Instructions:

• Answer 50 questions in 15 minutes.
• If you are not ready to take this test, you can study here.
• Match each statement with the correct term.
• Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. Two consecutive findings of atypical squamous cells of undetermined significance (ASCUS) on Pap smear. Follow - up evaluation?
OCPs
Dissociative fugue
Colposcopy and endocervical curettage
'Sawtooth' P waves


2. A young patient with a family history of sudden death collapses and dies while exercising.
Hypertrophic cardiomyopathy
Number of deaths per 1000 population
Malingering
Menometrorrhagia


3. Cold water is flushed into a patient's ear - and the fast phase of the nystagmus is toward the opposite side. Normal or pathological?
Number of deaths from 28 days to one year per 1000 live births
Cirrhosis - CHF - nephritic syndrome
Normal
Rate control - rhythm conversion - and anticoagulation


4. Glomerulonephritis with hemoptysis.

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5. A condition associated with red 'currant - jelly' stools.
Intussusception
30 cc/hour
68% - 95.5% - 99.7%
Pityriasis versicolor


6. Involuntary psychiatric hospitalization can be undertaken for which three reasons?
Bacillus cereus
Self - limited - painless vaginal bleeding
Ophthalmologic exam - CT - and MRI
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)


7. Joints in the hand affected in rheumatoid arthritis.
V/Q scan
Emergent laparotomy to repair perforated viscus - likely stomach
MCP and PIP joints; DIP joints are spared
Trichomonas vaginitis


8. In which patients do you initiate colorectal cancer screening early?
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction
Respiratory alkalosis
Identify cause; fluid and blood repletion
Patients with IBD; those with familial adenomatous polyposis (FAP)/hereditary nonpolyposis colorectal cancer (HNPCC); and those who have first - degree relatives with adenomatous polyps (< 60 years of age) or colorectal cancer


9. Treatment for AML M3.
IgA nephropathy (Berger's disease)
Lichen planus
Retinoic acid
Antipsychotics (neuroleptic malignant syndrome)


10. The number of true positives divided by the number of patients with the disease is _____.
Alzheimer's and multi - infarct
Immediate needle thoracostomy
Sensitivity
IgA nephropathy (Berger's disease)


11. Bone is fractured in fall on outstretched hand.

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12. Fetal mortality?

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13. A 50-year - old woman leaks urine when laughing or coughing. Nonsurgical options?
Squamous cell carcinoma
Fatigue and impending respiratory failure
Sheehan's syndrome (postpartum pituitary necrosis)
Kegel exercises - estrogen - pessaries for stress incontinence


14. Treatment of septic shock.
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6
Alport's syndrome
Slipped capital femoral epiphyses. AP and frog - leg lateral view
Fluids and antibiotics


15. Identify key organisms causing diarrhea:
Herpes simplex
Number of deaths from birth to 28 days per 1000 live births
E. coli O157:H7
Nitroprusside


16. Bias introduced when screening detects a disease earlier and thus lengthens the time from diagnosis to death.
Malingering
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
Lead - time bias
Normal


17. Pinkish - scaling - flat lesions on the chest and back. KOH prep has a 'spaghetti - and - meatballs' appearance.
Pityriasis versicolor
Pseudogout
M3
Salmonella


18. The most common type of testicular cancer.
Seminoma
Selective IgA deficiency
Number of deaths from 28 days to one year per 1000 live births
Rubella


19. A 55-year - old patient presents with acute 'broken speech.' What type of aphasia? What lobe and vascular distribution?

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20. Post - HBV exposure treatment.
Murphy's sign - seen in acute cholecystitis
HBV immunoglobulin
ALS
1


21. A first - born female who was born in breech position is found to have asymmetric skin folds on her newborn exam. Diagnosis? Treatment?
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction
Edrophonium
IV penicillin or ampicillin
Iron deficiency anemia


22. A painful - recurrent vesicular eruption of mucocutaneous surfaces.
Substance abuse
Toxoplasma gondii
Herpes simplex
Polymyalgia rheumatica


23. Acceptable urine output in a stable patient.
Emergent laparotomy to repair perforated viscus - likely stomach
Uveitis - ankylosing spondylitis - pyoderma gangrenosum - erythema nodosum - 1
Third - degree heart block
30 cc/hour


