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401 Flashcards

1
Q

1.
84-year-old female with difficulty swallowing, coughing associated with swallowing food, liquid and/or saliva, nasal regurgitation, feeling food sticking in her throat presents.
Which of the following is correct?
A. Esophageal stricture
B. Esophageal carcinoma
C. Neurological disease (Parkinson’s)
D. Eosinophilic esophagitis
E. Achalasia

A

C. Neurological disease (Parkinson’s)

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2
Q
  1. Which of the following is wrong for esophageal dysphagia?
    f
    A. Dyspgaia is an alarming symptom, careful questioning is very important.
    B. Dysphagia, both solid and liquid, from the outset is usually due to esophageal motility
    disorders.
    C. Dysphagia that starts with solid foods and then progresses to liquid foods is usually
    due to mechanical obstruction (Tumor, stricture, etc.)
    D. Progressive dysphagia is usually due to obstructive causes such as esophageal cancer.
    E. Intermittent dysphagia always due to a cause such as esophageal cancer.
A

E. Intermittent dysphagia always due to a cause such as esophageal cancer.

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3
Q
  1. What is the most likely type of esophagitis in patients using inhaled steroids for asthma?
    A. Reflü related esophagitis
    B. Eosinophilic esophagitis
    C. Chemical causes esophagitis
    D. Candida esophagitis
    E. Crohn’s Disease-related esophagitis
A

D. Candida esophagitis

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4
Q

Which of the following is not involved in the clinical pathology of gastrosophageal
reflux disease?
Decreased basal distal esophagus pressure
B. Achalasia
Increased gastric acid V
D. Hiatal hernia /
E. Increased gastric volume

A

B. Achalasia

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5
Q
  1. Which of the following is not a complication of chronic and untreated esophagitis?
    A. Bleeding Y
    Complication
    B. Stricture

C. Barrett’s esophagus
D. Diarrhea

E. Aeniration pneumonitis V

A

Diarrhea

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6
Q
  1. A 48-year-old male patient with hematemesis accompanied by abdominal pain is present in emergency services. Examination reveals hypotension and tachycardia. In his anamnesis, it is stated that he consumed heavy alcohol and vomited. Which of the following is your most probable diagnosis?
    A. Mallory Weiss Syndrome
    B. Zencer Diverticula
    C. Bulimia nervosa
    D. Gastroesophageal reflux disease
    E. Eosinophilic esophagitis
A

A

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7
Q
  1. Which of the following is not among the reasons of erosive/hemorrhagic gastritis?
    A. Non-steroidal anti-inflammatory drugs
    B. Alcohol
    C. Radiation
    D. Caustic substances
    E. Autoimmunity
A

Autoimmunity

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8
Q
  1. Which of the following is the most common type of peptic ulcer?
    A. Duodenal ulcers
    B. Gastric (stomach) ulcers
    C. Marginal ulcers
    D. Stress ulcers
    E. Curling ulcers
A

A

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9
Q
  1. Which of the following conditions is the most feared result in patients with ulcers caused by Helicobacter pylori?
    A. Mild gastrointestinal bleeding
    B. Diabetes
    C. Heart disease
    D. Stomach cancer
    E. Gastric obstruction
A

D. Stomach cancer

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10
Q
  1. Which of the following conditions is not alarm symptoms in patients with P. ulcer disease?
    A. Unintentional weight loss
    B. Progressive dysphagia
    C. Nausea and vomiting
    D. Recurrent and overt gastrointestinal bleeding
    E. Iron deficiency anemia
A

C

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11
Q
  1. Inflammatory bowel disease (IBID) includes both Crohn disease and ulcerative colitis.
    Which of the following is indicative of Crohn disease but not ulcerative colitis?
    A. Gross rectal bleeding is always present
    B. Inflammation is confined to mucosa except in severe cases
    C. Inflammation is uniform and diffuse
    D. It can involve the entire GIS from the mouth to the anus
    E. The small intestine is not involved in the discase
A

D

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12
Q
  1. The patient, followed with ulcerative colitis, presents to the emergency department with abdominal pain, nausea, and vomiting. Physical examination includes fever > 39, Tachycardia (Nb > 120/min), Leukocytosis ( > 25,000). In X-ray abdominal radiology, colonic dilatation (transverse colon diameter > 6 cm), was found. What is your diagnosis?
    A. Enterocutaneous fistula
    B. Toxic megacolon
    C. Obstruction
    D. Abscess
    E. Perforation
A

