Internal Medicine Comprehensive Quiz
Test your knowledge on Internal Medicine by answering the questions provided in this quiz.
1.
Erythrocyte sedimentation rate is markedly elevated in the following except:
2.
Which among these classes of anti hypertensives is considered nephroprotective, therefore preferred in patients with diabetes mellitus or chronic kidney disease?
3.
A microscopic picture is shown below. What is the diagnosis?
4.
The renal threshold for glucosuria is:
5.
Which of the following drugs is a first-line therapy for the treatment of acute exacerbations of chronic obstructive pulmonary disease (COPD)?
6.
Polycythemia vera is a disorder that results in:
7.
Aldosterone is secreted by:
8.
A 34 year old man presents to the emergency department with progressive abdominal pain localized to the left flank and radiating to his groin. He had no similar pain previously and is fit and well. Physiscal examination is unremarkable. What is the most suitable initial management?
9.
The strongest risk factor for development of asthma is?
10.
Which of the following is the most likely etiology of left-sided weakness in a HIV-positive patient whose brain CT scan shows multiple hypodense lesions?
11.
Indole positive, methyl red positive, citrate negative and Voges proskauer negative bacteria:
12.
Which of the following is not a chest xray finding in pulmonary edema?
13.
Which of the following lung cancers has a strong association with smoking, shows cavitation on imaging and is strongly associated with hypercalcemia as a paraneoplastic syndrome?
14.
A 45 year old previously healthy man has come for a physical examination. On examination you a grade II diastolic murmur is auscultated. He does not have chest pain, dyspnoea, edema, or any sycnopal or pre-syncopal episodes. On examination there are normal carotid pulses, a non-displaced apex beat and clear lung fields. EKG and Chest X-ray are normal. What is the best next step for investigating his murmur?
15.
Where are the most common drivers of atrial fibrillation anatomically located?
16.
In a patient with hypocalcemia, twitching of the facial muscles elicited by tapping the facial nerve below and in front of the ear is known as:
17.
A 45-year-old woman is admitted to the emergency room after a first episode of witnessed generalized tonic-clonic seizure. She is administered lorazepam 2mg with cessation of seizure activity. All of the following are likely possible causes of her seizure EXCEPT?
20.
Which is not a Vitamin K dependent clotting factor produced by the liver?
21.
Which of the following medications is commonly used as a first-line treatment for the management of type 2 diabetes mellitus?
22.
Ineffective erythropoiesis is characteristic of which one:
23.
Which antibody is commonly elevated in Waldenstrom macroglobulinemia?
24.
Which of the following is the most common mechanism for cardiac arrhythmia
26.
A patient suffered from nephrogenic systemic fibrosis (NSF) after gadolinium administration for an MRI. Which of the following is the strongest risk factors for NSF?
27.
Which of the following is not a criterion for diagnosis of metabolic syndrome?
28.
Salmonella food poisoning is common due to:
29.
Opportunistic CNS infections in patients with HIV include all of the following except?
31.
Which of the following coagulation factors is not involved in the intrinsic pathway?
32.
Hypocalcemia leads to the following effects EXCEPT?
33.
A 45 year old patient with a family history of kidney disease presents for evaluation. Imaging reveals multiple bilateral kidney cysts. Which of the following is the most common extra-renal manifestation of autosomal dominant polycystic kidney disease (ADPKD)?
34.
A 17 year old man attends the local sexual health clinic. He has developed a large, keratinised genital wart on the shaft of his penis. This has been around for 3 months but he has been too embarrassed to present before now. What is the most appropriate initial management?
35.
All of the following are causes of acquired hypopituitarism EXCEPT:
36.
Which is false regarding syphilis:
37.
The following are parts of the nail. Which one is not?
38.
Presentation with acute monoarthritis suggests the possibility of the following except:
39.
Sulfur granules in pus are seen in infection with:
40.
Which of the following statments regarding the treatment of gastroesophageal reflux disease (GERD) is TRUE?
41.
Which of the following is a long term complication of therapy with cytotoxic drugs:
42.
A 60-year-old female patient presented to the clinic with insidious onset of rectal bleeding and frequent stools with mucoid discharge. Physical exam revealed mild abdominal tenderness in the lower left quadrant. On serological testing pANCA (perinuclear antineutrophil cytoplasmic antibodies) was found to be positive. Histologically, the inflammation was found to be limited to the mucosa and submucosa, with continuous inflammation extending proximally from the rectum seen on colonoscopy. What is the most likely diagnosis?
43.
The following are non invasive tests for H.pylori except;
44.
The enzyme amylase is principally responsible for the breakdown of which one of the following?
45.
Which one of the following stains may be used to characterise bone marrow fibrosis?
46.
Which of the following is the most common inherited bleeding disorder?
47.
All of the following are risk factors for stroke in a patient with atrial fibrillation EXCEPT:
48.
Which of the following antibiotics is commonly recommended as the first-line treatment for uncomplicated community-acquired pneumonia?
50.
The specimen for coagulation testing is?
51.
In achalasia, the most effective long term therapy is:
52.
Which of the following infectious organisms is most likely to cause relative bradycardia during a febrile event?
53.
A 65-year old patient with chronic kidney disease has been undergoing hemodialysis for 6 years. What is she likely to die from?
