Medicine Exam 4th

Medicine Exam 4th year 2012 Infectious Infectious: (additions are welcomed, as I couldn't get them all) 1. All of the following are adverse effects of vancomycin EXCEPT a. phlebitis b. seizures** c. Red man syndrome 2. Brucellosis treatment 6 weeks of rifampcin and doxycylin 3.patient with PCP suspected to have AIDS, what test will you do? 1 a. ELISA** b. Western blot c. Virus load d.... 4. Which of the following medications should never be used in pregnancy a.levofloxacin ** b.lmatinib c.... 5. Which of the following may cause lupus a. Isoniazid** b. Rifampicin c. Pyrazinamide d. Ethambutol e. Streptomycin 6. Incorrect about metronidazol pseduomona 7. All of the following vaccines may be given to a patient who is immunosuppresed a. HBV b. Influenza c. MMR** 8. A patient susceptible to parasitic infections, mostly due to a. B cell deficiency b. T cell deficiency** 9-Q about PCP and its prophylaxis Trimethoprim and sulphomethaxazole 10-Septic shock--- wrong it start with vasoconstriction 11- 3 positive swabs MAC 12- splenectomy no vaccination for mycoplasma Rheumatology 1)Not associated with ankylosing spondylitis : Pulmonary Embolism**, anterior uveitis, Pulmonary fibrosis, .... 2) IncorrectaboutRheu matoidAri thri tis: bilateralsynovitis, subcutanous nodules are exclusively in seropositive patients, iron defeciency anemia**, detected radiographic changes 3)which of the following investigations is not required in a 35 female patient with a history of 1 month bilateral ankle swelling: -serum uric acid** - rectal swap - proctoscopy - ct scan ... 4)Which is the following has no relation with SLE: albumin, ESR, c3 and c4, anti DNA, ENA titer ( i guess this is the answer, not sure though) S)a case of SLE(butterfly Rash), which of the following tests is not related: ANCA and PANCA **,Coombs test ?)which of the following physical finding mostly differentiates between Limited and Diffuse Scleroderma: skin involvement (anahekjawabto), renal crisis (some say this is the answer) 8)a case of raynauds and sclerodactyly only: anti centromere** 9)Which of the following is not associated with Reactive arithritis: Raynauds 10)which of the following isn't of the criteria of inflammatory back pain: age less than 60**, decreases with exercise, doesn't decrease with rest, insidious onset ... 10) serum uric acid not increased in: SIADH** low dose aspirin 11) celecoxib most NSAID with GI protective 12) not present in rheumatoid: repeated abortion, Mononeuritis multiplex cardio: 1- pt with heart failure, all trus except: negativerales excludes increased PCWP. -no peripheral edema when overload and venous htn 2- pulsusparadoxus found in: cardiac temponade 3- all of the following are modifiable RF's of CAD except: thyrotoxicosis, hyperurecemia** 4- all of the following affect mortality rate post MI except: HTN ... 5- all of the findings are found in MS except: S3 6-one of the following is considered of major DUKES criteria: new valvular regurgitation 7- constrictive pericarditis is assosiated with all of the following except: ahepatomegaly, b. asci tis c. pulmonary edema** d. early diastolic sounde. raised )VP 8- renal artery stenosis as a cause ofHTN, on of the following physical findings doesn't expect that: a. mild renal impairment, b. flash edema, c. palpable kidney**, d. renal artery bruit diastolic and systolic. 9- wrong assosiation : a blockers : urine retention 10- which of the following increases HDL: a. statins, b. niacin, c. fibrates, d. excersise** 1l.all of the following exacerbates MS symptoms except: B blockers 12- troponin: not elevated in pulmonary edema 13- one of the following is not assosiated with improved prognosis in DCM except: a. digoxin***, b. nitrates 14-all increase the PR interval except :thyroxine. 15- unstable plaque- scattered calcification is wrong Nephro: 1- pt. with lymphoma, known to excrete 1.5 gram/day protein, was found to haveve dipstick for protein, what's your explanation: answer: dipstick detects only albumin 2- acid-base case, ph 7.6, HC03 45 Na 133 Cl 75 P02 60 PC02 59 ... answer: metabolic alkalosis only 3- Nephritic syndrome is ass. with all of the following except: a- hematuria b- HTN c- renal failure d-edema e- hypoalbuminemia (i don't know the answer) :/ 4- pt. ufw cholecystectomy, which is supportive for pre-renal failure: answer: a- orthostatic hypotension 5- female patient was running in a marathon and came later in the day (eno mainly with signs of dehydration), you expect to find all the following except: answer: urine osmolarity<300 6- all are supportive for glomerular cause of hematuria except: answer: e- blood clots 7- pt. with hemoptysis, nasal mucosal ulcer, recently became oliguric, ANCA +ve: answer: a- wegener'sgranulomatosis 8- blood hydrostatic pressure 55, blood oncotic pressure 30, bowman's capsule hydrostatic pressure 15, the net filtration pressure is: answer: 10 9- AD-PKD is ass with all the following