Test Prep Test Prep Certifications MCQS Questions & Answers

• Question 81:

  1-month-boy has brought to emergency room, he is conscious with cool peripheries and He a of -230/min. He has been irritable and feeding poorly for last 24 hours. CXR showed borderline card enlargement with clear lung fields.

  ECG-showed narrow complex tachycardia, with difficult finding what is the single most appropriate treatment?

  A. Synchronized DC cardioversion

  B. Administer IV fluid

  C. Oral Beta blocker

  D. Administer oxygen

  Correct Answer: A

• Question 82:

  A 25 year woman comes to sexual clinic and ask for advice for contraception.She is on sodium Valporate. COCP=combined oral contraceptive pills.

  A. She can use COCP with extra precaution

  B. She can use COCP

  C. She can use COCP with estrogen 50 microgram and progesterone higher dose D. She cannot use COCP

  Correct Answer: B

  Mammography above age 50 lowers mortality the most. Although screening should start at the age of 50, the mortality benefit is also greatest above the age of 50, because the number of cases of cancer detected will be greater above the age of 50. The age cutoff for mammography is somewhat controversial. Step 3 will likely avoid the issue.

• Question 83:

  A 27-year-old, generally healthy woman comes to the office with burning on urination. There are 50 white cells on the urinalysis.

  What is the next best step in management?

  A. Treat with TMP/SMX for 3 days

  B. Perform a renal ultrasound

  C. Treat with ciprofloxacin for 7 days

  D. Wait for results of urine culture

  Correct Answer: A

  When there are clear symptoms of cystitis and white cells in the urine, it is not necessary to obtain a urine culture or to wait for results of either the culture or a sonogram. For uncomplicated cystitis, go straight to treatment for 3 days. Ultrasound is important in male patients, as it is unusual for a male patient to have a urinary tract infection in the absence of an anatomic abnormality.

• Question 84:

  The drug of choice in the treatment of Oxyrus worm is?

  A. Levamisol

  B. Metronidazole

  C. Tenidazol

  D. Pyrantel pomoate

  Correct Answer: D

• Question 85:

  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

  Correct Answer: C

  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 86:

  A 20-year-old boy is hit by a car while riding his bicycle. He presents to the ED with severe groin pain after falling on the central bar of the bike. Physical examination reveals blood at the urethral meatus and a high-riding prostate.

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

  A. Get a retrograde urethrogram

  B. Discharge the patient with reassurance

  C. CBC and electrolytes

  D. Empiric antibiotics

  Correct Answer: A

  The patient has a urethral disruption that needs to be evaluated. A kidney, ureters, and bladder (KUB) x-ray followed by a retrograde urethrogram must be conducted prior to any other tests. Placing a Foley catheter without such an imaging modality can lead to further urethral damage. The step after urethrogram is a Foley catheter placement to aid in urination. There is no role for antibiotics for trauma without evidence of infection.

• Question 87:

  A 65-year-old woman comes to the emergency department with acute, severe shortness of breath; rales on lung exam; S3 gallop; and orthopnea.

  Which of the following is the most important step?

  A. ACE inhibitors

  B. Echocardiogram

  C. Oxygen, furosemide, nitrates, and morphine

  D. Digoxin

  Correct Answer: C

  Oxygen, furosemide, nitrates, and morphine are the mainstay of therapy for acute pulmonary edema. Although they are not associated with a concrete mortality benefit, they are the standard of care for pulmonary edema, which is the worst manifestation of CHF. Removing volume from the vascular system and, therefore, the lungs is more important than any form of diagnostic testing. Pulmonary edema is a clinical diagnosis. Shortness of breath, rales, S3, and orthopnea are more important in establishing the diagnosis than any single test.

• Question 88:

  A 60-year-old woman with metastatic breast cancer comes in with back pain. The spine is tender. She has hyperreflexia of the legs.

  What is the most urgent step?

  A. CT/MRI

  B. Steroids

  C. Biopsy

  D. Radiation

  Correct Answer: D

  The most urgent step in the management of cord compression is to administer steroids as soon as possible and to relieve pressure on the cord. Imaging studies are done after steroids are given, if the diagnosis of cord compression is clear (as it is in this case with pain, tenderness, and signs of hyperreflexia in the legs).

• Question 89:

  A patient presents with fever, dry cough and breathlessness. He is tachypneic but chest is clear Oxygen saturation is normal at rest but drops on exercise.

  What is the single most likely diagnosis?

  A. Pneumocystis carinii infection

  B. Cryptococcal infection

  C. Toxoplasma abscess

  D. CMV infection

  E. Candida infection

  Correct Answer: E

  In conclusion, our data confirm that patients with diabetes have excess mortality compared with patients with diabetes, and that men with diabetes suffer from a higher mortality rate than women. These observations are younger patients. Cardiovascular disease could be the most common cause of death in diabetic by cancer. Whether our diabetic patients suffer from a lesser proportion of death than that cardiovascular disease, as seen in the U.S. or the U.K., requires further investigation.

  Reference: http://care.diabetesjournals.org/content/27/7/1605.long

• Question 90:

  The most common side effect of streptokinase (Thrombolytic) is ______________.

  A. Hypotension

  B. Bleeding

  C. Stroke

  Correct Answer: A