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INTERNAL MEDICINE > 2ND BIMONTHLY > Flashcards

2ND BIMONTHLY Flashcards

1
Q

The most common form of paroxysmal supraventricular tachycardia?

a. AVNRT
b. AVRT
c. Atrial Fibrillation
d. Atrial Tachycardia

A

a. AVNRT

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2
Q

In patients with paroxysmal supraventricular tachycardia presenting with hypotension, which of the following is the next best step?

a. Defibrillation
b. Cardioversion
c. Adenosine 6mg intravenously
d. Verapamil 5mg intravenously

A

b. Cardioversion

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3
Q

These accessory _________ are abnormal connections that allow conduction between the atrium and ventricles across the AV ring. They are present from birth and are due to failure to complete partitioning of atrium and ventricles by the fibrous AV rings.

a. Bundles
b. Fibres
c. Pathways
d. Way

A

c. Pathways

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4
Q

This type of atrial fibrillation occurs continuously for >7 days but <1 year?

a. Paroxysmal
b. Persistent
c. Longstanding
d. Longstanding Persistent

A

b. Persistent

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5
Q

The following statements about atrial fibrillation is true?

a. AF is slightly more common in women and in the middle aged-groups
b. The most important consequence in AF patients is the significantly increased risk of cerebral bleed
c. There is increased risk of dementia in AF patients
d. AF is not a marker of worsened morbidity and mortality in patients with existing heart disease

A

c. There is increased risk of dementia in AF patients

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6
Q

In patients with atrial fibrillation who are anticoagulated using Warfarin, what is the target international normalized ratio (INR)?

a. 1.5
b. 2
c. >2
d. 2.3

A

c. >2

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7
Q

Treatment and management of patient with AF centers on three aims, which of the following is NOT one of the objectives?

a. Control of patient symptoms through rate and/or rhythm control
b. Electrical cardioversion to achieve sinus rhythm
c. Appropriate mitigation of thromboembolism risk
d. Addressing modifiable risk factors for progression of AF

A

b. Electrical cardioversion to achieve sinus rhythm

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8
Q

What is the pointed complex in the ECG tracing below?

a. Focal PVC
b. Multifocal PVC
c. Conducted PAC
d. Non-conducted PAC

A

b. Multifocal PVC

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9
Q

This has continuous irregular activation with no discrete QRS complexes and one of the “shockable rhythms?

A. Polymorphic VT
B. Unstable Sustained VT
C. Ventricular Fibrillation
D. Idiopathic ventricular arrhythmia

A

C. Ventricular Fibrillation

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10
Q

This drug blocks multiple cardiac ionic currents and has sympatholytic activity. It is the most effective anti-arrhythmic drug for suppressing ventricular arrhythmias. What is this drug

a. Sotalol
b. Metoprolol
c. Digoxin
d. Amiodarone

A

d. Amiodarone

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11
Q

Clinical manifestations of patients with ventricular arrhythmias may vary. Perhaps the most serious manifestation is an episode of pre-syncopal attack or outright syncope. Which of the following is a benign cause of syncope?
a. Carotid sinus syndrome
b. Primary autonomic failure
c. Drug-induced
d. Neuro-cardiogenic

A

d. Neuro-cardiogenic

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12
Q

The following statements are TRUE regarding ventricular arrhythmias, EXCEPT

a. PVCs & NSVT, with absence of structural heart disease or a genetic sudden death syndrome, no specific therapy is needed unless the patient has significant symptom
b. Avoiding stimulants, such as caffeine and alcohol is not helpful in some patients
c. Idiopathic ventricular arrhythmias frequently originate from the left or right ventricular outflow tracts near the valve annuli
d. PVCs are very common and can be due to enhance automatically triggered automaticity or entry

A

b. Avoiding stimulants, such as caffeine and alcohol is not helpful in some patients

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13
Q

Which of the following types of patients warrant an ICD implantation?

a. 56yo, male patient complaining of palpitations, shortness of breath and on 24-hour holter monitoring has 60% PVC burden.
b. 32YO female patient with symptoms of SOB on exertion and records a heart rate of 162 beats per minute on her iWatch
c. 70YO, male with atrial fibrillation, had experienced shortness of breath and palpitations with an LV ejection fraction of 35%
d. 62-year-old, male who had recent myocardial infarction 2 months ago with an LV ejection fraction of <30%

