Welcome to your ECN 2022 - Internal Medicine
1. Amphotericin B is the treatment of choice for all but one of the following infections; which one?
2. A 50-year-old man came to the emergency room complaining of substernal chest pain that started 6 hours ago. Which of the following enzymes is the most helpful in diagnosing his condition?
3. Which of the following drugs causes a syndrome similar to systematic lupus erythematosus?
4. Pruritus is not a common feature of which of the following diseases?
5. Common features of type B or centro-lobular emphysema include all but one of the following; which one?
6. Which of the following is not a characteristic of pain from acute myocardial infarction?
7. In adults, osteogenic carcinomas are frequently associated with which of the following conditions?
8. Primary hyperparathyroidism is frequently associated with which of the following conditions?
9. A 19-year-old male has been in a car accident. On arrival in the emergency room, he has unilateral pupil dilation. The most like diagnosis is:
10. Which of the following symptoms is most commonly associated with subacute bacterial endocarditis?
11. The most common ECG change associated with rheumatic fever is
12. A 30-year-old woman complains of recurrent attacks of confusion and sweating. The attacks are painless and occur before breakfast. The most like diagnosis is:
13. After the college graduation ceremony, 40 students go camping. They bring cheese, sugar, meat, salt, bread, etc. with them. They use river water as a source of drinking water. Six hours later half of the students have diarrhea, vomiting and abdominal cramps. The most likely diagnosis is:
14. Risk factors for colorectal cancer include the following conditions except:
15. A 35-year-old patient comes in with a transient ischemic attack. Which of the following drugs is the best prophylaxis?
16. A 20-year-old woman presents with a 2-day history of dysuria and pollakiuria. She states that she was recently married and not sexually active before marriage. Physical examination revealed a temperature of 38.20°C with normal vital signs. Gynecological examination reveals no discharge, vaginitis or cervicitis. Urinalysis reveals 14 white blood cells per field under high magnification with many gram-negative rods. Which of the following medications is the most appropriate treatment?
17. A 67-year-old man presents to the emergency department with shivering chills and a temperature of 38.00 C. laboratory examination reveals a hematocrit of 23% and the urine tests positive for blood. The patient states that he is taking only one medication for his infection. Which of the following medications most likely caused this patient to develop these signs and symptoms?
18. A 70-year-old man complains of heartburn. It is difficult for him to bend over and he sleeps on a wedge-shaped pillow to try to reduce the burning sensation. Which of the following agents would be most effective in reducing his symptoms?
19. Three months after needle stick exposure to the blood of a patient with hepatitis B, a nurse is evaluated for infection with the virus. The laboratory results: HBsag absent Anti body anti HBs absent IgM anti HBc present IgG anti HBc absent HBe Ag absent Based on these results, which of the following accurately describes the nurse’s hepatitis B status?
20. A patient admitted to the emergency department with chest pain is diagnoses with myocardial infarction. On discharge, the patient is prescribed aspirin but develops an allergic hypersensitivity reaction. Clopidogrel is prescribes instead as a maintenance anticoagulant. Which of the following is the mechanism of action of this drug?
21. All but one of the following statements about bronchogenic cancer are true
22. Complications of subacute bacterial endocarditis include which next condition
Question 23-24: a 35-year-old woman with numbness in her left-hand arthritis. These rheumatoid episodes usually occur complaining of pain and overnight and relieved by shaking the hand. If you hold the hand in extreme flexion for a short period of time, the pain and numbness return. 23. What is the most likely diagnosis?
24. Confirmation of the diagnosis of patient’s condition can be made by which of the following tests?
Question 25-26: A 25-year-old man with ulcerative colitis presents with progressive onset asthenia, pruritus and jaundice. Examination reveals hepatosplenomegaly and laboratory analysis is significant for elevated serum alkaline phosphatase and moderately increased transaminases. 25. The diagnosis would most likely be made by which of the following tests?
26. The most like diagnosis of this patient’s condition is:
27. In acute diaphragmatic pleurisy involving the central part of the diaphragm the patient is likely to complain of pain in the area:
28. A 58-year-old patient presented with the following symptoms: for several months he had observed fatigue, inflamed tongue, acroparesthesia and diarrhea. Examination reveals pallor, lack of positional sensitivity and vibration in the feet and atrophic tongue. Blood count reveals macrocytic anemia. One of the following substances that will produce the best reticulocytosis response is
29. A 35-year-old man is overweight for his age and height. He has no symptoms and it being examined solely in relation to his employment. Several of his urine samples are being tested and show glycosuria ranging from nothing a different time and are negative for ketones. A fasting (venous) blood glucose is 160mg per 100cc. The correct way to manage this patient at this stage is:
30. Death of patients with high blood pressure is most frequently caused by the disease
31. The characteristic murmur of aortic insufficiency is:
32. Clinically, atrial fibrillation should be different from:
33. A 35-year-old woman with diarrhea and lower abdominal pain lasting 3 days comes to see her doctor after various home remedies failed to relieve her symptoms. She denies having taken a recent trip. There is blood and pus in her stool. Stool culture reveals several gram-negative, oxidase-positive, curved, flagellated rods. Which of the following microorganisms is the most likely causative pathogen?
34. A 32-year-old woman with urinary frequency, suprapubic pain and dysuria for the past 3 days comes to the emergency room. She has no fever, nausea or vomiting. A gram stain reveals gram-negative rods. Which of the following microorganisms is the most likely causative agent?
35. A 57-year-old smoker with a long history of chronic obstruction pulmonary disease presents to the physician with a blood pressure of 150/95mmHg. Which of the following antihypertensive drugs is contraindicated in this patient?
36. All of the following clinical signs define severe malaria except one; which one?
37. Which of the following statements about mitral insufficiency is incorrect?
38. All of the following signs are highly suggestive or cardiac tamponade except one; which one?
39. All but one of the following is suggestive of malabsorption syndrome in chronic diarrhea; which one?
40. Which of the following would you recommend for a newborn of mother who is HBsAg and HBeAg positive?
