General Medicine Quiz

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Quiz on General Medicine

1) Which one of the following statements best describes Selexipag?
A) It is a guanylate cyclase stimulator
B) It is a phosphodiesterase type 5 inhibitor
C) It is an IP prostacyclin-receptor agonist
D) It is an endothelin-receptor antagonist

2) Indications for treating subclinical hyperthyroidism are all except
A) Age > 65 years
B) Presence of heart disease
C) Post menopausal women
D) Symptomatic patient

3) SIADH is diagnosed by:
A) Schwartz criteria
B) Serum vasopressin levels
C) Water loading tests
D) All of the above

4) Distinct complication of hepatic hydrothorax is
A) Hepatic encephalopathy
B) ARDS
C) Hydro-pneumothorax
D) Spontaneous bacterial empyema

5) What total kidney volume is a risk factor for rapid deterioration of GFR in ADPKD?
A) 750 ml
B) 2000 ml
C) 1500 ml
D) 500 ml

6) A patient with Systemic Lupus Erythematosus (SLE) has impaired kidney function. Which class is unlikely in renal histology?
A) Class IV
B) Class III
C) Class II
D) Class V

7) All the following drugs are associated with an increased risk of osteoporosis in adults except
A) Cyclosporine
B) Dilantin
C) Heparin
D) Ranitidine

8) All the following are effects of hypercalcemia except
A) Diarrhea
B) Confusion
C) Polyuria
D) Short QT interval

9) All of the following would be expected to increase serum prolactin levels except
A) Chest wall trauma
B) Hyperthyroidism
C) Renal failure
D) Sexual orgasm

10) Which one of the following statements about the clinical manifestations of narcolepsy is true?
A) Affected patient tend to have low body-mass index (BMI)
B) Complex auditory hallucinations are common
C) Rapid-eye-movement (REM) sleep can occur at any time of day
D) Symptoms usually begin in midlife

11) In IgA nephropathy, deposition of IgA occurs in –
A) Glomerular capillaries
B) Glomerular mesangium
C) Glomerular basement membrane
D) All of these

12) Which one of the following statements describes the ability of rifampin and levofloxacin to cross the blood-brain barrier?
A) CSF concentrations of both drugs are < 30% of the plasma concentrations.
B) CSF concentrations of both drugs reach 70% of the plasma concentrations.
C) CSF concentration of Levofloxacin reach 70% of the plasma concentration; those of rifampin reach < 30% of plasma concentration.
D) CSF concentration of rifampin reach 70% of the plasma concentration; those of Levofloxacin reach < 30% of plasma concentration.

13) Which one of the following statements about pharmacologic therapies for postmenopausal osteoporosis is true?
A) Denosumab cannot be used in compromised renal function.
B) Teriparatide works primarily by decreasing bone resorption.
C) Use of bisphosphonates should be limited to those who have normal serum Vitamin D levels.
D) Zoledronic acid causes flulike symptoms for up to 3 days after the first infusion in up to two thirds of patients.

14) High dietary intake of sodium leads to
A) Increased risk of calcium stone formation
B) Decreased risk of calcium stone formation
C) Has no effect on stone formation
D) None of the above

15) According to the current recommendations. metformin can be used in type 2 DM with CKD till e-GFR of:
A) 30 ml/min
B) 40 ml/min
C) 50 ml/min
D) 60 ml/min

16) Which is the safest sulfonylurea in chronic kidney disease?
A) Glibenclimide
B) Gliclazide
C) Glimepride
D) Glipizide

17) Which of the following therapies have been shown to retard deterioration of lung functions in COPD?
A) Salmeterol
B) Tiotropium
C) Inhaled steroids
D) None of the above

18) The indication of starting inhaled corticosteroids in COPD is:
A) FEV1 < 30%
B) FEV1 < 60%
C) More than 2 exacerbations per year
D) More than 4 exacerbations per year

19) What is true about angiotensin converting enzyme (ACE) levels in sarcoidosis:
A) Elevated ACE levels predict worse outcomes
B) ACE is a sensitive biomarker for diagnosis of sarcoidosis
C) ACE is a specific biomarker for diagnosis of sarcoidosis
D) ACE activity may predict disease activity in selected cases

20) The earliest site to be involved in Alzheimer’s disease is:
A) Perihippocampal region
B) Frontal lobe
C) Temporo-parietal region
D) Anterior thalamic nucleus

21) Which of the following statements about Syringomyelia is true?
A) > 50% cases associated with Chiari malformations
B) Symptoms typically begin in middle life
C) Syrinx cavities are always congenital
D) Vibration & position sense are usually diminished

22) Which drug can be used safely during pregnancy for treatment of chronic hepatitis-B infection –
A) Telbivudine
B) Tenofovir
C) Entecavir
D) Both A & B

23) Which one of the following statements about the management of functional dyspepsia is true?
A) Antacids are modestly effective in reducing symptoms
B) Psychological therapies have an established role in treatment.
C) The benefit of helicobacter pylori eradication therapy may be greatest for patients with postprandial fullness.
D) Tricyclic antidepressants such as amitriptyline are preferred over selective serotonin-reuptake inhibitors for treatment.

24) Which one of the following statements is true about the treatment of drug-resistant tuberculosis?
A) Regimens for MDR disease are substantially more toxic than standard regimens
B) Rifampin resistance in the absence of isoniazid resistance is not uncommon
C) Appropriate duration of treatment for MDR tuberculosis is 20 months
D) WHO recommends an induction phase lasting 4 months for MDR disease

25) Which one of the following statements is true regarding Vasculitis?
A) Associated cardiac disease is typically limited to disorders that affect the small vessels.
B) Cutaneous involvement is generally seen with disorders that affect the large vessels.
C) Skin findings include palpable purpura that may ulcerate.
D) Tests for ANA & ANCA are rarely positive.

