Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MBBS VI Medicine > M24 MCQ > Flashcards

M24 MCQ Flashcards

1
Q

A 25 year-old girl presents with chest pain for 2 days. ECG shows sinus tachycardia and ST elevation in anterior, lateral and inferior leads. What is the diagnosis?

A. Aortic dissection
B. Acute pericarditis
C. Pulmonary embolism
D. Takotsubo cardiomyopathy

A

B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the characteristic feature of cardiac apex beat exhibited in mitral stenosis?

A. Tapping and displaced
B. Displaced
C. Tapping
D. Heaving

A

C (due to loud first heart sound)

heaving apex (aortic stenosis, systemic hypertension, coarctation of aorta, HOCM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which of the following is the indication of intravenous thrombolytic therapy in pulmonary embolism?

A. S1Q3T3
B. Elevated troponin
C. Hypotension
D. Persistent chest pain

A

C. haemodynamically significant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Man presented with MI. Blood test shows hyperlipidemia with low density lipoprotein (LDL) 7.6. What feature is the most suggestive of familial hypercholesterolemia?

A. Arachnodactyly
B. Eruptive xanthomata
C. Lipaemia retinalis
D. Tendon xanthomas

A

D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Man present with chest pain 5h of onset. ECG ST depression and T wave inversion over II III aVF. Troponin was elevated.

What is the most appropriate oral therapy?

A. Aspirin only
B. Aspirin and CCB
C. Aspirin and nitrate
D. Aspirin and ticagrelor

A

D (C/I for nitrate use in inferior/RV involvement as will cause vasodilation and reduced preload causing reduced cardiac output and hypotension)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

21 year old girl, vasovagal syncope. Positive tilt table test. refractory to non-pharmacological intervention. What drug to prescribe?
A. Beta blocker
B. ACE inhibitor
C. Midodrine
D. Anticholinergic

A

C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which of the following antibiotics is bactericidal?
A. Chloramphenicol
B. Tetracycline
C. Macrolide
D. Vancomycin

A

D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which of the following about analgesic is true?
A. Aspirin is preferred in child
B. Codeine is an analgesic but it causes constipation
C. NSAID is disease modifying in rheumatic arthritis
D. Paracetamol is not useful in osteoarthritis as it has no anti-inflammatory effect

A

Ans: B

A: reye syndrome
D: paracetamol is COX3 inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Allergic contact dermatitis
A. Skin patch test is used
B. Skin prick test is used
C. Correlates with duration and volume of irritant
D. Is associated with allergic rhinitis and asthma

A

A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which of the following has palpable purpura?
A. Acute meningococcaemia
B. Thrombocytopenia
C. Warfarin overdose
D. Scurvy

A

D

Non palpable purpura typically indicates bleeding caused by a platelet or coagulation disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Treatment of tinea unguium includes the following except
A. Terbinafine
B. Itraconazole
C. Amphotericin
D. Griseofulvin

A

C (amphotericin is only available in IV preparations)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

You are a community geriatrics doctor. Recently, many patients come to ask you about how they can reflect their wishes to withdraw treatment when they no longer have the capacity to do so in the healthcare setting. What can they do?
A. Participate in advance care plan and sign advanced directive
B. Write to Guardianship Board and apply for legal guardianship
C. Enduring power of attorney
D. Find a lawyer and sign her will

A

A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Multidisciplinary team meeting to discuss switching from curative to palliative treatment for a cancer patient, which of the following principles is LEAST relevant in the discussion? (pp also?)
A. Autonomy
B. Medical futility
C. Non maleficence
D. Right to die

A

D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Bronchopneumonia, SIADH picture. First line treatment?
A. Fluid restriction
B. Vasopressin antagonist
C. Hypertonic saline
D. NaCl capsule

A

A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

LDL 2.8 patient on statin, which of the following is an indication to step up statin treatment?

A. Carotid stenosis
B. Fatty liver
C. Hyperthyroidism
D. Hypothyroidism

A

Ans: A

Hypothyroidism with high LDL use thyroxine to mx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

A case of adrenal incidentaloma. Blood tests were done to exclude functionality. What imaging modality would be used to follow up the patient if previous adrenal workup abnormal? (<- rmb abnormal ah)
A. Sestamibi scan
B. MIBG
C. MRI pituitary
D. USG adrenals

A

B. MIBG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Man develops epilepsy after road traffic accident, and he worries about it causing growth hormone deficiency (what an educated man…), which of the following dynamic tests is contraindicated?

