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year 2 med > Last year past paper Qs > Flashcards

Last year past paper Qs Flashcards

1
Q

Which of the following is the recommended treatment for an abdominal aortic aneurysm
measuring 5.5 cm?
.
A. Watchful waiting
B. Open surgical repair
C. Endovascular aneurysm repair (EVAR)
D. Medical management with beta-blockers

A

C. Endovascular aneurysm repair (EVAR)

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2
Q

Which of the following is the most common early symptom of Lyme disease?
.
A. Fever
B. Arthralgia
C. Erythema migrans
D. Neuropathy

A

C. Erythema migrans

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3
Q

What does a ground glass appearance on a CT scan most likely indicate?
.
A. Pulmonary edema
B. Interstitial lung disease
C. Lung carcinoma
D. Pneumothorax

A

B. Interstitial lung disease

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4
Q

In which scenario is Anti-D immunoglobulin administration necessary?
.
A. A Rh-negative mother with a Rh-positive baby
B. A Rh-positive mother with a Rh-negative baby
C. A Rh-positive mother with a Rh-positive baby
D. A Rh-negative mother with a Rh-negative baby

A

A. A Rh-negative mother with a Rh-positive baby

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5
Q

What is the most common cause of heart failure with reduced ejection fraction (HFrEF)?
.
A. Hypertension
B. Coronary artery disease
C. Diabetes mellitus
D. Valvular heart disease

A

B. Coronary artery disease

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6
Q

Which of the following statements is true regarding X-linked dominant inheritance?
.
A. Affected fathers transmit the disease to all their sons
B. Affected fathers transmit the disease to all their daughters
C. Affected mothers transmit the disease to all their sons
D. Both genders are equally affected

A

B. Affected fathers transmit the disease to all their daughters

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7
Q

How is sickle cell trait inherited?
.
A. Autosomal dominant
B. Autosomal recessive
C. X-linked recessive
D. X-linked dominant

A

B. Autosomal recessive

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8
Q

What is the primary indication for using prednisolone in sarcoidosis?
.
A. Skin lesions
B. Ocular involvement
C. Pulmonary involvement
D. Hypercalcemia

A

C. Pulmonary involvement

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9
Q

After identifying thrombocytopenia on a blood film, what is the next best step in
management?
.
A. Bone marrow biopsy
B. Peripheral blood smear review
C. Platelet transfusion
D. Coagulation studies

A

B. Peripheral blood smear review

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10
Q

Which of the following is a characteristic feature of polymyalgia rheumatica (PMR)?
.
A. Distal muscle weakness
B. Proximal muscle pain and stiffness
C. Rash
D. Joint erosions

A

B. Proximal muscle pain and stiffness

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11
Q

Which of the following is most commonly associated with rheumatoid arthritis (RA)?
.
A. Osteophytes
B. Joint space narrowing
C. Marginal erosions
D. Heberden’s nodes

A

C. Marginal erosions

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12
Q

Which of the following is a hallmark of osteoarthritis (OA)?
.
A. Symmetric joint space narrowing
B. Marginal erosions
C. Osteophytes
D. Soft tissue swelling

A

C. Osteophytes

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13
Q

What is a characteristic feature of psoriatic arthropathy?
.
A. DIP joint involvement
B. Symmetric polyarthritis
C. Absence of nail changes
D. Erosive arthritis

A

A. DIP joint involvement

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14
Q

Which organism is most commonly responsible for impetigo?
.
A. Streptococcus pneumoniae
B. Staphylococcus aureus
C. Pseudomonas aeruginosa
D. Escherichia coli

A

B. Staphylococcus aureus

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15
Q

What is a characteristic feature of the murmur associated with hypertrophic cardiomyopathy (HCM)?
.
A. It increases with squatting
B. It decreases with the Valsalva maneuver
C. It is best heard at the left lower sternal border
D. It radiates to the carotids

