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IM Interns Second Quiz

Total questions: 25

Worksheet time: 18mins

Name
Class
Date
1.

F.P. 54/M came in the ER due to a one week history of difficulty of breathing associated with intermittent fever Tmax 38.9oC, non productive cough, anosmia and ageusia. He is a known hypertensive and diabetic. On PE, he was conscious, coherent in cardio respiratory distress. BP 100/70 HR 121 RR 32 T 38.6 90% O2 saturation at room air. Chest radiograph revealed bilateral pneumonia with peripheral involvement and ABG showed uncompensated respiratory alkalosis with inadequate oxygenation. PF ratio was 232. RT-PCR for SARS-CoV 2 result is not yet available. Your impression?

a)

CAP MR COVID Suspect Severe

b)

CAP MR COVID Suspect Critical

c)

CAP MR COVID Probabe Severe

d)

CAP MR COVID Probable Critical

2.

RT-PCR for SARS CoV 2 of patient F.P. revealed positive result. He is now classified as:

a)

COVID Probable Severe

b)

COVID Probable Critical

c)

COVID Confirmed Severe

d)

COVID Confirmed Critical

3.

Your management will include:

a)

Dexamethasone 6mg/IV OD for 10 days

b)

Methylprednisolone 80mg/IV OD for 10 days

c)

Hydrocortisone 100mg/IV q 12 for 10 days

d)

Hydrocortisone 200mg/IV q 12 for 10 days

4.

Eventually, you decided to administer the antiviral remdesivir to patient F.P. Its dosing is:

a)

100mg intravenous infusion on the first day then 200mg intravenous infusion once a day for five to ten days

b)

100mg intravenous infusion on the first day then 200mg intravenous infusion once a day for ten to fifteen days

c)

200mg intravenous infusion on the first day then 100mg intravenous infusion once a day for five to ten days

d)

200mg intravenous infusion on the first day then 100mg intravenous infusion once a day for ten to fifteen days

5.

Type 1 DM is insulin _____________ while Type 2 DM is insulin _____________.

a)

resistance, deficiency

b)

resistance, intolerance

c)

deficiency, resistance

d)

deficiency, intolerance

6.

Crieteria for the diagnosis of diabetes mellitus, except:

a)

Symptoms of diabetes plus RBS of >200 mg/dL

b)

Fasting plasma glucose of >126mg/dL

c)

HbA1c >7.5%

d)

2h OGTT >200mg/dL

7.

Glucose is the key regulator of insulin secretion by the pancreatic beta cells. At what level does glucose stimulate insulin synthesis?

a)

70mg/dL

b)

80mg/dL

c)

90mg/dL

d)

100mg/dL

8.

Long acting insulin, except:

a)

Degludec

b)

Detemir

c)

Glargine

d)

Glulisine

9.

Diabetic ketoacidosis is characterized by the following, except:

a)

serum glucose >250mg/dL

b)

serum bicarbonate <15mmol/L

c)

positive serum ketones

d)

normal anion gap

10.

Most common clinical manifestation of gonorrhea in male patients?

a)

acute balanitis

b)

acute prostatitis

c)

acute urethritis

d)

acute epididymitis

11.

First line regimen in the treatment of uncomplicated gonococcal infection of the cervix, urethra, pharynx or rectum.

a)

Ceftriaxone 250mg IM + Azithromycin 500mg PO single dose

b)

Ceftriaxone 250mg IM + Azithromycin 1g PO single dose

c)

Ceftriaxone 500mg IM + Azithromycin 500mg PO single dose

d)

Ceftriaxone 500mg IM + Azithromycin 1g PO single dose

12.

J.G. 34/M, known case of HIV went to the laboratory for series of tests. His CD4+ T cell count is 183/uL. As his attending physician, you will start him on:

a)

Co-trimoxazole 160/800mg/tab one tablet 3x a week

b)

Clarithromycin 500mg/tab one tablet every 12 hours

c)

Vaganciclovir 900mg/tab one tablet every 12 hours

d)

Metronidazole 500mg/tab one tablet every eight hours

13.

After 3 months, patient J.G's CD4+ T cell count is now 33/uL. You will start him now on:

a)

Co-trimoxazole 160/800mg/tab one tablet 3x a week

b)

Clarithromycin 500mg/tab one tablet every 12 hours

c)

Vaganciclovir 1200mg/tab one tablet every 12 hours

d)

Metronidazole 500mg/tab one tablet every eight hours

14.

A.P. 22/F is a known asthmatic came in and complains of shortness of breath occurring 3-4 times a week. She also wakes up at night due to excessive coughing and occasional difficulty of breathing but only used her salbutamol MDI once on the past week. She still does her usual activities ike walking, doing household chores and going to the grocery. Her level of asthma symptom control is:

a)

well controlled

b)

partly controlled

c)

partly uncontrolled

d)

fully uncontrolled

15.

Your plan of management for patient A.P. is to:

a)

maintain on as needed SABA only

b)

Start on low dose inhaled corticosteroid

c)

Start on low dose ICS-LABA

d)

Start on medium dose ICS-LABA

16.

Expiratory flow variation consistent with asthma?

a)

FEV1 of >12%

b)

FEV1 of >8%

c)

FEV1 of >8% and > 200mL from baseline

d)

FEV1 of >12% and > 200mL from baseline

17.

M.A. 65/M has previously been treated for PTB, completed, in 1998. He came in to your clinic and based on your history, physical examination and diagnostics, he has a new episode of PTB. He is now classified as:

a)

New case

b)

Relapse

c)

Treatment after failure

d)

Treatment after lost to follow up

18.

This anti TB medication inhibits mycolic acid synthesis

a)

Pyrazinamide

b)

Rifampicin

c)

Ethambutol

d)

Isoniazid

19.

The usual dose of your previous answer in mg/kg is:

a)

5

b)

10

c)

15

d)

25

20.

Multidrug-resistant TB (MDR-TB):

a)

resistant to at least both isoniazid and rifampicin

b)

resistant to isoniazid, rifampicin, levofloxacin, kanamycin

c)

resistant to both pyrazinamide and ethambutol only

d)

none of the above

21.

C.L., 45/M, came in due coffee ground vomitus. He denies having black tarry stools nor loss of consciousness. He has no history of liver disease and denies failure nor anginal symptoms/equivalence. Vital signs were: BP 80/50 HR 121 RR 25 T 36.7 98% oxygen saturation at room air. Labs revealed: Hgb 68 BUN 19. His Glasgow-Blatchford score is:

a)

9

b)

10

c)

11

d)

12

22.

Your plan for patient C.L will include:

a)

Send home

b)

Do upper GI endoscopy within 24 hours

c)

Do lower GI endoscopy within 72 hours

d)

Observe for recurrence

23.

Procedure of choice in most patients admitted with LGIB:

a)

Colonoscopy after an oral lavage

b)

Colonoscopy after upper GI endoscopy

c)

Whole abdominal CT scan with triple and triphasic contrast

d)

CT angiography

24.

Recommended for colorectal cancer screening beginning at age 50 in average-risk adults:

a)

FIT test

b)

FOBT

c)

Colonoscopy

d)

ERCP

25.

Not a proton pump inhibitor:

a)

Omeprazole

b)

Rabeprazole

c)

Metronidazole

d)

Pantoprazole