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4. SMLE (difficult Qs) > MEDICINE > Flashcards

MEDICINE Flashcards

1
Q 
Young Patient presented with migratory polyarthritis and subcutaneous nodules. What will confirm doagnosis?
A- High ESR
B- High CRP
C- blood culture 
D- ASO titre
A

D- ASO titre✅

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2
Q

Pt with signs of hyperprolactinemia , MRI shows 0.7 mm pituitary adenoma , what’s the TTT:
A. Surgery
B. cabergolinec

A

B. cabergolinec (Cabergoline is an ergot medication and works by blocking the release of prolactin from the pituitary gland.)

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3
Q

child with mild respiratory infection increase symptoms & fever, develop respiratory distress. Xray shows lobar infiltration, CBC shows low HB and high Retic.
A- SCA
B- Mycoplasma pneumonia
C- pneumococcal pneumonia

A

A- SCA

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4
Q

Patient RTA with head trauma, increased urine output , decrease in Urine osmolarity increased blood osmolarity?

A

Central diabetes insipidus

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5
Q

Campylobacter infection how to manage :

A

Azithromycin

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6
Q

HIV patient developing CNS problem what to give?
A. sulfadiazine and pyrimethamine
B. Sulfa stimulation of CNS

A

A. sulfadiazine and pyrimethamine

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7
Q

patient with cannon A waves and raised JVP asking about the mx?
A. ICD
B. Permanent pacemaker

A

B. Permanent pacemaker

3rd Heart block

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8
Q

pt medically free go to tooth extraction and pt develop petechial rash and Hb high+, erythropoietin low + Platelet high
A. myelofibrosis
B essential thrombocytopenia
c- polycythemia vera

A

c- polycythemia vera

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9
Q

29-SLE with arthritis on NSAID , hydroxychloroquine what to add?
A. Methotrexate
B. azathioprine.
C. cyclosporine

A

A. Methotrexate

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10
Q

Case of WPW management: Answer is: Tx for Wolff-Parkinson-White syndrome:
➔ Stable:
➔ Unstable:
➔ Refractory:

A

➔ Stable: procainamide
➔ Unstable: cardioversion
➔ Refractory: radiofrequency ablation

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11
Q

Hereditary hemochromatosis asymptomatic all liver enzymes normal and ferritin around 850 asked about Tx:
A. penicillamine
B. initiate therapeutic phlebotomy
C. follow up after 6 wk or months forget.

A

B. initiate therapeutic phlebotomy

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12
Q

infertility, recurrent sinusitis, semen analysis they found normal counts, but decreased motility. Chest x-ray show situs inversus. Dx?

A

kartagener’s syndrome

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13
Q

year old girl presents with lower abdominal pain, diarrhea and fever (38°C). She has mucus and blood mixed with her stool. The most likely organism is?

A

amebiasis

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14
Q

tenderness all over the tibial tuberosity ?

A

osgood-schlatter

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15
Q

progressive tremors interfering with writing and eating, head bobbing ?

A

Propranolol (Not Levodopa)

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16
Q

extraintestinal symptom of crohn disease ?

A

A- Erythema nodosum

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17
Q

Pt with DVT given thrombolytics and after that he developed bleeding , what reverse the action of streptokinase
A-vit k
B-activator of VIII
C-Aminocaproic acid

A

C- Aminocaproic acid ✅

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18
Q 
-Hyponatremia euvolemia with decrease sensorium mangmment : 
A- NS
B- Half NS
C- 5% dextrose
D- Hypertonic Saline
A

D- Hypertonic Saline

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19
Q

Which of the following a leukotriene antagonist -

A

Montelukast ✅

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20
Q 
40-year-old lady presented with dribbling urine with dysuria and dyspareunia. No surgical history. Which of the following is the most likely cause?
A- Stress incontinence
B- Urge incontinence
C- Urethral diverticulum 
D- Over flow incontinence
A

C- Urethral diverticulum ✅

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21
Q

she has pulmonary edema and s3 gallop=medications is considered safest for glycemic control of this patient?

