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Dr. Batman
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Name: Batman
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MISCELLANEOUS REVIEW
(Total Questions - 104)Q.1. All of the following are side effects of furosemide except?
Correct Answer : A
Side effects of furosemide are hypotension, Hypokalemia, hyperglycemia, hemolytic anemia
Q.2. A 35-year-old female presents with right arm tenderness and a red streak line running up her arm. On examination, you find a palpable axillary lymph node. What is the most probable diagnosis?
Correct Answer : C
Lymphangitis is an inflammation of the lymphatic channels. Most common cause is S. pyogenes.
Q.3. Patient just received an organ transplantation. what is the sign of acute rejection?
Correct Answer : A
Q.4. Which of the following is correct sodium amount in Normal Saline [ 0.9% NaCl ] solution?
Correct Answer : C
Half NS [ 0.45% NaCl ] has 77 mmol, and Quarter NS [ 0.22% NaCl ] has 39 mmol.
Q.5. A 25-year-old male drug abuser presents to your clinic with no symptoms. He has a history of intravenous drug use but currently feels well. What is the most important investigation to perform in this case?
Correct Answer : D
Q.6. In aspirin overdose what can we see?
Correct Answer : A
The early signs and symptoms of aspirin overdose include impaired hearing and ringing in the ears. Other early signs of aspirin poisoning include lightheadedness, breathing rapidly, double vision, vomiting, fever, and dehydration The acutely toxic dose of aspirin is generally considered greater than 150 mg per kg of body mass. Moderate toxicity occurs at doses up to 300 mg/kg, severe toxicity occurs between 300 - 500 mg/kg.
Q.7. Man who is having severe vomiting and diarrhea and now developed leg cramps after receiving 3 liters of dextrose, which of the following is responsible for this condition?
Correct Answer : A
K+ is secreted in stool, as he is having a diarrhea he will lose a huge amount of K+, also muscle cramp is a symptom of Hypokalemia.
Q.8. During IV cannula and fluid infusion, where does the infection begins?
Correct Answer : A
Q.9. Patient come to ER with constricted pupil and respiratory compromise. What will you suspect?
Correct Answer : A
Certain drugs cause constriction of the pupils, such as alcohol and opioids. Other drugs, such as atropine, mescaline, psilocybin mushrooms, cocaine, and amphetamines may cause pupil dilation.
Q.10. Which of the following medicine is the best and cost-effective to give for the initial treatment of DVT patient?
Correct Answer : A
Q.11. Organophosphorus poisoning, which of the following is the antidote?
Correct Answer : A
Q.12. A 35-year-old male with a history of schizophrenia has been taking haloperidol for the past few weeks. He presents with severe rigidity, dystonia, and muscle spasms. What is the most appropriate treatment for this condition?
Correct Answer : A
Haloperidol is a dopamine antagonist used in psychosis. Side effects: Extrapyramidal side effects, Dystonia, Tremors, Dry mouth, Depression.
Q.13. What is the most sensitive indicator for factitious fever?
Correct Answer : A
Factitious fever: Fever produced artificially by a patient. This is done by artificially heating the thermometer or by self-administered pyrogenic substances. An artificial fever may be suspected if the pulse rate is much less than expected for the degree of fever noted. This diagnosis should be considered in all patients in whom there is no other plausible explanation for the fever. Patients who pretend to have fevers may have serious psychiatric problems.
Q.14. All of the following tests are necessary to be done before initiating lithium except?
Correct Answer : A
Renal function and thyroid function tests must be done before initiating Lithium.
Q.15. Patient complaining of hypotension & bradycardia. Electrolytes show: low-Na, high-K, high-Cl, high-Urea. Which electrolyte imbalance is responsible for it?
Correct Answer : A
Q.16. Besides IV fluids, which is the most important drug to be given in anaphylaxis?
Correct Answer : A
Q.17. Management of anaphylactic shock includes all of the following, EXCEPT ?
Correct Answer : C
Management of anaphylaxis is summarized by:- Epinephrine + Diphenhydramine, then oxygen + IV fluids.
