Internal Medicine MCQ I

Question 1 of 100

1. Question

Proteus species: Which of the statements below is correct?

They are lactose fermenters.
They acidify urine.
They characteristically produce swarming on agar culture plates.
They are very sensitive to streptomycin.

Question 2 of 100

2. Question

Treatment of acute pyogenic meningitis does not include which of the following?

Intravenous fluids.
Intravenous antibiotic.
Diazepam.
Sulfonamides.

Question 3 of 100

3. Question

Which of the following is a good prognostic sign in pneumococcal pneumonia?

Old age.
Normal white blood cell count.
Complete right-sided consolidation without involvement of the left.
Absence of concomitant disease.

Question 4 of 100

4. Question

Properties of a tubercle include which of the following?

There is a central area of caseation.
Lymphocytes are found immediately after the central area.
Its periphery is formed by giant cells.
It may be formed in an appropriate culture medium.

Question 5 of 100

5. Question

Typhoid fever: Which of the statements below is incorrect?

There is bacteremia.
The causative organism is excreted in urine.
Stool culture does not yield Salmonella typhi.
Bone marrow culture is necessary to establish the diagnosis.

Question 6 of 100

6. Question

Which of the following statements about COVID-19 is correct?

It is caused by a virus that is structurally similar to the etiological agent of severe acute respiratory syndrome.
It is in the same class as the virus that causes Ebola virus disease.
It is a disease with high mortality.
It originated from West Africa.

Question 7 of 100

7. Question

Anaerobic bacteria are not implicated in which of the following infections?

Quinsy.
Bronchiectasis.
Rhinitis.
Brain abscess.

Question 8 of 100

8. Question

Shigella infections may present as which of the following?

Pneumonia.
Gastroenteritis.
Meningitis.
Otitis media

Question 9 of 100

9. Question

Meningitis is not a presentation of which of the following?

Leptospirosis.
Anthrax.
Meningism.
Mumps.

Question 10 of 100

10. Question

Which of the following statements about non-pneumococcal bacterial pneumonia is incorrect?

Haemophilus influenzae pneumonia is likely in patients with bronchiectasis.
Prognosis of Haemophilus influenzae pneumonia is poor in spite of early and adequate antibiotic therapy.
Pneumonia caused by Friedlander’s bacillus is of bronchopneumonic pattern.
Diabetes mellitus predisposes to Klebsiella or other enterobacteriacea pneumonia.

Question 11 of 100

11. Question

Pulmonary tuberculosis is unlikely to be reactivated under which of the following conditions?

Uncontrolled diabetes mellitus.
Recurrent rhinitis.
Malnutrition.
Debilitating illness.

Question 12 of 100

12. Question

Typhoid fever: Which of the statements below is incorrect?

It is a feco-orally acquired infection.
It is not transmitted by the housefly.
It frequently mimics malaria.
It may manifest as psychiatric illness.

Question 13 of 100

13. Question

With respect to COVID-19, preventive measures do not include which of the following?

Wearing of face masks.
Maintaining a distance of at least 2 meters between persons.
Making telephone calls for business and family reasons.
Doctors wearing masks during physical examination of patients without the patient wearing masks.

Question 14 of 100

14. Question

Vincent’s angina: Which of the statements below is correct?

It is an aerobic infection.
It is caused by Bacillus fragilis.
It causes halitosis.
It is resistant to treatment with penicillins.

Question 15 of 100

15. Question

Which of the following drugs is not recommended for treating shigellosis?

Cefixime.
Ciprofloxacin.
Azithromycin.
Kanamycin.

Question 16 of 100

16. Question

Clostridium tetani: Which of the statements below is correct?

It is a Gram-positive coccus.
It belongs to the genus of aerobic bacteria.
It is the only causative organism of tetanus.
It exists as three types.

Question 17 of 100

17. Question

Usual complications of pneumococcal pneumonia do not include which of the following?

Endocarditis.
Pericardial effusion.
Lung abscess.
Pleural effusion.

