Internal Medicine MCQs (part 7)

Part: 7

1. A 45-year old woman underwent a modified radical mastectomy 4 years ago. She was treated for multiple bone metastases with cyclophosphamide, doxorubicin, and fluorouracil for 6 months. She is complaining of exertion on exercise, swelling of the legs, and swelling around eyes in the moming. On examination, she has
bilateral rales in the lungs, S1, S2 audible, S3, S4 gallop present. Her BP is 149/117 mm Hg, PR is 80/min, and RR is 18/min. What is the most likely cause for her cardiac condition?
a) Systolic dysfunction CHF
b) Drug induced cardiac toxicity
c) …

2. Which of the following statements is correct regarding adrenal histoplasmosis:
a) In active disease, calcification is commonly seen
b) Lymphadenopathy is not seen
c) The adrenal glands are usually symmetrically enlarged
d) Adrenal insufficiency is uncommon
Correct answer : c) The adrenal glands are usually symmetrically enlarged
Explanation : Adrenal histoplasmosis

3. Which of the following is not a B cell neoplasm?
a) Hairy cell leukemia
b) Angiocentric lymphoma
c) Mantle cell lymphoma
d) Burkitt’s lymphoma
Correct answer : b) Angiocentric lymphoma (All others are B cell neoplasms)
Read about angiocentric lymphoma here : Angiocentric lymphoma

4. A patient presents with a platelet count of 700 x 10(9)/L with abnormalitites in size, shape and granularity of platelets. WBC count of 12 x 10(9)/L, hemoglobin of 11g/dl and the absence of Philadelphia chromosome. The most likely diagnosis would be:
a) Polycythemia vera
b) Essential thrombocythemia
c) Chromic myeloid leukemika
d) Leukemoid reaction
Correct answer : b) Essential thrombocythemia

5. A 30-year old patient presented with history of jaundice for 10 days. His liver function tests showed bilirubin of 10mg/dl, SGOT/SGPT 1100/1450, serum alkaline phosphatase-240 IU. He was positive for Hbs Ag. What should be the confirmatory test to establish acute hepatitis B infection?
a) IgM Anti HBc antibody
b) HbeAg
c) HBV DNA by PCR
d) Anti HBc antibody
Correct answer : a) IgM Anti HBc antibody

6. The causes of systemic secondary insult to injured brain include all of the following except:
a) Hypercapnia
b) Hypoxaemia
c) Hypotension
d) Hypothemia
Correct answer : d) Hypothemia

7. A 30 year-old male presents with numbness of both lower limbs and right upper limb. Examination reveals pulse 88/minute and BP 160/110 mm of Hg. He also has digital gangrene involving right 2nd and 3rd finger. Urine routine examination is unremarkeable. Microscopic examination shows RBC’s Hemogram and serum
biochemistry is within normal limits. What is the most probable diagnosis?
a) Systemic lupus erythematosus
b) Polyarteritis nodosa
c) Malignant hypertension
d) Chrug-Strauss syndrome
Correct answer : b) Polyarteritis nodosa

8. All of the following are predominant motor neuropathy except:
a) Acute inflammatroy demyelinating polyradiculoneuropathy
b) Porphyric neuropathy
c) Lead intoxication
d) Arsenic intoxication
Correct answer : d) Arsenic intoxication

9. Which test is not useful in a patient with history of syncopal attack
a) Electrophysiological test
b) Table tilt test
c) PET scan
d) Holter monitoring
Correct answer : c) PET scan
Electrophysiological tests look for any defects in the signal generation and conduction in the heart, table tilt test checks for precipitation of syncope when the person is kept at abt 60 degree elevation for abt 20 minutes, Holter monitoring is used to check for any ECG abnormalities in a 24 hour period.
All these tests help in the evaluation of syncope whereas PET scan is …