A

d. 62-year-old, male who had recent myocardial infarction 2 months ago with an LV ejection fraction of <30%

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14
Q

Ventricular tachycardia that persists beyond 30 seconds is called?

a. Non-sustained VT
b. Sustained VT
c. Polymorphic VT
d. Idiopathic VT

A

b. Sustained VT

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15
Q

The following are strong risk factors for association with atrial fibrillation, EXCEPT

a. Hypertension
b. Alcoholism
c. Sleep apnea
d. Diabetes mellitus

A

b. Alcoholism

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16
Q

This is the most common valve lesion among adult patients with chronic valvular heart disease?

a. Mitral Stenosis
b. Mitral regurgitation
c. Pulmonic stenosis
d. Aortic stenosis

A

d. Aortic stenosis

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17
Q

Which of the following best describes the pathogenesis of aortic stenosis?

a. There is commissural fusion resulting in a bicuspid-appearing valve, makes the leaflets more susceptible to trauma, fibrosis & stenosis
b. For the most part, majority of the processes leading to aortic stenosis endothelial dysfunction.
c. Upon autopsy of patients who died of aortic stenosis, majority were tricuspid and about 20% are bicuspid
d. Different processes involved in aortic stenosis is multifactorial which involves endothelial dysfunction, lipid accumulation, inflammatory cell activation among others

A

d. Different processes involved in aortic stenosis is multifactorial which involves endothelial dysfunction, lipid accumulation, inflammatory cell activation among others

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18
Q

Which of the following best describes the response of the left ventricle when there is sudden left ventricular outflow obstruction?

a. The systolic pressure gradient between and the LV is minimal
b. There is dilation and reduction of stroke volume
c. LV adapts by concentric LV hypertrophy and maintains contractile performance and thus cardiac output
d. When afterload mismatch occurs, stroke volume can be maintained adequately

A

b. There is dilation and reduction of stroke volume

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19
Q

Which of the following best describes Pulsus parvus et tardus?

a. Carotid arterial sudden peak, and then a delayed decay
b. Carotid arterial pulse rises slowly to a delayed peak
c. Carotid arterial peak systolic upstroke, then sudden decay
d. Carotid arterial pulse is biphasic, with a delayed peak

A

b. Carotid arterial pulse rises slowly to a delayed peak

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20
Q

Which of the following aortic stenosis natural history is correctly paired?

a. Angina pectoris–4 years
b. Syncope–3 years
c. Dyspnea–3 years
d. Heart failure–1.5-3 years

A

b. Syncope–3 years

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21
Q

Which of the following statements is true regarding mitral stenosis?

a. Pure or predominant MS occurs in -60% of all patients with rheumatic fever
b. Acute Inflammation leads to diffuse thickening of valve leaflets with formation of fibrous tissue often calcific deposits
c. Mitral commissures are spared, with diffuse thickening of valve leaflets with formation of fibrous tissue often calcific deposits
d. Chordae tendineae fuse and shorten, the valvular cusps become rigid and pathologic process eventually leads to narrowing

A

d. Chordae tendineae fuse and shorten, the valvular cusps become rigid and pathologic process eventually leads to narrowing

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22
Q

Which of the following best describes the hallmark of significant mitral stenosis

a. The pressure gradient gradient between the LA and LV is minimal that passive blood still flows during early diastole
b. During diastole, there is passive movement of blood from the LA to LV, but atrial contraction starts earlier & diastasis is no longer occurs
c. Blood can flow from the LA to the LV only if propelled by an abnormally elevated left atrio-ventricular pressure gradient
d. A LA pressure of ~30 mmhg is required to maintain a normal cardiac output

A

c. Blood can flow from the LA to the LV only if propelled by an abnormally elevated left atrio-ventricular pressure gradient

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23
Q

Which of the following statements best describes the earliest changes seen on Chest X-ray in patients with mitral stenosis

a. Straightening of the upper left border of the cardiac silhouette and prominence of the main pulmonary artery
b. Displacement of the LV apex to the anterior axillary line, and signs of congestion
c. Posterior displacement of the esophagus by an enlarged RA
d. Kerley A and B lines are enlarged, non-dense, radiolucent horizontal lines are commonly seen.