Question 18 of 100

18. Question

Symptoms of pulmonary tuberculosis do not include which of the following?

Chronic cough.
Weight loss.
Frequent headaches.
Chest pain.

Question 19 of 100

19. Question

Common symptoms of typhoid fever do not include which of the following?

Headache.
Abdominal discomfort.
Hematuria.
Cough.

Question 20 of 100

20. Question

Management of mild cases of COVID-19 includes which of the following?

Identification of the virus before commencement of any form of treatment.
Referral to a medical facility with new and latest equipment.
Supportive measures with particular attention to the symptoms and signs.
Use of hydroxychloroquine.

Question 21 of 100

21. Question

Anaerobic infections are not caused by which of the following organisms?

Clostridium perfringens.
Bacillus fragilis.
Escherichia coli.
Actinomyces israelii.

Question 22 of 100

22. Question

Escherichia coli: Which of the statements below is incorrect?

It produces enterotoxin.
It can invade intestinal mucosa.
It does not cause mild diarrhea.
Its heat-labile toxin is antigenic.

Question 23 of 100

23. Question

Which of the following statements about clostridia is incorrect?

Clostridium botulinum was formerly known as Clostridium welchii.
Clostridium botulinum is the only clostridium known to cause botulism.
Gas gangrene is caused by Clostridium perfringens.
Clostridium perfringens causes food poisoning.

Question 24 of 100

24. Question

Which of the following organism-antibiotic relationships is correct in initial pneumonia therapy?

Mycoplasma – Ampicillin.
Klebsiella – Gentamycin.
Staphylococcus – Benzathine penicillin.
Haemophilus – Tetracycline.

Question 25 of 100

25. Question

The features of pulmonary tuberculosis include which of the following?

A dull percussion note on the chest.
High-grade pyrexia.
Uniform opacification of one lung on chest radiograph.
Areas of cavities without lung tissue on a chest radiograph.

Question 26 of 100

26. Question

Acute pyelonephritis: Which of the statements below is correct?

It is usually a unilateral bacterial infection.
It is usually a hematogenous infection.
It is commonly caused by Escherichia coli.
It is commoner in adult males than females.

Question 27 of 100

27. Question

So far, with respect to COVID-19, the best care for patients with the most critical cases is provided in centers with facilities for which of the following?

Intravenous fluids.
Extracorporeal membrane oxygenation (ECMO).
Ventilator services.
Ambulance services for rapid referral to another medical facility.

Question 28 of 100

28. Question

Yellow fever: Which of the statements below is incorrect?

It is caused by an arenavirus.
It has monkeys as reservoirs.
It is transmitted by mosquitoes.
It causes reduced serum levels of aminotransferases.

Question 29 of 100

29. Question

Pseudomonas aeruginosa: Which of the statements below is correct?

It does not produce water-soluble pigments.
It does not produce endotoxin.
It is a frequent cause of hospital-acquired infection.
It is usually sensitive to penicillins.

Question 30 of 100

30. Question

Which of the following statements about clostridia is incorrect?

Clostridium tetani produces an endotoxin called tetanospasmin.
Clostridium tetani is motile.
Clostridium perfringens causes myonecrosis.
Clostridium boulinum elaborates a neurotoxin.

Question 31 of 100

31. Question

Which of the following statements about lung abscess is correct?

There is suppuration in lung tissue.
Tuberculosis is the most important cause.
Anaerobic organisms are unlikely causes.
The lesions are usually multiple.

Question 32 of 100

32. Question

Which of the following is a complication of pulmonary tuberculosis?

Ascites.
Bronchial carcinoma.
Pyopneumothorax.
Ghon focus.

Question 33 of 100

33. Question

Which of the following is not a predisposing factor to acute pyelonephritis?

Urinary tract catheterization.
Urethral strictures.
Frequent consumption of cold drinks.
Benign prostatic hypertrophy.

Question 34 of 100

34. Question

Which of the following statements about picornaviruses is correct?

