Test Prep Test Prep Certifications MCQS Questions & Answers

• Question 21:

  At what CD4 count should antiretroviral treatment commence in asymptomatic HIV patients?

  A. Testosterone

  B. Growth hormone

  C. Somatostatin

  D. Oestrogen

  E. Somatostatin

  Correct Answer: D

  The growth spurt at puberty is brought about by the secretion of androgens in the male and oestrogens in the female. However, it is oestrogens that ultimately terminate growth by causing the epiphyses in the long bones to fuse. Thus oestrogens rather than androgens are responsible for skeletal maturation, epiphyseal fusion and cessation of growth in males and females. All the other hormones are involved in growth alone

• Question 22:

  A 74-year-old woman, who has been followed for the past 25 years for chronic obstructive pulmonary disease (COPD) comes to the emergency department complaining of 48 hours of temperatures to 38.6 C

  (101.4 F) and worsening shortness of breath. She has a chronic productive cough, which has become more copious. On physical examination, she has rhonchi and increased fremitus in the posterior mid-lung field. A Gram's stain reveals many epithelial cells and multiple gram-positive and gram-negative organisms; no neutrophils are seen.

  Which of the following is the most likely organism causing the symptoms?

  A. Escherichia coli

  B. Haemophilus influenzae

  C. Mycobacterium tuberculosis

  D. Mycoplasma pneumonia

  E. Klebsiella Pneumoniae

  Correct Answer: B

  The correct answer is B. This patient, with a long history of chronic obstructive pulmonary disease (COPD), has evidence of a community-acquired pneumonia. The common organisms causing pneumonias in patients with COPD are Streptococcus pneumonia, Haemophilus influenzae, and Moraxella catarrhalis

• Question 23:

  60-year-old male complains of decreased libido, decreased ejaculation, FBS= 6.5 mmol, increased prolactin, normal FSH and LH.

  What is the next step?

  A. Testosterone level

  B. DM

  C. CT of the head

  D. NL FBG

  Correct Answer: C

  Prolactinoma is the most common tumor of pituitary gland, comprising up to 45% of all pituitary tumors. Prolactinoma is the most common cause of hyperprolactinemia, which is a common cause of infertility in males and females. Clinical presentation of the prolactinomas are earlier in females compared with males, even when they are very small (microadenoma). This earlier presentation in females is due to greater symptom burden caused by hyperprolactinemia in them.[1] On the other hand, males present late till prolactinoma becomes large in size (macroprolactinoma) and start causing pressure over optic chiasm and presented as visual deterioration or visual field defects. They can also present with decreased libido. So clinical diagnosis of prolactinoma in male patents is late, which can lead to misdiagnosis of microprolactinoma in male patients.

  Reference: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3205532/

• Question 24:

  A 37-year-old lady strongly believes that a famous politician has been sending her flowers every day and is in love with her. However, this is not the case.

  What is the most likely diagnosis?

  A. Erotomania

  B. Kleptomania

  C. Pyromania

  D. Trichotillomania

  Correct Answer: A

  Erotomania is a type of delusion in which the affected person believes that another person, usually a stranger, high-status or famous person, is in love with them]. Kleptomania is the inability to refrain from the urge to steal items. Grandiosity refers to an unrealistic sense of superiority. Pyromania is an impulse control disorder in which individuals repeatedly fail to resist impulses to deliberately start fires, in order to relieve tension or for instant gratification. Trichotillomania is an impulse disorder characterized by the compulsive urge to pull out one's hair, leading to noticeable hair loss and balding

• Question 25:

  You are seeing a 45-year-old obese diabetic woman who reports bilateral lower extremity peripheral edema. In addition to diabetes, she has arthritis, hypertension, and depression.

  Which of the following medications is the likely cause of her edema?

  A. Lisinopril

  B. Fluoxetine

  C. Metformin

  D. Naproxen

  Correct Answer: D

• Question 26:

  Patient smoker and alcoholic come with difficulty in swallowing and neck mas.

  What is an investigation?

  A. Biopsy

  B. Neck CT

  C. Indirect laryngoscopy

  D. Head CT

  E. Aspiration

  Correct Answer: B

• Question 27:

  A person after oral sex diagnose with neisseria gonorrhoeae infection. Which is true regarding scenario?

  A. Treat his friends

  B. Treat his sexual partner

  C. Treat his family members

  Correct Answer: B

• Question 28:

  The cause of peptic ulcer?

  A. Use of NSAIDS

  B. H. Pyelori

  C. Both

  Correct Answer: C

  Peptic ulcer disease usually occurs in the stomach and proximal duodenum. The predominant causes in the United States are infection with Helicobacter pylori and use of nonsteroidal anti-inflammatory drugs. Symptoms of peptic ulcer disease include epigastric discomfort (specifically, pain relieved by food intake or antacids and pain that causes awakening at night or that occurs between meals), loss of appetite, and weight loss. Older patients and patients with alarm symptoms indicating a complication or malignancy should have prompt endoscopy. Patients taking nonsteroidal anti-inflammatory drugs should discontinue their use. For younger patients with no alarm symptoms, a test-and-treat strategy based on the results of

  H. pylori testing is recommended. If H. pylori infection is diagnosed, the infection should be eradicated and antisecretory therapy (preferably with a proton pump inhibitor) given for four weeks. Patients with persistent symptoms should be referred for endoscopy. Surgery is indicated if complications develop or if the ulcer is unresponsive to medications. Bleeding is the most common indication for surgery. Administration of proton pump inhibitors and endoscopic therapy control most bleeds. Perforation and gastric outlet obstruction are rare but serious complications. Peritonitis is a surgical emergency requiring patient resuscitation; laparotomy and peritoneal toilet; omental patch placement; and, in selected patients, surgery for ulcer control.

  Reference: http://www.aafp.org/afp/2007/1001/p1005.html

• Question 29:

  A 42-year-old salesman was admitted with a diagnosis of pneumonia. He is allergic to erythromycin. X-ray shows a hazy opacity in the right lower and mid-zone. Blood investigations show hyponatremia and slight rise in the level of liver aminotransferase. After starting the medication on the fifth day he became acutely jaundiced and his liver aminotransferase level became very high. He also complained of discoloration of his urine, which did not show hematuria on dipstick testing.

  Which of the following drugs probably caused the jaundice?

  A. Ciprofloxacin

  B. Clarithromycin

  C. Amoxicillin

  D. Rifampicin

  E. Flucloxacillin

  Correct Answer: D

  This patient has legionella pneumonia and therefore rifampicin was prescribed. However, rifampicin, as it is a hepatic enzyme inducer, can lead to acute jaundice with a rise in the liver aminotransferase level. It also causes red or orange discoloration of the urine and other body fluids. Patient should be warned about this side-effect. Rifampicin is generally not used as a monotherapy to treat legionella pneumonia. As this patient is allergic to the macrolides, ciprofloxacin is the other drug of choice. Monotherapy with rifampicin is associated with the development of resistance.

• Question 30:

  A person with suspicion of neisseria gonorrhoeae infection. Which test is necessary?

  A. blood culture

  B. urine culture

  C. throat swab culture on Thayer-Martin agar

  Correct Answer: C