SMLE 11 (medicine) Flashcards
1
Q
- hematemesis with abdominal pain first time no previous symptoms no medical hx no medication , all lab normal, dx?
A. Gastritis ,
B. peptic ulcer,
C. immune hepatitis,
D. mallory weiss
A
B. peptic ulcer
2
Q
- 36 male presented with hypertension (high blood pressure reading given) he have a family history of hypertension and both his sisters have hypertension
He have high ceriatinin and protein in urin
How will you manage?
A. ACEI
B. alpha blocker
C. beta blocker
D. ?
A
A. ACEI
3
Q
- pf after PE stared on heparin ..labs show prolong PT and PTTT
A. stop and give …?!(i forget the drug name but start with L!)
B. continue
C. switch to theraputic dose of enoxaprin
D. stop and !!!
Better recall: Case of P.E and recieve heparin after days give labs All normal except
platelet 80 PTT elevate Wts next?
A. Stop heparin and give Lepirudin
B. Give LMW
C. Increse heparin
A
A. Stop heparin and give Lepirudin
4
Q
- a case of child after brain surgery
Na177 i forget the exact lab for urin
A. central DI
B. SIADH
C. ?
A
A. central DI
5
Q
- diabatic pt and obese (i think bmi was 41 )failed to reduse weight
A. diabetic drug for reducing weight
B. bariatric surgery
A
B. bariatric surgery
6
Q
- female presented with left knee pain for 3 days there is swelling and fever
Labs showed slighty high wbc and ESR high
Joint aspiration showed leukocytosis i think 200
X ray left knee showed decreased joint space and osteophyte
Diagnosis
A. septic arthritis
B. osteoarthritis
C. gout
D. rheumatoid arthritis
A
A. septic arthritis
7
Q
- 60somthing female presentes after long travel with car for 5 hours with SOB
A. pericarditis
B. PE
C. -?
A
B. PE
8
Q
- 7yrs old with rash on her cheeks and joints pain and anima what the most
specific test regarding her disease activity
A- anti ccp
B- bnp
C- ANA
D- Anti dna ds
A
D- Anti dna ds
9
Q
- Old man says he sometimes forgets his friends’ names or celebrities in his
community. His wife is worried he has Alzheimer’s.?
Other recall: old man with tender joints, forgets his friends’ names, his wife is
worried , what diagnosis ?
A- Alzheimer’s
B- Benign-forgetfulness
A
B- Benign-forgetfulness
10
Q
- Young male had pharyngitis, then cough and fever, what is the most
likely organism?
a) Staph aureus
b) Streptococcus pneumonia
A
Group A streptococcus (streptococcus pyogenes) is the most common
causative organism.
11
Q
- DM obese on life modifications his A1c 8 what to add
A-dulaglutide is also GLP
B-DPP-4 inhibitors;
C-GLP-1 receptor agonists
D-SGLT2 inhibitors;
A
A-dulaglutide is also GLP
12
Q
- Patient with hyperthyroidism and palpitations, heat intolerance.tmt
A. Propriouracil
B. Methimazole????
C. Carbimaxole
D. Propranolol?????
A
D. Propranolol?????
13
Q
- unilateral neck swelling in the RT side by investigations : hot thyroid nodule
remaining of the gland cold TSH is low, T3, T4 high No LN enlargement (dx
hyperthyroidism toxic nodule) What is the initial Treatment?
A- antithyroid drug
B- RT thyroidectomy
C- Hemithyroidectomy
D- radioactive iodine
A
A- antithyroid drug
D- radioactive iodine صح
14
Q
- Hypothyroidism clear Hx and labs with low Na (it was 129) normal 134
What to do next ? - Levothyroxine
- treat the hyponatremia with hyper Na fluid
A
- Levothyroxine
15
Q
- A patient with renal failure presents with low calcium, high alkaline
phosphatase, and high PTH. What is the best form of vitamin D to give this patient?
A- Calcitriol
B- Vitamin D2
A
A- Calcitriol
16
Q
- Most effective method to decrease stone formation in pt with hypercalcemia
?