26) Primary antiepileptic drug which should be avoided in patients with pre-existing cardiac disease is:
A) Phenytoin sodium
B) Sodium valproate
C) Carbamazepine
D) Phenobarbitone

27) Drug of choice to treat early alcohol- related seizure in ICU is:
A) Midazolam
B) Diazepam
C) Phenytoin sodium
D) Lorazepam

28) All of the following are CNS manifestations of SLE except:
A) Myasthenis gravis
B) Demyelinating syndrome
C) Aseptic meningitis
D) Myelopathy syndrome

29) Which of the following are the dermatological manifestations of primary Sjogren’s syndrome?
A) Dryness of skin
B) Alopecia
C) Annular erythema
D) All the above

30) Which is the most common invasive fungal disease in lung transplant recipient?
A) Aspergillosis
B) Candidiasis
C) Pneumocystis jiroveci
D) Mucormycosis

31) Which of the following neurologic phenomena is classically associated with herniation of the brain through the foramen magnum?
A) Third nerve compression and ipsilateral papillary dilatation
B) Catatonia
C) “Locked in” state
D) Respiratory arrest

32) All of the following are side effects of phenytoin except
A) Leucopenia
B) Ataxia
C) Osteomalacia
D) Facial coarsening

33) Which of the following medicines has been most commonly implicated in development of noninfectious chronic meningitis?
A) Acetaminophen
B) Ibuprofen
C) Beta-lactam antibiotics
D) Phenobarbitone

34) All of the following match the anticoagulant with its correct mechanism of action except
A) Abciximab – GpIIb/IIIa receptor inhibition
B) Clopidogrel – inhibition of thromboxane A2 release
C) Fondaparinux – inhibition of factor Xa
D) Argatroban – thrombin inhibition

35) All the following types of cancer commonly metastasize to the central nervous system except
A) Ovarian
B) Breast
C) Melanoma
D) Hypernephroma

36) The cushing response is?
A) Slowing of respiration
B) Decrease of pulse rate
C) Increase in arterial blood pressure
D) Decrease of blood pressure

37) A 36 year old man with HIV (Cd4+ count 112) develops a scaly, waxy, yellowish, patchy, crusty, pruritic rash on and around his nose. Rest of his skin examination is normal. What is the likely diagnosis?
A) Molluscum contagiosum
B) Psoriasis
C) Reactivation herpes zoster
D) Seborrheic dermatitis

38) Which one of the following podocyte receptors is targeted by an autoantibody associated with primary membranous nephropathy?
A) DDR 1
B) IGF 1R
C) PLA 2R
D) PDGFR

39) A 40 year patient presented with ABG values – Na+ 140, K + 4.0, Cl- 106, HCO3 – 14, AG 20, PaCO2 24, pH 7.39, the diagnosis is –
A) Metabolic acidosis, respiratory acidosis
B) Metabolic acidosis, respiratory alkalosis
C) Metabolic alkalosis, respiratory alkalosis
D) Metabolic alkalosis, respiratory acidosis

40) All of the following factors increase the risk for Clostridium difficile-associated disease except
A) Antacids
B) C. difficile colonization
C) Enteral tube feeds
D) Older age

41) All of the following clinical findings are consistent with severe mitral stenosis except
A) Atrial fibrillation
B) Opening snap late after S2
C) Pulsatile liver
D) Right ventricular heave

42) Acute hyperkalemia is associated with which of the following ECG changes?
A) QRS widening
B) Prolongation of ST segment
C) Decrease in PR interval
D) T wave flattening

43) Which of the following organisms is unlikely to be found in the sputum of a patient with cystic fibrosis?
A) Haemophilus influenzae
B) Aspergillus fumigates
C) Staphylococcus aureus
D) Acinetobacter baumannii

44) A 20 year-old normal non-smoking female has pulmonary embolism while on oral contraceptive pills. Which of the following is the most likely predisposing factor?
A) Abnormal factor V
B) Abnormal protein C
C) Reduced protein C level
D) Reduced protein S level

45) Which of the following is the most potent stimulus for hypothalamic production of arginine vasopressin?
A) Hypertonicity
B) Hyperkalemia
C) Hypotonicity
D) Intravascular volume depletion

46) In patients with chronic renal failure, which of the following is the most important contributor to renal osteodystrophy?
A) Impaired renal production of 1,25-dihydroxy Vitamin D3
B) Hypocalcaemia
C) Hypophosphatemia
D) Loss of Vitamin D and calcium via dialysis

47) True about intra-hepatic cholestasis of pregnancy:
A) Presents with jaundice in first trimester of pregnancy
B) Treatment of choice is delivery of fetus
C) Associated with maternal mortality rate of upto 20%
D) Bile acid levels are elevated upto 10-25 fold

48) Febrile neutropenia is defined as
A) Fever > 100 F, ANC < 500
B) Fever > 100 F, ANC > 500
C) Fever > 101 F, ANC < 500
D) Fever >101 F, ANC > 500

49) Most common type of HIV-1 clade in India is:
A) Clade A
B) Clade B
C) Clade C
D) Clade D

50) Consensus expert opinion supports the use of which one of the following agents for pharmacologic treatment of anxiety at end of life?
A) Atypical antipsychotics
B) Benzodiazepines
C) Selective serotonin-reuptake inhibitors
D) Tricyclic antidepressants