A

C. It is best heard at the left lower sternal border

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16
Q

Which of the following is true regarding monoclonal gammopathy of undetermined
significance (MGUS)?
.
A. It always progresses to multiple myeloma
B. It is characterised by a monoclonal protein level < 3 g/dL
C. It requires immediate chemotherapy
D. It is associated with lytic bone lesions

A

B. It is characterised by a monoclonal protein level < 3 g/dL

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17
Q

Which of the following is a typical finding in the complete blood count (CBC) of a patient
with vitamin B12 or folate deficiency?
.
A. Microcytic anemia
B. Normocytic anemia
C. Macrocytic anemia
D. Thrombocytosis

A

C. Macrocytic anemia

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18
Q

What is the first-line treatment for symptomatic Wolff-Parkinson-White (WPW)
syndrome?
.
A. Pharmacologic therapy with beta-blockers
B. Catheter ablation
C. Implantable cardioverter-defibrillator (ICD)
D. Surgical maze procedure

A

B. Catheter ablation

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19
Q

Which of the following is most commonly associated with the JAK2 mutation?
.
A. Chronic myelogenous leukemia
B. Essential thrombocythemia
C. Acute lymphoblastic leukemia
D. Hodgkin lymphoma

A

B. Essential thrombocythemia

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20
Q

What is a characteristic finding on a complete blood count (CBC) for a patient with Felty
syndrome?
.
A. Thrombocytosis
B. Neutropenia
C. Eosinophilia
D. Basophilia

A

B. Neutropenia

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21
Q

Which of the following conditions is associated with hemoglobin having a high affinity for
oxygen?
.
A. Chronic hypoxia
B. Carbon monoxide poisoning
C. Methemoglobinemia
D. Anemia of chronic disease

A

B. Carbon monoxide poisoning

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22
Q

Which of the following is a common cause of secondary erythrocytosis?
.
A. Chronic obstructive pulmonary disease (COPD)
B. Polycythemia vera
C. Dehydration
D. Hemochromatosis

A

A. Chronic obstructive pulmonary disease (COPD)

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23
Q

Which of the following describes the murmur typically heard in mitral stenosis?
.
A. Holosystolic murmur at the apex
B. Mid-diastolic rumble with opening snap
C. Systolic ejection murmur at the left upper sternal border
D. Continuous machinery murmur

A

B. Mid-diastolic rumble with opening snap

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24
Q

Which of the following is a typical feature of a posterior cerebellar stroke?
.
A. Hemiplegia
B. Vertigo
C. Aphasia
D. Homonymous hemianopia

A

B. Vertigo

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25
Q

Which of the following symptoms is commonly associated with an anterior cerebellar
stroke?
.
A. Dysarthria
B. Hemiparesis
C. Diplopia
D. Amnesia

A

A. Dysarthria

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26
Q

What is the most appropriate immediate treatment for acute limb ischemia due to an
embolus?
.
A. Anticoagulation therapy
B. Embolectomy
C. Thrombolysis
D. Bypass surgery

A

B. Embolectomy

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27
Q

Which of the following is a common cause of hemorrhagic stroke?
.
A. Atherosclerosis
B. Hypertension
C. Embolism
D. Hyperlipidemia

A

B. Hypertension

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28
Q

What is a common presenting symptom of subarachnoid hemorrhage (SAH)?
.
A. Gradual onset of headache
B. “Thunderclap” headache
C. Progressive muscle weakness
D. Visual disturbances

A

B. “Thunderclap” headache

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29
Q

The “triangle of safety” is a reference point for which procedure?
.
A. Chest drain insertion
B. Central line placement
C. Lumbar puncture
D. Paracentesis

A

A. Chest drain insertion

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30
Q

Which of the following is a characteristic feature of small-cell lung cancer?
.
A. Slow growth rate
B. Peripheral lung location
C. Strong association with smoking
D. Typically diagnosed at an early stage

A

C. Strong association with smoking

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31
Q

Which of the following is a characteristic feature of squamous cell lung cancer?
.
A. Central lung location
B. Strong association with non-smokers
C. Slow growth rate
D. High metastatic potential

