A 43-year-old, insulin-dependent diabetic patient is diagnosed with hypertension and begins therapy with an antihypertensive agent. Three days later, he measures his blood glucose at home and finds that it is 53 mg/dL. He recalibrates his glucose testing apparatus and repeats the test, only to find that the first reading was accurate. He is concerned that his hypoglycemia did not produce the normal premonitory signs and symptoms. Which of the following medications was most likely prescribed to treat his hypertension?A. CaptoprilB. DiltiazemC. MethyldopaD. PrazosinE. PropranololAnswer
Which is NOT true about AIDS? It is an infectious disease caused by a retrovirus. It is an infection in which symptoms may not be seen for months or years. It is only seen in homosexuals or individuals who have intimate contact with homosexuals. It can be transmitted by contact with HIV contaminated blood, semen and vaginal secretions. AnswerTags: MCQ, Medicine, HIV
A 9-year-old white female comes to your office complaining of painful, cold finger tips which turn white when she attends evening football games in October and November. While there is no approved treatment for this condition at this time, which one of the following drugs has been shown to be useful?A.Propranolol (Inderal)B.Nifedipine (Procardia XL)C.Ergotamine/caffeine (Cafergot)D.Methysergide (Sansert)E.Alcohol (e.g., Budweiser, Lone Star, etc.)AnswerTags: MCQ, Medicine, Rheumatology
Which one of the following statements is most accurate concerning juvenile rheumatoid arthritis?A) Fever is a rare systemic manifestation.B) Ten years after the onset of disease, most patients have excellent functional status.C) Most patients have a permanent deformity of a least 1 extremity.D) The disease is characterized by lifelong recurrences.E) Most patients require sustained corticosteroid treatment(s).ANSWERTags: MCQ, Medicine, Rheumatology
A 74-year-old man is noted to have purplish-discolored right third and fourth toes 4 days after coronary angiography and a creatinine level of 2.4 mg/dL (creatinine level was normal on admission). He has a history of adult-onset diabetes mellitus, hypertension, and 50 pack-years of smoking. Cholesterol crystal atheromatous embolization is suspected. Which of the following may be present?A. Livedo reticularis B. Elevated erythrocyte sedimentation rate and/or leukocytosis and/or eosinophilia C. Prominent gastrocnemius pain or claudication D. Source(s) of the cholesterol emboli are usually the abdominal aorta or iliofemoral arteries rather than the more distal arteries.E. All of the above AnswerTags: MCQ, Medicine, Atheroma, emboli
Each of the following is characteristic of polymyalgia rheumatica, except A. Mild joint inflammation B. Stiffness of the shoulder and hip girdles C. Weakness of the shoulder and hip girdles D. Elevated erythrocyte sedimentation rate E. Normochromic normocytic anemia AnswerTags: MCQ, Polymyalgia rheumatica, Medicine
A 50-year-old white man is transferred to your hospital with a presumptive diagnosis of tuberculosis. His chest radiograph shows nodular cavitary lesions in both lung fields. His urinalysis shows 50 RBCs per high power field and 3+ proteinuria. He is scheduled for bronchoscopy with transbronchial lung biopsy in the morning. That evening he has a sudden deterioration consisting of massive hemoptysis and progressive renal failure. The most appropriate therapeutic intervention at this point would be supportive management andA. IV corticosteroidsB. Antituberculous medicationsC. IV cyclophosphamide 4 mg/kgD. Oral cyclophosphamide 2 mg/kgE. IV corticosteroids and IV cyclophosphamide 4 mg/kg AnswerTags: MCQ, Wegener's granulomatosis, Medicine
Extra-articular manifestations of rheumatoid arthritis that may be associated with severe morbidity or mortality include A. Rheumatoid vasculitis B. Pericarditis C. Cachexia D. Rheumatoid nodule within the aortic valve E. All of the above AnswerTags: MCQ, Medicine, Rheumatoid Arthritis
An 82-year-old woman was hospitalized for treatment of congestive heart failure. She experienced a warm, painful right knee on the 3rd hospital day. The most appropriate procedure would beA. Blood cultures followed by IV antibiotics B. Arthrocentesis for diagnostic/therapeutic purposes C. IV colchicine D. Allopurinol E. Ultrasound study of right knee, including popliteal fossa AnswerTags: MCQ, Medicine, Septic Arthritis
