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Internal Medicine II - SE1

Total questions: 25

Worksheet time: 13mins

Name
Class
Date
1.

Which of the following is a case of presumptive PTB?

a)

22 y/o male with 2 days history of fever

b)

54 y/o female diabetic complaining of difficulty in breathing for 2 weeks

c)

21 y/o male with CXR finding of left upper lobe cavitary infiltrate

d)

40 y/o male with weight loss

2.

The most likely etiology of an acute lung abscess developing in a young, previously healthy patient, especially in conjunction with influenza.

a)

Staphylococcus aureus

b)

Streptococcus pneumonia

c)

Mycobacterium tuberculosis

d)

Klebsiella pneumonia

3.

How often should monitoring of RPR or VRDL titers be for patients with secondary neurosyphilis?

a)

At 6 and 12 months

b)

At 6, 12, and 24 months

c)

Every 6 months until asymptomatic

d)

Every 6 months until normal

4.

M.T. a 36 year old, male came for consult due to 2 days history of cough productive of yellowish phlegm with undocumented fever. Upon physical examination he has stable vital signs. With noted crackles in the Left lower lung field. What is the most likely pathogen?

a)

Staphylococcus aureus

b)

Pseudomonas aeruginosa

c)

Streptococcus pneumoniae

d)

Gram Neg bacilli

5.

Which of the following statement is true regarding the pretreatment screening test in PTB?

a)

All patient should be screened for DM and HgbAIc must be requested

b)

Serum uric acid is routinely requested prior to starting anti-TB med

c)

Baseline serum ALT and Creatinine should be measured before starting anti-TB medications

d)

Patient should be referred to ophthalmologist for baseline eye function

6.

Duration of treatment of low risk uncomplicated pneumonia.

a)

3 days only

b)

3-5 days

c)

5-7 days

d)

10-14 days

7.

Which of the following is the risk factor for Pseudomonas aeruginosa infection?

a)

Bronchiectasis

b)

Diabetes Mellitus

c)

Hematologic malignancy

d)

Cerebrovascular disease

8.

Which of the following is an indirect method that can be used to confirm leptospirosis, but main caveat includes being time-consuming (requires acute and convalescent sera) and hazardous because it detects live antigens of the leptospire?. Single choice.

a)

Lepto-PCR

b)

Leptospirosis-MAT

c)

LeptoDipstick

d)

LAATS

9.

SARS-COV-2 virus is able to enter into the human cell via which receptor?

a)

ACE1 receptor

b)

CXCR4 co-receptor

c)

ACE2 receptor

d)

CD4 receptor + CCR5 co-receptor

10.

Which of the following statements is correct about exercise-induced asthma?

a)

The mechanism is linked to hypoventilation, which results to increased osmolality in airway lining fluid and triggers mast cell mediator release

b)

It is worst during hot, humid condition

c)

Typically begins after exercise has ended and resolves spontaneously within about 30 minutes

d)

It is best prevented by SABA treatment

11.

Once diagnosis of Asthma is confirmed, lung function is a most useful indicator of future risk and should be recorded at diagnosis, ________ at the time of diagnosis and periodically thereafter.

a)

2 - 4 weeks

b)

1 - 2 months

c)

2-4 months

d)

3-6 months

12.

A 22 year old male known asthmatic since childhood consulted your clinic for check up. Patient has poor compliance to maintenance medication( ICS+LABA) . He reported that he has daytime symptoms and limitations of activities and night time awakening 2-3x a week. This was relieved by intake of short acting B 2 agonist. What is the status of his Asthma?

a)

Controlled asthma

b)

Partly controlled

c)

Uncontrolled

d)

Exacerbation

13.

Lipopolysaccharide, which is found in the cell wall of gram-negative bacteria and is involved in the initiation of inflammation in septic patients, is considered under which category?

a)

Pattern Recognition Receptors

b)

Pathogen-associated Molecular Patterns

c)

Damage-associated Molecular Patterns

d)

Pathogen Recognition Receptors

14.

ETM, 40/M, came into ER because of a 4-day history of fever, with associated abdominal pain and vomiting. She also has no bowel movement for 3 days and oliguria. On PE, patient is awake, coherent, follows commands. Speaks in phrases. BP = 80/50, HR = 128, RR = 26, Temp = 38C, O2sat = 89% on room air. (+) Icteric sclerae. (+) Board-like rigidity of the abdomen, with hypoactive bowel sounds. Baseline CBC showed thrombocytopenia of 60. What is the qSOFA of the patient?

a)

1

b)

2

c)

3

d)

4

15.

