Family medicine exam - 2022

According to the EHA Guidelines the best hypotensive treatment for the patient with metabolic syndrome is:
Diuretic + Calcium channel blocker
Beta-blocker + diuretic
ACEl + beta-blocker
ACEI (or ARB) + calcium channel blocker
ACEl or diuretic
What is the minimal value of home BP measurements that allow the doctor to diagnose patient with hypertension?
120/80 mmHg
160/90 mmHg
140/90 mmHg
135/85 mmHg
135/95 mmHg
According to the Lalonde Report, which proposed the concept of the "health fields", the factor which has the largest impact on people's health is:
Biological factor (genetics)
Environmental factor
Lifestyle
Organization and functioning of the public healthcare
Genetic factor
All of the listed below risk modifiers have the reclassification potential while using SCORE chart BESIDE:
Family history of premature CVD
BMI and central obesity
Fasting glucose levels
Socio-economic status and lack of social support
Patient's height
5. SCORE chart allows estimation of 10-year risk of fatal cardiovascular incident, based on:
Sex
Age
Smoking status
Diastolic blood pressure;
total cholesterol
LDL cholesterol
HDL cholesterol
Incidence of diabetes mellitus.
Systolic blood pressure
The non-HDL target goal for patient with very high SCORE risk is:
<55 mg/dI + 30
<100 mg/ dI + 30
<70 mg/dI – 30 (
<100 mg/d| - 30
<145mg/d1 + 30
What speaks for viral (not bacterial) pathogenesis of acute pharyngitis:
Enlargement of cervical lymph nodes
High fever
Rapid start
Nausea and vomiting
Cough
What is the most popular schedule of vaccinating against hepatitis B and gives the best immunological response?
0-1-6 months
Two doses of vaccine 4 weeks apart
0-1-2 weeks
Only one dose of the vaccine is needed
0-1-6 weeks
Every patient with newly diagnosed primary hypertension must have all of the tests done APART FROM:
Sodium and potassium levels
Blood creatinine level and GFR
OGTT
CBC
Lipid profile
A 41-year-old man comes to his GP for evaluation of upper Gl discomfort that has been present for the last 2 months. He says that he has a "full" sensation in the epigastric region. He recently began smoking again due to increased stress at work. He denies visible blood in his stool, denies vomiting, and had no dysphagia. He has lost unintentionally 10 1b (5 kg) in the last few weeks, which he attributes to lack of appetite. His mother has hemorrhoids, and no family member has ever had colorectal cancer. He has never had a colonoscopy. Which of the following is the most appropriate way of treatment?
H.pylori "test-and-treat"
PPI therapy for 8 weeks
Faecal occult blood test
Upper endoscopy
Colonoscopy
A 55-year-old woman presents to your office for follow-up. She was discharged from the hospital 1 week ago following a heart attack. She has quitted smoking since then and vows to stay off cigarettes forever. Her lipid levels are: total cholesterol 240 mg/dL, HDL 50 mg/dL, LDL 150 mg/dL and triglycerides 150 mg/dL. Which of the following managements is the most appropriate at this time?
Institute therapeutic lifestyle changes alone
Institute therapeutic lifestyle changes and start on a statin
Start on a statin
Institute therapeutic lifestyle changes and start on a statin and nicotinic acid
Start on statin and fenofibrate combined therapy from beginning
CCS Scale is a classification system used to grade the severity of.
Heart failure
Chronic venous insufficiency
Angina pectoris (ICHD)
Asthma bronchiale
Urinary incontinence
Which or the listed diseases is caused by bacteria:
Measles
Mumps
Tuberculosis
Rubella
Chickenpox
14. OGTT- oral glucose tolerance test- should be performed:
In the morning, on an empty stomach
At least after 8 hours from the last meal
After maintaining normal diet before test
After a good night sleep
After maintaining low-carbohydrate diet before test
Contraindication for ACE - inhibitor treatment is:
Heart failure
Diabetes
Myocardial infarction
Pregnancy
Allergy to beta lactams
The cause of arterial hypertension is not:
Hypothyreosis
Chronic pyelonephritis
Coarctation of the aorta
Thyreotoxicosis
Hypocalcaemia
17. The hallmarks of atrial fibrillation (AF) are:
Irregular rhythm
Presence of distinct P-waves
Presence of f-waves
Elevation of ST in leads V1-V3
What is the correct dose of Vit.D3 for a healthy infant:
1200 I.u. daily
400-800 I.u. daily
400-800 I.u. Daily twice a day
400-800 I.u. Once a week
1200 I.u. Once a week
After what time should the patient with newly diagnosed grade Il hypertension and introduced anti-hypotensive treatment reach the values of well-controlled BP?