Rheumatoid factor may be present in each of these conditions, except A. Adult Still's disease B. Subacute bacterial endocarditis C. Vasculitis syndromes D. Sarcoidosis E. Sjögren's syndrome AnswerTags: MCQ, Medicine, Rheumatoid Factor
43-year-old woman presents with a 3-year history of progressive rheumatoid arthritis that has been partially responsive to various nonsteroidal anti-inflammatory drugs (NSAIDs) and to low-dose oral corticosteroids. After the examination, you decide to treat her active arthritis with methotrexate, currently the most widely used and effective agent for rheumatoid arthritis. Some of the facts to tell her about methotrexate therapy includeA. Therapeutic effects are delayed so that clinical improvement is not generally seen for 3 to 6 weeks after initiation of treatment.B. Adverse effects may include oral ulcers, nausea, vomiting, pneumonitis, bone marrow suppression, and cirrhosis. C. CBC, platelet count, alkaline phosphatase level, and serum glutamic-oxaloacetic transaminase (SGOT) level should be obtained every 4 to 6 weeks to monitor therapy.D. Birth control measures must be in use before methotrexate is started. E. All of the above. AnswerTags: MCQ, Medicine, Methotrexate
Which of the following is not true about serum amylase in a case of acute pancreatitis?a) It is widely used as a screening testb) Remains elevated for weeksc) 85% have elevated levelsd) Maybe normal with coexisting hypertrigyceridemiaAnswerTags: MCQ, Medicine, Pancreatitis
A 75 year old man presents with a 1 year history of progressive memory loss. He has a past history of MI, hypertension & type II diabetes. Examination reveals absent peripheral pulses & bilateral carotid bruits. Which of the following tests is most likely to determine the cause of his memory loss?Psychometric testing CSF examination CT Brain EEG Carotid dopplerAnswerTags: MCQ, Medicine, Dementia
Which one of the following patients should be screened for hepatitis C virus (HCV) infection?A) A 15-year-old who received a blood transfusion in 1996 subsequent to a serious motor vehicle accident.B) An 18-year-old nurse finishing her first year of work in a dialysis unit.C) A 17-year-old day-care worker after a 1-year-old child in her room was diagnosed with hepatitis C.D) A 9-month-old born to a mother positive for HCV.E) An 18 year old presenting to an STD clinic with penile discharge.AnswerTags: MCQ, Medicine, Hepatitis C Virus
WHEN CONSIDERING THE ORGANISATION OF CARE FOR THOSE WITH GOUT. A. Allopurinol is contra-indicated in the presence of renal calculi.B. The majority of patients with gout will have co-existing hypertension.C. Lipid levels are higher in those with gout than in the general population.D. Alcohol increases the real urate clearance.E. The majority of those with gout will have a positive family history.AnswerTags: MCQ, Medicine, Gout
Nocturnal Cramps have been shown to be caused by all except A. Cirrhosis of the liver. B. Peripheral arterial disease C. L5 / S1 disc compression. D. Salbutamol administration.AnswerTags: MCQ, Medicine, Cramps
OWNING DOGS HAS BEEN SHOWN TO BE ASSOCIATED WITH ALL EXCEPT A. a decrease in presentation of minor health problems to the general practitioner.B. an increase in one year survival following a myocardial infarction.C. a lower blood pressure when matched with the average population.D. lower lipid levels when matched with the average population.E. increase in gastrointestinal infections.AnswerTags: MCQ, Medicine, Pets
One of the following statements is incorrect about Jaundiced patients A. non A - non B hepatitis can be transmitted by drinking contaminated water.B. hepatitis B is associated with the development of hepatocelllular carcinoma.C. acute cholangitis carries a mortality of about 40%.D. hepatitis A typically produces a carrier state following the acute infection.AnswerTags: MCQ, Medicine, Jaundice, Hepatitis
An elderly patient has dysphagia. The patient is at high risk of aspiration with which of the following?A. Refusal to eatB. Absent gag reflex bilaterallyC. DysarthriaD. Facial weakness & droolingE. Weak cough & decreased voice strengthAnswerTags: MCQ, Medicine, Geriatrics, Aspiration
What is the most common organism causing pneumonia in an elderly lady living in a rest home?St pneumonia H influenzae Mycoplasma Klebsiella Chlamydia pneumonia Answer Tags: MCQ, Medicine, Pneumonia