A

a. Straightening of the upper left border of the cardiac silhouette and prominence of the main pulmonary artery

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24
Q

Which of the following statements best definitive treatment (Class I) for a 40 year old, with no comorbidities but with severe mitral stenosis NYHA FC III-IV functional capacity?

a. Percutaneous mitral balloon commissurotomy (PMBC)
b. Mitral valve repair
c. Mitral valve replacement
d. PMBC + MV replacement

A

c. Mitral valve replacement
?

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25
Q

The hemodynamic consequences of patients with mitral regurgitation is best described by which of the following statements?

a. Resistance to LV emptying (LV afterload) is increased
b. The late compensation to MR is more complete LV emptying
c. Resistance to LV emptying (LV afterload is reduced)
d. A consequence to MR, the LV is comprised into LA during ejection/systole

A

c. Resistance to LV emptying (LV afterload is reduced)

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26
Q

Which of the following best describes the characteristics of mitral regurgitation?

a. Holosystolic murmur in chronic MR, and S1 is quite loud and audible
b. In acute MR, there is still holosystolic murmur but there is wide physiologic splitting of S2
c. Diastolic murmur is best heard on the apex. with the patient lying on the left side
d. The murmur is described as “machinery-like” murmur, during diastole

A

b. In acute MR, there is still holosystolic murmur but there is wide physiologic splitting of S2
???

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27
Q

In patients who have MS or MR, and with an ECG evidence of atrial fibrillation and a CHADSVASC score of 2, and HASBLED score of 2 (low risk). Which of the following treatment strategies is best to reduce the risk of stroke?

a. Aspirin
b. Clopidogrel
c. Apixaban
d. Clostazol

A

c. Apixaban

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28
Q

Most patients with mitral valve prolapse, the cause is?

a. Myxomatous degeneration
b. Collagen disorder
c. inflammation of the mitral valve leaflets
d. Unknown

A

d. Unknown

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29
Q

Which of the following is true in mitral valve prolapse?

a. It is more common in men than in women
b. There is no familial incidence
c. Occurs most frequently in ages 30-40 years old
d. Most patients are asymptomatic

A

d. Most patients are asymptomatic

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30
Q

The following are the phases of diastole, except?

a. Rapid inflow
b. Diastasis
c. Atrial contraction/systole
d. Ejection

A

d. Ejection

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31
Q

Which of the following hepatotropic viruses is DNA based?

a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
d. None of the above

A

b. Hepatitis B

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32
Q

The following are groups at high risk of HAV infection EXCEPT

a. Healthy persons with infected family members
b. Persons with a clotting factor disorder
c. Men who have sex with men
d. Persons with uncontrolled diabetes mellitus

A

d. Persons with uncontrolled diabetes mellitus

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33
Q

Recommended prevention of Hepatitis A after exposure:

a. Immune globulin 0.02 mL/kg IM within 1 week to household
b. Immune globulin 0.02 mL/kg IM within 2 week to household
c. Inactivated HAV vaccine 0.5 mL IM
d. Inactivated HAV vaccine 1 mL IM

A

a. Immune globulin 0.02 mL/kg IM within 1 week to household
?? or b??

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34
Q

Recommended dosing schedule for Hepatitis A vaccine in adults

a. 0, 2-6 months
b. 0, 6-12 months
c. 0, 1, 6 months
d. 0, 2, 6 months

A

b. 0, 6-12 months

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35
Q

This gene codes for the major envelope protein in hepatitis b virus

A. S gene
B. P gene
C. C gene
D. X gene

A

A. S gene

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36
Q

The first phase of hepatitis b infection for patients who are infected in early life

A. Immune clearance
B. active phase
C. immune tolerance
D. reactivation

A

C. immune tolerance

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37
Q

When is the optimal treatment time for hepatitis b infection

A. During the immune tolerant phase
B. during the immune clearance phase
C. during the reactivation state
D. both a and b