A

A. Central lung location

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32
Q

Which of the following is most commonly associated with mesothelioma?
.
A. Asbestos exposure
B. Smoking
C. Radon exposure
D. Silica exposure

A

A. Asbestos exposure

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33
Q

What is the most common route of spread for tuberculosis (TB) within the body?
.
A. Hematogenous spread
B. Lymphatic spread
C. Direct extension
D. Inhalation

A

A. Hematogenous spread

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34
Q

What is the underlying mechanism of hypercalcemia in sarcoidosis?
.
A. Increased intestinal absorption of calcium
B. Increased bone resorption
C. Increased renal reabsorption of calcium
D. Increased production of 1,25-dihydroxy vitamin D by activated macrophages

A

D. Increased production of 1,25-dihydroxy vitamin D by activated macrophages

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35
Q

Which of the following is considered a hypertensive emergency?
.
A. Blood pressure > 180/120 mmHg without symptoms
B. Blood pressure > 180/120 mmHg with evidence of acute end-organ damage
C. Blood pressure > 160/100 mmHg with headache
D. Blood pressure > 160/100 mmHg without symptoms

A

B. Blood pressure > 180/120 mmHg with evidence of acute end-organ damage

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36
Q

Which of the following is the most common cause of a transudative pleural effusion?
.
A. Congestive heart failure
B. Pneumonia
C. Pulmonary embolism
D. Malignancy

A

A. Congestive heart failure

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37
Q

Which of the following is a key principle of motivational interviewing?
.
A. Direct confrontation
B. Emphasizing autonomy
C. Providing unsolicited advice
D. Highlighting discrepancies

A

B. Emphasizing autonomy

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38
Q

During which phase of the cardiac cycle does coronary artery perfusion primarily occur?
.
A. Early systole
B. Mid systole
C. Early diastole
D. Mid diastole

A

C. Early diastole

39
Q

Which of the following spirometry findings is most likely in a patient with severe kyphosis?
.
A. Obstructive pattern
B. Restrictive pattern
C. Mixed obstructive and restrictive pattern
D. Normal spirometry

A

B. Restrictive pattern

40
Q

The Ann Arbor classification is used for staging which type of cancer?
.
A. Breast cancer
B. Lung cancer
C. Lymphoma
D. Colon cancer

A

C. Lymphoma

41
Q

Which disease is caused by Coxiella burnetii?
.
A. Q fever
B. Tularemia
C. Brucellosis
D. Leptospirosis

A

A. Q fever

42
Q

Which of the following movements is primarily facilitated by the supraspinatus muscle?
.
A. Shoulder abduction
B. Shoulder adduction
C. Shoulder internal rotation
D. Shoulder external rotation

A

A. Shoulder abduction

43
Q

Damage to the ulnar nerve most commonly results in which of the following symptoms?
.
A. Wrist drop
B. Claw hand deformity
C. Loss of forearm pronation
D. Loss of shoulder abduction

A

B. Claw hand deformity

44
Q

Injury to the radial nerve typically results in which of the following clinical signs?
.
A. Wrist drop
B. Claw hand deformity
C. Loss of thumb opposition
D. Loss of elbow flexion

A

A. Wrist drop

45
Q

Which of the following conditions is associated with Gorlin syndrome?
.
A. Basal cell carcinoma
B. Melanoma
C. Squamous cell carcinoma
D. Merkel cell carcinoma

A

A. Basal cell carcinoma

46
Q

Which genetic mutation is most commonly associated with hypertrophic cardiomyopathy
(HCM)?
.
A. MYH7
B. CFTR
C. BRCA1
D. FBN1

A

A. MYH7

47
Q

Which of the following is a hallmark feature of alopecia areata?
.
A. Scarring
B. Circular patches of hair loss
C. Diffuse hair thinning
D. Scaly skin

A

B. Circular patches of hair loss

48
Q

Which of the following is a common feature of primary ciliary dyskinesia?
.
A. Recurrent sinopulmonary infections
B. Hemolytic anemia
C. Thrombocytopenia
D. Hypercalcemia