B

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13
Q
  1. Which of the following disorders is not clearly associated with IBD?
    A. Aphthous stomatitis
    B. Arthritis
    C. Diabetes Mellitus
    D. Erythema nodosum
    E. Uveitis
A

C

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14
Q
  1. Which of the following is wrong for Celiac disease?
    A. Celiac disease is an enteropath-of the small intestine
    B. It is triggered by exposure to gluten in the diet of susceptible people
    C. The condition is chronic, and currently, the only treatment consists of permanent
    exclusion of gluten from the food intake
    D. Patients with celiac disease can present with diarrhea and failure to thrive; some may be asymptomatic.
    E. The Celiac risk is not increased in first-degree relatives of people affected by celiac disease
A

E

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15
Q
  1. Which type of hepatitis can cause acute liver failure in pregnan
    A. Hepatitis A
    B. Hepatitis B
    C. Hepatitis C
    D. Hepatitis D
    E. Hepatitis E
A

Hepatitis E

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16
Q
  1. Which of the following is wrong for GIS bleeding?
    A. Hematemesis always indicates upper gastrointestinal bleeding
    B. Melena is a sign of upper gastrointestinal bleeding g
    C. Angiography is the first line diagnostie and therapeutic method in management of gastrointestinal bleeding
    D. Hematochezia generally indicates lower GI bleeding
    E. Hematochezia may result from upper Gl bleeding if the bleeding is of large enough
    volume
A

C

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17
Q
  1. Which of the following is most commonly associated with nonviral acute liver failure?
    A. Amoxicillin
    B. Acetaminophen V
    C. Topiramate
    D. Naproxen
    E. Proton pump inhibitör
A

B

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18
Q
  1. Which of the following factors does not cause acute liver failure?
    A. Mushroom poisoning V
    B. HBV
    C. Cholelitiazis
    D. Wilson disease V
    E. Autoimmune hepatitis
A

C

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19
Q
  1. Which of the following is a sign of decompensation in cirrhosis?
    A. Weight loss
    B. Easy bleeding and bruising
    C. Ascites V
    D. Nausea
    E. Spider veins
A

C

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20
Q
  1. Which of the following condition is not recommended to insert a nasogastric (NG)
    tube?
    A. In people who are malnourished or at risk of malnutrition
    B. NG tubes can also be used to deliver certain medications directly
    C. NG tubes may also be used for the removal of gastric contents include, spirating ingested toxic material
    D. Assessment of the presence or volume of actively bleeding esophageal or gastric varices
    E. Gastric decompression in patient with bowel obstruction
A

D

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21
Q

21 Which one of the following cell types has the highest capacity of differentiation?

A. Epithelial cells
B. Mesencyhmal stem cells
C. Embryonic stem cells
D. Hematopoietic stem cells
E. Proerythroblasts

A

C. Embryonic stem cells

22
Q
  1. Which one of the following is used for staining iron in the bone marrow specimens
    A. Prussian blue
    B. Methylene blue
    C. Periodic Acid-Schiff (PAS)
    D. Giemsa
    E. Sudan-Black
A

A. Prussian blue

23
Q
  1. Which one of the following should not be observed in a normal peripheral blood smear?
    A. Mature neutrophils
    B. Mature lymphocytes
    C. Platelet clumps
    D. Schistocytes
    E. Basophils
A

D. Schistocytes

24
Q
  1. Which one of the following can be used as a control parameter during the evaluation of a hemogram result?
    A. MPV
    B. RDW
    C. MCV
    D. MCH
    E. MCHC
A

E

25
Q
  1. Which of the following conditions is not expected to cause anemia of chronic disease?
    A. Rheumatoid arthritis
    B. Tuberculosis
    C. Chronic renal failure
    D. Ulcerative colitis
    E. Chronic obstructive pulmonary disease
A

E. Chronic obstructive pulmonary disease

26
Q
  1. Which of the following blood products should never be irradiated before transfusion?
    A. Packed erytrocyte suspensions
    B. Pooled platelet suspensions
    C. Hematopoietic stem cells
    D. Apheresis platelet suspensions
    E. Apheresis granulocyte suspensions
A

C. Hematopoietic stem cells

27
Q
  1. Which one(s) of the following conditions necessitate(s) the permanent deferral of a blood donor candidate?
    I . HIV infection
    II . Vaccination with live attenuated vaccines within the past 4 weeks
    III .Strong suspicion of illicit drug use
    A. OnlyI
    B. I and III
    C. land IT
    D. Il and I
    E. I, Il, and III
A