A. decrease ptn
B. thiazide
C. allopurinol
D. decrease calcium intake
A
B. thiazide
17
Q
- Pt with diffuse thyroid enlargement on exam there is 1 nodule in each lobe,
labs showed hyperthyroidism what will you do?
A. Thyroid scan.
B. FNA from both nodule
A
A. Thyroid scan.
18
Q
- 32 year old pregnant lady in 3rd trimester was complaining of palpitations
and sweating and heat intolerance along being restless she have notice a large
goiter but no dyspnea or difficult swallowing and change in both orbits that
became more prominent. ECG - sinus tachycardia. CBC -LFT - RFT within normal.
TSH 0.1 ( low ) , T4 10 ( high ). Thyroid Scan showed diffuse homogenous uptake.
Anti-Thyroid Stimulating Antibody is pending. what is your next step for
management ?*
A. Thyroidectomy
B. Radio-active Iodine Therapy
C. Methimazole
D. Propylthiouracil
A
C. Methimazole
19
Q
- A 72 year old man presented with an episode of right sided weakness that
lasted 10 minutes and fully resolved and he is clinically stable, he has no other
medical illness. On examination: BP 110/70, HR 95, T 36.6 Which of the following is
the most appropriate next step in the management?
A.Aspirin.
B. Warfarin, INR 3-4
C. Warfarin, INR 2-3
D. No additional drug treatment
A
A.Aspirin.
20
Q
- A 67 year old male is brought to the ED by his wife saying that he developed
weakness and dysarthria after he woke up. She says that he went to sleep having
no complaints, then woke up 2 hours later with symptoms of weakness and slurred
speach. O/E power 2/5 in left side and 5/5 on the right side. CT picture included
and shows hypodensity in the right hemisphere. What is the management?
A. clopidogrel
B. Aspirin
C. Thrombolytic
A
C. Thrombolytic
21
Q
- 65 year-old male patient k/c of DM, HTN and PAD, presented with severe
claudication, admitted to the hospital as a case of acute limb ischemia and received
thrombolytic therapy. Which of the following is a cause of death during hospital
admission?
A. Bleeding
B. Hemorrhagic stroke
C. Pulmonary embolism
D. Myocardial infarction
A
B. Hemorrhagic stroke
22
Q
- patient complaining of chest pain, diaphoresis and other symptoms of Ml that
started 2 hours ago. He has a history of ischemic stroke (2 months ago). what would
you give him next? ]
A. Thrombolytic Therapy
B. Aspirin
C. PCI
D. Statin
A
B. Aspirin
23
Q
- 50 years male returned from vacation ,drowsy, poor concentration,difficult
awaking from sleep ,he described multuple fulls but all labs and brain images are
free
A. Post concussion syndrome
B. Chronic subdural hemorrhage
A
A. Post concussion syndrome
24
Q
- 9-month Hx of MI came to clinic for smoking cessation he was in respiratory
distress raised JVP nicotine tear in his hand what is the most appropriate drug?
A. Nicotine replacement therapy
B. Varenicline
C. Bupropion
A
B. Varenicline
25
66. 9-month Hx of MI came to clinic for smoking cessation he was in respiratory
distress raised JVP nicotine tear in his hand what is the most appropriate drug?
A. Nicotine replacement therapy
B. Varenicline
C. Bupropion
B. Varenicline
26
67. Pt with systemic sclerosis ..comes with fatigue and dizziness Bp188/90 Renal
impairment. What medications to add?
A.Lisinopril
B.Amilodipin
C. BB
A.Lisinopril
27
68. 70 old male with forgetfulness, progressive gradually for 2 years.. devolop
signs of aggression and violence after he was calm ,caring ,and kind:
A. Lewi body
B. Alzheimer’s
C. Vascular dementia
B. Alzheimer’s
28
70. 78y/o male presented with change level of consciousness and fever , lumber
puncture was doe show CSF gram +ve bacilli , hem catalase +ve , how will you
treat ?