A

B. during the immune clearance phase
???or c also??

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38
Q

A 25 year old seafarer came in for medical clearance. He has the following serology results:

HBsAg: +
Anti-HBs: -
Anti-HBc: IgG
HBeAg: +
Anti-HBe: -

A. Acute hepatitis B, high infectivity
B. Chronic Hepatitis B, low infectivity
C. Acute hepatitis B, low infectivity
D. Chronic hepatitis B, high infectivity

A

D. Chronic hepatitis B, high infectivity

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39
Q

A 30 year old nursing staff came in for her annual physical examination. She has the following serology result:

HBsAg: -
Anti-HBs: +
IgM Anti-HBc: -
IgG Anti-HBc: +
HBeAg: -
Anti-HBe: +

A. Chronic hepatitis
B. Low infectivity
C. Recovered (immune)
D. Inactive carrier

A

C. Recovered (immune)

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40
Q

Recommended prevention for after exposure in persons that are unvaccinated to hepatitis b

A. HBIg x 1 dose immediately in combination with vaccination series
B. HBIg x 1 dose and give one vaccine booster dose
C. HBIg x 2 doses 1 month apart in combination with vaccination series
D. HBIg x 2 doses 1 month apart and give one vaccine booster dose

A

A. HBIg x 1 dose immediately in combination with vaccination series

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41
Q

Recommended pre-exposure hepatitis b vaccination schedule in adults not on hemodialysis

A. 0-2, 1-4, 4-6 mos.
B. 0, 1-2, 4-6 mos.
C. 0, 1, 2 ,6 mos.
D. 0, 1, 6 mos.

A

A. 0-2, 1-4, 4-6 mos.

42
Q

The following are treatment options for hepatitis b, except

A. Tenofovir disoproxil
B. Lamivudine
C. Pegylated interferon
D. Sofosbuvir

A

D. Sofosbuvir

43
Q

Incubation period of hepatitis c virus

A. 1-2 wks
B. 3-4 wks
C. 5-6 wks
D. 7-8 wks

A

D. 7-8 wks

44
Q

Screening test for hepatitis c infection

A. HCV RNA
B. serum ALT
C. Anti-HCV
D. AFP

A

A. HCV RNA

45
Q

Hepatitis virus that requires HBV for its replication

A. Hepatitis A
B. Hepatitis C
C. Hepatitis D
D. Hepatitis E

A

C. Hepatitis D

46
Q

A skin manifestation in acute rheumatic fever described as pink macules the clear centrally, leaving a serpiginous, spreading edge usually occurring on the trunk

A. Subcutaneous nodules
B. erythema marginatum
C. Erythema multiforme
D. Splinter haemorrhage

A

B. erythema marginatum

47
Q

This occurs as painless small (0.5-2 cm) mobile lumps beneath the skin overlying bony prominences particularly in the hands and feet in patients with rheumatic fever.

A. Subcutaneous nodules
B. osler nodes
C. roth spots
D. arteritis

A

A. Subcutaneous nodules

48
Q

You have a 34 year old patient who recently recovered from an acute rheumatic fever with carditis and a persistent valvular disease. Until what age should should be given the secondary prophylaxis for rheumatic fever

A. Until she is 36 years old
B. Until she is 39 years old
C. Until she is 40 years old
D. Until she is 44 years old

A

D. Until she is 44 years old

49
Q

Recommended secondary prevention of rheumatic fever (prevention of recurrent attacks) for adults

A. Benzathine penicillin G 600,000 U every 3-4 weeks
B. Benzathine penicillin G 2.4 M U every 3-4 weeks
C. Benzathine penicillin G 1.2 M U every 3-4 weeks
D. Penicillin V 250mg every 3-4 weeks

A

C. Benzathine penicillin G 1.2 M U every 3-4 weeks

50
Q

Recommended anti-inflammatory therapy in rheumatic fever with moderate or severe arthritis without carditis or with carditis but without failure