B

28
Q
  1. Which one of the following donor types would not be expected to have a compatible cross-match with an A Rh (+) patient?
    A. O Rh (-) donor +
    B. A Rh (-) donor +
    C. O Rh (+) donor -+
    D. AB Rh (-) donor
    E. None of the above
A

D

29
Q

29.
30.
Which of the following conditions may not require an urgent initiation of a broad spectrum antibiotic treatment?
A. An asymptomatic female with findings of lower urinary tract infection
B. A patient with symptoms and findings of acute bacterial meningitis Berm-omusl
C. A febrile neutropenie patient
erferayer
D. An elderly patient with suspected urinary tract infection and accompanying findings of systemic inflammatory response syndrome (SIRS)
E. Necrotising fasciitis

A

E

30
Q

Which one of the following is the hallmark mutation observed in chronic myeloid leukemia?
A. t(15;17)
B.) t(9:22)
C. (8;14)
D. t(11;14)
E. t(8;21)

A

B

31
Q
  1. You are called to see a male patient who suddenly develops fever, chills and lower back pain while receiving a blood transfusion in the ward. What is the next step in his management?
    A. Intravenous fluids
    B. Intravenous corticosteroids
    C. Intravenous antibiotics
    D. Blood cultures
    E. Stop the transfusion
A

E

32
Q
  1. A 30-year-old patient presents with an episode of jaundice associated with feeling tired. On examination there is anemia, splenomegaly and jaundice. He has had several such episodes in the past and recently undergone a cholecystectomy for recurrent episodes of cholecystitis. The blood smear shows reticuloctosis and the red cells demonstrate increased osmotic fragility. Considering the probable diagnosis, what is likely to be the most successful treatment?
    A. Chemotherapy
    B. Blood transfusion
    C. Splenectomy
    D. Radiotherapy
    E. Hematopoietic stem-cell transplantation
A

C

33
Q
  1. A 38-year-old patient is investigated for pancytopenia. A bone marrow biopsy shows a reduction of hematopoietic cells and infiltration with fatty bone marrow. Given the likely diagnosis, what is the most effective long term treatment?
    A. Anti-thymocyte globulin (ATG)
    B. Splenectomy
    C. Blood transfusions
    D. Hematopoietic stem-cell transplantation
    E. Corticosteroids
A

D

34
Q
  1. An 18-year-old male presented with excessive bleeding following a tooth extraction.
    His investigations revealed: platelet count: 260 x 10°L, prothrombin time (PT): 13 secs (normal range: 11.5-15.5), activated partial thromboplastin time (normal range: aPTT): 86 s
    (25-40), Factor VIII: 110 IU/dL (normal range: 50-150)
    Deficieney of which of the following clotting factors is the most likely explanation for this patient?
    A) Factor II
    B) Factor IX 9
    C) Factor VII ext
    D) Factor V
    E) Factor X
A

B

35
Q
  1. A 24-year-old nulliparous female with a history of recurrent deep vein thrombosis presents with shortness of breath. The full blood count and clotting screen reveals the following results: Hemoglobin: 12.4 g/dL, platelet count: 137x109 /L, leukocyte count: 7.5x109 /L, prothrombin time (PT): 14 secs (normal range: 11.5-15.5), activated partial thromboplastin time (aPTT): 46 secs (25-40). What is the most likely underlying diagnosis?
    a. Activated protein C resistance
    b. Antithrombin III deficiency
    c. Oral contraceptive pill use
    d. Antiphospholipid syndrome
    e. Protein C deficiency
A