A

SGLT2

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22
Q

Patient with neck pain radiate to the (((left shoulder))) and numbness of the arm?
A. Cervical stenosis
B. Long thoracic nerve

A

B. Long thoracic nerve

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23
Q

anaemia is seen in copper deficiency?

A

Sideroblastic

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24
Q 
25 yrs old male referred from orthopedic clinic with fragility fracture , he has sparse axillary and face hair . What inv . You will do ?
A: calcitonin
B: testosterone and gonadotropin
C: bone densitometry
D: TSH
A

B: testosterone and gonadotropin

Klinefelter syndrome

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25
Q 
patient lost sensation over medial side of leg but motor function is intact. Which nerve is injured?
A. obturator
B. femoral
C. saphenous 
D. sciatic
A

C. saphenous ✅

A IF ONLY THIGH

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26
Q

FDA approved drug for ttt of malignant induced hypercalcemia?
A-Alandronate
B-Denumab

A

B-Denumab

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27
Q

Female patient presented with lethargy Ct scan shows area of hypodensity in the frontotemporal lobe ?
A-herpes encephalitis
B-brain abs….

A

A-herpes encephalitis ✅

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28
Q 
best way to deliver oxygen in COPD pt? 
A. Mask
B. Nasal cannula
C. Venture bag ✅
D. Non-rebreather mask
A

C. Venture bag ✅

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29
Q

First line treatment for hep B ?

A

First line treatment for hep B is entacavir or tenovir or peglyated interferon If peglyated interferon and entacavir in choices go for entacavir

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30
Q

Associated with pulmonary tuberculosis?
A) Silicosis
B) Asbestosis
C) Anthracosis

A

A) Silicosis

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31
Q

Pt with no surgical Hx came with splinter hemorrhage what is the most causative organism?
Sterpt species
Staph epidirmisis

A

Strep A

  • if native or post dental procedure go with Viridans streptococci
  • s.aures: Most common cause of acute IE for all groups (including IV drug users and patients with prosthetic valves or pacemakers/ICDs)
    Affects previously healthy valves
    Usually fatal within 6 weeks (if left untreated)
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32
Q

MOST hepatotoxic one?

A

INH ✅

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33
Q

What symptom makes you suspect eosinophilic esophagitis the most?

A

prolonged chewing of food

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34
Q

productive cough and fever given antibiotics he become ok then worsen (SOB) sx x ray
show pleural effusion dx ?

A

para pneumonic effusion

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35
Q

Calcium pyrophosphate crystals ?

A

pseudogout

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36
Q

Medication to decrease ascites formation:
A) Thiazide
B) aldosterone antagonist✅
C) Loop diuretic

A

B)aldosterone antagonist✅

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37
Q

-chronic with hyperuricemia and negative birefringent urate crystal, how to manage ?

A

Probenecid ✅ ✔️ is a medication that increases uric acid excretion in the urine. It is
primarily used in treating gout and hyperuricemia.

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38
Q

4 year old male came with with fatigue “prolonged diarrhea” he drink goat milk and picky in his food
Labs :
Anemia with high MCV
What’s the diagnosis

A

giardiasis

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39
Q

Case of inferior MI present with clear lung sound, JVP ,hypotension not mentioned muffled sound and no murmur ?
A. Papillary muscle rupture (new murmur, cracklse….)
B. Right ventricular infarction
C. Cardiac tamponade

A

B. Right ventricular infarction

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40
Q

cluster headache ?

A

verapamil

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41
Q

Case of Parathyroid adenoma with hypercalcemia and low Phosphate, how to manage?

A

Rehydrate and diuretics ✅ )Diuretics = for sever hypercalcemia(

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42
Q

ICU patient developed abnormal thyroid function test (low TSH, low T4, low T3). What’s the diagnosis? And what lab highly indicates your diagnosis?

A
  • This is Sick Euthyroid Syndrome (SES) ✅

- Reverse T3 will be high ✅

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43
Q

Paper like cells of bone marrow ?

