Family med 2020

The most sensitive and cardiac specific enzymes which rise in plasma at the beginning of MI are:
CPk-MB + Troponin T
CPK
GGTP
LDH
Early management of acute MI does not include:
Bed rest
Oral aspirin
Iv access
ECG
Acute pyelonephritis should be distinguished from:[
Acute appendicitis
Salpingitis
Cholecystitis
All
Choose the correct statements:
You can safely give Ciprofloxacin to 13 year old boy who weight 70 kg
There is approx. 10 % cross allergy between penicillins and cephalosporins
You can treat simple cystitis with Bactrim, Ciprofloxacin, Amoxicillin or Doxycycline
Single dose of 200 mg of Doxycycline can be effective means of prophylaxis after tick bite
Which disease is caused by bacteria:
Measles
Mumps
Tuberculosis
Rubella
Choose false LBBB in ECG:
Wide QRS complexes
QRS complexes with M- shaped configuration in leads V1-V2+
QRS complexes with M- shaped configuration in leads V5-V6
QRS complexes with the loss of Q wave
In pulmonary embolism:
Cough, shortness of breath and tachycardia are typical signs
Chest x - ray is usually normal
Hypotension is a sign of extensive PE
Normal D-dimer level usually rules out the condition
8. You have a 60y old patient with shrunken one kidney, who states that he had pneumonia during the war. He has no urinary symptoms and no bacteria can be cultured from the urine. You suspect:
Schistosomiasis
Viral UTI
Urinary tuberculosis
Fungal infection
Which medical treatment will you use for eradication of Helicobacter pylori?
Amoxicillin, H+ blocker, macrolides
Amoxicillin, insulin
H+ blocker, beta blocker, macrolides
Alfa adrenolytics, H+ blocker, amoxicillin
In pregnancy:
Carbonated beverages with high sugar content are to be avoided
When she has hypertension, you avoid Hydralazine and give Methyldopa
Treatment of asymptomatic bacteriuria is generally approved
Occurrence of HELLP syndrome may be associated with thrombosis
Choose the false:
Pain of MI are typically substernal, diffuse with squeezing or pressure quality
It may radiate to the neck or jaw and shoulders or arms too
Pain of MI lasts shorter than 15 min, and responds to nitroglycerine
Most often the pain of MI is accompanied by nausea or vomiting
Choose the false:
Mitral prolapse is usually asymptomatic
Pain associated with mitral prolapse can be substernal and crushing
The typical mitral prolapse patient is old but otherwise healthy
Echocardiography is the most effective diagnostic test
ACE inhibitor contraindication is:
Heart failure
Diabetes
MI
Renal artery stenosis
The reason of arterial hypertension is not:
Hypocalemia
Chronic pyelonephritis
Coarctation of aorta
Hyperthyroidism
Beta blocker contraindication is not:
Hyperthyroidism
Asthma bronchiale
Bradycardia 50/min
Arteriosclerosis obliterans
There is no vaccination against:
Hepatitis viral A
Haemophilus influenzae
Hepatitis viral C
Streptococcus pneumoniae
Choose the false: Ischemic heart disease causes in ECG:
Flat or down sloping ST-segment depression of 0,1 mV
Negative T-wave in aVR
Flattening or inversion of the T wave
ST-segment elevation
What is the correct dose of vit D3 for a healthy infant:
1200 IU daily
400 - 800 IU daily
400 - 800 IU twice a day
400 - 800 IU once a week
Frequent side effect after treatment with glucocorticoids is:
Oral candidiasis
Pretibial edema
Diaphoresis
Tachycardia
Patient with Streptococcal tonsillitis and allergy to penicillin you may apply
Amoxicillin
Cephalosporins
V ziline
Macrolides
Contraindications to vaccination include:
Positive HIV status with CD4 count of 700
History of TB
SLE
Conjunctivitis and temperature of 38,5 C
Woman, 42y old, comes with substernal pain which is worse when she takes a deep breath and relieved when she leans forward. On auscultation you can hear pericardial rub. ECG shows elevated ST segment. She had the flu 1 week ago. Most likely the diagnosis is:
Pericarditis
Mitral prolapse
Stable angina
Unstable angina
To unstable angina belong:
Prinzmetal's angina
Non Q infarct
Angina at rest
All
Complications of bisphosphonate therapy for osteoporosis include:
Jaw osteonecrosis
Ophthalmopathy
Hypocalemia
All
Most common cause of chest pain:
AMI
Pneumonia
Musculoskeletal pain
GERD
The incubation period of varicella lasts:
1 - 5 days
Once a week
2 - 3 weeks
Depends on child“s age
The recommended medicine for patient with hypertension occurring along with diabetes and heart failure is:
Diuretics
ACE inhibitor
Ca channel inhibitor
Beta adrenolytics
ACE inhibitors side effects do not include:
Cough
Skin blemishes
Angioedema
Bradycardia
Medicines you would apply to patients with hypertension and diabetes:
Diuretics
Ca channel blockers
Alfa adrenolytics
ACE inhibitors
Which of the side effects refer to nonselective beta-adrenolytics:
Diminished secretion of endogenous insulin in type 2 diabetes
Orthostatic hypotension
Intensification of lower limb arteriosclerosis
Hypertriglyceridemia
Uric acid retention
Which of the following are for middle aged patients with hypertension:
Rezerpin
Alpha adrenolytics
Guanethidine
Thiazide or thiazide derivatives
If you follow EBM rules, you would treat a newly diagnosed patient with hypertension with:
Diuretic
ACE inhibitor
Beta blocker
Calcium channel blocker
Presence of liquid within pleural space cavity can be recognized if over infected area there are:
Increased auscultation sound, decreased soft air sacs susurrus/murmur
Decreased vocal fremitus, low auscultation sound
No pectoral shivers, low auscultation sound, bronchial susurrus/murmur
Increased fremitus, loud/apparent auscultation sound, loud air susurrus
Possible causes for chronic pancreatitis are:
Alcohol
Cholecystolithiasis
Hyperlipidemia
Calcium distribution disorders
All
UTI are most often caused by:
Enterobacter
Corynebacterium
E. coli
Proteus
Diabetic patient comes to stating that he has had pain in his left arm for past 2 weeks and it got worse after physical therapy last week. Physical exam is normal except for slight weakness in the left arm and positive Babinski sign in the left foot.
You refer patient for neuro consults within next 48 hours
You send him straight to a hospital
You tell the patient to count every 7 in reverse
You do LP (lumbar puncture), send the patient for vit. B 12 and serum and RBC folate levels
To mucolytics group of medicine belong:
Codeine phosphate
Sodium nedocromil
Oxeladin
Acetylcysteine
Symptoms like bellyaches, jaundice, diabetes, phlebitis suggests:
Pancreas cancer
Duodenal ulcer
Chronic hepatitis
Stomach cancer
In a treatment of a patient with new onset diabetes, whose fasting sugar levels don't exceed 200 mg%, besides diet, one should apply:
Adequate amount of physical exercise
Oral hypoglycemics
Intermediate/mediate action time insulin
Secondary[4] causes of arterial hypertension do not include:
Hyperthyroidism
Hypothalamic failure
Cushing syndrome
Gestosis
*Healthy man, on no meds who smokes 1 PPD, comes to you with vague chest discomfort for a few weeks. On ECG you see NSR (normal sinus rhythm) and LBBB:
It is certain patient has MI
You need to check his troponin today
Coronary angiogram on urgent basis is advised
You give him aspirin and clopidogrel, provided there are no contraindications
*In treating diabetes by injecting the insulin twice a day (conventional insulin therapy) the morning and evening doses should be divided as follows:
30 % in the morning, 70 % in the evening
70 % in the morning, 30 % in the evening
20 % in the morning, 80 % in the evening
50 % in the morning, 50 % in the evening
To a patient with arteriosclerosis obliterans occuring along with hypertension must not be applied:
ACE inhibitors
Ca channel inhibitors
Beta adrenolytics
Alpha adrenolytics
The contraindications[7] in applying quinolones to patients with UTI are:
Pregnancy
Liver insufficiency/hepatitis
Children and teens up to 16
Urolithiasis
For a 60y old woman with type 2 diabetes and arterial hypertension the most efficient is:
Thiazide diuretic
Beta adrenolytics
ACE inhibitor
Potassium sparing diuretic
For a pregnant woman with UTI the safest is:
Cotrimoxazol
Amoxicillin
Cephalosporin
Quinoline
****For a patient who had anterior wall MI 6 years ago and has now 48%[9] [10] you are obligated to do the following:
Aggressively treat cholesterol
Give aspirin
Give beta blocker
Give LMWH
Have him exercise twice a week for 30 min
For a patient with hypertension after heart-attack the most efficient is:
Beta blocker and thiazide diuretic
ACE and Ca channel inhibitors
ACE inhibitor and diuretics
Beta blocker and ACE inhibitor
*You are making rounds with Dr Z, a prominent hematologist in your city who remarks, while examining a diabetic patient, that diabetics are more likely to develop AAA. You know that according to statistics, a surprise to any clinician. After quick consideration you decide to:[11]
Tell what you think, because you believe that exchange of information is a key for acquiring medical knowledge for you and other members of the team
Wait till the end of the rounds to talk about the issue with her in private
Since she is 20 years older than you she knows better who can and who cannot have AAA, so you decide not to speak
4. Since she is known serial career killer, ever to Harvard graduates, and you have mortgage to pay, you decide to keep your mouth shut
Atypical pneumonia is caused by following bacteria with the exception of:
Chlamydia pneumoniae
Mycoplasma pneumoniae
Legionella
Staphylococcus aureus
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