Test Prep MCQS Online Practice Questions and Exam Preparation

Test Prep MCQS Online Questions & Answers

• Question 91:

  A 75 year's lady who had mitral valve replacement 13 years ago has developed recurrent breathlessness. There is a prominent pulsation in her neck. She complains of abdominal pain and ankle swelling. What is the most probably diagnosis?

  A. Aortic regurgitation
  B. Mitral stenosis
  C. Tricuspid regurgitation
  D. Mitral regurgitation
  E. Pulmonary stenosis
  C. Tricuspid regurgitation

• Question 92:

  A 47-year old man comes to the emergency department with fever, headache, photophobia, and a stiff neck. What is the next best step in the management of this patient?

  A. Head Ct scan
  B. Lumbar puncture
  C. Ceftriaxone and vancomycin
  B. Lumbar puncture

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  When you suspect bacterial meningitis, administer antibiotics quickly. Further, do blood cultures stat simultaneously with a lumbar puncture (LP), or immediately prior. Penicillin can never be used as empiric therapy for meningitis; it is not sufficiently broad in coverage to be effective empiric therapy. In this case, perform the LP.

• Question 93:

  10 years old boy presented to clinic with 3-weeks history of limping that worsen in the morning, this suggests which of the following:

  A. Legg–Calvé–Perthes disease (LCPD)
  B. Tumor
  C. Septic arthritis
  D. Slipped capital femoral epiphysis
  E. RA
  D. Slipped capital femoral epiphysis

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  Slipped capital femoral epiphysis (SCFE or skiffy, slipped upper femoral epiphysis, SUFE or souffy) is a medical term referring to a fracture through the growth plate (physis), which results in slippage of the overlying end of the femur (epiphysis). Normally, the head of the femur, called the capital, should sit squarely on the femoral neck. Abnormal movement along the growth plate results in the slip. The femoral epiphysis remains in the acetabulum (hip socket), while the metaphysis (end of the femur) move in an anterior direction with external rotation. SCFE is the most common hip disorder in adolescence. SCFEs usually cause groin pain on the affected side, but sometimes cause knee or thigh pain. One in five cases involve both hips, resulting in pain on both sides of the body. SCFEs often occur in obese adolescent males, especially young Black males, although it also affects females. Symptoms include the gradual, progressive onset of thigh or knee pain with a painful limp. Hip motion will be limited, particularly internal rotation.

• Question 94:

  The strongest type of epidemiological studies is:

  A. Time line
  B. Prospective cohort studies
  C. Retrospective control case studies
  D. Cross sectional
  B. Prospective cohort studies

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  Prospective cohort study is a cohort study that follows over time a group of similar individuals (cohorts) who differ with respect to certain factors under study, to determine how these factors affect rates of a certain outcome. For example, one might follow a cohort of middle-aged truck drivers who vary in terms of smoking habits, to test the hypothesis that the 20-year incidence rate of lung cancer will be highest among heavy smokers, followed by moderate smokers, and then nonsmokers. The prospective study is important for research on the etiology of diseases and disorders. The distinguishing feature of a prospective cohort study is that at the time that the investigators begin enrolling subjects and collecting baseline exposure information, none of the subjects have developed any of the outcomes of interest. After baseline information is collected, subjects in a prospective cohort study are then followed "longitudinally," i.e. over a period of time, usually for years, to determine if and when they become diseased and whether their exposure status changes outcomes. In this way, investigators can eventually use the data to answer many questions about the associations between "risk factors" and disease outcomes. For example, one could identify smokers and non-smokers at baseline and compare their subsequent incidence of developing heart disease. Alternatively, one could group subjects based on their body mass index (BMI) and compare their risk of developing heart disease or cancer. Prospective cohort studies are typically ranked higher in the hierarchy of evidence than retrospective cohort studies and can be more expensive than a case璫ontrol study. One of the advantages of prospective cohort studies is they can help determine risk factors for being infected with a new disease because they are a longitudinal observation over time, and the collection of results is at regular time intervals, so recall error is minimized.

• Question 95:

  A 36-year-old woman presents with pains in both hands for the last few months and stiffness that improves as the day goes on. Multiple joints are swollen on exam. X-rays of the hands show some erosion. What is the single most accurate test?

  A. ANA
  B. Rheumatoid factor
  C. Sedimentation rate
  D. Anti-cyclic citrullinated peptide (anti-CCP)
  D. Anti-cyclic citrullinated peptide (anti-CCP)

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  Rheumatoid factor (RF) is present in only 75?5 percent of patients with rheumatoid arthritis (RA).It can also be present in a number of other diseases; hence, the RF is rather nonspecific. Anti-cyclic citrullinated peptide (anti-CCP) is the single most accurate test for RA. It is > 95 percent specific for RA, and it appears earlier in the course of the disease than the RF. There is nothing specific on joint aspiration to determine a diagnosis of RA.

• Question 96:

  A 6-year-old girl presents with her 3rd episode of pallor and mildly icteric sclera associated with symptoms of mild upper RTI. On examination, she has an easily tipped spleen.

  Which one of following investigations is most likely to confirm her diagnosis?

  A. Eosin-5-maleimide (E5M) staining test
  B. Hb electrophoresis
  C. Howell-jolly bodies in a RBC smear
  D. Reticulocyte count
  B. Hb electrophoresis

• Question 97:

  A child with a small head, minor anomalies of the face including a thin upper lip, growth delay, and developmental disability can have all of the following, except:

  A. A polygenic syndrome
  B. Teratogenic syndrome
  C. A mendelian syndrome
  A. A polygenic syndrome

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  The features given can occur as a part of a chromosomal / teratogenic / mendelian syndrome. Polygenic in answer of exclusion. In a polygenic inheritance, multiple genes are involved in the phenotypic expression. of polygenic inheritance are hypertension and diabetes.

• Question 98:

  Which of the following will have the lowest glucose level on pleural effusion?

  A. Cancer
  B. Pulmonary tuberculosis
  C. Rheumatoid arthritis
  D. Pneumonia
  C. Rheumatoid arthritis

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  Rheumatoid arthritis has the lowest glucose level of all the causes of pleural effusion described here.

• Question 99:

  A 24-year-old woman known to be suffering from panic disorder presents to the hospital with tingling and nu fingers. ABG: pH=7.52, PCO2=2.2kPa, PO2=11kPa, Bicarbonate-20. What is the most likely condition?

  A. Acute respiratory alkalosis
  B. Compensated metabolic acidosis
  C. Compensated respiratory alkalosis
  D. Acute metabolic alkalosis
  A. Acute respiratory alkalosis

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  In panic attack there occurs hyperventilation which causes washout of acute respiratory alkalosis resulting in raised pH >7.45 (here 7.52), low PCO2 (here 2.2 kPa) with compensatory HCO3 (here 20meq/l).

• Question 100:

  Which of the following is an absolute contraindication to the use of beta blockers?

  A. Emphysema
  B. Diabetes
  C. Asthma
  D. Symptomatic bradycardia
  D. Symptomatic bradycardia

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  Symptomatic bradycardia is an absolute contraindication for the use of beta blockers. The overwhelming with peripheral artery disease can still use beta blockers. In a patient with a myocardial infarction, the more metoprolol far exceeds the risk of its use when asthma, emphysema, or peripheral artery disease is present patients can tolerate beta blockers.