They measure approximately 70 nanometers.
They are small DNA viruses.
Rhinoviruses and Echoviruses are picornaviruses.
They are characteristically acid stable.

Question 35 of 100

35. Question

Vibrio cholerae: Which of the statements below is correct?

It causes watery stools which are clear with mucus flecks.
It does not grow on blood agar plates.
It produces a heat-stable enterotoxin.
It is no longer treated with tetracycline.

Question 36 of 100

36. Question

Tetanus: Which of the statements below is correct?

It has an incubation period of three days.
It leads to life-long immunity in the patient.
It is the only infection with neck stiffness.
It may result from chronic suppurating otitis media.

Question 37 of 100

37. Question

Organisms frequently found in lung abscess do not include which of the following?

Actinomyces.
Staphylococcus.
Rickettsiae.
Klebsiella.

Question 38 of 100

38. Question

Which of the following is expected in a patient presenting with pulmonary tuberculosis to a doctor of first contact in a rural setting?

A patient with extensive involvement of the lungs.
An affluent patient.
A patient with a clear understanding of the cause of his illness.
Hospitalization for treatment is mandatory.

Question 39 of 100

39. Question

Clinical features of acute pyelonephritis do not include which of the following?

Fever.
Diarrhea.
Vomiting.
Costovertebral tenderness.

Question 40 of 100

40. Question

Rhinoviruses: Which of the statements below is correct?

They are not inactivated by gastric acid.
They grow best at a temperature of 37oC.
They cause rhinitis which responds satisfactorily to rest.
They have a few serotypes so vaccination is practical.

Question 41 of 100

41. Question

Bacteroides: Which of the statements below is correct?

They are Gram-negative bacilli in the small intestines.
They cause abdominal abscesses.
They are identified with difficulty by Gram-staining specimen of pus.
Infections caused by them respond to treatment with tetracycline.

Question 42 of 100

42. Question

Tetanus: Which of the statements below is correct?

It should be treated with diazepam just to reduce the patient’s anxiety.
It does not lead to respiratory failure.
It cannot be diagnosed clinically only.
Patients should be investigated by lumbar puncture if there is doubt about the diagnosis.

Question 43 of 100

43. Question

Predisposing factors to developing lung abscess include which of the following?

Coma.
Drinking alcohol at a party.
Enteric fever.
Chicken pox.

Question 44 of 100

44. Question

Which of the following statements about pulmonary tuberculosis is correct?

Erythrocyte sedimentation rate (ESR) is usually normal.
BCG gives satisfactory protection against frank infection.
BCG should be given to those found to be tuberculin positive.
A positive result to tuberculin testing means the patient is adequately protected against the infection.

Question 45 of 100

45. Question

Acute hepatitis is typically caused by which of the following?

Plasmodia.
Drugs.
Schistosomes.
Entamoeba histolytica.

Question 46 of 100

46. Question

Which of the following is not a slow-virus disease?

Kuru.
Creutzfeldt-Jakob disease (CJD).
Subacute sclerosing panencephalitis (SSPE).
Yellow fever.

Question 47 of 100

47. Question

Findings in typhoid fever do not include which of the following?

Pyrexia every third day.
Mild hepatomegaly.
Vague abdominal tenderness.
Clear lung fields.

Question 48 of 100

48. Question

Management of tetanus includes which of the following?

Massive doses of antibiotics without wound debridement.
Intravenous fluid therapy.
Tracheostomy in every case.
Counseling the patient on prevention and early treatment of wound before the patient is discharged from the ward.

Question 49 of 100

49. Question

Features of lung abscess do not include which of the following?

Foul-smelling, purulent sputum.
Air-fluid levels in the lungs.
Unilateral global lung opacification.
Good response to early postural drainage.

Question 50 of 100

50. Question

Which of the following statements about tuberculin tests is correct?

Mantoux test is injected intramuscularly.
Mantoux test contains a concentrated extract of purified protein derivative.
Heaf test is a multiple puncture skin test.
A ring-shaped induration following a Heaf test indicates tuberculosis.