A

gaucher disease

44
Q 
Burning chest pain for 6 months increased at night and unpleasant taste when lifting heavy objects:
A. Esophagitis
B. Acute gastritis
C. Boerhaave syndrome 
D. Perforated peptic ulcer
A

A. Esophagitis

45
Q

ulcerative colitis ERCP done showed intra and extra hepatic bile duct strictures what is diagnosis ?

A

primary sclerosing cholangitis

46
Q

case of STMI and center doesn’t have PCI what will give this pt?
A. ASA streptokinase heparin BB
B. ASA streptokinase nitroglycerin BB
C. other choices I exclude BV was no streptokinase

A

ASA streptokinase heparin BB

47
Q

Cause of psoriasis (pathophysiology) ?

A

epidermal hyperproliferation

48
Q

case with flat T wave what you will find in the pt the :

A

hypokalemia

49
Q

DM, HTN, claudication after walk 200m, cold leg and pain there is pulse in femoral but no distal pulse. ECG show A.fib
What is the most appropriate (next step) management?
A. Heparin
B. CT angio
C. Duplex US

A

A. Heparin ✅

50
Q

Treatment on brucellosis not affect on cns ?

A
  • First-line therapy: doxycycline and rifampin for 6-8 wks.

- Second-line therapy: doxycycline and streptomycin

51
Q

Sharp, shooting pain of neck radiated to shoulder and jow dx?
A-Cervical disk prolapse
B. MS
C. rheumatica myalg

A

A-Cervical disk prolapse

52
Q

Patient with hyperlipidemia started on anti lipid then developed facial flushing, the doctors prescribed to him aspirin to relive this adverse effect:
A. niacin
B. Atorvastatin
C. cholestyramine

A

A. niacin

53
Q

Patient with duodenal ulcer had an endoscopic clipping of the ulcer he is doing well , what to give him?
A. Iv PPI for 24 hours then oral PPI
B. Iv PPI for 72 hours then oral PPI
C. High dose oral PPI

A

B. Iv PPI for 72 hours then oral PPI ✅

54
Q

Alcoholic with + babinski sign + blood smear was given ?

A

B12 deficiency

55
Q

Mollascum contagisum with picture and symptoms =

A

A-Suppurative (not antibiotic)

56
Q

bloody diarrhea biopsy shows transmural inflmation where is the most commen site ?

A

Ileum colon

its chron’s

57
Q

Which of the following is true regarding intssespicion
•A-Shock is the most common compilation
•B-Required surgery immediately
•C-Recuurence is common after surgery
•D-Enema should be carried in cases of peritonitis

A

•A-Shock is the most common compilation

58
Q

Prevalence of disease affect?
A) Specificity
B) Sensitivity
C) Predictive value

A

C) Predictive value

59
Q

Patient with nephrotic syndrome , abdominal pain what is the complication that happened?

A

Peritonitis (Peritonitis is a complication in nephrotic syndrome)

60
Q

Case of patient with past history of Tb presented with chest pain on examination elevated JVP, cardiac exam no murmur:
A. cor pulmonale
B. constrictive pericarditis

A

B. constrictive pericarditis

61
Q

autoimmune hepatitis lab?

A

elevated lgG

62
Q

65 y/o female with DVT which of the following factor indicate thrombophilia assessment?
A. Age
B. Hx of OCP
C. Connective tissue disease

A

C. Connective tissue disease

63
Q

history of kidney stone 2 weeks ago His labs showed hypercalcemia , hyperparathyroid , hypophosphatemia Urea and creatinine elevated What is the cause of hypercalcemia?

  • 1ry hyperparathyroidism
  • 2nry hyperparathyroidism
  • High 1,25 dihydroxycholecalciferol
A

-1ry hyperparathyroidism

64
Q

feels better when walking while leaning forward, ?

A

Spinal stenosis

65
Q

Boy with glomerulonephritis (hematuria), after week he developed hemoptysis what is the diagnosis?
A. henochschenolein purpra
B. good pasture syndrome

A

B. good pasture syndrome

66
Q

-women came to infertility clinic, her period every 45 days and now period in past 6 months lab show high TSH and high prolactin… what the cause?

