Question no. 373

  

A one year old child is brought in for a regular "well baby" check up. The child appears to have strabismus. The reflection of a bright light from the ceiling of the examination room comes from a different place in each eye. The family explains that the child has always looked that way, and there has been no recent change in the appearance his eyes. Which of the following is the most effective management? 

Question no.372

A previously healthy male postal worker complains of fever, headache, myalgia and cough for the past 3 days.He reports that several of his coworkers have also been ill with similar complaints. His leukocyt count is normal with a relative lymphopenia. A chest X-ray shows only enlarged hilar shadows.

Question no.371

A 7-month old patient presents with a history of 3 days of ferver to 104 F, Which resolved the same day that an exanthem erupted. The exanthem is prominent on the neck and trunk. It is macular, with

Question no.369

        A 19 year old high school senior complains of feeling "fat & ugly" despite being extremely thin. She takes small amounts of food at meals and occasionally gags herself to induce vomiting after meals.

Which of the following is commonly associated with this disorder?

a) Menorrhagia.

b) Metrorrhagia.

c) Loss of body hair.

d) Bradycardia.

e) Thrombocytopenia.

Question no.366

     A 22 year old woman presents with " skipped heartbeats" & on cardiac examination is found to have a midsystolic click followed by a late systolic murmur. Echocardiogram shows prolapse of the mitral valve.

Which of the following is true about this condition?

a) Mitral valve prolapse is present in up to 10% of the population.

b) Mitral valve prolapse is more commom in men.

c) Prophylaxis against bacterial endocarditis is never recomended.

d) Risk of pulmonary embolism is high.

e) Ventricular arrhythmias don't occur.

Question no.362

        You make the diagnosis of Marfan syndrome in a very tall 22 year old man with long, thin extremities.

1) What other finding is associated with this disease?

        A) Family history in 100%of the patients.

        B) Upward sublaxation of the lenses.

        C) Mental retardation.

        D) Malar rash.

        E) Increased length of trunk compared with the limbs.

USMLE 31

   A 60 year-old patient with long standing diabetes has a creatinine of 3.6, which has been stable for several years.

Which of the following antibiotics requires the most dosage modification in chronic renal failure?

A) Gentamycin.

B) Tetracycline.

c) Erythromycin.

D) Nafcillin.

E) Chloramphenicol.

USMLE 30

     

    A 54 year old man presents to ER complaining of epigastric discomfort, which began while he was walking after dinner about one hour earlier.He hasn't received medical care for several years.On examination he is moderately obese and  his Bp 160/98. His ECG reveals inferior wall myocardial infarction.

Which of the following is the most appropriate next step in management?

A) Trial of antacid immediately.

B) Reassurance and arrange outpatient follow up.

C) Arrange for cardiac ICU bed.

D) Begin thrombolytic therapy in the ER.

E) Arrange for urgent echocardiogram.

USMLE 25

57 year old woman had a left modified radical mastectomy for intraductal carcinoma 2 year previously. She presents with lethergy, confusion and thigh pain.X rays reveal a lytic lesion in the shaft of the femur.

Which of the following blood abnormalities is most likely?

a) High magnesium.

b) Low calcium.

c) High glucose.

d) High calcium.

e) High potassium.

Which of the following is the most appropriate initial therapy?

a) Tamoxifen.

b) Vigorous saline infusion.

c) Radiotherapy to the femur.

d) Chemotherapy.

e) Glucocorticoids.

USMLE 24

A 19 year old high school senior complains of feeling (fat & ugly) despite being extremely thin.She takes small amounts of food at meals and occasionally gags herself to induce vomiting after meals.

Which of the following is commonly associated with this disorder?

a)Metrorrhagia.

b)Menorrhagia.

c)Loss of body hair.

d)Bradycardia.

e)Thrombocytopenia.