Question 51 of 100

51. Question

Which of the listed viruses is not a common cause of acute viral hepatitis?

Hepatitis A virus.
Hepatitis B virus.
Hepatitis C virus.
Cytomegalovirus.

Question 52 of 100

52. Question

RNA tumor viruses include which of the following?

Papilloma viruses.
Retroviruses.
Polyomaviruses.
Adenoviruses.

Question 53 of 100

53. Question

Treatment of typhoid does not include which of the following?

Procaine penicillin G.
Chloramphenicol.
Ciprofloxacin.
Intravenous or oral fluids.

Question 54 of 100

54. Question

The pneumococcus: Which of the statements below is correct?

It is synonymous with staphylococcus.
It forms long-chained colonies.
It is usually resistant to penicillins.
It causes type-specific immunity after an infection.

Question 55 of 100

55. Question

Bronchiectasis: Which of the statements below is correct?

It is an acute lung parenchyma infection.
It is unlikely to be a secondary infection.
It is a primary suppurative lung disease.
It involves destruction of bronchi.

Question 56 of 100

56. Question

Tuberculous lymphadenitis is unlikely to involve which of the following lymph nodes?

Cervical lymph nodes.
Mediastinal lymph nodes.
Mesenteric lymph nodes.
Popliteal lymph nodes.

Question 57 of 100

57. Question

Which of the following diseases is not associated with Hepatitis B virus?

Liver cirrhosis.
Chronic hepatitis.
Hepatoma.
Liver abscess.

Question 58 of 100

58. Question

Which of the following statements about Lassa fever is correct?

It is caused by a coronavirus.
It has a long incubation period of over one month.
The first case was reported in Liberia.
It presents as upper respiratory tract infection initially.

Question 59 of 100

59. Question

Klebsiella species: Which of the statements below is incorrect?

They are coliform bacilli.
They are Gram-negative enteric bacilli.
They are non-lactose fermenters.
They are non-motile.

Question 60 of 100

60. Question

The pneumococcus is not a cause of which of the following?

Otitis media.
Enteric fever.
Pyogenic meningitis.
Septicemia.

Question 61 of 100

61. Question

Which of the following statements about staphylococci is incorrect?

They are Gram-positive cocci.
They are grape-like on culture.
Staphylococcus aureus is coagulase negative.
Staphylococcus albus is the old name for Staphylococcus epidermidis.

Question 62 of 100

62. Question

Which of the following statements about extrapulmonary tuberculosis is correct?

Cranial nerve palsies are a feature of tuberculous meningitis.
Infertility is unlikely in tuberculous salpingitis.
Hemiparesis is a feature of tuberculosis of the spine.
Renal tuberculosis is common.

Question 63 of 100

63. Question

Which of the following statements about acute viral hepatitis is incorrect?

Hepatitis B surface antigen is detectable in blood during the incubation period.
Detection in blood of antibodies against the Australia antigen indicates current infection.
The presence of antibodies against Hepatitis B core antigen indicates current infection.
IgG antibodies against Hepatitis A antigens indicate immunity to a recurrent infection.

Question 64 of 100

64. Question

Carcinoma of the bronchus: Which of the statements below is incorrect?

It is likely in those who have smoked cigarettes heavily for decades.
It is a known cause of finger clubbing.
It causes weight loss with hematemesis.
It metastasizes to bone and the brain.

Question 65 of 100

65. Question

Klebsiella pneumoniae: Which of the statements below is incorrect?

It appears mucoid on culture plates.
It is a known cause of meningitis.
It causes severe pneumonia.
It is usually sensitive to tetracyclines.

Question 66 of 100

66. Question

Streptococcus pneumoniae: Which of the statements below is incorrect?

It is a lancet-shaped diplococcus.
It is difficult to identify by Gram-staining of sputum from a patient with pneumonia.
Virulence is related to its polysaccharide caspsule.
It exhibits a form of DNA transfer known as transformation.

Question 67 of 100

67. Question

Which of the following is not elaborated by Staphylococcus aureus?