6 months
6 weeks
3 months
3 weeks
There are no such recommendations
What is the proper dose of ibuprofen for a 2-year-old with a fever? ****(en av de)
20-30 mg/kg/day
20-30 mg/kg/dose
10 mg/kg/day
10 mg/kg/dose
10-20 mg/kg/day
According to the newest EHA/ESC recommendations what is the best initial therapy for iN!y
Administer single agent drugs in low risk grade 1 HT or in very old patients over wO)
Double agent combination in one pill
Triple agent combination in one pill
A mother comes to the Clinic with a 4 year-old child suffering from acute otitis media. The general condition of the child is good. What would be the proper treatment for this patient?
You prescribe 2-week antibiotic treatment
You advise "watchful waiting" - give the mother prescription for antibiotic and say she should apply it only if the condition of the child gets worse- otherwise just bed rest and anti- inflammatory drugs (e.g ibuprofen)
Immediate hospitalization
You prescribe antibiotic for 5-day treatment and advise bed-rest
You prescribe antibiotic in drops for 5-day treatment
The minimal interspace between two vaccinations containing living pathogens is:
3 weeks
4 weeks
3months
The time is irrelevant
1 week
What are the characteristic features of infectious mononucleosis?
White patches on tonsils
diarrhoea
Swelling of neck lymph nodes
Spleen enlargement
Conjunctivitis
25. Possible causes for chronic pancreatitis are:
Alcohol,
Cholecystolithiasis
Hyperlipidaemia
Calcium distribution disorders.
H.pylori infection
Urinary system/ tracts infections are most often caused by:
Enterobacter spp.
Corynebacterium spp.
Escherichia coli
Proteus spp.
Klebsiella pneumoniae
A 65-year-old man with a history of rheumatoid arthritis is found to have a microcytic anemia. He had a colonoscopy 1 year ago which was normal and fecal occult blood test is negative. Which of the following is the most likely cause of his anemia?
Iron deficiency
Anaemia of chronic diseases
Pernicious anaemia
Folate deficiency
Chronic GI bleeding
Symptoms like bellyaches, jaundice, diabetes, arterioflebitis suggest-
Pancreas
Duodenal ulcers
Chronic hepatitis
Stomach cancer
Cholelithiasis
In a treatment of a patient with newly recognized diabetes type 1, whose levels of glucose on an empty stomach don't exceed 200 mg%, besides diet, one should apply:
Adequate amount of physical exercise
Oral antidiabetics
Intermediate/medial action time insulin
Proper diet
Answers a, b and d are correct
Which of the following tests are most useful for the diagnosis of Hasimoto's diseases
FT3, fT4 and TSH plasma levels
Thyroid gland scintigraphy
Thyroid gland USG
What is the proper monthly weight-gain in the first 5 months of the healthy baby?
Min. 700 g/ month
Min. 500 g/month
Min. 450 g/month
Min. 200 g/month
Min. 900 g/month
There are vaccinations against:
Rubella
Mumps
Hand, foot and mouth disease
Adenoviral diarrhoea
Chickenpox
Pregnant woman with urinary tracts infection the safest drug is:
Cotrimoxazole
Amoxicillin
Cephalosporin
Hinolon
Acrolide
What is characteristic for erythema infectiosum (fifth disease)?
Very high fever, headache and severe symptoms in most of the patients
Appearance of the rash after 3 days of high fever
Lack of joint symptoms
Lack of immunization after exposition to the pathogen
Viral ethology - it is caused by parvovirus B19
Atypical pneumonia is caused by all of the following bacteria with the exception of:
Chlamydia pneumoniae
Mycoplasma pneumoniae
Legionella spp.
