Internal Medicine MCQs (part 5)

Part 5:

1. Which of the following is least likely to cause infective endocarditis?
A. Staphylococcus albus
B. Streptococcus faecalis
C. Salmonella typhi
D. Pseudomonas aeruginosa
Correct answer : C. Salmonella typhi
Infective endocarditis is a rare complication of Salmonella typhi infection.

2. Sudden cardiac death may occur in all of the following except:
A. Dilated cardiomyopathy
B. Hypertrophic cardiomyopathy
C. Eisenmengers syndrome
D. Ventricular septal defect
Correct answer : D. Ventricular septal defect
VSD is the best answer among the options given

3. All of the following are true for mitral valve prolapse, except:
A. Transmission may be as an autosomal dominant trait
B. Majority of the cases present with features of mitral regurgitation
C. The value leaflets characteristically show myxomatous degeneration
D. The disease is one of the common cardiovascular manifestations of Marfan’s Syndrome
Correct answer : B. Majority of the cases present with features of mitral regurgitation
Features of Mitral valve prolapse:

Majority of patients are asymptomatic
Some present with non specific chest pain, dyspnoea, fatigue or palpitation
Myxomatous degeneration of heart valves is seen (mostly mitral valve)
Autosomal dominant pattern …

4. All of the following may be seen in patients of cardiac tamponade except:
A. Kussmaul’s sign
B. Pulsus paradoxus
C. Electrical alternans
D. Right ventricular diastolic collapse in echocardiography
Correct answer : A. Kussmaul’s sign
Kussmaul’s sign is seen in constrictive pericarditis.

5. All of the following may occur due to hyperkalemia except:
A. Prolonged PR interval
B. Prolonged QRS interval
C. Prolonged QT interval
D. Ventricular asystole
Correct answer : C. Prolonged QT interval

6. All of the following are risk factors for atherosclerosis except:
A. Increased waist hip ratio
B. Hyperhomocysteinemia
C. Decreased fibrinogen levels
D. Decreased HDL levels
Correct answer : C. Decreased fibrinogen levels
Atherosclerosis risk is increased with increase in fibrinogen levels.

7 .True regarding dengue fever
A. It is both epidemic and endemic
B. Most common arbo virus infection
C. Can survive in ambient temperature
D. Incidence is decreasing in India for past 2-3 decades
E. ??

8. True regarding cardiac tamponade is?
A. Kussumal sign positive
B. Widened mediastinum
C. Steep y descent absent
D. Pulsus alternans
E. Muffled heart sounds
Please contribute to the discussion by posting the answer with references and pointing out any errors in the question!

9. All of the following are major complications of massive transfusion, except:
A. Hypokalemia
B. Hypothermia
C. Hypomagnesemia
D. Hypocalcemia
Correct answer :A. Hypokalemia
Massive transfusions can cause hyperkalemia due to loss of potassium from the transfused red cells.

10. A patient with leukemia on chemotherapy develops acute right lower abdominal pain associated with anemia, thrombocytopenia and leukopenia. Which of following is the clinical diagnosis?
A. Appendictis
B. Leukemic colitis
C. Perforation peritonitis
D. Neutropenic colitis
Correct answer : D. Neutropenic colitis
Acute right lower abdominal pain in an immunocompromised patient after chemotherapy is characteristic of neutropenic colitis.