Penicillinase.
Neurotoxin.
Beta-lactamase.
Coagulase.

Question 68 of 100

68. Question

Features of tuberculous peritonitis include which of the following?

Ascites of low protein concentration.
Amenorrhea.
Elevated neutrophil count in ascitic fluid.
Resolution of the problem following aspirating all the ascetic fluid.

Question 69 of 100

69. Question

Common early symptoms of acute viral hepatitis do not include which of the following?

Fever.
Anorexia.
Ascites.
Malaise.

Question 70 of 100

70. Question

Which of the following is expected in massive pneumothorax?

Increased movements of the affected side of the chest.
Dull chest pain.
Hyper-resonant chest percussion note.
Whispering pectoriloquy.

Question 71 of 100

71. Question

Meningococci: Which of the statements below is correct?

They are Gram-positive cocci.
They normally occur in pairs when cultured.
They are morphologically similar to the organism which causes typhoid.
Isolation of the organisms is enhanced if the culture medium contains blood or serum.

Question 72 of 100

72. Question

Clinical features of pneumococcal pneumonia do not include which of the following?

High grade fever.
Pleuritic pain.
Initially dry cough.
Hemothorax.

Question 73 of 100

73. Question

Enterotoxins are not produced by which the following organisms?

Escherichia coli.
Entamoeba histolytica.
A bacillus specie
Clostridium tetani.

Question 74 of 100

74. Question

Which of the following statements about tuberculous meningitis is correct?

It is commonest in young adults.
Rich’s focus is a feature.
Headache and vomiting are rare.
There is markedly reduced cerebrospinal fluid sugar level.

Question 75 of 100

75. Question

Which of the following statements about acute viral hepatitis is correct?

Alanine aminotransferase level in blood is elevated.
Acid phosphatase level in blood is high.
The degree of rise in serum aminotransferases correlates well with the severity of the illness.
In the prodromal phase diagnosis is easy.

Question 76 of 100

76. Question

Severe breathlessness of sudden onset may be caused by which of the following?

Pleural effusion.
Left ventricular failure.
Asthma.
Pulmonary embolism.

Question 77 of 100

77. Question

Acute meningitis is not caused by which of the following organisms?

The pneumococcus.
Haemophilus influenzae.
Escherichia coli.
Neisseria gonorrhoeae.

Question 78 of 100

78. Question

Which of the following is not expected in a young adult with pneumococcal pneumonia?

Elevated white blood cell count.
Bronchopneumonic type opacification on a chest radiograph.
Upper abdominal pain.
Bronchial breath sounds.

Question 79 of 100

79. Question

Empyema thoracis: Which of the statements below is correct?

It is accumulation of excess serous fluid in the pleural cavity.
It is a cause of severe dyspnea and chest pain.
It is unusual in children.
It should be treated with a chest drainage tube connected to a drainage bag.

Question 80 of 100

80. Question

Which of the following is not an enteric Gram-negative bacillus?

Bacteroides.
Fusobacterium.
Vibrio.
Haemophilus.

Question 81 of 100

81. Question

Liver damage may not result from ingestion of which of the following drugs?

Acetaminophen.
Chlorpromazine.
Ascorbic acid.
Isonicotinic acid hydrazide.

Question 82 of 100

82. Question

Which of the following statements about chronic bronchitis is correct?

There is chronic cough with excessive production of sputum.
Breathlessness is of sudden onset.
Coughing and sputum expectoration are worse before the patient goes to sleep.
Bronchopneumonia is a rare complication.

Question 83 of 100

83. Question

Which of the following statements is correct of meningococcal septicemia?

It is a common presentation of meningococcal infection.
Petechial hemorrhages are readily identified in dark-skinned patients.
Severe hypertension is a complication of the infection.
Disseminated intravascular coagulation (DIC) is a complication.

Question 84 of 100

84. Question

Which of the following is an unlikely cause of acute bacterial pneumonia?

Friedlander’s bacillus.
Haemophilus influenzae.
Staphylococcus aureus.
Mycobacterium tuberculosis.

