10/ 10. He told you that this has been recurrent for a month now. You further probed that he frequently skips meals and is fond of drinking coffee. On PE, he had stable vital signsft and the only pertinent PE finding is the direct tenderness on the epigastric area. What would be the best initial management?

a. Diclofenac IM ANST
b. Ranitidine IM
c. Metoclopramide IM
d. Tramadol IM

Answer 6

B

Question 7

After 4 hours, there was no relief of symptom despite giving what you think is the appropriate management. He then started to vomit on PE, he had rigid abdomen, what would be the next step that you could suggest?

a. observe patient further
b. schedule patient for ultrasound on OPD basis
c. refer for admission
d. discharge patient on home meds

Answer 7

C

Question 8

Mario, 38, with no known comorbidities, came in at the ambulatory care because of nape pain. His blood pressure at that time was 140/90 mmHg. Accdg to JNC 7 classification, how would you classify Mario?

a. hypertension suspect
b. pre-hypertension
c. hypertension stage 1
d. Hypertensive urgency

Answer 8

A

Question 9

How will you manage the case of Mario?

a. repeat BP after 15 mins
b. give centrally acting antiHPN
c. give long-acting antiHPN
d. advise the patient that his BP is normal at his age

Answer 9

A

Question 10

What advise will you give him upon discharge?

a. strict compliance with his medications
b. monitor his BP at home
c. add pineapple juice in his daily meals
d. ff up if there is another episode of elevated BP

Answer 10

B

Question 11

after 1 week, Mario came back with a BP of 140/100 mm Hg. Accdg to JNC 7 classification, how would you classify Mario?

a. hypertension suspect
b. pre-hypertension
c. hypertension stage I
d. hypertension stage II

Answer 11

C

Question 12

What would you prescribe Mario?

a. ACE inhibitors
b. Beta blockers
c. Ca channel blockers
d. Combination therapy

Answer 12

A

Question 13

Lolita, 67, is a known diabetic for 5 years on metformin 500 mg TID and glimepride 5 mg BID, HPN for 9 years maintained on losartan 100 mg ID and HCTZ 25 mg OD. she came to the ER due to dizziness and nape pain. Her BP at that time was 200/110. How would you classify Lolita’s condition?

a. hypertensive urgency
b. hypertensive emergency
c. hypertension stage II, fairly controlled
d. hypertension stage II, uncontrolled

Answer 13

B

Question 14

Which of the ff lab tests/ancillary procedures is recommended before initiating hypertensive therapy?

a. urinalysis
b. chest x-ray
c. BUN
d. abdominal ultrasound

Answer 14

A

Question 15

Mang Jose, 34, farmer, came in with a chief complaint of moderate fever of 3 days duration associated with productive cough of yellowish sputum. He self-medicated with Paracetamol with relief of fever but noted worsening of cough. You saw him at the ambu with BP of 120/70, HR 88, RR 21, T 36.9. Chest findings showed crackles at the R lower lung field. What is the probable diagnosis?

a. CAP-LR
b. CAP-MR
c. CAP-HR
d. Atypical pneumonia

Answer 15

A

Question 16

The dose recommendation for amoxicillin PCAP is

a. 10-15 mg/kg/dose
b. 20-30 mg/kg/dose
c. 30-50 mg/kg/dose
d. 50-70 mg/kg/dose

Answer 16

A

Question 17

Aling Nena, 77, known diabetic, with poor compliance to meds was recently diagnosed with CKD stage 3. She came in with a complaint of dyspnea. History revealed 5 day history of nonproductive cough associated with intermittent fever. On PE you noted
decreased breath sounds on both lower lung fields. What is your management?
a. give antibiotics and do a chest x-ray as an out-patient basis
b. give antibiotics and send the patient home
c. give antibiotics and do sputum AFB as out-patient
d. transfer to DEMS

Answer 17

D

Question 18

Which among the ff patients most likely has CAP?

a. 3 y/o male with cough for 2 days, no alar flaring, RR 24
b. 14 y/o female 2 week cough and dyspnea on exertion with wheezes relieved by nebulizer
c. 54 y/o male chronic smoker with intermittent cough within 6 months no fever
d. 86 y/o female presenting with weakness and anorexia with occasional fever for 1 week duration

Answer 18

D

Question 19

A patient was seen at the ambu but was transferred to DEMS because he was diagnosed with mod CAP. He was started on IV antibiotics and was observed. When would be the best time to shift the patient to oral antibiotics?

a. when the patient is able to take oral meds after 24 hrs
b. when the patient is improving clinically after 24-72 hrs
c. when the patient is not able to comply with IV antibiotics and opt to take a cheaper oral meds
d. when the patient wants to go home and keeps on taking off his IV line

Answer 19

B

Question 20

A 16y/o male came in with a complaint of cough for 3 days and 1 day fever. He sought consult at a private MD wherein chest x-ray done showed normal results. He was given Paracetamol and advised to increased fluid intake. There was however progression of symptoms. He sought consult at the ambu and was noted to have crackles on R lower lung field. What would be your management?

a. repeat chest x-ray
b. advise to take carbocisteine 500 mg/cap TID for 3 days
c. start amoxicillin TID for 7 days
d. For sputum culture and sensitivity

Answer 20

C

Question 21

A nonpregnant 23 year old female came to you for consult at the AMBU. she presented with 7 days history of fever (39), chills, back pain, dysuria, nausea and vomiting. You diagnosed her as having acute pyelonephritis. What empiric antibiotic regimen will you start her on?

a. Co-amoxiclav 625 mg BID x 14 days
b. Ofloxacin 400 mg BID x 14 days
c. Ciprofloxacin 250 mg BID x 14 days
d. TMP-SMX 800/160 BID x 14 days

Answer 21

B

Question 22

A nonpregnant 18 y/o female came to you for consult at the FMC. she was complaining of painful urination, feeling of incomplete emptying and back pain. your diagnosis then was acute uncomplicated cystitis. Which among the ff will you NOT consider as a treatment regimen?

a. Ofloxacin 200 mg BID x 3 days
b. Co-amoxiclav 625 mg BID x 7 days
c. Ciprofloxacin 250 mg BID x 3 days
d. Ampicillin 500 mg TID x 3 days

Answer 22

D

Question 23

A nonpreggy 20 year old female came to you for consult at the AMBU with a complaint of back pain. History started 7 days PTC when she developed fever (40), chills and back pain. This was associated with dysuria, nausea and vomiting. On PE you noted CVA tenderness. What is your impression?

a. complicated cystitis
b. uncomplicated cyfstitis
c. acute pyelonephritis
d. symptomatic bacteriuria

Answer 23

C

Question 24

A 25 y/o female, pregnant at 16 wks AOG came in for prenatal consult. The test of choice in screening for asymptomatic bacteriuria is?

a. urinalysis only
b. urinalysis with leukocyte esterase
c. standard urine culture
d. urine gram stain and urinalysis

Answer 24

C