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. Signs of active ischemia during stress testing.
Endometrial biopsy
Angina - ST- segment changes on ECG - or ? BP
Never
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse


2. Findings in 3
Displacement
Acute pancreatitis
Obstructive pulmonary disease (e.g. - asthma)
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms


3. An elderly male with hypochromic - microcytic anemia is asymptomatic. Diagnostic tests?
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
No. Parental consent is not necessary for the medical treatment of pregnant minors
Graves' disease
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes


4. Classic CXR findings for pulmonary edema.

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5. Maternal mortality?
Weight gain - type 2 DM - QT prolongation
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed
Paget's disease
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births


6. Defect in an X- linked syndrome with mental retardation -
M3
1
Oral or topical metronidazole
Lesch - Nyhan syndrome (purine salvage problem with


7. A 40-year - old obese female with elevated alkaline phosphatase - elevated bilirubin - pruritus - dark urine - and clay- colored stools.
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
Identify cause; pressors (e.g. - dobutamine)
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
Biliary tract obstruction


8. Red plaques with silvery- white scales and sharp margins.
Oral surgery
Psoriasis
Anorexia
Femoral hernia


9. RTA associated with aldosterone defect.
46 -XX
Type IV (distal) RTA
TICS
Toxoplasma gondii


10. Complication of overly rapid correction of hyponatremia.
Central pontine myelinolysis
Cohort studies can be used to calculate relative risk (RR) - incidence - and/or odds ratio (OR). Case - control studies can be used to calculate an OR
Type IV (distal) RTA
Postinfectious glomerulonephritis


11. Four characteristics of a nevus suggestive of melanoma.
a - antagonists (phentolamine and phenoxybenzamine)
Asymmetry - border irregularity - color variation - large diameter
Flumazenil
Dressler's syndrome: fever - pericarditis - ? ESR


12. Treatment for Guillain - Barr
IVIG or plasmapheresis
Ulcerative colitis
Spinal stenosis
Rate control with carotid massasge or other vagal stimulation


13. The most common organism in burn - related infections.
Fluids and antibiotics
High reliability - low validity
Pseudomonas
Alport's syndrome


14. Classic causes of drug - induced hepatitis.
Sensitivity
Alzheimer's and multi - infarct
Central pontine myelinolysis
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline


15. Perinatal mortality?

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16. ? risk of what infection with silicosis?
Mycobacterium tuberculosis
Anemia of chronic disease
Administration of DDAVP ? serum osmolality and free water restriction
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths


17. Treatment of septic shock.
Fluids and antibiotics
Oral or topical metronidazole
Guillain - Barr
Calcium oxalate


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

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19. An eight -year - old child is in a serious accident. She requires emergent transfusion - but her parents are not present.
Blast crisis (fever - bone pain - splenomegaly - pancytopenia)
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis
Treat immediately. Consent is implied in emergency situations
Nitroprusside


20. Fetal mortality?

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21. Involuntary commitment or isolation for medical treatment may be undertaken For what reason?
Frotteurism (a paraphilia)
Kegel exercises - estrogen - pessaries for stress incontinence
When treatment noncompliance represents a serious danger to public health (e.g. - active TB)
Multiple myeloma


22. Diagnostic test for hereditary spherocytosis.
Highly sensitive for TB
Partial mole
Osmotic fragility test
Displacement


23. Name the organism:
ARDS
Bacillus cereus
Pseudomonas
Actinomyces israelii


24. Appropriate diagnostic test?
Reaction formation
Transitional cell carcinoma
Pharmacologic stress test (e.g. - dobutamine echo)
Dissociative fugue


25. If you want to know if race affects infant mortality rate but most of the variation in infant mortality is predicted by socioeconomic status - then socioeconomic status is a _____.
Transitional cell carcinoma
1
Confounding variable
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations


26. Cause of neonatal RDS.
Stasis - hypercoagulability - endothelial damage
HGPRTase deficiency)
Surfactant deficiency
A patient with chest trauma who was previously stable suddenly dies


27. The most common cause of Cushing's syndrome.

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28. Treatment of AF.
S. aureus
Pemphigus vulgaris
Rate control - rhythm conversion - and anticoagulation
MCP and PIP joints; DIP joints are spared