A

hypothyroidism

67
Q

with inflammatory bowel dis resection of the lesion done fat – soluble supplements gut was resection?

A

Jejneum

68
Q

chron.s disease and have strictures it was single 1cm from the ileocecal valve?

A

Endoscopic dilatation

69
Q

Long scenario at the end the Patient had schistosomiasis , what do predict to be associated with ?

A

a) Pulmonary HTN ✅

70
Q

drug used for osteoporosis and malignancy AND bone metastasis??

A

Denosumab

71
Q

Long long case with ECG pic but in hx they mentioned yellow vision so its:

A

digoxin toxicity

also will cause hyperkalemia

72
Q

What is the parameter that indicate LV function?
A-CK
B-Troponin
C-BNP

A

C-BNP ✅

73
Q

patient had loss of sensation of lower ear lobe ear pinna and skin covering angle of mandible:

1) great oricular
2) lesser oricular
3) great occipital
4) lesser occipital i think

A

1) great oricular

74
Q 
Pt with history of recurrent vomiting for 2 weeks what is the expected metabolic abnormality:
A- Metabolic Acidosis
B- Metabolic Alkalosis 
C-Compensated Metabolic acidosis 
D- Compensated Metabolic Alkalosis
A

B- Metabolic Alkalosis

75
Q 
scenario about a man with epilepsy poor controlled, have productive cough and fever, Asked about what the source of infection?
A- Aspiration 
B- TB
C- Infectious mononucleosis 
D – Pneumonia
A

A- Aspiration ✅

76
Q

Young female has jaundice , leathergy , arthralgia , on labe result high LFt and ((((alkaline phosphatase)))) What is the diagnosis ?
A. Autoimmune hepatitis
B. Primary biliary cirrhosis

A

B. Primary biliary cirrhosis

77
Q

Crohn’s with vomiting for 10 days
Patient develop refractory hypokalemia despite adequate replacement with KCL
A- IV Mg sulfate
B- spironolactone

A

A- IV Mg sulfate ✅

Note = To correct the Hypomagnesemia

78
Q

SLE ask about diagnostic test:

A

anti dsDNA

79
Q 
What is an Euthyroid Sick Syndrome? 
A-elevated T4,T3, revers T3 
B-elevated T4,T3, low reverse T3 
C-low T4, T3, revers T3
D-Normal T3 reserve and low T3,T4
A

D-Normal T3 reserve and low T3,T4

80
Q

Old with productive cough , Fever ,Dyspnea +crepetion + bilateral right middle lobe Cold agglutination test postive ?

A

Atypical pneumonia

81
Q

Interstitial pneumonitis” is a pathologic hallmark for:

A

Viral pneumonia

82
Q

pt has chron since 3 m he sterted on striod and pentasa from 3 weeks , he is complaing of anal discharge and fistula what is the give hem?
A- Metho
B- Azathioprine
C- infliximab

A

C- infliximab

83
Q

Hepatic cirrhosis due to hepatitis B + ascites + lower limbs edema + basal lung crepitations + slight hypoalbuminemia + good renal function. Management ?
A.Furosemide + spironolactone
B. Terlipressin + albumin
C. Paracentesis

A

A.Furosemide + spironolactone

84
Q

Female patient who has dizziness when standing and noticed a scar on the back of the hand that is getting darker( only these symptoms) , how to confirm?
A. Cortisol level
B. synacthen test
C. suppression test

A

B. synacthen test ✅

addison = adrenal insufficiency
low na
hugh k

85
Q

female child with breast tissue engorgment, congenital adrenal hyperplasia excluded, has adult like features, what investigation?

A

A- pelvic us

86
Q

seizure and low Na and high osmolarity in urine?.

A

SIDAH

87
Q

Which one is the only approved in helping quit smoking?
A-hypnosis
B-Varenicline
C- BICOM

A

B-Varenicline ✅

88
Q

Old patient, parkinsonism + visual hallucinations. Diagnosis?