D. Antiphospholipid syndrome

36
Q
  1. A 28-year-old woman is brought to the emergency department by her husband. She has had a fever and abdominal pain for 4 days and has been complaining of a headache for the past 24 hours. On examination, she is restless and has a temperature 6f 38°C.
    pallor and a
    purpuric rash on her legs and abdomen. There is no nuchal rigidity. Her blood pressure is 150190 mm Hg. The rest of the examination is normal. The results of laboratory tests are as meretus
    • Mörolgike hastallk beltrei daLitir
    Hemoglobin: 8.7 g/dL, leukocyte count: 11 x 10°L, platelet count: 10 x 10°/L
    » Ken pinti
    Peripheral smear: anisocytosis, poikilocytosis, frequent schistocyres
    and praclenssyla
    polychromasia, marked thrombocytopenia, leukocytes normal; D-dimer: negative.
    = pint
    urea: 8.4 mmol/L, creatinine: 1.5 g/dC, lactate dehydrogenase (LDH): 2160 IU/L
    got
    (normal range: 200-450)
    L Have hasel gUskir
    Urinalysis: trace proteinuria; Antinuclear antibody (ANA): negative, direct agglutination test (DAT): negative; A CT scan of the brain and an abdominal ultrasound scan are both normal.
    Lumbar puncture is not performed because of the thrombocytopenia.
    Which one of the following diagnoses best fits the above picture?
    A. Systemic lupus erythematosus (SLE)
    B. Thrombotic thrombocytopenic purpura (TTP)
    Meningococcal meningitis
    D. Metastatic carcinoma
    E. Evan’s syndrome
A

B

37
Q
  1. A 35-year-old patient is 1-month post-allogenic bone marrow transplantation, when her condition deteriorates. She has developed a maculopapular rash of the palms of the hands and the soles of her feet and has become jaundiced. The patient has also been having bouts of vomiting and diarrhea and as a result has lost weight. She is currently taking cyclosporine. Laboratory investigations: Na+ :137 mmol/L, K+ :3.4 mmol/L, urea 9.2 mmol/L, creatinine 1.1 mg/dL, bilirubin 79 mmol/L, alkaline phosphatase: 310 IU/L, ALT 55 IU/L, albumin 27 g/L.
    Skin biopsy shows a lymphocytic infiltrate in the dermis. What is the most appropriate diagnosis?
    a. Drug allergy
    b. Acute gastroenteritis
    c. Relapse of acute leukemia
    d. Parasitic infection
    e. Acute graft versus host disease
A

e. Acute graft versus host disease

38
Q
  1. A 25-year-old African-American woman with a history of menorrhagia and dysmenorrhea presents to you with the chief complaint of fatigue. She says that she “wears out” halfway through the day and needs to take a nap frequently when she gets home from work as a personal trainer. Laboratory values are listed below:
    Hemoglobin: 10.5 mg/dL, MCV:69, Peripheral smear: Microcytosis Which of the following is not a likely diagnosis?
    a. Iron deficiency anemia
    b. Myelodysplastic syndrome
    c. Anemia of chronic disease
    d. Thalassemia
    e. Sideroblastic anemia
A

b. Myelodysplastic syndrome

39
Q
  1. A 19-year-old African-American man is being evaluated for a pre-sport physical. His history and physical examination are normal. Laboratory values are listed below:
    Hemoglobin: 16.0 mg/dL, hematocrit: 55%, MCV: 71 fL, leukocyte count: 8x109 /L, with normal differential
    You order a hemoglobin electrophoresis and it is normal. Serum ferritin and transferrin saturation are also within normal limits. Which of the following explains his laboratory findings?
    a. Sickle cell trait
    b. Beta-thalassemia trait
    c. Alfa-thalassemia trait
    d. Sickle beta-thalassemia
    e. Sickle cell disease
A

c. Alfa-thalassemia trait

40
Q

. A 67-year-old woman is referred to the hematology clinic. Her general practitioner has noted that her platelet count is persistently elevated and no reactive cause can be found. Bloods test taken a week before clinic are as follows: Hemoglobin: 15.4 g/dL, platelet count: 784x109 /L, leukocyte count: 5.3x109 /L, JAK2 kinase (V617F mutation): positive.
What is treatment of choice?
a. Hydroxyurea
b. Imatinib
c. Phlebotomy
d. Vincristine
e. Hematopoietic stem-cell transplantation

A

a. Hydroxyurea

41
Q

Which of the followings is wrong?
A. Oncological emergencies can be classified as metabolic, anatomical, infectious or surgical oncological emergencies.
B. In severe neutropenia, the absolute neutrophil count (ANC) is less than 500 per microliter, or ANC is expected to decrease below 500 cells/microL in the next 2 hours.
C. In most cases, the infectious etiology of febrile neutropenia is able to be determined.
D. According to the MASCC scoring, febrile neutropenic patients should be classified as low and high risk and a treatment plan should be made.
E. Febrile neutropenia is the most common serious and common complication of cancer therapy.