A

A. Recurrent sinopulmonary infections

49
Q

Which of the following conditions is commonly associated with primary ciliary dyskinesia (PCD)?
.
A. Hypoglobulinemia
B. Hypothyroidism
C. Hypocalcemia
D. Hyponatremia

A

A. Hypoglobulinemia

50
Q

Which of the following conditions is characterized by a honeycombing pattern on
high-resolution CT?
.
A. Chronic obstructive pulmonary disease (COPD)
B. Connective tissue disease-associated interstitial lung disease (CTD-ILD)
C. Idiopathic pulmonary fibrosis (IPF)
D. Sarcoidosis

A

C. Idiopathic pulmonary fibrosis (IPF)

51
Q

In a randomized controlled trial, what is the primary purpose of randomization?
.
A. To ensure the study is double-blind
B. To eliminate selection bias
C. To maximize the sample size
D. To increase the study’s power

A

B. To eliminate selection bias

52
Q

Which of the following is the most common cause of papilloedema?
.
A. Optic neuritis
B. Increased intracranial pressure
C. Glaucoma
D. Retinal detachment

A

B. Increased intracranial pressure

53
Q

Which of the following conditions is commonly treated with doxycycline?
.
A. Streptococcal pharyngitis
B. Lyme disease
C. Herpes simplex infection
D. Influenza

A

B. Lyme disease

54
Q

Which of the following conditions is most commonly associated with thymoma?
.
A. Myasthenia gravis
B. Multiple sclerosis
C. Guillain-Barré syndrome
D. Amyotrophic lateral sclerosis

A

A. Myasthenia gravis

55
Q

What is the recommended anticoagulation therapy for a patient with atrial fibrillation (AF)
who has recently had a stroke?
.
A. Aspirin
B. Warfarin
C. Clopidogrel
D. Rivaroxaban

A

D. Rivaroxaban

56
Q

What is the appropriate management for a patient two weeks post-ischemic stroke (cause was found to be atrial fibrillation) to prevent recurrence?
.
A. Dual antiplatelet therapy
B. High-dose statins
C. Anticoagulation therapy
D. Carotid endarterectomy

A

C. Anticoagulation therapy

57
Q

Which of the following is a common surgical treatment for chronic arterial stenosis?
.
A. Angioplasty with stent placement
B. Embolectomy
C. Bypass graft surgery
D. Endarterectomy

A

C. Bypass graft surgery

58
Q

Which of the following is a common characteristic of a neuropathic ulcer?
.
A. Painless
B. Irregular edges
C. Presence of granulation tissue
D. Bleeding easily

A

A. Painless

59
Q

Which of the following is a typical feature of acute pericarditis?
.
A. Pleuritic chest pain relieved by leaning forward
B. Midsternal chest pain worsened by exertion
C. Crushing substernal chest pain radiating to the left arm
D. Chest pain relieved by rest and nitroglycerin

A

A. Pleuritic chest pain relieved by leaning forward

60
Q

Which of the following structures is derived from the mesoderm?
.
A. Brain
B. Liver
C. Heart
D. Lungs

A

C. Heart

61
Q

Which approach is considered essential in motivational interviewing?
.
A. Offering direct advice
B. Using open-ended questions
C. Providing immediate solutions
D. Giving strict instructions

A

B. Using open-ended questions

62
Q

What is the primary indication for endovascular aneurysm repair (EVAR)?
.
A. Abdominal aortic aneurysm > 5.5 cm
B. Thoracic aortic aneurysm
C. Peripheral artery disease
D. Carotid artery stenosis

A

A. Abdominal aortic aneurysm > 5.5 cm

63
Q

Which heart valve is most commonly affected by infective endocarditis in the general
population?
.
A. Aortic valve
B. Mitral valve
C. Tricuspid valve
D. Pulmonary valve