24. The coagulation parameter affected by warfarin.
Weight loss and OCPs
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
PT
Kegel exercises - estrogen - pessaries for stress incontinence


25. Classic ultrasound and gross appearance of complete hydatidiform mole.

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26. May be seen in children who are accused of inattention in class and confused with ADHD.
Cerebral berry aneurysms (AD PCKD)
ACEI
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6
Absence seizures


27. A patient presents with tachycardia - wild swings in BP - headache - diaphoresis - altered mental status - and a sense of panic.
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid
Pheochromocytoma
V/Q scan
Calcium oxalate


28. The most common type of tracheoesophageal fistula (TEF). Diagnosis?
Pulsus paradoxus (seen in cardiac tamponade)
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
Esophageal atresia with distal TEF (85%). Unable to pass NG tube


29. Relative risk?
? protein intake - lactulose - neomycin
Vibrio - HAV
The IR of a disease in a population exposed to a particular factor
Allergic interstitial nephritis


30. Postnatal mortality?
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension
Number of deaths from 28 days to one year per 1000 live births
Rate control with carotid massasge or other vagal stimulation
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed


31. Caf
Murphy's sign - seen in acute cholecystitis
Betamethasone or dexamethasone
Nephritic syndrome
Neurofibromatosis 1


32. Acid - base disturbance commonly seen in pregnant women.
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
Beta- blockers - digoxin - calcium channel blockers
Respiratory alkalosis
Endometrial biopsy


33. First - line treatment for moderate hypercalcemia.
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
IV hydration and loop diuretics (furosemide)
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
Kegel exercises - estrogen - pessaries for stress incontinence


34. Macrocytic - megaloblastic anemia with neurologic symptoms.
BP > 140/90 on three separate occasions two weeks apart
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis
Conversion disorder
B12 deficiency


35. A five - month - old girl has ? head growth - truncal dyscoordination - and ? social interaction.

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36. The most common cause of bloody nipple discharge.
MCP and PIP joints; DIP joints are spared
S. aureus
Naloxone
Intraductal papilloma


37. Appropriate diagnostic test?
Postinfectious glomerulonephritis
Headache
Pharmacologic stress test (e.g. - dobutamine echo)
Menometrorrhagia


38. Peaked T waves and widened QRS.
Hyperkalemia
Asherman's syndrome
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)


39. CSF findings:
Parkinson's disease
Uremic syndrome seen in patients with renal failure
Septic or anaphylactic shock
Aseptic (viral) meningitis


40. Findings in 3
Suspect ankylosing spondylitis. Check HLA- B27
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Tetracycline - fluoroquinolones - aminoglycosides - sulfonamides
Abdominal ultrasound and CT


41. Treatment of SIADH?
Type I (distal) RTA
Fluid restriction - demeclocycline
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer


42. A four -year - old child presents with oliguria - petechiae - and jaundice following an illness with bloody diarrhea. Most likely diagnosis and cause?
Rett's disorder
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
Both have ? hematocrit and RBC mass - but polycythemia vera should have normal O2 saturation and low erythropoietin levels
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7


43. An agent that reverses the effects of heparin.
Hypotension and bradycardia
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
Amoxicillin
Protamine


44. Sudden onset of mental status changes - emesis - and liver dysfunction after taking aspirin.

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45. Goal hemoglobin A1c for a patient with DM.
Murphy's sign - seen in acute cholecystitis
O2 - analgesia - hydration - and - if severe - transfusion
Coarctation of the aorta
< 7.0


46. An elderly male with hypochromic - microcytic anemia is asymptomatic. Diagnostic tests?
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
Regression
Hypertension - bradycardia - and abnormal respirations
Crohn's disease


47. An eight -year - old child is in a serious accident. She requires emergent transfusion - but her parents are not present.
Mycobacterium tuberculosis
Treat immediately. Consent is implied in emergency situations
Out
Pityriasis versicolor


48. Honey- crusted lesions.
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
Lesion of 1
Impetigo
High reliability - low validity


49. A history significant for initial altered mental status with an intervening lucid interval. Diagnosis? Most likely etiology? Treatment?
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births
105 bacteria/mL
Pentad of TTP


50. Type of ARF in a patient with FeNa < 1%.
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
Angina is new - is worsening - or occurs at rest
Prerenal
Hypoxia and hypocarbia