Streptococcus pneumoniae
Candida
Patients with hypothyroidism should be advised to take levothyroxine
On an empty stomach, 30-60 minutes before a meal
On an empty stomach, immediately before breakfast
During breakfast
Up to half an hour after a meal
Two hours after breakfast
In a 10-day-old, naturally-fed male infant, the following should be considered an abnormal condition requiring specialist intervention:
The presence of yellowing of the skin
The presence of the Moro reflex
Unilateral lack of a testicle in the scrotum
Presence of an umbilical hernia
None of the above
The most common cause of non-toxic goiter is:
Treatment with amiodarone
Excessive iodine intake
Iodine deficiency
Chronic thyroiditis
Subacute thyroiditis
Levine's scale is used to determine the volume of the murmur over the heart. According to it, the murmur described as grade Ill is:
A soft murmur, audible immediately after placing the stethoscope on the chest, also during breathing
Very soft murmur, audible only after some time of auscultation, when breathing is held
A very loud murmur, audible when the stethoscope is 1 cm away from the child's chest
A moderately loud murmur, but no thrill
A very loud murmur, audible when the stethoscope is 2 cm away from the child's chest
What is not a characteristic feature of an innocent murmur?
The loudness is less than 3/6 in intensity on the Levine's scale
The loudness is 4-6 on the Levine's scale
It is variable depending on the circumstances; its intensity is increased by factors such as exercise, fever, and changes in body position
It usually occurs over a limited area of the chest and does not radiat
Is a systolic murmur, except for a venous hum
Indicate the most likely diagnosis in the case of high temperature, chills and malaise accompanying a vivid red, sharply delineated erythema with taut and shiny skin on the lower limb:
Boil
Inflammation of a hair follicle
Erysipeloid
Erysipelas
Measles
In a patient with high cardiovascular risk, target level of LDL-cholesterol is:
<115 mg/dl
< 100 mg/dI
<70 mg/dl
<55 mg/dl
<35 mg/dI
The target level of HbA1C in most patients with well controlled diabetes type 2 is lower than or equal to:
7%
6,5%
8%
5%
8,5%
Anti- diabetic drugs that are characterized by a significant reduction of cardiovascular events are:
Metformin
SGLT2 inhibitors
Sulfonylurea derivatives
Adverse Vaccine Reaction (pol. NOP) is any vaccine-related health disorder that has occurred within 4 weeks from vaccination. An adverse reaction might be:
High fever after meningococcal vaccine
Mild rash after varicella vaccine
Inconsolable crying for over 3 hours in babies
Anaphylactic shock
All above
Choose the contraindication to vaccination in premature babies:***
Bronchopulmonary dysplasia
Iron deficiency anemia.
Severe immune disorders.
Administration of palivizumab (Synagis).
History of intraventricular bleeding
The mother comes to GP with a 3-week-old newborn baby, concerned with baby’s regurgitations that occur after almost every meal. A child was born on time, is fed with formula, drinks greedily, has gained 500 g since birth. The proper treatment for this baby
Recommendation to mother to thicken the milk with rice glue.
Calming the mother down, advising her on proper positioning of the baby during feeding need to rebound baby after feeding.
Referral of the child for urgent surgical consultation.
A 20-years old male comes to GP's office complaining of pain in his right eye. On physical examination you can find swelling and erythema of the upper eyelid that is painful on palpation. Also small painful nodule at the edge of the eyelid can be found. What is the most probable diagnosis and the correct treatment?
Barley - topical treatment with antibiotic ointment
Barley- antihistaminic drops to the conjunctival sac
Thymoma- topical treatment with antibiotic ointment
Eyelid margin inflammation caused by Demodex nematode- treatment with warm compresses
Allergic conjunctivitis- antihistamine drops to the conjunctival sac
Choose the vaccinations that are recommended in pregnancy:
Rubella vaccine,
Influenza vaccine,
COVID-19 vaccine,
Pertussis vaccine,
Hepatitis type B
Pediatric inflammatory multisystem syndrome temporally associated with SARS-COV-2 (PIMS) could be suspected in children presenting with:
Persistent high fever,
High value of inflammation markers in laboratory tests (e.g. CRP, PCT),
Lymphopenia,
Conjunctivitis
After exclusion of infectious causes.
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