Q.18. A 30 years old patient developed lightheadedness and SOB after bee sting. Which of the following is the appropriate treatment plan for him?
Correct Answer : A
Q.19. In a patient with anaphylactic shock, all are correct treatments EXCEPT?
Correct Answer : B
Q.20. A Burn patient is treated with Silver Sulfadiazine, the toxicity of this drug can cause which of the following?
Correct Answer : B
Q.21. Which is the most important factor in the development of spinal headaches after spinal anesthesia?
Correct Answer : B
When epidural anesthetics are placed with a larger needle than that used for spinal anesthetics, the likelihood of headache is higher.
Q.22. What is the most common complication of mumps in Adults ?
Correct Answer : B
In children the most common complication is Meningitis Labyrinthitis --> (0.005% of cases) Orchitis --> (30% of cases) Meningitis --> (10% of cases)? Encephalitis ? (less than 1% of cases)
Q.23. A patient is a alcohol drinker complains of headache, dilated pupil, hyperactivity, agitation. he had history of alcohol withdrawal last week, what is the treatment?
Correct Answer : A
Diazepam is a Benzodiazepine
Q.24. A 30 years old male patient presented with blood pressure 180/100 mmHg ,tachycardia, Mydriasis, and profuse sweating. what is the probable toxicity?
Correct Answer : B
Sympathomimetic drugs mimic the action of the sympathetic nervous system. Examples: Cocaine, Ephedrine, Amphetamine, Epinephrine (Adrenaline), Dopamine.
Q.25. The drug Clonidine decreases the effect of which of the following?
Correct Answer : B
Clonidine, a centrally acting alpha-2 adrenergic agonist, can reduce the effectiveness of warfarin due to its effect on platelet aggregation. Clonidine may also lower the effectiveness of other anticoagulants by affecting vascular tone and fluid balance. This interaction can decrease the anticoagulant effect of warfarin, potentially increasing the risk of thrombosis.
Q.26. A 35-year-old woman comes to your clinic for a routine check-up. She asks about the recommended daily caloric intake for her to maintain a healthy weight. You assess that she has a moderate activity level and is in good health. What is the normal daily caloric intake for her?
Correct Answer : D
Normal daily caloric requirement is 20-40 kCal/kg, and 0.2 g nitrogen/kg.
Q.27. What is the ratio of ventilation to chest compression in a one person CPR ?
Correct Answer : A
Q.28. Which of the following would most likely indicate a hemolytic transfusion reaction in an anesthetized patient?
Correct Answer : D
darkened urine is a hallmark of hemolysis.
Q.29. Which of the following is the most common cause of gingivitis?
Correct Answer : B
Explanation: The most common cause of gingivitis is poor oral hygiene which encourages plaque to form.
Q.30. Which of the following combination is safe?
Correct Answer : C
but INR needs to be monitiored
Q.31. All of the following can cause photosensitivity EXCEPT?
Correct Answer : A
Q.32. Which of the following drug is least absorbed in presented of Aluminum hydroxide & magnesium hydroxide?
Correct Answer : A
Q.33. What is the osmolarity of 0.9% Normal saline?
Correct Answer : A
Because if we multiply 155 by 2 = 310
Q.34. Female patient had carpopedal spasm after measuring her BP. This is caused by which of the following?
Correct Answer : A
Q.35. What is the antidote of acetaminophen?
Correct Answer : A
Q.36. All belong to hypokalemia, except?
Correct Answer : B
Q.37. Which of one of the following combination of drugs should be avoided ?
Correct Answer : D
Administration of tetracycline with aluminum, calcium, or magnesium salts significantly decreases tetracycline serum concentrations. Digoxin should be avoided from quinidine, amiodarone, and verapamil.
Q.38. Side effects of steroids are all, except?
