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. Natural history of a leiomyoma.
Regression
Regresses after menopause
Ampulla of the oviduct
Prevalence


2. The most common causes of hypercalcemia.
Surfactant deficiency
Pasteurella multocida
Malignancy and hyperparathyroidism
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states


3. Glomerulonephritis with deafness.

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4. Non - small cell lung cancer (NSCLC) associated with hypercalcemia.
Slipped capital femoral epiphyses. AP and frog - leg lateral view
Chronic lymphocytic leukemia (CLL)
Clomiphene citrate
Squamous cell carcinoma


5. A 55-year - old man is diagnosed with prostate cancer. Treatment options?
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
Wait - surgical resection - radiation and/or androgen suppression
Neither
Treat because the disease represents an immediate threat to the child's life. Then seek a court order


6. Treatment for neuroleptic malignant syndrome.
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
Dantrolene or bromocriptine
? protein intake - lactulose - neomycin
Diverticulosis


7. Vaccinations at a six- month well - child visit.
IV benzodiazepine
Spinal stenosis
Administration of DDAVP ? serum osmolality and free water restriction
HBV - DTaP - Hib - IPV - PCV


8. Rigidity and stiffness with resting tremor and masked facies.

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9. Pinkish - scaling - flat lesions on the chest and back. KOH prep has a 'spaghetti - and - meatballs' appearance.
Regresses after menopause
Mycoplasma
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline
Pityriasis versicolor


10. Joint pain and stiffness that worsen over the course of the day and are relieved by rest.
Osteoarthritis
Kegel exercises - estrogen - pessaries for stress incontinence
Huntington's disease
CHF - shock - and altered mental status


11. Treatment of central DI.
Seborrheic keratosis
Administration of DDAVP ? serum osmolality and free water restriction
Mycobacterium tuberculosis
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)


12. Breast cancer type that ? the future risk of invasive carcinoma in both breasts.
Displacement
Lobular carcinoma in situ
Nitroprusside
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


13. True or false: Withdrawing life - sustaining care is ethically distinct from withholding sustaining care.
Wrist drop - loss of thumb abduction
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)
Seminoma
False. Withdrawing and withholding life are the same from an ethical standpoint


14. A young child presents with proximal muscle weakness - waddling gait - and pronounced calf muscles.
Broca's aphasia. Frontal lobe - left MCA distribution
Duchenne muscular dystrophy
Lichen sclerosus
Hypernatremia


15. When should a vaginal exam be performed with suspected placenta previa?
Never
Diamond - Blackfan anemia
Immediate cardioversion
Iron overload; use deferoxamine


16. Findings in 3
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
O2 - analgesia - hydration - and - if severe - transfusion
Number of deaths per 1000 population
Observational bias


17. Fetal mortality?

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18. A 'blueberry muffin' rash is characteristic of what congenital infection?
Rubella
Pseudomonas
1
Phototherapy (mild) or exchange transfusion (severe)


19. Indications for medical treatment of ectopic pregnancy.

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20. Auer rods on blood smear.
Higher incidence
Amoxicillin
Hypoparathyroidism
Acute myelogenous leukemia (AML)


21. Unilateral - severe periorbital headache with tearing and conjunctival erythema.
Cluster headache
RUQ pain - jaundice - and fever/chills in the setting of ascending cholangitis
Fever - heart murmur - Osler's nodes - splinter hemorrhages - Janeway lesions - Roth's spots
Levodopa/carbidopa


22. Bias introduced when screening detects a disease earlier and thus lengthens the time from diagnosis to death.
M3
Duodenal atresia
Protamine
Lead - time bias


23. Infant mortality?
Ampulla of the oviduct
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)
Allergic interstitial nephritis
Rubella


24. Method of calculating fluid repletion in burn patients.
Parkland formula
Fatigue and impending respiratory failure
Psoriasis
Out


25. Perinatal mortality?

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26. PFT showing ? FEV1/FVC.
Osmotic fragility test
Sarcoidosis
Snowstorm on ultrasound. 'Cluster - of - grapes' appearance on gross examination
Restrictive pulmonary disease


27. Inflammation and epithelial thinning of the anogenital area - predominantly in postmenopausal women.
Lichen sclerosus
Lyme disease - Ixodes tick - doxycycline
Continuous - painful vaginal bleeding
Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make patient NPO and give IV fluids - O2 - analgesia - and 'tincture of time'


28. Four characteristics of a nevus suggestive of melanoma.
Asymmetry - border irregularity - color variation - large diameter
Chronic granulomatous disease
Hereditary spherocytosis
ETEC


29. Galactorrhea - impotence - menstrual dysfunction - and ? libido.
Patient on dopamine antagonist
Confounding variable
A patient's family cannot require that a doctor withhold information from the patient
Toxoplasma gondii


30. The coagulation parameter affected by warfarin.
False. Patients may change their minds at any time. Exceptions to the requirement of informed consent include emergency situations and patients without decision - making capacity
Salmonella
PT
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)


31. A crescent - shaped hyperdensity on CT that does not cross the midline.
Subdural hematoma
A patient's family cannot require that a doctor withhold information from the patient
Dissociative fugue
IV penicillin or ampicillin


32. Acceptable urine output in a trauma patient.
50 cc/hour
1
Reaction formation
Never


33. The percentage of cases within one SD of the mean? Two SDs? Three SDs?
Neuroleptic malignant syndrome
68% - 95.5% - 99.7%
Pain - pallor - pulselessness - paralysis - paresthesia - poikilothermia
Endometrial biopsy


34. A patient presents with recent PID with RUQ pain.
Polymyalgia rheumatica
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid
Consider Fitz - Hugh - Curtis syndrome
Hemolytic - uremic syndrome (HUS) due to E. coli O157:H7


35. Birth rate?
Number of live births per 1000 population
Displacement
7-10 days
Gout. Needle - shaped - negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid


36. Flat - topped papules.
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
Lichen planus
Campylobacter
Higher prevalence


37. A 50-year - old male presents with early satiety - splenomegaly - and bleeding. Cytogenetics show t(9 -22). Diagnosis?
Stable - unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation
Infection - febrile seizures - trauma - idiopathic
CML
They can mask symptoms of hypoglycemia


38. The most common cause of postpartum hemorrhage.
BP > 140/90 on three separate occasions two weeks apart
Uterine atony
Restrictive pulmonary disease
Multiple myeloma


39. The most common cause of seizures in young adults (18-35 years).
Fever - pharyngeal erythema - tonsillar exudate - lack of cough
Trauma - alcohol withdrawal - brain tumor
Flumazenil
High TSH - low T4 - antimicrosomal antibodies


40. Presence of red cell casts in urine sediment.
Taenia solium (cysticercosis)
Nephrotic syndrome
Angina is new - is worsening - or occurs at rest
Glomerulonephritis/nephritic syndrome


41. Cohort study
Number of deaths from 20 weeks' gestation to one month of life per 1000 total births
DI
Incidence and prevalence
Membranous glomerulonephritis


42. Meningitis in neonates. Causes? Treatment?
S. aureus
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin
Retinoic acid
von Willebrand's disease; treat with desmopressin - FFP - or cryoprecipitate


43. The most common cancer in men and the most common cause of death from cancer in men.
a - antagonists (phentolamine and phenoxybenzamine)
Suspect retinoblastoma
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Number of deaths from 20 weeks' gestation to one month of life per 1000 total births


44. The most common causes of dementia.

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45. Microcytic anemia with ? serum iron - ? total iron - binding capacity (TIBC) - and normal or ? ferritin.
Nitroprusside
Anemia of chronic disease
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)
Central pontine myelinolysis


46. A patient develops endocarditis three weeks after receiving a prosthetic heart valve. What organism is suspected?
Choriocarcinoma
S. aureus or S. epidermidis.
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)
Fluid restriction - demeclocycline


47. A 14-year - old girl presents with prolonged bleeding after dental surgery and with menses - normal PT - normal or ? PTT - and ? bleeding time. Diagnosis? Treatment?

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48. Dyspnea - lateral hilar lymphodenopathy on CXR - noncaseating granulomas - increased ACE - and hypercalcemia.
? protein intake - lactulose - neomycin
Transitional cell carcinoma
Sarcoidosis
Trauma; the second most common is berry aneurysm


49. A 25-year - old African - American male with sickle cell anemia has sudden onset of bone pain. Management of pain crisis?
Duodenal atresia
Agranulocytosis
Beta- hCG; the most common cause of amenorrhea is pregnancy
O2 - analgesia - hydration - and - if severe - transfusion


50. Treatment for ventricular fibrillation.
Immediate cardioversion
Surfactant deficiency
'Sawtooth' P waves
Rate control - rhythm conversion - and anticoagulation