A. Paracetamol
B. aspirin
C. prednisone
D. ibuprofen

A

B. aspirin

51
Q

The following are major criteria under jones criteria, except

A. Chorea
B. Carditis
C. Polyarthritis
D. Prolonged PR interval

A

D. Prolonged PR interval

52
Q

Streptococcal antigens that are structurally similar to those in cardiac myosin and laminin in the heart causing antibody-mediated cellular destruction of the heart tissue.

a. M protein
b. CD4+ T cells
c. Aschoff bodies
d. ASO

A

a. M protein

53
Q

Most common clinical feature of infective endocarditis

a. Fever
b. Chills and sweats
c. Back pain
d. Heart murmur

A

a. Fever

54
Q

These are oval pale retinal lesions surrounded by hemorrhage, usually located near the optic disk.

a. Janeway lesions
b. Splinter hemorrhages
c. Roth spots
d. Cotton wool spots

A

c. Roth spots

55
Q

endocarditis from persistently blood cultures is defined as follows, EXCEPT:

a. At least two positive cultures of blood samples drawn >12h apart
b. All of three or majority of four or more separate cultures of blood (with first and last sample drawn at least 1 h apart)
c. Single positive blood culture of Coxiella burnetti
d. Single positive blood culture of Coagulase-negative Staphylococcus

A

d. Single positive blood culture of Coagulase-negative Staphylococcus

56
Q

The following are possible causes of culture-negative endocarditis, EXCEPT:

a. HACEK spp
b. viridans streptococci
c. Chlamydia psittaci
d. Bartonella spp

A

b. viridans streptococci

57
Q

Which of the following is cardiac surgical treatment required for patients with infective endocarditis for optimal outcome to be achieved?

a. Moderate/ severe CHF or shock due to native-valve dysfunction
b. Large (>10 mm) hypermobile vegetation for native-valve endocarditis
c. Prosthetic valve endocarditis with relapse after optimal antimicrobial therapy
d. Persistent unexplained fever (≥ 10 days) in blood culture-negative

A

a. Moderate/ severe CHF or shock due to native-valve dysfunction

58
Q

Recommended antibiotic regimen for prophylaxis of endocarditis in adults with high risk cardiac lesions

a. Levofloxacin 500mg per orem 1 hour prior to procedure
b. Cephalexin 2g per orem 1 hour prior to procedure
c. Amoxicillin 1g per orem prior to procedure
d. Azithromycin 250mg per orem 1 hour prior to procedure

A

b. Cephalexin 2g per orem 1 hour prior to procedure

59
Q

Most common heart valve involved in infective endocarditis

a. Pulmonic valve
b. Tricuspid valve
c. Mitral valve
d. Aortic valve

A

c. Mitral valve

60
Q

The following are systolic murmurs EXCEPT:

a. Mitral regurgitation
b. Tricuspid regurgitation
c. Aortic stenosis
d. Tricuspid stenosis

A

d. Tricuspid stenosis

61
Q

The following are part of the Child Pugh classification of cirrhosis, EXCEPT:

a. Total Bilirubin
b. Albumin
c. Protime
d. SGPT and SGOT

A

d. SGPT and SGOT

62
Q

A 58 year old man came in due to shortness of breath on examination, patient is awake and coherent, with distended abdomen and the fluid wave test is positive. Laboratories shows albumin of 3, SGPT 50, SGOT 80, serum Bilirubin is 45, protime showed prolonged at 5s and INR of 4, what is the Childs Pugh Classification?

a. A
b. B
c. C
d. D

A

c. C

63
Q

A 80 year old morbidly obese man presents with complaints of fatigue, worsening exertions, dyspnea, 3-pillow orthopnea, lower extremity edema, and cough occasionally productive frothy sputum, He has a long-standing history of type II diabetes and hypertension. On examination, you note the presence of bibasilar rales, a s3 gallop, jugular venous distention and 2+ pitting edema in both legs up to knees. There does not appear to be an arrhythmia present.

What test would be the most sensitive for diagnosis of this condition?

a. Troponin
b. LDH
c. Creatine kinase MB isoenzyme
d. Brain natriuretic peptide

A

d. Brain natriuretic peptide?