A

B. Mitral valve

64
Q

Which heart valve is most commonly affected by infective endocarditis in intravenous
drug users?
.
A. Aortic valve
B. Mitral valve
C. Tricuspid valve
D. Pulmonary valve

A

C. Tricuspid valve

65
Q

What is the most appropriate management for an abdominal aortic aneurysm measuring
9 cm in a patient unfit for surgery?
.
A. Regular surveillance with ultrasound
B. Medical management with beta-blockers
C. Palliative care
D. Endovascular aneurysm repair (EVAR)

A

C. Palliative care

66
Q

What is the initial imaging modality of choice for suspected aortic dissection?
.
A. Chest X-ray
B. MRI
C. CT angiography
D. Echocardiography

A

C. CT angiography

67
Q

Which of the following conditions is commonly treated with TNF-alpha inhibitors?
.
A. Rheumatoid arthritis
B. Osteoarthritis
C. Gout
D. Systemic lupus erythematosus

A

A. Rheumatoid arthritis

68
Q

((Which antibiotic is recommended for prophylaxis in patients taking azathioprine?
.
A. Trimethoprim-sulfamethoxazole
B. Amoxicillin
C. Ciprofloxacin
D. Azithromycin))

A

A. Trimethoprim-sulfamethoxazole

69
Q

Which of the following is a characteristic feature of Acinetobacter infections in
hospital-acquired pneumonia (HAP)?
.
A. Rapid onset of symptoms
B. High resistance to multiple antibiotics
C. Exclusively affects immunocompromised patients
D. Commonly presents with cavitating lung lesions

A

B. High resistance to multiple antibiotics

70
Q

Which of the following best describes the principle of autonomy in medical ethics?
.
A. Acting in the patient’s best interest
B. Ensuring fair treatment of all patients
C. Respecting the patient’s right to make their own decisions
D. Doing no harm to the patient

A

C. Respecting the patient’s right to make their own decisions

71
Q

Which of the following is most likely the inheritance pattern of a severe bleeding disorder
affecting only males?
.
A. Autosomal dominant
B. Autosomal recessive
C. X-linked dominant
D. X-linked recessive

A

D. X-linked recessive

72
Q

Which of the following is a classic symptom of cauda equina syndrome?
.
A. Hemiplegia
B. Bilateral leg weakness
C. Unilateral leg pain
D. Foot drop

A

B. Bilateral leg weakness

73
Q

Which of the following prenatal tests is most commonly used to diagnose chromosomal
abnormalities in an unborn baby?
.
A. Ultrasound
B. Amniocentesis
C. Maternal blood test
D. Fetal MRI

A

B. Amniocentesis

74
Q

Which of the following conditions is most likely in a child presenting with acute hip pain
and a limp?
.
A. Septic arthritis
B. Slipped capital femoral epiphysis
C. Legg-Calvé-Perthes disease
D. Transient synovitis

A

D. Transient synovitis

75
Q

Which of the following is a typical feature of seborrheic keratosis?
.
A. Rapidly growing lesion
B. Verrucous surface
C. Bleeds easily
D. Painful on palpation

A

B. Verrucous surface

76
Q

What does anatomical deadspace in the respiratory system refer to?
.
A. Alveoli that are not perfused
B. Airways that do not participate in gas exchange
C. Lung tissue that has lost elasticity
D. Areas of the lung affected by infection

A

B. Airways that do not participate in gas exchange

77
Q

Which of the following best describes an exotoxin?
.
A. A toxin released upon cell lysis
B. A toxin secreted by living bacteria
C. A toxin that triggers an allergic reaction
D. A toxin that inhibits protein synthesis

A

B. A toxin secreted by living bacteria

78
Q

Which benefit is most commonly associated with attending a rheumatoid arthritis (RA)
support group?
.
A. Improved medication adherence
B. Enhanced physical therapy outcomes
C. Increased emotional support
D. Reduced need for surgical interventions

A

C. Increased emotional support

79
Q

Which of the following medications is used to prevent relapse in alcohol dependence?
.
A. Methadone
B. Naltrexone
C. Buprenorphine
D. Varenicline