A

C

42
Q

42- Which of the followings is wrong?
A. The signs and symptoms of tumor lysis syndrome can develop spontaneously or about
72 hours after the initiation of chemotherapy.
B. Most of the symptoms seen in patients with tumor lysis syndrome are related to the release of intracellular chemical substances that cause impairment in the functions of target organs.
C. Chvostek sign is related to hypercalcemia.
D. In Tumor lysis syndrome, level of uric acid increases by 25% from baseline or its level needs to be greater than or equal to 8.0 mg/dL.
E. Hyperkalemia is a potential cause of fatal arrhythmia in tumor lysis syndrome.

A

C

43
Q

43- Which of the followings is correct for vena cava superior syndrome (VCSS)?
A. Vena cava superior syndrome is mostly seen with benign etiologies.
B. Pulsus paradoxus is the most typical finding of physical examination.
C. ECG may be helpful for diagnosis of VCSS.
D. Elevation of the patient’s head is a simple maneuver with the goal of decreasing venous pressure.
E. If not treate, It can cause thoracic aortic aneurysm.

A

D

44
Q

4 Which of the followings is wrong for Syndrome of Inappropriate Antidiurelic Hormone secretion(SIADH)?
A. SIADH is characterized by impaired water excretion leading to hyponatremia with hypervolemia or euvolemia.
B. The main function of ADH is osmoregulation.
C. Signs and symptoms depend upon the rate and severity of hyponatremia.
D. Serum osmolality is greater than 275 mOsm/kg.
E. The goal of treatment is to maintain the level of sodium higher than 130 mEg/L.

A

D. Serum osmolality is greater than 275 mOsm/kg.

45
Q

45- Which of the followings is wrong for colorectal cancer?
A. Howel-Evans syndrome or tylosis nearly develop 40% in colorectal cancer
B. Surgery is the only universally accepted and potentially curative treatment for colorectal cancer.
C. Adjuvant chemotherapy for stage II colon cancer (no lymph node involvement) is controversial.
D. Rectal cancers have a higher incidence of causing lung metastasis compared with colon cancers.
E. A history of colorectal cancer in first-degree relatives exists in 15% of all patients with colorectal cancers.

A

A

46
Q

46-Which of the followings is wrong for gastric cancer?
A. Diffuse gastric cancer is associated with hereditary factors and a proximal location.
B. Acanthosis nigricans occurs in 55% of cases with gastric carcinoma.
C. Onc-third of all gastric cancers arise in the proximal stomach.
D. Stage and number of positive lymph nodes are prognostic.
E. Intestinal-type gastric cancer is seen more in distal part and occurs more in older patients.

A

E

47
Q

47- Which of the followings is correct for lung cancer?
A. Lung cancer is the most common visceral malignancy, accounting for roughly one-half of all cancer deaths.
B. Small cell lung cancer predominantly occurs in a peripheral location.
C. Adenocarcinomas present as centrally nodules.
D. Involuntary weight loss of 5% or more is an independent and negative prognostic factor.
E. Carcinosarcomas are small lesions that have a tendency to spreads other area.

A

D

48
Q

48- Which of the followings is wrong for lung cancer?
A. Adjuvant chemotherapy is recommended for patients with resected stage Ila, Ib, and Illa nonsmall cell lung cancer.
B. Adjuvant Radiotheraphy does not improve long-term survival in node negative or in
N1 disease.
C. Randomized controlled trials have demonstrated the superiority of concurrent chemoradiotherapy over sequential therapy.
D. Prophylactic cranial irradiation (PCI) decreases the rate of brain metastases in small cell lung cancer patients.
E. Greater than 60% of patients with SCLC have stage I or Il disease.

A

E

49
Q
  1. Which of the followings is wrong for cancer drugs?
    A. Alkylating agents are cell cycle phase nonspecific.
    B. Antitumor antibiotics generally are drugs derived from bacteria and in nature provide defense against other hostile microorganisms.
    C. Topoisomerase inhibitors are natural or semisynthetic products.
    D. Antimetabolite drugs activity is greatest in the S phase of the cell cycle.
    E. Cisplatin is a Cell Cycle M Phase Specific Agent,
A

E

50
Q

50- Which of the followings is wrong for targeted drugs?
A. Monoclonal antibodies are proteins secreted by one clone of immune cells and each type has single specificity.
B. They acts by binding soluble antigens that affect tumor growth/survival.
C. They cause delivery of toxins into cancer cells.
D. They act by binding of antigens on immune cells and enhance anticancer immune responses.
E. Their toxicities are same as of classical cancer drugs.

A

E

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