64
Q

Which of the following medications should be given initially

a. Metoprolol
b. Diltiazem
c. Furosemide
d. Carvedilol

A

c. Furosemide

65
Q

A patient you see routinely in the clinic has elevated liver function tests. ALT is 89, AST 75, total bilirubin and alkaline phosphatase are normal. The patient has no past history of hepatitis, taking medications or excessive drinking. You order hepatitis serologies. The results are:

Positive: HBsAg and anti-HBc
Negative: Anti-HBs, anti-HBc IgM, anti-HAC, anti-HCV

a. The patient has acute hepatitis B
b. The patient has chronic hepatitis B
c. The patient needs a test for IgM antibody to hepatitis A virus to rule out Acute Hepatitis A
d. The patient needs a test for hepatitis C to exclude acute hepatitis C

A

b. The patient has chronic hepatitis B

66
Q

The most common site on inflammation in Crohn’s disease

a. Terminal ileum
b. Cecum
c. Distal esophagus
d. Perianal

A

a. Terminal ileum

67
Q

Endoscopic features of CD include except

A. Rectal sparing
B. Aphthous ulcerations
C. skip lesions
D. Submucosal lesions

A

D. Submucosal lesions

68
Q

The test for detection of H. pylori in PUD which in noninvasive, inexpensive, convenient but not useful for early follow up

A. Rapid urease
B. Urea Breath Test
C. Serology
D. Culture

A

C. Serology

69
Q

The test for detection of H. Pylori in PUD which is noninvasive, inexpensive, convenient and useful for early follow up

A. Stool antigen
B. histology
C. Serology
D. Urea Breath test

A

D. Urea Breath test

70
Q

Acute or Chronic liver disease can cause abnormal prothrombin time, because the liver produce the following clotting factors, EXCEPT

A. IX
B. X
C. V
D. 2

A

A. IX

71
Q

The most common cause of acute gastritis are

A. Acute infection with H. Pylori
B. NSAIDS intake
C. Parasitic
D. Mycobacterial

A

A. Acute infection with H. Pylori

72
Q

The MELD score

A. Can assess the risk of bleeding varice
B. Liver cancer screening
C. Assessing the need for transplantation
D. Assessing the risk for intubation

A

C. Assessing the need for transplantation

73
Q

True of albumin, except

A. Synthesized exclusively by hepatocytes
B. 20 days half life
C. Good indicator for hepatic dysfunction
D. Not a specific for liver disease

A

C. Good indicator for hepatic dysfunction

74
Q

The lesion is a large caliber arteriole that runs immediately beneath the Gastrointestinal mucosa and bleeds through a focal mucosal erosion

A. Dieulafoy’s
B. Mallory-weiss tear
C. Vascular ectasis
D. Diverticula

A

A. Dieulafoy’s

75
Q

A linear mucosal rent near across the Gastroesophageal junction that is associated with vomiting

A. Dieulafoy’s
B. Mallory-weiss tear
C. Vascular ectasis
D. Diverticula

A

B. Mallory-weiss tear

76
Q

The most sensitive test for the diagnosis of GERD

A. 24h ambulatory pH monitoring
B. 24h holter monitoring
C. CPET
D. Endoscopy

A

A. 24h ambulatory pH monitoring

77
Q

In alcoholic which concomitant hepatitis advances to cirrhosis

A. Acute hepatitis A
B. Acute hepatitis B
C. Chronic hepatitis B
D. Chronic hepatitis C

A

C. Chronic hepatitis B or
D. Chronic hepatitis C

78
Q

To manage hypertension, lifestyle medications include except

A. < 6 NaCl/day
B. < 2 drinks for men
C. Brisk walking for 30 mins
D. BMI < 30kg/m2

A

D. BMI < 30kg/m2

79
Q

The most frequent cause of cardiogenic shock

A. Acute Myocardial infarction with LV dysfunction
B. Cardiac tamponade
C. SOB
D. Myocarditis

A

A. Acute Myocardial infarction with LV dysfunction

80
Q

The test of choice for quantitative assessment of liver fat

A. Ultrasound of whole abdomen
B. Xray of abdomen
C. CT scan
D. MRI proton density fat fraction

A

D. MRI proton density fat fraction

81
Q

The gold standard in the evaluation of patients with liver disease, particularly chronic liver disease