Correct Answer : A
Steroid side effects : I. Major: Increased blood sugar for diabetics, Difficulty controlling emotion, Difficulty in maintaining a train of thought, Weight gain, Depression, mania, psychosis or other psychiatric symptoms, Facial swelling, Unusual fatigue or weakness, Mental confusion/indecisiveness, Blurred vision, Abdominal pain, Peptic ulcer, Infections, Painful hips or shoulders, Steroid-induced osteoporosis, Stretch marks, Osteonecrosis, Long-term migraines, Insomnia, Severe joint pain, Cataracts or glaucoma, Anxiety, Black stool, Stomach pain or bloating, Severe swelling, Mouth sores or dry mouth & Avascular necrosis. II. Minor: Acne, Rash, Increased appetite, Frequent urination, Diarrhea, Removes intestinal flora & Leg pain/cramps.
Q.39. 43-years-old man is brought to the emergency department after a motor vehicle accident involving a head-on collision. He mentioned that he is having headache and dizziness. During his overnight admission for observation, he developed polyuria and his serum sodium level rises to 151 meq/L. All of the following tests are indicated EXCEPT?
Correct Answer : D
Explanation: ADH reabsorbs water from the kidneys back to the body. So when absent or not working such as in diabetes insipidus, water is not reabsorbed so a sodium concentration in the body is high (hypernatremia) while the concentration in urine is low due to the large amounts of non-reabsorbed water in it. Likewise, serum osmolality is high while urine osmolality is low. The opposite is found in cases of the syndrome of inappropriate ADH secretion (SIADH), which is a diagnosis of exclusion where you have to exclude hypothyroidism and adrenal insufficiency. Head trauma is a well-known cause of both. In DI serum and plasma osmolality are essential, water deprivation test and response to desmopressin differentiate it from other differentials. MRI of the brain would show any damage or cut to the pituitary stack which causes interference with the delivery of ADH which in turn leads to DI in head trauma. Morning cortisone level is useless and not done.
Q.40. Which drug binds to the bile and prevent its reabsorption?
Correct Answer : A
Q.41. An old man is on list for brain surgery and he is on aspirin, which of the following steps needs to be taken for hemodynamic stability?
Correct Answer : D
Q.42. All of the following are causes of weight loss EXCEPT?
Correct Answer : C
Explanation: Nephritic syndrome causes an increase in weight due to fluid retention.
Q.43. Regarding Blood pH, which of the following statement is TRUE?
Correct Answer : D
Explanation: A --> After diarrhea (which is alkali) the blood will be acidic (low pH). B --> After vomiting (which is acidic “Hcl”) the blood pH will be alkali (high pH). C -->O2 low H+ and high pH, so the pH in the right atrium “low O2” will be lower than the left atrium “high O2”. D --> The Left ventricle has more oxygenated blood than the right atrium. E -->blood in arteries is more oxygenated than that in veins.
Q.44. The depressed patient ingested a large quantity of aspirin 6 hours ago, and came to the ER complaining of nausea, vomiting, and increased respiration. The investigation showed a highly elevated level of ASA, what is your action?
Correct Answer : D
Aspirin toxicity: in the early stages, salicylate will stimulate the respiratory center -->to increase RR --> respiratory alkalosis that will be compensated by metabolic acidosis. In late stage, it will interfere with COH, fat, & protein metabolism as well as Oxidation phosphorylation leads to an increase in lactate, pyruvate, & keton bodies. All will lead to decreased pH. Signs & symptoms include nausea, vomiting, increased RR, temp and HR, sweating, cerebral or pulmonary edema, & coma. +ve anion gap. Treatment: hydration, correct K+, gastric lavage or activated charcoal, urine alkalization, hemodialysis).
Q.45. A 70-year-old male with a history of hypothyroidism presents with severe lethargy, altered mental status (not responding to painful stimuli), and a serum sodium level of 108 mEq/L. His TSH is high, and he has not been compliant with his thyroid medication. What is the most appropriate management for this patient?
Correct Answer : D
This patient presents with symptoms consistent with myxedema coma, a severe form of hypothyroidism. The primary treatment involves administering IV levothyroxine (a high dose initially), fluid restriction, and gradual correction of hyponatremia. In some cases, corticosteroids (e.g., IV hydrocortisone) should also be administered due to the possibility of coexisting adrenal insufficiency.
Q.46. Anti-inflammatory drugs can cause all except?