except: answer :angiodysplasia 10- all retard progression of D-nephropathy excepy: answer :B.p< 140/90 11- pt. with Chronic renal failure developed osteitisfibrosacystica, all the following may be associated except (i'm not sure 3n 9ee3'et el so2aal bsenno el muhemmbeddo el 3a'al6) a- hyperPTH b- Hypocalcemia c- aluminu toxicity** d- hyperphosphatemia e- met. Acidosis 12- angiotensin 2 --wrong decrease ADH 13- aldosterone- increase Na-k channel .. -· . -=--·""-""'-=·--- " 14- goal for Bp in dm = 130/90 Respiratory 1. polysomnography: central apnea 2. Flow volume loop: residual volume 3. one is not different between emphysyma and chronic bronchitis: c. challenge test** 4-death in asthma: mucous plug 5-Mechanism of hypoxia in COPD: a. Mixed hypoventilation v jq mismatch** 6- Pt in lCU having hypercapnia: hypoventilation 7- dead space : area not perfused but ventillated normally 8- One corresponds with the most severe asthma: a. P02 SO/ PC02 43 9- diagnosis of BKS : CT scan 10- curp score- 3 11- asthma airway limitation- fev1jfvc< 70 or reversible by 12% 12- ash rna ..... dirunal variability 25 pefr He rna to 1)G6PD associated with»> 563c--->T 2)GlanzmannThrombasthenia, a simple cheap test to dx it: 1-platelet count? 2-Ciot retraction** 3-Platelet aggregation 3)Hemophila A» intron 22 inversion ... 4)a patient with 9;22 chromosomal abnormality, asymptomatic, )Ak2 -ve: 1) CML with acute leukemia phase 2) CML in chronic phase** 3)PCV S)a patient who is jaundiced with normocytic anemia»MCV=96, HB=9?, blood smear shows polychromatophilicerythrocytes, high reticulocytes=S, +veCoomb: 1- autoimmune hemolytic anemia** 2-SCD? 3-anemia of chronic disease 6)an 18 year old boy presents to the ER with seizures, CBC was done, platelets were low, and his PT and PTT were normal, Best test to Dx his condition: 1- FDP(fibrin degradation product) 2-ADAMTS-13 ** (nt sure) 7), a girl had cervial,axillary and inguinal lymph node enlargement, very large spleen up to her umbilicus, normal platelets and no anemia, her blood smear showed metamylocytes and blasts,» in Rai system it is 2 and in Pi net it's B, (be aware that in Rai there is 0 as well) S)a girl has AML, MS .. which is the worst prognosis »chr 7 deletion. 9) Thalaesemia has improved greatly regarding trasfusion because 1- HB vaccine, 2chelating agents** 10) TRALI 1- 1-4 hours after transfusion** 2- next day? 11) Heparin, which is wrong: it causes deep venous thrmbosis !! **I thrombocytopenia 12) MM case, 82 microglobulin is 6, and albumin is smth, so which stage in ISS» stage 3 ** Endocrine 1- Hemochromatosis hemochromatosis: transferrin saturation 2- silent thyroitidits no idea wt is the q 3- thyroxine and monitor free t4 4- patient with high prolactin and hypothyroidism, pituitary enlargement next step is : a. levothyroxine alone** 5- polycestic ovary msh congenital adrenal hyperplasia bnaa2n 3la 7ky doc aiman :/ 6- 1-18 yrs old, small testicles ,low testosterone, low FsH and LH, Long arms, can't smell: a-marfanb.GnRHgnrh deficiency**c.karyotype 7- ACTH (cosyntropin) stimulation test 8- diagnosis of diabetes: woman with OGTT, FBS> 21 0 ... , A1c > 7 9- fe so2al el hypoglycemia with phsycological manifestations? men 1.. .. men 2a ... wella isolated pancreatic tumor** 10-25 vitamin D 11- Osteomalacia - hypercalcemia 12- Hypoparathyroidism??? 1-18 yrsold, small testicles ,low testosterone, low FsH and LH, Long arms, can't smell: a-marfan b.GnRHgnrh deficiency c.karyotype ... 2. DM :a-random blood glucose 220 asymptomatic b- asymptomatic HbAlc=7 c-pregnant lady w 94 FBS twice 3. lowca ,normal pth, high alkaline phosphatase: a- vit D defficiency b-1,25-dihydroxyvitamin D c-pseudohypoparathyroidism d-hypoparathyroidism 4- low BP, dark pigmentation of skin, next step :a-aldosterone and renin 2-Acth 5- symptoms of prolactinoma and hypothyroidism: a- levothyroxine alone b- leva and bromocriptine. 6- pt with non tender thyroid nodule, high t4 and t3 ,low tsh, low uptake ,high thyroglobulin ,positive anti peroxidase anti bodies: 1- silent thyroiditis 2-subacute thyroiditis 3-iodine induced thyrotoxicsis 7- ER, Blood sugar= 16 ,negative sulphonylurea ,high insulin ,high c-peptide ,high pro-insulin :a- insulinoma b- men1 c- men2 8- signs of acromegaly, next step : a-lGF-1 , b-growth hormone 9- normalca ,low PTH, diagnosed to have hypothyroidism, he doesn't take medication high tsh, low phosphate: next step: 1- t4, 2-vit D GIT: 1- 1 day bloody bleeding: C.jujeni 2-specific for UC: psuedopolyps 3-HBV wrong: chronic infection 4- + p-anca: primary sclerosing cholangitis S-liver cyst: hydatid serology 6-decrease b12: pancreatic exocrine inefficiency 8-bile acids: absorbed by small intestines 9- decrease hcl secretion misoprostil 10- pt with 6 year hx of diahrea +constipation, colonoscopy was normal -reassure 11- Patient complaining of regurgitation of food that was eaten several day before< and have fouly smelling breath, he has : zincker diverticulum