A. Glucagon test
B. Insulin tolerance test
C. Macimorelin test
D. Exercise test

A

B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which DM drug is associated with facial puffiness after taking it?
A. GLP1 agonist
B. SGLT2 inhibitor
C. TZD
D. DPP4 inhibitor

A

Ans: C (TZD induced fluid retention)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

ALT 120 (2x ULN) in a background of asymptomatic chronic hep B. What additional investigation is the most appropriate for management?
A. Liver USG
B. Recheck LFT in 2 weeks
C. HBV DNA
D. HBeAg

A

Ans: C (when LFT >UL and DNA >2000 need antiviral)

Indications for oral antiviral therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

40 Tx for mild ulcerative proctitis
A. azathioprine
B. mesalazine suppository
C. infliximab
D. Systemic corticosteroids

A

Ans: B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Known chronic hep B, presents with fresh haematemesis. Hb currently at 9.2. OGD did not reveal fresh blood, showed 2 grade II oesophageal varices with red wale sign. What is subsequent Mx.
A. Endoclip haemostasis
B. Blood Transfusion
C. Non-selective beta blocker
D. Cyanoacrylate injection

A

Ans: C (secondary prevention of rebleeding of esophageal varices)

Endoclip haemostasis is used for ulcers. Banding for varices.

22
Q

40/M LFT only shows modestly elevated ALT and GGT. Other LFT normal
A. Fatty liver disease
B. Alcoholic hepatitis
C. Wilson’s disease
D. ?Chronic Hepatitis B

A

A (NASH: abnormal LFT)

23
Q

LFT interpretation, no clinical picture given
GGT 600 ALP 200
AST 300 ALT 100
A. Alcoholic hepatitis
B. Primary biliary cirrhosis
C. Biliary stone
D. Hepatitis B

A

A

24
Q

45/M. 20-year history of heavy drinking, presents with abdominal distension.
INR 1.3. Bilirubin 42. Albumin 29.
GGT 800. ALP 100. ALT 70? AST 140?
Which is correct?
A. FFP always needed before paracentesis
B. Consider referral to deceased donor liver transplant
C. Consider oral benzodiazepine
D. Oral corticosteroids contraindicated

A

C

25
Q

Man with chronic hep B has MCD nephropathy and is prescribed 45 mg prednisolone
A. Prescribe entecavir right away
B. Check liver enzymes then prescribe entecavir if ALT > 2x upper limit of normal
C. Check HBV DNA and prescribe entecavir if HBV DNA increases by more than 10-fold
D. Check HBV DNA and if positive then switch to tacrolimus

A

A (high chance of reactivation due to immune suppression)

26
Q

Old lady with memory loss in a short period of time, also has symptoms of fall and movement problems. PE shows cogwheel rigidity and tremor. What is the diagnosis?
A. Lewy body dementia
B. Vascular dementia
C. Alzheimer’s disease
D. Frontotemporal lobe dementia

A

A

27
Q
  1. An old lady living alone and could manage all her activities all along. She had diabetes for many years and require oral medications and self injection of insulin. However, this time she was admitted to hospital for hyperglycaemia. Patient’s son went to her home and found multiple packs of medicine medications and insulin in patient’s own drawer of ~ 3 months amount. What is the most appropriate diagnosis?
    Dementia
    Mild cognitive impairment
    Subjective memory loss
    Delirium
A

A (as there is instrumental ADLs affected)

28
Q

Old lady observed by her husband to have recurrent episodes of loss of consciousness, with eye uprolling, incontinence, tongue biting. Remain confused for 2 hours after regaining consciousness. Her CT brain only mild cerebral atrophy. What is the next investigation?
A. EEG
B. Holter
C. Carotid doppler
D. MRI brain

A

A

29
Q

68/F presents with SOB. After investigations, she was found to have severe aortic stenosis planning for aortic valve replacement. Pre-op blood work showed isolated prolonged APTT with normal CBC, WBC, platelet. No inhibitor was found in mixing study. What’s the most likely diagnosis?
A. Acquired haemophilia A
B. Acquired vWF deficiency
C. Inherited XIII deficiency
D. Lupus anticoagulant

A

B

30
Q

Which of the following is associated with Return traveller diarrhoea?
A. Acinetobacter baumanii
B. Mycobacterium avium complex
C. Mycoplasma pneumoniae
D. Plasmodium falciparum

A

D

31
Q

In typhoid fever (pp)
A. Relative bradycardia
B. Frequently bloody diarrhoea
C. No vaccines available
D. Caused by Salmonella paratyphi

A

Ans: A (pulse temperature deficit and caused by salmonella typhi)

32
Q

Dengue haemorrhagic fever is associated with which of the following? (m23 pp)
A. Marked thrombocytopenia
B. Long incubation period (3 months)
C. Subsequent infection by the same serotype
D. Transmitted by Anopheles mosquitoes

A

Ans: A

Incubation period commonly 4-7 days
Dengue hemorrhagic fever due to infection of another serotype

33
Q
  1. 68/F with Whipple one week ago and she is currently on TPN. She developed confusion. Clinically she is dehydrated, BP 92/56, Pulse 110 BPM, RR 26 SaO2 98%, on 1L O2. Random blood glucose 36 (ref 11). Which of the following?

A. HyperK, hyperNa, metabolic acidosis
B. HypoK, hypoNa, metabolic acidosis
C. HyperK, hypoNa, respiratory acidosis
D. HyperK, hyperNa, respiratory acidosis

A

A. hyperNa, hyperK metabolic acidosis
DKA (metabolic acidosis) –> dehydration –> Na will be high due to loss of water
Hence correct the hydration status and hyperK to prevent TdP –> VF

34
Q
  1. 62/M essential hypertension, on thiazide, now present with generalized malaise. what is his electrolyte and ABG
    A. HyperK, hyperNa, metabolic acidosis
    B. HypoK, hypoNa, metabolic alkalosis
    C. HypoK, HypoK, respiratory acidosis
    D. HypoK, hypoNa, respiratory acidosis
A

B. (thiazide causes hypoK, hypoNa metabolic alkalosis)
decrease Na reabsorption –> increase in fluid loss in urine. Increased excretion of K and HCO3-.

