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Internal medicine UTAR

Total questions: 10

Worksheet time: 20mins

Name
Class
Date
1.

A 27-year-old male, an intravenous drug user, complains of intermittent fever and tiredness for 3 months. Auscultation of his heart reveals a harsh pan-systolic murmur in his tricuspid area. He has splinter haemorrhages of his finger nails. Which of the following organisms is likely to be positive in his blood cultures?

a)

Fungi

b)

Bacteroides

c)

Staphylococcus aureus

d)

Pseudomonas aeruginosa

e)

Streptococcus viridans

2.

A 60-year-old man, with a 13-year history of ulcerative colitis, has developed pruritus and progressive jaundice in the last 2 months. Which of the following is the MOST likely complication that he has developed?

a)

Portal hypertension

b)

Hepatocellular carcinoma

c)

Gastric Carcinoma

d)

Primary Sclerosing Cholangitis

e)

Gall stones

3.

A 23-year-old office clerk, a non-smoker, has been getting episodes of wheezing and breathlessness, which are worse in morning. His sister has hay fever. A spirometry is performed. Which of the following is the MOST likely finding in this patient?

a)

FEV1 increased during attacks

b)

FVC increased during attacks

c)

FEV1/FVC < 70% when normal with no symptoms

d)

FEV1/FVC < 70% during attacks

e)

Poor reversibility with bronchodilators

4.

A 30-year-old gentleman presents with fever for 5 days. He lives in a dengue endemic area. What is the symptom that requires him to be admitted to the hospital?

a)

Abdominal pain

b)

fever

c)

joint and body pains

d)

macular rash

e)

Retro-orbital pain

5.

Which of the following Malaria parasites is MOST commonly found in East Malaysia?

a)

Plasmodium falciparum

b)

Plasmodium ovale

c)

Plasmodium malariae

d)

Plasmodium vivax

e)

Plasmodium knowlesi

6.

A 65-year-old man presents with racing heart rates and difficulty in breathing. On examination, he is in discomfort with blood pressure of 101/50mmHg and SpO2 of 93% on air. His ECG is reported as follows: Heart rate- 199/min, Rhythm-

a)

Atrial fibrillation

b)

Supraventricular tachycardia

c)

Ventricular tachycardia

d)

Complete heart block

e)

Sinus tachycardia

7.

A 16-year-old student complains of a 6-week history of recurrent headaches and vomiting. He is not able to concentrate to prepare for his school examination. Fundoscopy shows blurring of optic discs bilaterally. He has no other clinical signs. His erythrocyte sedimentation rate (ESR) is normal. Which of the following is the MOST likely diagnosis?

a)

Migraine

b)

Cluster headache

c)

Anxiety attacks associated with his school examination

d)

Intracranial tumours

e)

Giant cell arteritis

8.

A 55-year-old housewife has been feeling increasingly sleepy and generally more tired for the last 6 months. She thought her skin is getting very dry. She feels depressed as her memory is not the same as before. Examination reveals a small non-tender goitre. No bruits are heard. Which of the following blood test result MOST likely to be found in her condition?

a)

Low thyroid stimulated hormone (TSH)

b)

Positive thyroid peroxidase antibody

c)

Normal Triiodothyronine (T3)

d)

High Thyroxine level (T4)

e)

Normal T4

9.

A 67-year-old man, who is a heavy smoker, has a 3-month history of increasing dyspnoea, lethargy and weight loss. On examination, he has finger clubbing. His trachea is deviated to the right side. There are reduced breath sounds, tactile fremitus, and vocal resonance, and stony dullness of the right lower zone posteriorly. What is the MOST likely diagnosis?

a)

Consolidation of right lower lobe

b)

Large effusion of right lung

c)

Effusion with collapse of right lower lobe

d)

Previous left lobectomy

e)

Previous left pneumonectomy

10.

A 78-year-old-gentleman presents to the hospital with complaint of having fever with cough for the past 3 weeks. On examination, patient is febrile with crepitations over the right apex of the lung the chest radiography shows right upper lobe consolidation. Which of the following is the most likely diagnosis?

a)

Pulmonary tuberculosis

b)

Streptococcus pneumonia

c)

Legionella pneumonia

d)

Mycoplasma pneumonia

e)

Staphylococcus aureus