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Low-Yield > Internal Med > Flashcards

Internal Med Flashcards

Competition Q

1
Q

Patient with adrenal hypofunction and severe infection; treatment

a. Stop cortisol
b. Reduction in cortisol
c. Elevation in cortisol
d. Unchanged cortisol

A

c. Elevation in cortisol

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2
Q

Cause of Chronic primary adrenal insufficiency

a. Autoimmune adenitis
b. Tuberculosis
c. Amyloidosis
d. Sepsis with adrenal hemorrhage.

A

a. Autoimmune adenitis

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3
Q

Treatment of hypothyroidism includes…

a. L-thyroxine
b. High-dose radioiodine
c. Propylthiouracyl
d. Any of the above

A

a. L-thyroxine

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4
Q

Treatment for diabetic nephropathy, EXCEPT

a. Optimize glucose control
b. Optimize blood pressure control
c. Limit protein intake to 0,8-1g/kg/day in early chronic kidney disease
d. Treat with ACE inhibitors and ARB if albuminuria

A

d. Treat with ACE inhibitors and ARB if albuminuria

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5
Q

Fibrate therapy in dyslipidemia is the most efficient therapy to…

a. Halt the progression of coronary atherosclerosis
b. Decrease triglycerides level
c. Decrease cholesterol level
d. All of the above

A

b. Decrease triglycerides level

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6
Q

Glucocorticoids effect on protein metabolism

a. Enhance protein catabolism in the periphery
b. Increase amino acid uptake in extrahepatic tissues
c. Decrease amino acid uptake in liver
d. Stimulates lipolysis

A

a. Enhance protein catabolism in the periphery

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7
Q

Cause of secondary amenorrhea

a. Hypothyroidism
b. Prolactinoma
c. Polycystic ovary syndrome
d. All

A

d. All

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8
Q

In case of diffuse thyroid tumor, treatment

a. Surgery+high dose of radioiodine+chemotherapy
b. Surgery+chemotherapy+suppressive thyroxine
c. Surgery+high dose radioiodine+suppressive thyroxine
d. Surgery+inhibition of hormone production+chemotherapy

A

c. Surgery+high dose radioiodine+suppressive thyroxine

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9
Q

Causes of Cushing’s syndrome, EXCEPT

a. Adrenal adenoma
b. Congenital adrenal hyperplasia
c. Ectopic ACTH production
d. ACTH producing tumor in the pituitary

A

b. Congenital adrenal hyperplasia

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10
Q

Diagnosis of pohechromocytoma is based on…

a. Precutaneous biopsy and histologic evaluation of the tumor
b. Measurement of the plasma norepinephrine level
c. Measurement of the urine epinephrine level
d. Measurement of the urine metanephrine level

A

d. Measurement of the urine metanephrine level

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11
Q

Prevention of osteoporotic fractures include…

a. Vitamin D and calcium supplementation
b. Biphosphonates
c. PTH analogs
d. Any of the above

A

d. Any of the above

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12
Q

Absolute indication for insulin therapy, EXCEPT:

a. Significant hyperglycemia (HbA1c >10%)
b. Type 2 diabetes
c. Metabolic decompensation related to infection
d. Allergy to oral anti diabetic drugs

A

b. Type 2 diabetes

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13
Q

The combination of normal TSH and low fT3/fT4 suggests…

a. Subclinical secondary hyperthyroidism
b. Subclinical hypothyroidism
c. Primary hypothyroidism
d. Non-thyroidal illness

A

d. Non-thyroidal illness

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14
Q

Effects associated with hypercalcemia, EXCEPT,

a. Constipation
b. Fatigue
c. Nausea
d. Oliguria

A

d. Oliguria

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15
Q

Osteoporosis

a. T-score > -2,5
b. T-score < -2,5
c. T-score > 2,0
d. T-score < -1,5

A

b. T-score < -2,5

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16
Q

Mitochondrial diabetes

a. Diabetes + deafness
b. Diabetes Mellitus + Diabetes insipidus
c. Diabetes + Hasimoto thyroiditis
d. Diabetes + renal insufficiency

A

a. Diabetes + deafness

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17
Q

Autonomous symptoms of hypoglycemia, EXCEPT,

a. Palpitations
b. Tremor
c. Sweating
d. Aggression

A

d. Aggression

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18
Q

Treatment of hypercalcemia includes

a. Thiazide diuretics
b. Vitamin D supplementation
c. Biphosphonates
d. Decreased fluid intake

A

c. Biphosphonates

19
Q

MEN IIA syndrome, EXCEPT:

a. Ovarian cancer
b. Medullary thyroid carcinoma
c. Pheochromocytoma
d. Hyperparathyroidism

A

a. Ovarian cancer

20
Q

Dyslipidemia in metabolic syndrome

a. Elevated cholesterol + elevated triglycerides
b. Elevated triglycerides + decreased LDL
c. Elevated cholesterol + decreased LDL
d. Elevated triglycerides + decreased HDL

A

d. Elevated triglycerides + decreased HDL

21
Q

Genetic disease that cause primary hypogonadism in male

a. Turner syndrome
b. Marfan syndrome
c. Tourette syndrome
d. Klinefelter syndrome