54.
A clinical feature commonly seen in Von Willebrand disease is?
55.
Causes of secondary osteoarthritis include all the following except:
57.
Which of the following is usually the first to be affected (e.g., is the patient most likely to name incorrectly) in the assessment of patient orientation?
58.
A 40 year old woman presents with sudden onset, severe flank pain raditaing to the groin. A non-contrast CT scan confirms a 6mm stone in the ureter. Which of the following is the most appropriate next step in management?
59.
Which one of the following lung cancers is most common in women and non-smokers?
60.
A 14 year old female student presents with a three day history of a 1cm, golden crusted lesion on the border of her lower lip. What is the most appropriate management?
61.
Which of the following is a potential complication of right sided heart failure?
62.
Which of the following statements regarding the assessment of proteinuria in patients with chronic kidney disease is incorrect?
63.
Which is not a possible cause of blisters in a patient?
64.
Skin lesions can be classified as primary or secondary. Which of the following is a secondary lesion?
65.
Which of these is true of the endocrine system?
66.
Which of the following statements regarding the use of triptan agonists in the treatment of migraine is INCORRECT?
67.
Which of the following is not true regarding the Reed-Sternberg cell?
68.
Romanowsky stains are used universally for routine staining of blood films. Which of the following is not among them?
69.
A 28-year-old woman has had difficulty concentrating at work for the past month. She complains that the work area is too hot. She seems nervous and often spills her coffee. She has been eating more but has lost 5 kg in the past 2 months. On physical examination her temperature is 37.5°C, pulse 108/minute, respiratory rate 24/minute, and blood pressure 145/85 mmHg. Which of the following laboratory findings is most likely to be present in this woman?
70.
All of the following conditions occur as a result of iodine deficiency EXCEPT:
72.
Aedes aegypti is a mosquito species vector transmitting several viruses except:
75.
Which of the following conditions is characterized by a deficiency of the enzyme glucose-6-phosphate dehydrogenase (G6PD)?
76.
Which class of medications is commonly prescribed for the long-term management of stable angina to reduce the frequency and severity of angina attacks?
77.
All of the following are effective in treating pure tension-type headaches except?
78.
Oral lesions of syphilis that are highly infectious are:
79.
Starry sky appearance is seen in:
80.
A patient presents complaining of double vision. When he looks forward his right eye turns downwards and outwards. On looking left he is unable to adduct the right eye and double vision worsens. On looking right the angle of the squint is less. What is the most likely diagnosis?
81.
Which of the following is correct about the presentation of polycythemia vera?
82.
A cerebrospinal fluid sample was collected from a patient who presented with fever, headache, neck stiffness and photophobia. The sample was cloudy with a positive India ink preparation. Which was the most likely causative organism?
83.
Which of the following is true about polycythemia vera?
84.
A 47-year-old man is evaluated in the emergency department for chest pain that developed at a restaurant after swallowing a piece of nyama choma. He reports intermittent episodes of meat getting stuck in his lower chest over the past 3 years., but none as severe as this event. He denies food regurgitation outside of these episodes of heartburn. He is able to swallow liquids without difficulty and has not had any weight loss. Which of the following is the most likely diagnosis?
85.
Which of the following is an established risk factor for Acute Myeloid Leukemia?
86.
A 52-year-old female with a history of hepatitis C-related cirrhosis decompensated by ascites presents with progressive weight gain, leg swelling, and exertional dyspnea over the past 2 months. She is compliant with salt restriction and is on furosemide 80 mg daily and spirinolactone 200 mg daily. Physical exam reveals an elevated jugular venous pulse, holosystolic murmur along the left sternal border (which increases with inspiration), tense ascites, and leg edema. What might be a reason for the change in clinical symptoms?
87.
A 67 year old man with a history of Parkinson's disease presents due to the development of an itchy, red rash on his neck, behind his ears and around the nasolabial folds. He had a similar flare up last winter but did not seek medical attention. What is the most likely diagnosis?
88.
The following are features of eye disease in hyperthyroidism EXCEPT?
89.
Which one of the following is an example of a lung neuroendocrine tumor?
90.
Dermatitis herpetiformis is associated with:
91.
All of the following lab tests are helpful in determining the cause of photosensitivity in a patient EXCEPT:
92.
A 21-year old woman presents to the emergency department. She has a 2 day history of left sided ear pain and facial paralysis. Her mouth is drooping downwards on the left and she cannot completely close her left eye. You suspect Bell’s Palsy. What findings would you expect if you asked the patient to raise her left eyebrow and why?
93.
Which of the following is not a risk factor for basal cell carcinoma?
94.
A 70-year-old male patient presents with bone pain in the back and renal failure. Bone marrow aspirate shows abnormal blasts. Which finding is expected in the RBCs of the peripheral smear?
95.
The following are features typical of ulcerative colitis except:
96.
Which of the following cells is diagnostic for Hodgkin Lymphoma:
97.
Which of the following is NOT true about Hodgkin’s lymphoma?
98.
Which of the following hormones does not increase appetite?
99.
Which of the following means the QRS vectors in the frontal electrocardiographic plane is matched appropriately to its designation
100.
Which of the following causes oral hairy leukoplakia?