A

Lewy Body Dementia

89
Q

case of multiple gastroduodenal ulcers with UGIB, asking about what lab test to do:

1) fasting gastrin
2) VIP

A

1)fasting gastrin ✅

90
Q

Confirmatory test for Subclinical thyroiditis ?

A

HIGH TSH.

Thyroid function tests

  • Thyrotoxic phase: ↑ T3 and T4 , ↑ thyroglobulin, ↓ TSH
  • Hypothyroid phase: ↓ T3 and T4, ↑ TSH
91
Q

Most common organism causing lobar pneumonia ?

A

Strept pneumoniae

92
Q 
bone resorption asking about the cause, they gave increased PTH and Ca + high phosphate?
A-2ry hyperparathyroidism
B-parathyroid cancer 
C-parathyroid adenoma
D-Tertiary hyper parathyrioidism
A

D-Tertiary hyper parathyroidism

93
Q

patient had MI 2 wk ago and PCI were done and discharged, came back with pale , cold limb swelling Dx?
A- DVT
B- acute ischemic emboli
C- chronic ischemic thromboembolism

A

B- acute ischemic emboli ✅

94
Q
  • Female with 3 wks hs of productive cough With decrease both FEV and ratio, What other finding?
    A. Increase lung compliance
    B. Decrease lung compliance
    C. Increase air way resistant
A

C. Increase air way resistant ✅✅

95
Q

Most nephrotoxic anti TB?

A

Rifampicin ✅

96
Q
  • Primary PTH

- 2ndary PTH

A
  • Primary PTH: High Ca, Low Po4
  • 2ndary PTH: Low Ca, High Po4 or both normal
  • 3ary PTH: High all
97
Q

Diabetes patient with severe unilateral knee joint pain, on exam it’s erythematous, swollen, warm. patient has fever, joint aspiration shows I think 55.000 wbc Culture was negative , crystals still pending. Diagnosis?
A-Gout
B- Septic arthritis

A

B- Septic arthritis ✅

98
Q

Patient is caucasian and symptoms started when he was introduced to regular food Patient has no history of drug use or alcohol drinking, presented with vomiting, diarrhea and jaundice. Which of the following indicates her infection?
A. HAV IgM
B. HAV IgG

A

A. HAV IgM

99
Q

long scenario about female that complain of non-pitting edema , what is the initial test you will order ?

A. Venous duplex
B. CTA
C. MRA

NOTE:
The same Q but he said what is the best investigation?

A

A. Venous duplex

then best is Lymphoscintigraphy

100
Q 
55 years old, male , have a family history of diabetes, HgA1C is 6.3 fasting 7.3 what will you do next?
A. Random glucose
B. Fasting after 3months
C. HgA1C after 6weeks 
D. 2 hours glucose ✅
A

D. 2 hours glucose

101
Q

hepatitis c type 4 management ?

A

A-Sofosbuvir / Ledipasivr

102
Q 
66 years old patient come with progressive difficulty breath. In history he is being treated for bronchogenic carcinoma. In P/E: JVP elevated, lung clear and heart sound very quiet. What’s the confirmatory investigation?
A. CXR
B. ECHO
C. ECG
D. ABG
A

B. ECHO

103
Q

Case of a cancerous pt did multiple pleural tap due to pleural effusion with no improvement, next?

A

Chemical pleurodesis.

104
Q

pt will go for renal dialysis what the most common cause of death?

A

Cardiac disease

105
Q 
30 Y.O female with jaundice and yellow sclera started 2 weeks ago. No flapping tremor or stigmata of liver failure. LFTs: High AST(1400), ALT(1300), GGT (70?), Bilirubin High direct and. Indirect. US: biliary strictures and dilatation. Next step in management?
A. discharge with F/U.
B. admit and start iv dextrose. 
C. order PT & INR 
D. refer to liver transplant
A

C. order PT & INR ✅

106
Q

Schistosoma mansoni case, cardiac or pulmonary complication but can’t recall the details. Best diuretic for ascites?
A-Loop.
B-thiazide
c-osmotic

A

A-Loop.

4. SMLE (difficult Qs) (6 decks)

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