A

d. Klinefelter syndrome

22
Q

Hirsutism in body parts, EXCEPT

a. Breast
b. Lower back
c. Forearm
d. Upper lip

A

c. Forearm

23
Q

Metformin

a. First choice in diabetes with impaired kidney function
b. Increases the risk of hypoglycemia
c. May decrease HbA1c by 1-1,5%
d. Associated with significant weight gain

A

c. May decrease HbA1c by 1-1,5%

24
Q

Polycystic ovary syndrome, elevation of hormones, EXCEPT

a. FSH
b. LH
c. Androstenedione
d. Insulin

A

a. FSH

25
Q

Paracetamol overdose requires… as an antidote.

a. Nothing (as there is no known antidote)
b. N-acetylcystein
c. Active charcoal
d. Flumazenil

A

b. N-acetylcystein

26
Q

Syndrome that is NOT associated with hypopituitarism

a. Kallman syndrome
b. Bardet-Biedl syndrome
c. Creutzfeldt-Jakob syndrome
d. Prader-Willi syndrome

A

c. Creutzfeldt-Jakob syndrome

27
Q

Specific test for pheochromocytoma

a. Plasma epinephrine
b. Plasma dopamine
c. VMA (vanillyl mandelic acid) excretion in urine
d. Metanephrine excretion in urine

A

d. Metanephrine excretion in urine

28
Q

Klinefelter’s syndrome is associated with…

a. Elevated FSH and LH levels
b. Streak gonade
c. Short stature
d. 47, XYY karyotype

A

a. Elevated FSH and LH levels

29
Q

Characteristics of hyperthyroidism, EXCEPT:

a. Lack of lateral eyebrows
b. Exophtalmus
c. Pretibial myxedema
d. Loss of weight despite having appetite

A

a. Lack of lateral eyebrows

30
Q

Pancreatic cholera is equivalent to:

a. Zollinger-Ellison syndrome
b. Somatostatinoma
c. Werner-Morrison syndrome
d. Waterhouse-Friderichsen syndrome

A

c. Werner-Morrison syndrome

31
Q

Diagnostic measures for diabetic ketoacidosis, EXCEPT:

a. Elevated blood glucose at least > 20 mmol/l
b. Arterial pH <7.3 (or 7.35)
c. Plasma bicarbonate < 15 mmol/l
d. Increased anion gap

A

a. Elevated blood glucose at least > 20 mmol/l

32
Q

Treatment of hypercalcemia includes

a. Thiazide diuretics
b. Vitamin D supplementation
c. Bisphosphonates
d. Decrease fluid intake

A

c. Bisphosphonates

33
Q

A low TSH and normal fT3/fT4 suggests…

a. Secondary hypothyroidism
b. Subclinical hypothyroidism
c. Subclinical hyperthyroidism
d. Non-thyroidal illness

A

c. Subclinical hyperthyroidism

34
Q

Acromegaly:

a. Consequence of pre-pubertal excess of GH
b. Accompanied with excess sweating
c. Represents only a cosmetic problem
d. Always requires surgical intervention

A

b. Accompanied with excess sweating

35
Q

Thyroid scan molecule

a. Selenium 74
b. Technetium 99
c. Stronium 89
d. Samarium 153

A

b. Technetium 99

36
Q

Treatment of prolactinoma

a. Dopamine antagonists
b. Transsphenoidal surgery
c. Radioiodine treatment
d. All

A

b. Transsphenoidal surgery

37
Q

Cervical pain is associated with

a. Graves’ disease
b. Chronic lymphocytic thyroiditis
c. Subacute thyroiditis
d. Nodular goiter

A

c. Subacute thyroiditis

38
Q

True for diabetic ketoacidosis

a. It is best treated with large dose of subcutaneous insulin
b. Associated with Cheyne-Stokes respiration
c. Complication seen only in DM1
d. None of the above

A

d. None of the above

39
Q

Disturbed vision in the following, EXCEPT

a. Amanita phalloides mushroom poisoning
b. Methanol poisoning
c. Digitalis poisoning
d. Botulism

A

a. Amanita phalloides mushroom poisoning

40
Q

Most common malignancy in the background of SIADH

a. colorectal carcinoma
b. planocellular carcinoma
c. small cell lung carcinoma
d. multiple myeloma

A

c. small cell lung carcinoma

41
Q

Older patients with hyperthyroidism…

a. Often have atrial fibrillation
b. May not show the classical symptoms of sympathetic hyperactivity
c. May present with apathy
d. All of the above

A

d. All of the above

42
Q

Treatment of acute attack of gout

a. Loop diuretics
b. Colchicine
c. Allopurinol
d. Antibiotics

A

b. Colchicine

43
Q

Depending on the clinical situation, treatment of prolactinoma may include…

a. Bromocriptin, quinagolid
b. Transsphenoidal operation
c. Irradiation
d. Any of the above

A

d. Any of the above

44
Q

Tests of pituitary-adrenal responsiveness include…

a. Metyrapone test
b. Insulin hypoglycemia test
c. CRH test
d. All of the above

A

d. All of the above

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