This stage of exudative pleural effusion is characterized by polymorphonuclear leukocytosis, normal glucose, and normal pH?

a)

Exudative stage

b)

Fibrinopurulent stage

c)

Organization stage

d)

Fibrosis

16.

LR a 34 year-old smoker consulted your clinic due to 2 weeks history of productive cough with associated afternoon fever, anorexia and weight loss. No previous antibiotic intake reported. However, the patient claimed that 1 year ago, he was prescribed with anti-Tb medications because of an incidental finding of PTB on CXR. He took the medicine for 2 weeks and was lost to follow up. How would you classify this patient?

a)

New Case

b)

Retreatment

c)

Relapse

d)

Treatment after lost to follow

17.

According to the Updated Sepsis-3 Definition (2018) and the Philippine Clinical Practice Guidelines on Sepsis and Septic Shock (2020), when is the best time to administer empiric antibiotics?

a)

Within 6 hours after recognition of sepsis

b)

Within 4 hours after recognition of sepsis

c)

Within 3 hours after recognition of sepsis

d)

Within 1 hour after recognition of sepsis

18.

Which HIV enzyme is responsible for the incorporation of proviral DNA from viral RNA to the nucleus?

a)

Integrase

b)

Protease

c)

RNA polymerase

d)

Reverse transcriptase

19.

85.SR, 41/M, a construction worker, came to ER because of fever for 4 days, with calf pain. On PE, conjunctival suffusion, crackles on both lung fields and meningismus were noted. Which of the following is the best disposition for the patient?

a)

Send the patient home and prescribe with doxycycline

b)

Admit the patient and watch out for hemoptysis and respiratory distress

c)

Send the patient home, prescribe antibiotics and for OPD follow-up.

d)

Observe the patient at the ER for 48 hours and observe

20.

TCA, 46/F, was brought in to the ER because of vomiting, headache, fever and decreasing sensorium of 14-day duration. On PE, vital signs were 110/90, HR = 115, RR = 24, Temp = 38.6C. (+) Kernig’s and brudzinski signs, (+) nuchal rigidity. Plain cranial CT scan: (+) meningeal enhancement. S/P Lumbar tap, with opening pressure at 320. CSF analysis: WBC 600, predominantly polymorphonuclear cells, with hypoglycorrhachia, protein 170, and gram stain has negative yield. CALAS: (+). What is the most probable etiologic agent of the CNS infection?

a)

Cryptococcus neoformans

b)

Streptococcus pneumoniae

c)

Herpesvirus

d)

Mycobacterium tuberculosis

21.

Massive hemoptysis is defined as hemoptysis of:

a)

>50-100 cc in 12 hrs

b)

>50-100 cc in 24 hrs

c)

>200-600 cc in 12 hrs

d)

>200-600 cc in 24 hrs

22.

In children, the most common cause of FUO after infection is

a)

Neoplasm

b)

Granulomatous disease

c)

Collagen vascular disease

d)

Habitual hyperthermia

23.

In which of the following patients will you suspect the presence of fever of unknown origin?

a)

16 years old female with 3 days fever, with normal CBC, and urinalysis

b)

34 years old engineer with fever of more than three weeks

c)

21 years old student with fever, chills, and diaphoresis every three days

d)

45 years old construction worker with fever of 38 deg Celsius

24.

Which of the following statements regarding Acute Kidney Injury in septic patients is correct?

a)

AKI increases the risk of in-hospital death ten time

b)

AKI is documented in less than 50% of septic patients

c)

AKI may occur in up to 25% of patients in the absence of overt hypotension

d)

AKI manifests as uremia and rarely requires dialysis

25.

32/M consulted due to history of wading in flood. On physical exam, you noted that there were no open wounds on both feet. How should the patient be advised?

a)

Take Doxycycline 2 capsules 100 mg single dose within 24 to 72 hours from exposure

b)

Take Doxycycline 2 capsules 100 mg OD for 3-5 days within 24 to 72 hours from exposure

c)

Take Amoxicillin 2 capsules 500 mg single dose within 24 to 72 hours from exposure

d)

Take Amoxicillin 2 capsules 100 mg OD for 3-5 days within 24 to 72 hours from exposure