A. Liver biopsy
B. Liver ultrasound
C. Liver CT scan
D. MRI proton density fat fraction

A

A. Liver biopsy

82
Q

The rate limiting step in bilirubin metabolism

A. Conjugation of bilirubin
B. Transport of conjugated bilirubin into bile canaliculi
C. Fractionation of bilirubin
D. Binding to albumin

A

B. Transport of conjugated bilirubin into bile canaliculi

83
Q

The more specific indicator of liver injury

A. AST
B. ALT
C. ALK PHOS
D. ALBUMIN

A

ALT

84
Q

The following increases risk for progression of ALD, except

a. Cigarette smoking
b. 1-2 drinks per day for men
c. Increased Fat content
d. Female gender

A

b. 1-2 drinks per day for men

85
Q

The 3 genes that increased risk of alcohol-associated liver cirrhosis, EXCEPT
a. Patatin-like phospholipase domain containing (/PNPLA3)
b. Transmembrane 6 superfamily member2 (TM6SF2)
c. Membrane bound O-acyltransferase domain-containing 7 (MBOAT7)
d. Apolipoprotein L1 (APOL1)

A

d. Apolipoprotein L1 (APOL1)

86
Q

Elevation of the hepatic venous pressure gradient to >5mmHg

a. Portal Hypertension
b. Nonalcoholic Steatohepatitis
c. Primary Biliary Cholangitis
d. Aneurysm abdominal aorta

A

a. Portal Hypertension

~~~

```

87
Q

True in liver cirrhosis

a. Baclofen reduce cravings of alcohol use
b. Acetaminophen can be given if not more than 2g/day
c. Acetaminophen is discouraged in patients with cirrhosis
d. All of the above

A

d. All of the above

88
Q

The following are complications of cirrhosis, except

a. Neutropenia
b. Gastroesophageal varices
c. Osteomalacia
d. Primary Sclerosing Cholangitis

A

d. Primary Sclerosing Cholangitis

89
Q

The most common organism in SBP(spontaneous bacterial peritonitis)
a. Entamoeba histolytica
b. E. coli
c. Salmonella
d. Fungal

A

b. E. coli

90
Q

**

The presence of scleral icterus indicates a serum bilirubin

a. >2 mg/dl
b. >2.5mg/dl
c. > 3 mg/dl
d. >3.5mg/dl

A

c. > 3 mg/dl

91
Q

In patient who has jaundiced, which of the following indicates liver disease

a. Bilirubinemia
b. Splenomegaly
c. Fever
d. Ascites

A

Bilirubinemia

92
Q

In patients with hepatic encephalopathy, this medication is usually given to remove ammonia from gut

a. Domperidone
b. Mebendazole
c. Lactulose
d. Omeprazole

A

c. Lactulose

93
Q

The 3 primary complications of portal hypertension, except

a. Gastroesophageal varices
b. Ascites
c. Hypersplenism
d. Jaundiced

A

d. Jaundiced

94
Q

Ethanol is mainly absorbed in the

a. Stomach
b. Small intestine
c. Distal esophagus
d. colon

A

b. Small intestine

95
Q

An enzyme system for the metabolism, of alcohol in the liver that utilizes the inducible cytochrome p450

a. Cytosolic ADH
b. Microsomal ethanol oxidizing system
c. Peroxisomal catalase
d. All of the above

A

b. Microsomal ethanol oxidizing system

96
Q

TRUE OR FALSE

Palmar erythema is associated with alcohol-associated cirrhosis

A

TRUE

97
Q

TRUE OR FALSE

In PUD, breaks in the mucosal surface > 5 mm in size with depth to the submucosa is ulcer

A

TRUE

98
Q

TRUE OR FALSE

the earliest lesion of ulcerative colitis are aphthous ulceration and focal crypt abscess

A

FALSE

99
Q

TRUE OR FALSE

Granuloma are characteristic of CD

A

TRUE

100
Q

TRUE OR FALSE

Glucocorticoids in patients with crohn’s disease is beneficial

A

TRUE

INTERNAL MEDICINE (1 decks)

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