Test Prep MCQS Online Practice Questions and Exam Preparation

Test Prep MCQS Online Questions & Answers

• Question 111:

  A 28-year-old man presents with a 2 hours' history of rapid palpitations. He feels a little light headed but is other exam: pulse=170 bpm and regular, BP=100/68 mmHg. He has had 2 similar episodes in the past. What is the most disturbance?

  A. SVT
  B. VF
  C. A-fibrillation
  D. VT
  E. Ventricular-ectopic
  A. SVT

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  Palpitation, light headedness with a tachycardia of 170 bpm that is regular are most likely a SVT.

• Question 112:

  The child bought by a mother having bouts of severe abdominal pain that cause child to bring his legs to fold to abdomen, settles after sometime, now again he had this attack with vomiting. On examination child is distressed with pain and

  there is a mass in epigastrium.

  What Investigation you will do?

  A. Ultrasound
  B. Chest x-ray
  C. Ct abdomen
  D. Air enema
  D. Air enema

  ---

  This investigation is both diagnostic and therapeutic and is the initial investigation of choice if strong clinical suspicion of intussusception (e.g. palpable mass and bowel obstruction) There is a small risk of bowel perforation and bacteremia during the gas enema (the surgical registrar as well as a suitably trained nurse should attend with appropriate resuscitation equipment) Ultrasound scan Diagnostic investigation of choice (unnecessary if high level of suspicion) Useful if there is a suggestive history but no mass palpable or signs on plain AXR and may identify other pathology.

• Question 113:

  A 45-year-old woman has a 2-cm breast cancer tumor removed by lumpectomy, and the breast is irradiated. The cancer is negative for estrogen receptors and positive for progesterone receptors. Three of 14 nodes removed from the axilla are positive for cancer.

  What is the next best step in management?

  A. Tamoxifen and adjuvant chemotherapy
  B. Oophorectomy and chemotherapy
  C. Anastrozole (aromatase inhibitor) for 5 years
  D. Tamoxifen for 5 years
  A. Tamoxifen and adjuvant chemotherapy

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  Tamoxifen is used whenever there are either estrogen receptors or progesterone receptors positive. If both receptors are positive, tamoxifen will be of greater benefit. Adjuvant chemotherapy is used whenever the axillary nodes are positive or the cancer is > 1 cm in size.

• Question 114:

  A pregnant woman comes with weakness and elevated liver function tests. She is in her 35th week of pregnancy. The prothrombin time is normal. The smear of blood shows fragmented red cells. Platelet count is low. What is the treatment?

  A. Delivery of the baby
  B. Fresh frozen plasma
  C. Prednisone
  A. Delivery of the baby

  ---

  Deliver the baby with the HELLP syndrome. HELLP syndrome stands for hemolysis, elevated liver function tests, and low platelets. This disorder is idiopathic and can be distinguished from DIC by the normal coagulation studies, such as the prothrombin time and aPTT.

• Question 115:

  What is the most common serious complication of PM/DM?

  A. Malignancy
  B. Metabolic acidosis
  C. Phabdomyolysis
  D. Hyperkalemia
  A. Malignancy

  ---

  For unclear reasons, the most common serious threat to life from PM/DM is malignancy. DM has a greater risk than PM. Cancer hits the cervix, lungs, pancreas, breasts, and ovaries.

• Question 116:

  A 28-year-old female presents with 1-week history of jaundice and 2days history of altered sleep pattern and moods. She was diagnosed with hypothyroidism for which she is receiving thyroxine. Thyroid function showed increased TSH. PT=70s.

  What is the most probable diagnosis?

  A. Hyper-acute liver failure
  B. Acute liver failure
  C. Acute on chronic liver failure
  D. Autoimmune hepatitis
  D. Autoimmune hepatitis

• Question 117:

  A 61year man was found with K+=7.5 and ECG with prolong QRS complex.

  What is the best possible treatment?

  A. IV calcium gluconate
  B. Dialysis
  C. Loop diuretics
  D. Salbutamol nebulizer
  E. IV insulin and dextrose
  A. IV calcium gluconate

  ---

  In this high level of potassium, we have to shift this potassium into cells to red level and save heart from arrest or life threatening arrhythmia. For keep the heart safe option of first choice in emergency is IV calcium gluconate! However, it does not shift or reduce potassium level but protects heart from buy time for definitive measure to take place.

• Question 118:

  A 41-year-old woman awoke from a nap with severe pain in her index finger and found it to be flexed while all other fingers were extended. When she tried to pull it free she heard a loud popping sound and the pain subsided. The following day she comes to her doctor's office concerned about the sound and pain.

  What is the most appropriate next stop in the management of this patient?

  A. Steroid injection
  B. Admit to the hospital.
  C. NSAID therapy
  D. Amputate the finger
  E. Rehabilitate the finger
  A. Steroid injection

  ---

  Trigger finger is an acutely flexed and painful finger. Steroid injections have been shown to decrease pain and recurrence of trigger finger. It is the most cost-effective treatment, and studies have shown a trial of steroids should be attempted prior to surgery. Trigger finger is caused by a stenosis of the tendon sheath leading to the finger in question. If steroids fail, surgery to cut the sheath that is restricting the tendon is the definitive treatment.

• Question 119:

  A 42-year-old obese woman with 5 children presents with a "gnawing" pain that recently has become severe. She notes the pain right after she finishes a meal and states that it radiates to her right shoulder. Physical exam reveals a cessation of inspiration upon palpation of the right upper quadrant and rebound tenderness. Laboratory analysis shows white cell count of 15,000 and a left shift.

  What is the most likely diagnosis?

  A. Acute diverticulitis
  B. Cholecystitis
  C. Acute appendicitis
  D. Ectopic pregnancy
  E. Acute pancreatitis
  B. Cholecystitis

  ---

  Acute cholecystitis is a common inflammatory condition that occurs often in obese women in their 40s. A gallstone occludes the lumen of the cystic duct. Patients have peritoneal signs and a positive Murphy sign. A sonographic Murphy sign is the ultrasound probe causing a cessation of breathing when it presses against the abdominal wall. On ultrasound, cholecystitis is characterized by pericholecystic fluid and a thickened gallbladder wall. Diverticulitis would be lower left or right quadrant pain in an elderly person with a history of constipation. Pancreatitis would have deep epigastric.

• Question 120:

  Which type of contraceptive is contraindicative in lactation?

  A. UID
  B. Depo-Provera
  C. Mini pills
  D. OCPs
  E. Condom
  D. OCPs

  ---

  Based on the available evidence, expert opinion in the United States holds that the risks of combination contraceptive products usually outweigh the benefits before 4 weeks postpartum. Between 4 weeks and 6 months postpartum, the advantages of using the method generally outweigh the theoretical or proven risks, although the evidence of lack of effect on lactation is poor and does not include preterm or ill infants. Introduction of a combined oral contraceptive containing 30 mcg of ethinyl estradiol on day 42 or beyond may not affect milk intake or infant growth. After 6 months postpartum, combination contraceptives, including oral tablets, the transdermal patch and vaginal ring, can be used, but progestin-only methods are preferred if breastfeeding will be continued.