Test Prep MCQS Online Practice Questions and Exam Preparation

Test Prep MCQS Online Questions & Answers

• Question 71:

  The patient passed a 4 mm stone in his urine. Does he have a 3mm stone in the renal pelvis found on an ultrasound?

  A. ESWL
  B. None
  C. Surgery
  D. Dormia basket
  E. PCNL
  B. None

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  Stones less than 5 mm in diameter pass spontaneously in up to 80% of people. -Stones between 5 mm and 10 mm in diameter pass spontaneously in about 50% of people. -Stones larger than 1 cm in diameter usually require intervention.

• Question 72:

  A 38-year-old man presents with acute infection of skin in the leg. Diagnosis of cellulitis has been made. What should be prescribed?

  A. Ceftriaxone + Flucloxacillin
  B. Vancomycin + Metronidazole
  C. Metronidazole + Erythromycin
  D. Ceftriaxone + Terbinafine
  E. Penicillin + Flucloxacillin
  E. Penicillin + Flucloxacillin

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  Penicillin + Flucloxacillin. Cellulitis is usually caused by bacteria, such as staphylococci or streptoc are commonly present on the skin. So Penicillin + Flucloxacillin should be given.

• Question 73:

  An HIV-positive man comes in with progressive dysphagia and odynophagia. He has 75 CD4 cells but no history of opportunistic infections. What is the next best step in management?

  A. Barium swallow
  B. Endoscopy
  C. Fluconazole
  D. Amphotericin
  C. Fluconazole

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  Odynophagia is pain on swallowing. Dysphagia is simply difficulty swallowing (i.e., food getting "stuck"in the esophagus). When odynophagia occurs in an HIV-positive patient, particularly when there are < 100 CD4 cells, the diagnosis is most likely esophageal candidiasis, and giving empiric fluconazole is both therapeutic as well as diagnostic. Amphotericin is not necessary. 63-Answer: C. Proton pump inhibitors (PPIs) are preferred as the first line of therapy and also serve as a diagnostic test. Using PPIs is far easier than other testing.

• Question 74:

  A 73-year-old woman has lymphadenopathy and splenomegaly. She feels well but has had recurrent chest infections recently.

  Choose the single most likely blood film findings?

  A. Plasma cells
  B. Multiple immature granulocytes with blast cells
  C. Atypical lymphocytes
  D. Excess of mature lymphocytes
  D. Excess of mature lymphocytes

• Question 75:

  A young woman fell and hit her knee. Exam: valgus test +ve. What ligament was most probably injured?

  A. Lateral collateral
  B. Ant cruciate
  C. Post cruciate
  D. Medial collateral
  E. Meniscus
  D. Medial collateral

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  Medial collateral. The valgus stress test involves placing the leg into extension, with one hand place on the knee. With the other hand placed upon the foot applying an abducting force, an attempt is then made to at the knee into valgus. If the knee is seen to open up on the medial side, this is indicative of medial collateral damage.

• Question 76:

  A 45-year-old man has developed an annular rash with a scaly edge on his thigh. The rash has been spreading. He has some general aches and pains. What is the single most useful investigation?

  A. ANA
  B. Skin scrap for mycology
  C. Skin swab for bacteria
  D. Biopsy lesion
  E. Lyme antibodies
  E. Lyme antibodies

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  Spreading annular rash suggests erythema migrans of lyme disease.

• Question 77:

  Which of the following is most sensitive for detecting diabetic nephropathy?

  A. Urine albumin
  B. Glucose tolerance test E-Ultrasonography
  C. Serum creatinine level
  D. Creatinine clearance
  A. Urine albumin

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  Nephropathy is a leading cause of death in diabetic patients. Diabetes may be functionally silent for 10 to 15 years. Clinically detectable diabetic nephropathy begins w development of microalbuminuria (30 to 300 mg of albumin per 24 h). The glomerular filtration may be elevated at this stage. Only after the passage of additional time will the proteinuria be (0.5 g/L) to be detectable on standard urine dipsticks. Microalbuminuria precedes nephropathy with both non-insulin- dependent and insulin-dependent diabetes. An increase in kidney size al the initial hyper filtration stage. Once the proteinuria becomes significant enough to be detected a steady decline in renal function occurs, with the glomerular filtration rate falling an average of minute per month. Therefore, azotemia begins about 12 years after the diagnosis of diabetes.

• Question 78:

  A 64-year-old man complains of increasing dyspnea and cough for the past 18months. He coughs up a Table mucopurulent sputum with occasional specks of blood.

  What is the most likely underlying cause?

  A. Acute bronchitis
  B. Bronchiectasis
  C. Chronic bronchitis
  D. Lung cancer
  E. Pneumonia
  C. Chronic bronchitis

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  Chronic bronchitis. There may be specks of blood in sputum in both bronchiectasis, acute and chronic. Duration of disease is 18 months, so it is not acute bronchitis. Again only one tablespoonful sputum does not term copious sputum of bronchiectasis in which sputum will be much more in amount.

• Question 79:

  A 55 year's man who is hypertensive suddenly lost his vision. The retina is pale and fovea appears as a spot. What is the single most appropriate treatment?

  A. Corticosteroids
  B. Pan retinal photocoagulation
  C. Press over eyeball
  D. Scleral buckling
  C. Press over eyeball

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  In central retinal artery occlusion (CRAO) retina becomes pale and fovea. Hypertension is a major cause of CRAO. Apply direct pressure for 5-15 seconds, then release. Repeat several massage can dislodge the embolus to a point further down the arterial circulation and improve retinal perfusion.

• Question 80:

  A 24-year-old male with a history of gang violence presents to the emergency room with 3 stab wounds to the abdomen. He was intubated in the field for airway protection and is barely conscious. Blood pressure is 70/30 mm Hg and pulse is 140/min. On exam, 3 penetrating wounds covered by abdominal pressure pads are noted.

  Which of the following is the best next step in management of this patient?

  A. IV fluids
  B. Abdominal x-ray
  C. Obtain consent for surgery
  D. IV antibiotics
  A. IV fluids

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  This patient is in hemorrhagic shock and requires immediate resuscitation. Of the choices listed, the best next step in management is IV fluids after obtaining venous access. The best form of venous access is 2 large-bore IVs in the periphery and/or central venous access. Applying direct pressure to the abdomen (a) does not treat the underlying cause. Getting an abdominal x-ray (b) will take too long for a patient with this rate of blood loss. IV antibiotics (c) may be needed later in the care of this patient, but stabilizing blood pressure is now the more urgent need. Surgical consent (e) is implied in a life-threatening emergency in which a patient cannot communicate his wishes.