Correct Answer : C
Increase in the risk of myocardial infarction, gastrointestinal (most commonly), inflammatory bowel disease, Interstitial nephritis, Nephrotic syndrome, Acute renal failure, Acute tubular necrosis, Photosensitivity, metabolic and respiratory acidosis, and hyperkalemia.
Q.47. Which is the best economical NSAID ?
Correct Answer : B
Q.48. Which one of the following condition does not cause hypokalemia?
Correct Answer : D
Acute tubular necrosis cause hyponatremia, hyperkalemia, hypermagnesemia, hypocalcemia, hyperphosphatemia and metabolic acidosis.
Q.49. In which condition Cherry red skin is found?
Correct Answer : B
Q.50. What is NOT true about hypokalemia ?
Correct Answer : D
Q.51. Patient with severe vomiting and diarrhea was brought in ER. Patient reported that when he stand he feel dizziness. Supine Bp 120/80 on sitting 80/40. He had loss of sensorium. What is most likely diagnosis?
Correct Answer : B
Q.52. Which of the following drugs is contraindicated in elevated liver transaminase levels?
Correct Answer : C
Q.53. An elderly patient known case of IHD is admitted in medical ICU. You transfused him PRBC, but during transfusion, he had fever with temperature of 38.5F what you will do?
Correct Answer : B
Q.54. Patient came in OPD with pitting edema grade 1, where does fluid will accumulate?
Correct Answer : C
Q.55. Which of the following conditions can cause stroke?
Correct Answer : B
Q.56. A patient with secondary polycythemia is being treated with oxygen therapy via a mask, but no improvement in symptoms is observed. What would be the next best step in management?
Correct Answer : B
Q.57. Patients who work in hot weather came with clammy cold skin. On examination, his BP= 100/50, heart rate=109 bpm. What is an appropriate diagnosis?
Correct Answer : B
Heat exhaustion: This condition often occurs when people are exposed to high temperatures especiallywhen combined with strenuous physical activities and humidity. Body fluids are lost through sweating,causing dehydration and overheating of the body. The person's temperature may be elevated, but notabove 104 F. Heat stroke: also referred to as sun stroke, is a life-threatening medical condition. The body's coolingthe system, which is controlled by the brain, stops working and the internal body temperature rises to thepoint at which brain damage or damage to other internal organs may result (temperature may reach 105 F[40.5 C] or greater).
Q.58. Patient walking for relatively long time on ice when she was in Siberia during her vacations. Her feet are pale with marked decrease in pain sensation but the pulse is palpable over dorsalis pedis. what is the appropriate thing to do?
Correct Answer : B
Q.59. In case of fever of unknown origin with enlarged lymph node. All test are negative for T.B. what is the next step?
Correct Answer : A
Q.60. Patient with a digoxin toxicity, what is the most important management?
Correct Answer : A
Q.61. What advice would you give to a patient who has to avoid food high in cholesterol?
Correct Answer : B
Q.62. 100% O2 given for prolonged periods, it can cause all, except?

Correct Answer : C
Q.63. What drug is likely to cause heat-stroke as it inhibits sweating?
Correct Answer : B
Hyoscyamine sulfate Warnings: In the presence of high environmental temperature, heat prostration can occur with drug use (fever and heat stroke due to decreased sweating). other drugs: Anticholinergics, Neuroleptics, Diuretics, Sympathomimetics, Antihypertensives
Q.64. What drug reverses the effect of Benzodiazepines?
Correct Answer : A
Flumazenil (Anexate) is a competitive benzodiazepine receptor antagonist that can be used as an antidote for benzodiazepine overdose.
Q.65. A patient presents with a wound that has greenish discharge. Gram stain reveals Gram-positive cocci in long chains. Which of the following organisms is most likely responsible for this infection?
Correct Answer : A
Q.66. Which of the following best suits about Pneumococcal vaccine ?
Correct Answer : D
Q.67. A patient presents with normal sodium (Na), chloride (Cl), and urine pH levels, but their bicarbonate (HCO3-) level is low. What is the most likely diagnosis based on these laboratory results?
Correct Answer : A
Q.68. A 70 years old man presented in ER with sever muscle pain, diarrhea, and disorientation. He take furosemide as a part of his prescription. what is the likely cause of illness ?