29. Acceptable urine output in a stable patient.
Wait - surgical resection - radiation and/or androgen suppression
Menometrorrhagia
Hypotension - distant heart sounds - and JVD
30 cc/hour


30. Breast cancer type that ? the future risk of invasive carcinoma in both breasts.
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
Squamous cell carcinoma
Lobular carcinoma in situ
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6


31. IV drug use with JVD and holosystolic murmur at the left sternal border. Treatment?
Pityriasis versicolor
Squamous cell carcinoma
Treat existing heart failure and replace the tricuspid valve
Ultrasound


32. A 50-year - old woman leaks urine when laughing or coughing. Nonsurgical options?
Consider Fitz - Hugh - Curtis syndrome
Malingering
Kegel exercises - estrogen - pessaries for stress incontinence
RCC or other erythropoietin - producing tumor; evaluate with CT scan


33. Epidemics such as influenza
Intracellular inclusions seen in thalassemia - G6PD deficiency - and postsplenectomy
Higher incidence
Avascular necrosis
IV hydration and loop diuretics (furosemide)


34. A neonate has meconium ileus.

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35. Treatment for AML M3.
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
Fanconi's anemia
A patient's family cannot require that a doctor withhold information from the patient
Retinoic acid


36. An 11-year - old obese - African - American boy presents with sudden onset of limp. Diagnosis? Workup?
Metformin
Actinomyces israelii
Menometrorrhagia
Slipped capital femoral epiphyses. AP and frog - leg lateral view


37. A 13-year - old male has a history of theft - vandalism - and violence toward family pets.
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
Rate control - rhythm conversion - and anticoagulation
CA-125 and transvaginal ultrasound
Conduct disorder


38. The number of bacterial culture on a clean - catch specimen to diagnose a UTI.
105 bacteria/mL
Niacin
S. aureus or S. epidermidis.
Graves' disease


39. PFT showing ? FEV1/FVC.
Substance abuse
Restrictive pulmonary disease
Folate deficiency
Hypocalcemia


40. 'Stones - bones - groans - psychiatric overtones.'
Treat existing heart failure and replace the tricuspid valve
Restrictive pulmonary disease
Signs and symptoms of hypercalcemia
DM - SLE - and amyloidosis


41. What is the immunodeficiency?

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42. A young child presents with proximal muscle weakness - waddling gait - and pronounced calf muscles.
Choriocarcinoma
Taenia solium (cysticercosis)
MS
Duchenne muscular dystrophy


43. Ring - enhancing brain lesion on CT with seizures
A patient with chest trauma who was previously stable suddenly dies
Reactive (Reiter's) arthritis. Associated with Campylobacter - Shigella - Salmonella - Chlamydia - and Ureaplasma
Type II (proximal) RTA
Taenia solium (cysticercosis)


44. The most common histology of bladder cancer.
Seminoma
Absence seizures
Transitional cell carcinoma
105 bacteria/mL


45. Non - small cell lung cancer (NSCLC) associated with hypercalcemia.
Sheehan's syndrome (postpartum pituitary necrosis)
Ophthalmologic exam - CT - and MRI
Pseudogout
Squamous cell carcinoma


46. A 25-year - old Jewish male presents with pain and watery diarrhea after meals. Exam shows fistulas between the bowel and skin and nodular lesions on his tibias.

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47. When can a physician refuse to continue treating a patient on the grounds of futility?
Osteoarthritis
Displacement
Number of deaths from 20 weeks' gestation to birth per 1000 total births
When there is no rationale for treatment - maximal intervention is failing - a given intervention has already failed - and treatment will not achieve the goals of care


48. Natural history of a leiomyoma.
Yersinia
Polymyalgia rheumatica
Regresses after menopause
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity


49. Signs of air embolism.
Substance abuse
Factitious disorder (Munchausen syndrome)
A patient with chest trauma who was previously stable suddenly dies
Malingering


50. Caf
Distal radius (Colles' fracture)
INH - penicillamine - hydralazine - procainamide
Central pontine myelinolysis
Neurofibromatosis 1