A-ceftriaxone + vancomycin + steroid
B- ceftriaxone + ampicillin + vancomycin
C- ceftriaxone + vancomycin + ampicillin
D- ampicillin
D- ampicillin
29
72. In a patient with suspected transient Ischemic attack full recovery should take
place within:
A. 6 Hours
B. 12 Hours
C. 18 Hours
D. 24 Hours
E. 48 Hours
D. 24 Hours
30
78. What is the AB that use in ICU patient have pneumonia:
A. Vancomycin
B. Azithromycin
C. Ceftoxime
D. Amoxicillin
B. Azithromycin
C. Ceftoxime
31
80. A case of interstitial pneumonitis most commonly associated with?
A-Viral pneumonia
B- Lobar pneumonia
C- Bronchopneumonia
D-Secondary tuberculosis
VIRAL OR ATYPICAL
32
84. 80 year old smoker for 40 years , all labs normal except high Ca , Dx ?
A. paget dis
B. hyperparathyroidism
C. lung cancer
C. lung cancer
33
85. 32 non smoker presented with lung nodule 7 mm otherwise normal except
for ca 4 mmol :
A. Repeat CT scan within 3-6 months
B.Pulmonary funtion test
C. Biopsy of the lesion
D. PET scan
A. Repeat CT scan within 3-6 months
34
86. Copd patient his FEV1% is 39 he is on inhaled salbutamole (SABA) and
ipratropiam and still not controlled What to add ?
A. Inhaled salmeterol
B. Inhaled slameterol + Inhaled corticosteroid Long o2 therapy
B. Inhaled slameterol + Inhaled corticosteroid Long o2 therapy
35
87. COPD pt on high flow o2 3 L with O2 saturation 93% , develop acidosis and
hypercapnia, what will you do ? ]
A. Decrease O2 flow
B. Mechanical ventilation
C. Increase O2 flow
D. CPAP
A. Decrease O2 flow
36
89. Chronic kidney disease picture of iron def anemia and and high ferritin what is
the treatment ?
A Oral iron
B erythropoietin
C IV iron
B erythropoietin
37
92. Plt were low, PT&PTT&INR all normal, high bilirubin and reticulocytes and low
Hb (indicates hemolysis), creatinine was normal, your management:
A.Steroids and IVIG
B. Exchanged transfusion
C. Platelet transfusion
B. Exchanged transfusion
38
93. 81 yo woman DM, HTN on medications at risk or known to have DVT asking
about prophylactic for DVT?
A. Aspirin 81 mg oral
B. Enoxaparin 40mg SC
B. Enoxaparin 40mg SC
39
94. Female c/o urine leakage with cough, sneezing, exercise and with urgency.
What type of incontinence does she have?
A. Urge incontinence
B. Stress incontinence
C. Mixed incontinence
D. Overflow incontinence
C. Mixed incontinence
40
95. 80 yr old male c/o inability to urinate with Abd. Pain and severe need of
urination What to do?
A. Cystoscopy
B. Emergency TURP
C. Foley cath + culture
C. Foley cath + culture
41
23. Female patient came to ER complaining of RUQ pain from 8h, the patient has
jaundice with fever of 37.9
Elevated WBC.
A. pancreatitis
B. cholangitis
C. Cholecystitis
....
42
29. RTA one lung dull to percussion
A- tension pneumothorax
B- massive hemothorax
C- pulmonary contusion
....
43
51. Patient with hyperthyroidism on anti thyroid medications for 10 months, still
symptomatic. TSH: 0.1 and T4 was 27 I think. Best next step?
A. Continue anti thyroid
B. Subtotal thyroidectomy
C. Near total thyroidectomy
D. RAI or increase the dose of drug
.... D. RAI or increase the dose of drug
44
77. Elderly had cough with white sputum that turned yellowish with
diffused infiltration bilaterally and more dense in right lung . Dx?
A. Atypical pneumonia
B. pneumococcal pneumonia
C. Viral pneumonia
....
45
79. What causes interstitial pneumonia / Interstitial pneumonitis?
A-Viruses
B- tuberculosis
C- bacteria (Atypical pneumonia)
....