Medical MCQ 41

Hypercyanoptic spell of T.O.F. is best treated with all of the following except:

a- Knee chest position.

b- Morphine.

c- Digoxin.

d- Propranolol.

e- Sodium bicarbonate.

USMLE 21

A 17 year old girl presents with a 2 day history of lower abdominal discomfort, burn in micturition & increased frequency of urination. She had her first sexual intercourse last week. Her vital signs are stable.

Examination shows supra-pubic tenderness. Urinalysis shows +ve esterase, 50+ WBC and many bacteria.

Which of the following is the most likely mechanism responsible for her clinical condition?

A- Hematogenous spread of infection.

B- Lymphatic spread of infection.

C- Sexual transmission.

D- Poor genital hygiene.

E- Ascending infection.

USMLE 19

A 32 year old woman is visiting you in your primary care office as a new patient.Overall, she is healthy.On taking a a family history , you learn that her mother was diagnosed with colorectal cancer at the age of 52.

When should this patient start being screened for colorectal cancer?

a) There is no proven benefit for colorectal cancer screening.

b) at age of 40

c) at age of 30

d) at age of 60

e) at age of 50

USMLE 18

You make the diagnosis of Marfan syndrome in a very tall 22 year old man with long, thin extremities.

1- What other finding is associated with this disease?

a) Family history in 100 % of the patient.

b) Mental retardation.

c) Malar rash.

d) Upward sublaxation of the lenses.

e) Increased length of trunk compared with the limbs.

2- The major cause of morbidity & mortality in Marfan patients is cardiac.

Which of the following is  common complications?

a) Aortic root dilatation.

b) V.S.D.

c) Coronary artery disease.

d) Pulmonary stenosis.

e)  Pulmonary hypertension.

USMLE 17

A dentist asks you to evaluate a 42-year-old woman before tooth extraction.

1-Which of the following would prompt you to prescribe prophylactic antibiotics?

a) Midsystolic click at the left sternal border.

b) Insulin dependent diabetes.

c) a prior history of infective endocarditis.

d) a history of conestive heart failure.

e) S4 gallop.

2- Which of the following is the prophylactic antibiotic of choice for dental procedures?

a) Amoxicillin.

b) Cephalexin.

c) Penicillin.

d) Vancomycin.

e) Clindamycin.

3-  In patients who aren't (IV) drug users and who don't have prosthetic valves.

Which of the following organisms is the most common cause of bacterial endocarditis?

a) Enterococcus.

b) Sterptococcus.

c) Candida.

d) Gram negative bacilli.

e) Pseudomonas.

Medical MCQ 40

Haemoptysis occurs most frequently in:

a) Mitral  regurgitation.

b) Mitral stenosis.

c) Tricuspid regurgitation.

d) Aortic regurgitation.

e) Aortic stenosis.

Medical MCQ 39

The carey coomb murmur is due to:

a) Inflammation of the mitral valve.

b) Increased diastolic flow across the mitral valve.

c) Cardiac decompression.

d) Defibrillation.

Medical MCQ 38

   LMN facial paralysis, otalgia, vesicular eruption on the concha and may be SNHL are diagnostic of:

a) Myringitis bullosa hemorrhagica.

b) Ramsy Hunt syndrome.

c) Bell's palsy.

d) Diffuse otitis externa.

Medical MCQ 37

The following diagnostic tests are appropriate except:

a) A.S.O. for arthritis.

b) HLA B27 for ankylosing spondylitis.

c) Alkaline phosphatase for Reiter's syndrome.

d) Serum uric acid for gout.

e) Wasserman reaction for Charcot's joint.

Medical MCQ 36

Digitalis glycosiedes are characterized by the following except:

a) Digitoxin is more lipid soluble than digoxin.

b) t 1\2 of digoxin is more than of digitoxin.

c) Plasma protein binding of digitoxin is more than that of digoxin.

d) Vd of digoxin is more than that of digitoxin.

e) Digoxin is mainly eliminated by kidney , While digitoxin is mainly eliminated by liver.