A

B. Naltrexone

80
Q

Which echocardiographic finding is characteristic of mitral stenosis?
.
A. Enlarged left ventricle
B. Thickened mitral valve leaflets
C. Increased aortic root diameter
D. Reduced left atrial size

A

B. Thickened mitral valve leaflets

81
Q

Cognitive behavioral therapy (CBT) is most effective in managing which of the following
conditions in a teacher with chronic pain?
.
A. Anxiety related to pain
B. Structural spinal deformity
C. Acute infectious process
D. Nutritional deficiencies

A

A. Anxiety related to pain

82
Q

What is the primary indication for below-knee bypass surgery?
.
A. Chronic venous insufficiency
B. Peripheral artery disease with critical limb ischemia
C. Diabetic foot ulcer
D. Deep vein thrombosis

A

B. Peripheral artery disease with critical limb ischemia

83
Q

Which of the following is the hallmark of type 1 diabetes mellitus?
.
A. Insulin resistance
B. Autoimmune destruction of beta cells
C. Obesity-related pathophysiology
D. Increased C-peptide levels

A

B. Autoimmune destruction of beta cells

84
Q

What is the primary mechanism of action of ramipril?

A. Beta-adrenergic blockade
B. Calcium channel blockade
C. Angiotensin-converting enzyme inhibition
D. Diuretic effect

A

C. Angiotensin-converting enzyme inhibition

85
Q

Pulse pressure is defined as the difference between which two blood pressure
measurements?
.
A. Systolic and diastolic
B. Mean arterial and systolic
C. Mean arterial and diastolic
D. Systolic and mean arterial

A

A. Systolic and diastolic

86
Q

What is the characteristic finding in small vessel vasculitis?
.
A. Granulomatous inflammation
B. Immune complex deposition
C. Thrombosis of large arteries
D. Aneurysm formation

A

B. Immune complex deposition

87
Q

Which of the following is a primary benefit of mindfulness-based stress reduction?
.
A. Improved cardiovascular fitness
B. Enhanced cognitive function
C. Reduced stress and anxiety
D. Increased muscle strength

A

C. Reduced stress and anxiety

88
Q

What is the primary concern when a patient on methotrexate for rheumatoid arthritis
develops recurrent infections?
.
A. Methotrexate toxicity
B. Methotrexate-induced immunosuppression
C. Drug interactions with antibiotics
D. Ineffectiveness of methotrexate

A

B. Methotrexate-induced immunosuppression

89
Q

What is a key advantage of switching from warfarin to a direct oral anticoagulant
(DOAC)?
.
A. Increased need for regular monitoring
B. Reduced dietary restrictions
C. Lower cost
D. Longer half-life

A

B. Reduced dietary restrictions

90
Q

Which of the following deficits is most commonly associated with a middle cerebral artery (MCA) infarct?
.
A. Hemianopia
B. Hemiparesis
C. Ataxia
D. Diplopia

A

B. Hemiparesis

91
Q

Which of the following is a common cause of sinus bradycardia?
.
A. Hypothyroidism
B. Hyperthyroidism
C. Anemia
D. Dehydration

A

A. Hypothyroidism

92
Q

Elevated levels of Troponin I are most indicative of which condition?
.
A. Myocardial infarction
B. Congestive heart failure
C. Pulmonary embolism
D. Aortic dissection

A

A. Myocardial infarction

93
Q

In which situation is the use of an Epipen indicated?
.
A. Acute asthma attack
B. Severe allergic reaction
C. Hypertensive crisis
D. Hypoglycemic episode

A

B. Severe allergic reaction

94
Q

Which of the following is a common clinical feature of coarctation of the aorta?
.
A. Low blood pressure in the arms
B. High blood pressure in the legs
C. Rib notching on chest X-ray
D. Cyanosis in the upper extremities

A

C. Rib notching on chest X-ray

year 2 med (16 decks)

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