Correct Answer : A
Q.69. What is the mechanism of action of heparin?
Correct Answer : A
Q.70. A patient with chronic use of alcohol came to your clinic. Which of the following is the first drug to give to this patient ?
Correct Answer : A
All patients being treated for AW should be given 100 milligrams (mg) of thiamine as soon as treatment begins and daily during the withdrawal period.
Q.71. Chickpeas, Kidney beans and Lentils contain which element of following ?
Correct Answer : C
Q.72. What are the important tools for listening to a patient?
Correct Answer : C
Q.73. Patient admitted as a case of emphysema, according to the vaccination guideline, what will you advise?
Correct Answer : C
Q.74. A 20 year old patient received varicella vaccine in your hospital. After 30 mins, he developed itching. What is the treatment ?
Correct Answer : A
Q.76. For a Obese female patient, What is the next step we should do?
Correct Answer : A
Q.77. What is the antibiotic of choice for Neisseria Gonorrhea?
Correct Answer : A
Q.78. Patient with seizure using Aspirin and phenytoin for 2 years, came in your OPD, complaining of mild mid epigastric pain and bilateral painless axillary lymph nodes enlargement 2Γ2cm. Biopsy of the lymph nodes showed Hyperplasia. What is the diagnosis?
Correct Answer : A
Q.79. During blood transfusion, the patient develops fever and pain at the infusion site. What will be your action ?
Correct Answer : D
Q.80. All of the following are signs of allergy to local anesthesia, EXCEPT?
Correct Answer : C
Q.81. Patient recovering from Viral Gastroenteritis, vomiting and diarrhea abated but still having Anorexia. What will you advice?
Correct Answer : A
Q.82. Which of the following b-blocker have an alpha blocking effect?
Correct Answer : A
Q.83. What are the side effects of Roaccutane(isotretinoin)?
Correct Answer : B
Q.84. Which of the following organism will grow in the agar medium from a cat-bite sample?
Correct Answer : B
Q.85. A male patient who was working in a hot climate was brought to ER due to dizziness. He was vitally stable, What you will do for him?
Correct Answer : A
Q.86. All of the following will improve the patient compliance except?
Correct Answer : A
Q.87. What is true regarding Paracetamol toxicity?
Correct Answer : B
Q.88. What can you give to increase iron absorption to the body?
Correct Answer : B
Q.89. A Young male with depression is on citalopram. He presented in ER due to unconsciousness with toxicity of unknown substance. Investigation results are: metabolic acidosis and anion gap of 18 , what is the cause?
Correct Answer : B
Q.90. Diuretic causes which of the following?
Correct Answer : A
Q.91. A patient with over dose of medication is in ICU. He is in coma with absent gag reflex. What is the appropriate initial treatment that you would give?
Correct Answer : A
Q.92. In supine portable CXR, all of the followings are expected, except?
Correct Answer : D
Q.93. For high serum lactate, all are true except?
Correct Answer : D
Q.94. Which drug can cause hirsutism?
Correct Answer : A
Q.95. Bupropion is contraindicated in which of the following?
Correct Answer : A
Q.96. A 30-year-old male patient with Raynaud's phenomenon presents with complaints of worsening symptoms. He lives in an area with high exposure to smoke. What is the best advice to manage his condition?
Correct Answer : B
Q.97. What is the most serious symptom of CO poisoning?
Correct Answer : D
Q.98. What is the food that should be avoided by hyperlipidemia patient?
Correct Answer : B
Avocado is a source of omega-6 (linoleic) fatty acid with many benefits. So, I would choose organic meat from the mentioned answers!
Q.99. There is an interaction between CARVIDILOL and which of the drugs below?
Correct Answer : B
Carvidilol drug reaction with digoxin. They both lower the serum K level
Q.101. All can cause secondary hyperlipidemia except?
Correct Answer : D
Secondary hyperlipidemia causes: Diabetes mellitus, use of drugs such as diuretics, beta-blockers, and estrogens, hypothyroidism, renal failure, Nephrotic syndrome, alcohol usage, and some rare endocrine and metabolic disorders.