35
Q
  1. 72/F ESRD with CAPD , abdominal pain and cloudy dialysate, afebrile and stable hemodynamics
    A. Intraperitoneal Augmentin
    B. Intraperitoneal cefazolin and ceftazidime
    C. Intraperitoneal vancomycin
    D. IV Augmentin
A

B

36
Q
  1. F/68 CKD and IgA nephropathy. Recently present with mild SOB.
    Hb9
    K 5.1
    Ca 2.23
    PO4 1.6x

Ferritin 110 ng/mL
Transferrin 26%

On losartan sevelamer statin amlodipine

What’s the management?
A. 1,25 OH vit D
B. EPO/ ESA
C. Aluminum hydroxide
D. stop losartan

A

B

Serum ferritin should exceed 100ng/ml and iron saturation >20% before EPO is considered in CKD patients

37
Q
  1. 50/F presents with ?SOB. Periorbital puffiness… Hx of bipolar affective disorder on lithium. Known hep C carrier. No hep B.
    Urine: protein 4+, no blood
    Blood: albumin 18. Na: 135. Serum creatinine: ?107. HCV Ab +ve with low level of HCV RNA. HBV -ve. RF -ve.
    A. Cryoglobulinemia
    B. Minimal change disease
    C. Membranoproliferative glomerulonephritis
    D. Nephrogenic diabetes insipidus
A

C

38
Q

Man Crush injury, given frusemide 40mg an hour ago, oliguria with only 30mL over the past 6 hours
K 6.x, high PO4?, high CK Plz help supplement
rhabdo picture, mx
A. Haemodialysis
B. Give fruesmide infusion 10mg every hour
C. PD
D. ??

A

A

39
Q

Common side effect of levodopa
A. Depression
B. Oculogyric crisis
C. Postural hypotension
D. Restless leg syndrome

A

C

40
Q

Empirical Abx for bacterial meningitis
A. IV ceftriaxone
B. IV vancomycin
C. IV ampicillin

A

A

41
Q

35/F Prominent neck pain and left sided hemiplegia. No fever, no headache.
A. Cervical artery dissection
B. Cerebral venous thrombosis
C. TB meningitis
D. Hemiplegia migraine

A

A

42
Q

Most likely clinical picture of a patient with mid thoracic transverse myelitis (time from symptom onset not specified)
A. Bilateral positive Babinski
B. Bilateral foot drop
C. Bilateral ankle hyporeflexia
D. Bilateral UL hyperreflexia

A

A

43
Q

Right facial weakness and right upper limb weakness. No dysphagia, aphasia, vision involvement. No cerebellar signs. (pp)
A. Left internal capsule
B. Midbrain
C. Pons
D. Medulla

A

A

44
Q

Massive paracetamol overdose is most commonly associated with:
A. Heart failure
B. Liver failure
C. Kidney failure
D. Pancytopenia

A

B

45
Q

M/45 presenting with fever, cough and greenish sputum for 1 week. CXR showed LUL consolidation. Sputum microscopy found WBC+++ and Gram positive organism. Urine pneumococcal antigen was detected. He has history of penicillin allergy. Which antibiotics should be prescribed?
A. Augmentin
B. Ceftazidime
C. Levofloxacin
D. Metronidazole

A

C

46
Q

F/77 with history of hypertension and DM treated with amlodipine, ramipril, gliclazide and metformin presented with nausea and dizziness. ABG was done: pH 7.06, PaO2 11.2, PaCO2 3.8, HCO3 8, BE -19. Which is the culprit drug?
A. Amlodipine
B. Ramipril
C. Metformin
D. Gliclazide

A

C

47
Q

Woman with SLE on prednisolone and MMF has fever sputum and shortness of breath, CXR showing bilateral diffuse reticular shadows, nurse discovers that the saturation decreases when she goes from recumbent to sitting, which empirical should u give? (pp)
A. Augmentin
B. Co-trimoxazole
C. Azithromycin

A

B

48
Q

Patient presents with Raynauds phenomenon and is on multiple meds. Which is possibly responsible?
A. Indapamide
B. Inderal
C. Losartan
D. Prazosin

A

Ans: B (propranolol)

49
Q

76/M with HTN and DM, now AF, echocardiogram showed normal heart structures. Which drug to prevent cardio-embolic stroke?

A. Apixaban
B. Warfarin
C. Clopidogrel
D. Aspirin

A

A

50
Q

Food-dependent exercise-induced anaphylaxis, which test to identify the culprit allergen?
A. Intradermal test
B. Skin patch test
C. Skin prick test
D. Specific IgG food panel

A

C

MBBS VI Medicine (98 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions