MY FILES IM & Surgery

exams

MarB, [5/26/2022 11:37 AM] A 45-year-old man presents with a 3-week history of progressive dyspnea, increasing fatigue, fever, and malaise. He has a history of intravenous drug abuse and has received a new diagnosis of AIDS, with a viral load of 300,000 copies/mL and a CD4 cell count of 5/μL. He began receiving antiretroviral therapy with TDF+3TC+DTG. On examination, he appears ill. His temperature is 39.4 °C, blood pressure 100/60 mm Hg, and pulse 120 beats per minute. Oxygen saturation on room air is 83 %. Oral thrush is noted, and findings on lung examination are normal. Chest radiography shows bilateral symmetrical infiltrates. What is the most likely etiologic agent of his respiratory illness? a. Mycobacterium tuberculosis b. Streptococcus pneumoniae c. Pneumocystis jiroveci d. Histoplasma capsulatum Clear my choice Question 63 Not yet answered Marked out of 1.00 Flag question Question text Which of the following is an established risk factor of atherosclerosis? a. Diabetes mellitus b. Black race c. High physical activity d. High HDL-cholesterol Clear my choice Question 64 Not yet answered Marked out of 1.00 Flag question Question text The following is a feature of thyrotoxicosis secondary to sub-acute thyroiditis a. Hyper active thyroid gland indicated by high radio-iodine uptake b. Thyrotoxicosis results from a release of preformed (stored) thyroid hormones from the inflamed gland c. Low TSH and low FT4 d. Increased TSH level Clear my choice Question 65 Not yet answered Marked out of 1.00 Flag question Question text Regarding myxedema coma, which one of the following statements is true? a. It is a severe form of untreated thyrotoxicosis b. It indicates the thyroid enlargement has transformed malignant c. Patient could present with hypoventilation d. It complicates an over- treated hypothyroidism

MarB, [5/26/2022 11:37 AM] A 62 years old woman experiences occasional palpitations, fatigue and forgetfulness. Past Medical History: HTN on Lisinopril. On Examination: BP:145/80, PR:84bpm. Thyroid exam: nodular goiter.Lab: TSH < 0.01 mU/L, Free T4: 1.4 ng/dl (nl: 0.8-1.8), Total T3: 165 ng/dl (nl: 90-190) What will be the possible Diagnosis? a. Overt Hyperthyroidism b. Euthyroid c. Sub clinical Hypothyroidism d. Subclinical Hyperthyroidism Clear my choice Question 53 Not yet answered Marked out of 1.00 Flag question Question text One of the following vector-borne infections is transmitted by the louse. a. Lyme disease b. Epidemic typhus c. Murine typhus d. Leptospirosis Clear my choice Question 54 Not yet answered Marked out of 1.00 Flag question Question text Which of the following is the most common cause of death for people with chronic kidney disease (CDK) (estimated glomerular filtration rate [eGFR] <60 ml/min/1.73 m2)? a. Sepsis b. Withdrawal from dialysis c. Cardiovascular disease d. Failure of dialysis access Clear my choice Question 55 Not yet answered Marked out of 1.00 Flag question Question text All of the following case scenario on community acquired pneumonia is an indication for inpatient management except a. A 70-year-old man with mental confusion b. A 50-year-old man known hypertensive c. A 60-year-old lady with respiratory rate of 32 breaths per minute. d. A 30-year-old female with blood pressure of 80/50 mmHg Clear my choice A 40 years old man is recently diagnosed to have HIV infection. He came today to chest clinic with cough productive of whitish sputum, sweating and low grade fever of three weeks duration. P/E showed PR = 120BPM, RR = 30BPM, T = 38.3oC. His current CD4 is 360cells/mm3. Which of the following disease entity is most likely? a. PCP b. CMV pneumonitis c. Cryptococcal Pneumonitis d. Pulmonary TB Clear my choice Question 57 Not yet answered Marked out of 1.00 Flag question Question text Cerebellar ataxia is associated with deficiency of which of the following vitamin? a. Vitamin B6 b. Vitamin E c. Vitamin D d. Vitamin A Clear my choice Question 58 Not yet answered Marked out of 1.00 Flag question Question text Which of the following clinical feature is NOT associated with cerebellar lesion? a. Pendular reflexes b. Dysdiadokinesia c. Saccadic dysmetria d. Spasticity Clear my choice Question 59 Not yet answered Marked out of 1.00 Flag question Question text Secondary acute leukemias are characterized by all of the following, EXCEPT a. Antecedent myeloproliferative disorders b. Previous exposure to chemotherapeutic agents c. Transformation following few months after the diagnosis of myelodysplastic neoplasm d. Random acquisition of somatic mutations in hematopoietic progenitors Clear my choice Question 60 Not yet answered Marked out of 1.00 Flag question Question text A 35-year-old overweight male from Addis presents with pain in the epigastric area which worsens after meal and which usually occurs at night. He is also diagnosed to have bronchial asthma and he seems not to respond to the inhaler therapy. Which one of the following is the most likely diagnosis in this patient? a. Peptic Ulcer disease b. Non Ulcer dyspepsia c. Erosive Gastritis d. Gastroesophageal reflux disease Clear my choice Filtration at the glomerulus is a passive process. Which of the following statements is true? a. Albumin is too large to be filtered. b. Hydrostatic pressure in the glomerular capillaries is the only force for filtration. c. Albumin is not filtered because the glomerular barrier is positively charged. d. Dilation of the afferent arteriole, but not the efferent arteriole, can increase filtration rate. Clear my choice Question 62 Not yet answered Marked out of 1.00 Flag question Question text

Question 44 Not yet answered Marked out of 1.00 Flag question Question text MarB, [5/26/2022 11:37 AM] A 25-year-old male from Metema is seen in the ED for symptoms of fevers and abdominal swelling, early satiety, and weight loss. His symptoms began abruptly 2 weeks ago. He was previously healthy and is taking no medications. On physical examination, temperature is 39.0°C and pulse is 120 bpm, with normal blood pressure and respiratory rate. The remainder of the exam is notable for cachexia and a distended abdomen with a massively enlarged spleen. The spleen is tender and soft. The liver is not palpable. Mild peripheral adenopathy is present. Which of the following statements is correct regarding this patient? a. He probably has normal cell counts on peripheral blood smear. b. Leishmania donovani is not endemic in Ethiopia. c. Eosinophilia is a characteristic finding. d. Splenic aspiration offers the highest diagnostic yield. Clear my choice Question 45 Not yet answered Marked out of 1.00 Flag question Question text Which of the following is not true about rheumatic heart disease(RHD)? a. Benzathine Penicillin prophylaxis should be given until ten years after the diagnosis of RHD b. Previous history of acute rheumatic fever is elicited in about 90 % of patients presenting with RHD c. All patients should receive anticoagulation regardless of valve lesion or CHA2DVASC2 score if they develop atrial fibrillation. d. Multivalvular involvement is characteristic A 55 years old male patient came for symptom complexes of anemia. Further history revealed that he has symptoms of malabsorption. Physical examination revealed pallor, a mildly icteric sclera. On peripheral morphology he has macrocytic RBCs with many hyper segmented neutrophils. What should be the immediate next step in the patient’s evaluation? a. Giving him folate treatment as it is the most likely cause of the anemia b. Evaluating him for hemolytic anemia since he is jaundiced c. Giving him IM cyanocobalamin treatment d. Measuring serum B12 & RBC folate level Clear my choice Question 47 Not yet answered Marked out of 1.00 Flag question Question text Which of the following examination findings would be most specific in differentiating spinal cord processes from peripheral nerve processes? a. Impaired vibration sense b. Bilateral weakness c. Sensory level d. Depressed reflex Clear my choice Question 48 Not yet answered Marked out of 1.00 Flag question Question text A 53-year-old man with no known medical problems complained of a throbbing headache for more than 2 days. A few hours prior to presentation, he complained of severe vertigo, nausea with vomiting, imbalance, and inability to grasp objects with his right arm. Clinical examination showed a BP of 244/138 mmHg. Where do you localize the lesion? a. Left cerebral hemisphere b. Right cerebral hemisphere c. Right cerebellar hemisphere d. Left cerebellar hemisphere Clear my choice Question 49 Not yet answered Marked out of 1.00 Flag question Question text Which is not a feature of atypical pneumonia a. Are caused by intracellular organism b. Are common causes of parapneumonic effusion c. Viruses are common causes d. It causes bronchopneumonia Clear my choice Question 50 Not yet answered Marked out of 1.00 Flag question Question text One of the following is FALSE regarding Enteric fever. a. It is clinically indistinguishable from paratyphoid fever. b. “Gold standard” for the diagnosis is bone marrow culture. c. It is transmitted through the fecal-oral route. d. There are animal reservoirs for the etiologic bacteria. Which of the following statement is FALSE regarding Cryptococcal meningitis? a. Headache and fever are the hallmarks. b. Infection is acquired through inhalation and is hematogenously spread to the meninges and brain. c. Low CSF white blood cells indicates benign prognosis d. Meningeal signs are mild Clear my choice Question 52 Not yet answered Marked out of 1.00 Flag question Question text

Renin-angiotensin-aldosterone system b. Atrial natriuretic peptides c. MarB, [5/26/2022 11:37 AM] Sympathetic nervous system d. Endothelin Clear my choice Question 99 Not yet answered Marked out of 1.00 Flag question Question text Eskedar is a young lady who presented with complaints of palpitation, sweating, weight loss and insomnia for the last one year. Physical examination revealed an anxious looking patient with a pulse rate of 120 bpm, BP of 100/60 mmHg, exophthalmos, and non-tender, diffuse and soft anterior neck swelling. The most likely diagnosis is a. Toxic multinodular goiter b. Thyroiditis c. Graves’ disease d. Thyroid malignancy Clear my choice Question 100 Not yet answered Marked out of 1.00 Flag question Question text A 70-year-old female, a long time heavy smoker, presented with exertional dyspnea and cough of 3 years duration. On physical examination, JVP is not raised and there are wheezes on both lung fields. Post bronchodilator FEV1/FVC is 0.6. What is the most probable diagnosis? a. Pulmonary Tuberculosis b. Asthma c. Chronic Obstructive Lung Disease(COPD) d. Lung cancer Which of the following suggests spontaneous bacterial peritonitis in a known decompensated cirrhotic patient with Ascites? a. Ascitic fluid culture demonstrating growth of gram negative organism b. Ascitic fluid mononuclear cell count is 600/ml. c. Ascitic fluid gram staining is positive for gran negative cocci d. Presence of high grade fever and abdominal tenderness Clear my choice Question 37 Not yet answered Marked out of 1.00 Flag question Question text A nurse caring for a human immunodeficiency virus (HIV)-positive patient incurs a needle stick injury. Which statement does not provide information pertinent to the proper management of this situation? a. The likelihood of transmission is influenced by whether blood was visible on the needle b. Depth of injury DOES NOT influence the likelihood of transmission. c. The average risk of HIV transmission from a needle stick is 0.3 %. d. The HIV RNA value (viral load) influences the likelihood of transmission. Clear my choice Question 38 Not yet answered Marked out of 1.00 Flag question Question text Deficiency of which of the following ions can result in renal potassium wasting? a. Sulfate b. Phosphate c. Magnesium d. Calcium Clear my choice Question 39 Not yet answered Marked out of 1.00 Flag question Question text Which one is the reasonable diagnostic test for diabetes mellitus in 50 years old chronic smoker with COPD and secondary polycythemia who is recently admitted with heart failure; otherwise no other striking complaint? a. RBS b. HgA1C c. OGTT d. FBS Clear my choice Question 40 Not yet answered Marked out of 1.00 Flag question Question text A 35-year-old male patient presented with polyuria and polydipsia. Past history is positive for head trauma. On investigations RBS =180 mg/dl and U/A: ketone =negative, glucose= negative and specific gravity =1.005. What is most likely diagnosis of the patient? a. Diabetic ketoacidosis b. Diabetes mellitus c. Diabetes insipidus d. Prediabetes In a patient presenting with episodes of gross hematuria, which one of the following is indicative of glomerular origin of hematuria? a. Presence of flank pain b. Presence of 1+ protein on urinary dipstick examination c. Report of too many RBCs per high power field on microscopic examination d. Presence of RBC casts in the urine Clear my choice Question 42 Not yet answered Marked out of 1.00 Flag question Question text Which of the following finding is a clue for secondary hypertension? a. Left ventricular hypertrophy b. Low serum potassium c. Raised serum creatinine d. Age between 40-50 years. Clear my choice Question 43 Not yet answered Marked out of 1.00 Flag question Question text One of the following in not a peripheral sign of liver cirrhosis. a. Dupuytren’s contracture b. Palmar Erythema c. Kayser-Fleischer ring d. Spider angioma Clear my choice

Atrial fibrillation b. Hypertension c. MarB, [5/26/2022 11:37 AM] Hyperthyroidism d. Anemia Clear my choice Question 89 Not yet answered Marked out of 1.00 Flag question Question text A 60-year-old woman was brought to the ED for altered mentation that developed this morning. She has several days of the history of fever and productive cough. On exam, she is febrile (38.2 Co) and confused. Her lungs reveal dullness to percussion and bronchial breath sounds in the right lower lung field. Her neck is stiff and when flexed, results in bilateral hip flexion. CBC showed a white blood count of 18,000 cells with the left shift. What is the most likely result of a Gram stain of CSF in this patient? a. Gram-positive bacilli b. Gram positive diplococci c. Gram-negative extracellular coccobacilli d. Gram negative intracellular diplococci Clear my choice Question 90 Not yet answered Marked out of 1.00 Flag question Question text A 27-year-old young lady is referred to the hospital with a diagnosis of AKI following delivery and postpartum hemorrhage. Which test result is most consistent with pre-renal azotemia (preserved renal tubular function) in this person whose kidneys were known to be healthy before this incident? a. Urine osmolality of 1000 mOsm/kg b. Spot urine sodium of 40 mEq/l c. Blood urea nitrogen of 34 mg/dl d. Fractional excretion of urea of 45% he commonest mechanisms for Covid-19 transmission are a. Droplet and contact b. Contact and airborne c. Airborne and hematogenous d. Airborne and droplet Clear my choice Question 92 Not yet answered Marked out of 1.00 Flag question Question text Which of the following liver biopsy result defines Liver Cirrhosis? a. Extensive uniformly distributed regenerative nodules. b. Extensive fibrosis with regenerative nodules. c. Extensive fibrosis involving the portal area with bridging. d. Extensive fibrosis involving the central vein. Clear my choice Question 93 Not yet answered Marked out of 1.00 Flag question Question text Which of the following statement is true about the common myeloproliferative neoplasms? a. Essential thrombocytosis is common in males than females b. Essential thrombocytosis has a higher risk of transformation than polycythemia Vera c. CML is more common in males than females d. Thrombotic complications occur less commonly in polycythemia Vera than essential thrombocytosis Clear my choice Question 94 Not yet answered Marked out of 1.00 Flag question Question text Among the following lists, which one is the major role of D-xylose test in the work up of malabsorption syndrome? a. Helps to identify specific etiologies of malabsorption syndrome b. Helps to establish Steatorrhea c. Distinguishes excess enteral protein loss d. Distinguishes enteral from pancreatic-biliary causes Clear my choice Question 95 Not yet answered Marked out of 1.00 Flag question Question text Signs of severity for mitral stenosis include: a. Presence of opening snap. b. Wide pulse pressure c. Strong apical impulse d. Short interval between S2 and opening snap Clear my choice A 21-year-old male comes to infectious diseases OPD with a complaint of purulent discharge from his urethra with painful micturition. He had unprotected sex with a new partner 03 days ago. What pathogen should he be treated for (based on the aetiologic agent)? a. Neisseria gonorrhea and Mycoplasma genetalium b. Chlamydia trachomatis only c. Neisseria gonorrhea and Chlamydia trachomatis d. Neisseria gonorrhea only Clear my choice Question 97 Not yet answered Marked out of 1.00 Flag question Question text Which one is the appropriate diagnostic test for asthma? a. Chest x-ray b. DLCO c. Spirometry d. High resolution CT scan Clear my choice Question 98 Not yet answered Marked out of 1.00 Flag question Question text Short-term (within seconds to minutes) regulation of blood pressure in normal humans is most often attributed to which of the following physiologic systems? a.

d. MarB, [5/26/2022 11:37 AM] Strongyloides stercoralis Clear my choice A 34-year-old male patient presented with a shortness of breath on mild exertion of one-week duration associated with orthopnea of two pillows and bilateral leg swelling. He gives a history of cough, runny nose and fever that occurred a month prior to the onset of the shortness of breath. Which of the following is the most likely underlying cause for the symptoms of this patient? a. Ischemic Heart Disease b. Dilated cardiomyopathy c. Valvular Heart Disease d. Congenital Heart Disease Clear my choice Question 82 Not yet answered Marked out of 1.00 Flag question Question text A 40-year-old female presented with a positive - Immunoblot serology test for HCV. Her HCV RNA qualitative test is negative. Which of the following conditions is the likely diagnosis? a. Active HCV infection b. Inactive carrier of HCV c. Resolved HCV infection d. False positive for HCV Clear my choice Question 83 Not yet answered Marked out of 1.00 Flag question Question text A 17 years old female patient from Addis came with 05-months history of menorrhagia & epistaxis. In addition, she complains that recently she is experiencing repeated attacks of tonsillopharyngitis. Her physical examination is unremarkable, except for pallor & evidence of platelet type of bleeding. CBC showed Pancytopenia & PM was unremarkable except for the cytopenia. Which of the following would be the best diagnostic test for her most likely diagnosis? a. Reticulocyte count b. Serum erythropoietin level c. Doing iron studies d. Bone marrow study Clear my choice Question 84 Not yet answered Marked out of 1.00 Flag question Question text Which of the following statements regarding proteinuria is correct? a. In orthostatic proteinuria, urinary protein is typically increased with the patient lying down. b. Functional proteinuria typically occurs after heavy meals with high protein intake. c. Proteinuria exceeding 3.5 g/day (i.e., “nephrotic” proteinuria) inevitably results in hypoalbuminemia. d. Overflow proteinuria is typical of urinary light chain excretion. Clear my choice Question 85 Not yet answered Marked out of 1.00 Flag question Question text Of the following signs of meningitis in adults, which one is most indicative of a bacterial infection over a viral infection? a. Mental confusion b. Headache c. Meningismus d. Fever All of the following is correct regarding the clinical features of acute leukemias EXCEPT a. CNS involvement is seen at the time of diagnosis in the majority of patients with acute leukemia b. Symptoms & signs due to cytopenias predominate the clinical picture of acute leukemias c. The blast percentage cut off acute leukemia diagnosis is 20% according to WHO criteria in general. d. Coagulation abnormalities are common in AML – M3 morphologic type Clear my choice Question 87 Not yet answered Marked out of 1.00 Flag question Question text A 50 years old male presented with left upper quadrant vague discomfort and early satiety of 3-months duration. Otherwise, the patient is well. Laboratory investigations were done and the CBC profiles are as follows. CBC: WBC count is 136,000 cells/ µl, Hgb: 10.3g/dl and Platelet counts: 344,000/µl. If CML was the working diagnosis of this patient, in which phase of the disease this patient is likely to be? a. Accelerated phase b. Blast crisis c. Chronic phase d. It is difficult to tell Clear my choice Question 88 Not yet answered Marked out of 1.00 Flag question Question text A 60-year-old female with a history cardiac problem that occurred 3 years back presents with worsening shortness of breath, and fatigue. She is currently taking aspirin and atorvastatin. On physical examination, the pulse rate is 128 bpm and irregularly irregular, BP 120/70 mm Hg, rales at basal lung fields, raised JVP, and & edema in lower limbs. Which of the following is the most likely precipitating factor for the worsening symptoms in this patient? a.

MarB, [5/26/2022 11:37 AM] A 16-year-old male has recurrent thigh hematomas. He has been active in sports all of his life and has had one episode of upper GI bleeding. Laboratory analysis in clinic reveals a normal platelet count, a prolonged activated partial thromboplastin time and a normal prothrombin time. He takes no medications. What is the most likely reason for his coagulation disorder? a. Prothrombin deficiency b. Factor VII deficiency c. Factor VIII deficiency d. Von Willebrand disease Clear my choice Question 72 Not yet answered Marked out of 1.00 Flag question Question text Which of the following is not a dietary risk factor for primary hypertension? a. Coffee b. Sodium c. Sugar d. Alcohol Clear my choice Question 73 Not yet answered Marked out of 1.00 Flag question Question text A 40-year-old woman presents with six months of progressive headache. She now has new onset right-sided hemibody numbness and some mild weakness with gait stumbling over the past 1 month. Examination shows right-sided drift and pronation. Brain MRI showed a homogeneously enhancing left-convexity lesion. What is the most likely diagnosis? a. Tuberculoma b. Meningioma c. Glioblastoma multiform (GBM) d. Brain metastasis Clear my choice Question 74 Not yet answered Marked out of 1.00 Flag question Question text In which one of the following patients is a kidney biopsy immediately needed? a. A 6-year-old boy with anasarca of 1 month with proteinuria of 4 grams in 24-hours urine, serum albumin of 2.8gm/dl and normal creatinine b. A 28-year-old man who presented who presented with malaise, minimal edema and whose serum creatinine had increased from 1.3 mg/dl 2 weeks ago to 3 mg/dl today. c. A 14-year-old girl with edema, hypertension and hematuria 2 weeks after a sore throat d. A 55-year-old man with 20 years history of diabetes, with diabetic eye complications who has 3 + proteinuria and serum creatinine of 2mg/dl Clear my choice Question 75 Not yet answered Marked out of 1.00 Flag question Question text A 65-year-old woman with a long history of uncontrolled hypertension presents for evaluation. She complains of fatigue, shortness of breath and bilateral leg swelling. Which of the following findings is the distinguishing feature of left ventricular failure in this patient? a. Elevated liver enzymes b. Peripheral edema c. Pulmonary edema d. Jugular venous distention Which of the following is false about CLL? a. One of the causes of anemia in these patients is autoimmune phenomenon. b. Individuals with family history of CLL are at increased risk of developing the disease. c. A quarter of patients with CLL are asymptomatic at presentation. d. All patients require chemotherapy immediately after diagnosis. Clear my choice Question 77 Not yet answered Marked out of 1.00 Flag question Question text The most common organism causing acute endocarditis in previously normal heart valves? a. Enterococci b. HACEK c. Strep. Viridans d. Staph. aureus Clear my choice Question 78 Not yet answered Marked out of 1.00 Flag question Question text One of the following Laboratory parameter is used in Model of end stage liver disease (MELD) but not in Child-Pugh score in assessing severity of liver disease. a. Bilirubin b. Creatinine c. INR d. Albumin Clear my choice Question 79 Not yet answered Marked out of 1.00 Flag question Question text Which of the following is correct statement about lung neoplasms? a. Squamous cell carcinoma is least associated with cigarette smoking b. Benign lung tumors account for > 50% of all resected lung neoplasms c. Adenocarcinoma is the most common subtype in women and nonsmokers d. Lung cancer is the second common cause of cancer deaths in Ethiopia Clear my choice Question 80 Not yet answered Marked out of 1.00 Flag question Question text Which parasite causes infection that is not characterized by significant eosinophilia? a. Trichinella spiralis b. Toxocara canis c. Entamoeba histolytica

MarB, [5/26/2022 11:37 AM] A 27-year-old woman comes to the emergency room with a severe “viral syndrome” and the clinician considers acute HIV in the differential diagnosis. Which cluster of clinical manifestations best describes a typical presentation for persons with acute HIV? a. Fever, rash, lymphadenopathy, pharyngitis, and headache b. Fever, cough, sore throat, diarrhea, and melena c. Fever, cough, shortness of breath, lethargy, and diarrhea d. Headache, cough, shortness of breath, confusion, and weight loss e. Diarrhea, abdominal pain, jaundice, peripheral edema, and cough Clear my choice Question 29 Not yet answered Marked out of 1.00 Flag question Question text A 65 years old female referred to you for evaluation of hypercalcemia. She has no Symptom. her Lab = ionized calcium elevated, low phosphate, PTH was elevated, RFT was Normal and Serum Vitamin D Level Was Normal. What is the most Likely Diagnosis? a. Secondary Hyperparathyroidism b. Primary Hypoparathyroidism c. Primary Hyperparathyroidism d. Pseudo-hypoparathyroidism Clear my choice Question 30 Not yet answered Marked out of 1.00 Flag question Question text A 50-year-old patient presented with palpitation, shortness of breath on moderate exertion and bilateral leg swelling. On physical examination, the pulse rate is 86 bpm, blood pressure is 180/100 mmHg, Temperature 36.7oC. There are crepitations on the right lower lung field, displacement of the apical impulse and an S4 gallop. Which of the following investigations is less important in the initial work up of this patient? a. Serum creatinine b. Echocardiography c. Chest X-ray d. Cardiac MRI Clear my choice A 32-year-old patient is being examined after suffering a new onset seizure. He describes a strong feeling of déjà vu prior to and during the seizure. Based on this information, where do you localize? a. Right hemisphere b. Temporal lobe c. Supplemental motor area d. Olfactory region of the frontal lobe Clear my choice Question 32 Not yet answered Marked out of 1.00 Flag question Question text Which of the following statements is correct? a. Pre diabetes is a condition characterized by an increased risk for the future development of type 2 diabetes b. The rise in insulin concentration after meal ingestion is reduced in type 1 but not in type 2 diabetes c. Insulin mediates glucose uptake in the brain d. Insulin suppresses the activity of glycogen synthase Clear my choice Question 33 Not yet answered Marked out of 1.00 Flag question Question text Podocytes: a. Are unable to replicate b. Are in direct contact with mesangial cells c. Have a positively charged glycocalyx d. Are connected by gap junctions Clear my choice Question 34 Not yet answered Marked out of 1.00 Flag question Question text Which of the following statement most accurately relates a seizure's location to its symptom profile? a. Frontal lobe seizures do not cause motor symptoms. b. Right hemisphere seizures are more likely to cause parasympathetic symptoms. c. Lateral temporal lobe seizures result in abdominal discomfort and nausea. d. Seizures in the primary sensory cortex produce positive sensory findings. Clear my choice Question 35 Not yet answered Marked out of 1.00 Flag question Question text When there is a clinical suspicion of thyroid abnormality, it is recommended to do laboratory hormonal tests wisely starting with the most important one and follow up additional tests depending on the findings, rather than doing multiple tests routinely for initial evaluation. Which one of the following is the most sensitive measure of thyroid function? a. Free Thyroid Hormone Levels b. Total Thyroid Hormone Levels c. Thyroid Releasing Hormone (TRH) Levels d. Thyroid Stimulating Hormone (TSH) Levels

MarB, [5/26/2022 11:37 AM] Among the following, which is the least common characteristic complication anticipated in the myeloproliferative neoplasms? a. Risk of transformation to acute leukemia b. Tumor lysis syndrome c. Thrombosis at unusual sites d. Hyperleukocytosis and hyper viscosity syndrome Clear my choice Question 22 Not yet answered Marked out of 1.00 Flag question Question text A 40-year-old man with type 1 diabetes mellitus and 24-hour urine protein excretion of 1200 mg begins angiotensin-converting enzyme(ACE) inhibitor therapy to slow the progression of kidney disease. Within 2 weeks, eGFRcr declines from 75 to 65 ml/min/1.73 m2. What is the most likely cause for decline in eGFR? a. Effect of ACE inhibitor on muscle mass b. Effect of ACE inhibitor on tubular secretion of creatinine c. Effect of ACE inhibitor on serum creatinine assay d. Effect of ACE inhibitor on GFR Clear my choice Question 23 Not yet answered Marked out of 1.00 Flag question Question text Three days ago, a 15-year-old boy complained of progressive numbness and tingling in his feet that was restricted to his legs. He had noticed weakness in his lower extremities that initially affected his feet and progressed proximally over 24 hours. On examination, there was mild bilateral abduction paresis, facial diplegia, quadriparesis with areflexia. He was admitted with diagnosis of Gullian Barre Syndrome (GBS). Which of the following statement is FALSE regarding GBS? a. In 10% of the patients CSF analysis may never show albuminocytologic dissociation. b. Respiratory failure requiring intubation may occur in 5% of the patients. c. Children have a more favorable prognosis than adults. d. CSF analysis may show elevated cell count in the presence of HIV infection. Clear my choice Question 24 Not yet answered Marked out of 1.00 Flag question Question text A 30-year-old male patient has undergone bilateral adrenalectomy for cushing syndrome where the primary lesion could not be localized. This patient is expected to have clinically significant deficiency of: a. ACTH b. Androgens c. Epinephrine d. Aldosterone Clear my choice Question 25 Not yet answered Marked out of 1.00 Flag question Question text A young woman came to the outpatient clinic with severe headache, high blood pressure and palpitation. You considered a possibility of pheochromocytoma. Which one of the following is highly likely to be the finding in your subsequent work up of this patient? a. Benign adrenal mass b. Bilateral adrenal mass than a unilateral lesion c. High serum but low urinary catecholamines d. Recurrent hypoglycemia A 29-year-old man from Ghana presents for an initial visit. He reports a prior positive HIV test 3 years ago at an outside facility; he has no recollection of taking antiretroviral therapy and has not had regular medical follow-up. He does not have confirmation of the prior HIV result. Laboratory tests are ordered and show a CD4 count of 849 cells/mm3 and an undetectable plasma HIV-1 RNA level. You do not have documentation of his prior HIV diagnosis and would like to confirm the HIV diagnosis. Which one of the following would you recommend based on the available information? a. Order plasma HIV 2 RNA assay b. Repeat CD4 count c. Order genotypic drug resistance test d. Order an HIV antibody test Clear my choice Question 27 Not yet answered Marked out of 1.00 Flag question Question text Which of the following is true Regarding IBD i.e. Crohn’s disease and ulcerative colitis? a. Apthous ulcers are more common in Crohn’s disease b. Crohn’s disease spares the terminal ileum usually c. It is very common in Blacks than whites d. Fistula is more common in Ulcerative colitis Clear my choice Question 28 Not yet answered Marked out of 1.00 Flag question Question text

MarB, [5/26/2022 11:37 AM] d. Taenia solium Clear my choice Question 10 Not yet answered Marked out of 1.00 Flag question Question text Which of the following clinical features in a patient are more suggestive of Myasthenia gravis than Inflammatory myopathy? a. Sensory impairment b. Fluctuating fatigable weakness c. Early morning ptosis d. Exaggerated deep tendon reflex Which of the following statement about pituitary adenomas is true? a. Cushing disease is associated with glucose sensitivity b. Prolactinoma is the commonest functioning pituitary adenoma c. Acromegaly is associated with growth hormone deficiency d. Growth hormone excess is associated with galactorrhea Clear my choice Question 12 Not yet answered Marked out of 1.00 Flag question Question text A 25-year-old female with HCV related liver cirrhosis presented with signs of Ascites and mild abdominal tenderness on examination. Which of the following confirms the highly suspected diagnosis? a. Ascitic fluid Gram staining revealing Gram negative bacteria. b. Ascitic fluid Neutrophil count exceeding 250/ml. c. Ascitic fluid appearance looks straw colored. d. Ascitic fluid lymphocyte count exceeding 250/ml. Clear my choice Question 13 Not yet answered Marked out of 1.00 Flag question Question text Which of the following is not an endocrine disorder that can lead to Diabetes Mellitus? a. Hemochromatosis b. Hyperthyroidism c. Acromegaly d. Cushing syndrome Clear my choice Question 14 Not yet answered Marked out of 1.00 Flag question Question text A 65-year-old gentleman has been under medical evaluation for recurrent middle lobe pneumonia. He gives smoking history of 40-pack years. The next step should be: a. Pneumococcal and Influenza vaccination b. Prescribe broad-spectrum antibiotics like Meropenem c. Do routine sputum culture and sensitivity d. Perform Bronchoscopy Clear my choice Question 15 Not yet answered Marked out of 1.00 Flag question Question text A 65-year-old man presented with Ascites. His Serum ascites albumin gradient (SAAG) is 1.5 and Ascites Albumin 2.8gm/dl. The most likely cause of Ascites is. a. Congestive heart failure- cardiac cirrhosis b. Tuberculosis peritonitis c. Malignancy of the peritoneum. d. Post necrotic- Viral cirrhosis A 65-year-old male patient presents with intermittent melena, easy fatigability and generalized body weakness of 3 months duration. He doesn’t have other complaints. Evaluation revealed only pale conjunctiva. His Hemoglobin was 9.6 gm/dl, WBC was 9,500 and platelet count was 192,000. MCV was 67.5 fl. Which of the following is the next most important step in the work up of this patient? a. Bone marrow Iron staining b. Colonoscopy c. H pylori test d. CT scan of the abdomen Clear my choice Question 17 Not yet answered Marked out of 1.00 Flag question Question text In case of schistosomiasis, what is the main cause of pathology? a. Egg b. Cercaria c. Miracidium d. Schistosomula Clear my choice Question 18 Not yet answered Marked out of 1.00 Flag question Question text Which of the following is a cause of heart failure of an abrupt onset? a. Acute Myocardial Infarction b. Aortic Stenosis c. Dilated Cardiomyopathy d. Mitral stenosis Clear my choice Question 19 Not yet answered Marked out of 1.00 Flag question Question text Which of the following is true about Parapneumonic effusion? a. Pleural protein to serum protein ratio < 0.5. b. Pleural LDH to serum LDH ratio < 0.6. c. It is usually transudative. d. PH < 7.2 requires chest tube insertion. Clear my choice Question 20 Not yet answered Marked out of 1.00 Flag question Question text While examining a 32-year-old man, you hear a diastolic murmur that is increased when the patient is sitting and leaning forward. What is the most likely valvular defect? a. Tricuspid stenosis b. Aortic regurgitation c. Pulmonic regurgitation d. Mitral stenosis

Which one of the following is not true regarding TB/HIV co-infection? a. Anti-TB drugs have no interaction with ART and can be used safely together b. TB diagnosis in HIV is challenging c. Atypical presentation is common in case of advanced immunosuppression d. The yield of AFB from sputum in patients with CD4 count <100cells/mm3 is low Clear my choice Question 2 Not yet answered Marked out of 1.00 Flag question Question text A 60 years old non-smoker gentleman presented to Tikur Anbessa Specialized hospital with a complaint of productive cough of 10 days duration. He also informed his physician that his sputum is foul smelling and it is worse while lying on his left side. He had similar symptoms 3 years back which was followed by hemoptysis for which he took unspecified medications for a week and his symptoms improved. He recalled that he was treated for pulmonary TB 15 years back and completed his treatment successfully. What is the most likely diagnosis of his current complaint? a. Adenocarcinoma of the lung b. Plural effusion c. Bronchiectasis d. Chronic Obstructive Lung Disease Clear my choice Question 3 Not yet answered Marked out of 1.00 Flag question Question text A 28-year-old right handed female patient presented to emergency room with headache, fever, and fluctuating mentation of three weeks duration. In addition, she reported nausea, vomiting, photophobia, and photophobia since the past one week. Examination showed bilateral grade 1 papilledema. Serology test confirmed HIV infection and the CD4 cells count was 98. What is the best next step in the evaluation process of this patient? a. Initiating empirical antifungal medications. b. Brain imaging c. Initiating empirical anti toxoplasmosis medications. d. Perform lumbar puncture and CSF analysis. Clear my choice Question 4 Not yet answered Marked out of 1.00 Flag question Question text A 30 years old female patient came with a Hb of 4g/dl and she also has noticed recent yellowish discoloration of the eyes. She has spleen palpable 8cm BRCM. The evaluating physicians working diagnosis is uncomplicated hemolytic anemia. Which one of the following would be against it on workup? a. A mild macrocytosis on peripheral morphology b. Reticulocyte percentage of 1% c. An elevated indirect bilirubin d. A high LDH value Clear my choice Question 5 Not yet answered Marked out of 1.00 Flag question Question text Which of the following is true about iron deficiency anemia? a. For elderly male patients coming with Fe deficiency anemia workup should include upper & lower GI endoscopy b. Transferrin level is decreased in iron deficiency anemia c. Bone marrow iron stain is required in most patients to confirm the diagnosis d. Serum iron measurement is the best way to diagnose it How are the majority of single brain abscesses acquired? a. Hematogenous spread b. Direct spread of organisms from a contiguous site c. Complication of surgery d. Direct inoculation of pathogen following trauma Clear my choice Question 7 Not yet answered Marked out of 1.00 Flag question Question text Massive splenomegaly is usually a feature of which of the following hematological condition? a. Multiple Myeloma b. Idiopathic Primary Myelofibrosis c. Immune Thrombocytopenia (ITP) d. Acute Myeloid Leukemia (AML) Clear my choice Question 8 Not yet answered Marked out of 1.00 Flag question Question text The corticomedullary osmotic gradient is required for urine concentration. Which of the following would diminish this gradient? a. Increased circulating vasopressin b. Increased blood flow through the renal medulla c. Increased urea recycling through the collecting duct system d. Activation of the sympathetic nervous system Clear my choice Question 9 Not yet answered Marked out of 1.00 Flag question Question text Pigs or dogs are the sources of human infection by each of the following parasites except: a. Echinococcus granulosus b. Ascaris lumbricoides c. Trichinella spiralis

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