Question 85 of 100

85. Question

Which of the following infections frequently precedes empyema thoracis?

Tuberculosis.
Chronic sinusitis.
Amebic liver abscess.
Typhoid fever.

Question 86 of 100

86. Question

Enterobacteriaceae do not include which of the following?

Escherichia coli.
Proteus species.
Pseudomonas aeruginosa.
Salmonella typhi.

Question 87 of 100

87. Question

Which of the following statements about influenza is incorrect?

The etiological agent is a helical RNA virus.
Reye’s syndrome is a common sequela.
It may present as very high fever.
Influenza virus is known to produce hemadsorption and hemagglutination.

Question 88 of 100

88. Question

Which of the following statements about septicemia is correct?

Thrombocytopenia is unexpected.
Jaundice is an unusual feature.
It is good practice to obtain specimen for blood culture.
Antibiotic treatment should be started after sensitivity results are obtained.

Question 89 of 100

89. Question

Which of the following is correct of pyogenic meningitis?

The meningococcus is an uncommon cause of epidemic meningitis.
Meningitis following chronic bone or paranasal sinus infection is most likely due to Haemophilus influenzae.
The features usually unfold over a period of two weeks.
An adult may present with just fever and confusion.

Question 90 of 100

90. Question

Predisposing factors to developing pneumonia do not include which of the following?

Exposure to severe cold.
Poor nutritional status.
Frequent exercise.
Upper respiratory infection of viral origin.

Question 91 of 100

91. Question

ycobacterium tuberculosis: Which of the statements below is correct?

It is acid-fast on Ziehl-Neelsen staining.
It is alcohol-fast.
It has a low lipid content.
It is an obligate anaerobe.

Question 92 of 100

92. Question

Which of the following statements about Salmonella species is incorrect?

They are non-lactose fermenters.
They invade bowel mucosa causing diarrhea.
Some species are responsible for paratyphoid fever.
They do not produce hydrogen sulfide.

Question 93 of 100

93. Question

Which of the following statements about infections caused by Mumps virus is correct?

Painless parotid gland enlargement associated with fever.
Upper respiratory tract involvement.
Reduced serum amylase in parotitis.
Infertility frequently follows orchitis complicating parotitis.

Question 94 of 100

94. Question

Which of the following statements about septicemia is incorrect?

It starts from a focus of infection.
It may result from chronic otitis media.
Leukocytosis or leucopenia are features of septicemia.
Hypothermia is a good prognostic sign.

Question 95 of 100

95. Question

Which of the following is a positive indicator of pyogenic meningitis in an adult?

Cerebrospinal fluid under pressure during lumbar puncture.
Clear cerebrospinal fluid.
Reduced cerebrospinal fluid protein concentration.
Raised levels of glucose in the cerebrospinal fluid.

Question 96 of 100

96. Question

Management of pneumococcal pneumonia does not involve which of the following?

Endotracheal intubation.
Administration of oxygen.
Intravenous penicillin therapy pending antibiotic sensitivity results.
Maintaining a satisfactory state of hydration.

Question 97 of 100

97. Question

Which of the following statements about Mycobacterium tuberculosis is correct?

Its rate of growth on culture media is similar to most bacteria.
It is infective to others only after diagnosing the infection.
It is a non-motile coccus.
The organism is spread as droplet infection.

Question 98 of 100

98. Question

Salmonella typhi: Which of the statements below is correct?

It is found in humans and many mammals.
It is just one of the salmonella species which cause typhoid fever.
Its carriers should be treated if they are food handlers.
It is the only cause of salmonellosis.

Question 99 of 100

99. Question

Epstein-Barr virus: Which of the statements below is incorrect?

It causes the syndrome of heterophile-negative infectious mononucleosis.
It is intracellular in the chromosomes of Burkitt’s lymphoma.
It provokes high antibody titers in cases of nasopharyngeal carcinoma.
It commonly causes acute renal failure and arthritis.

Question 100 of 100

100. Question

Anaerobes are unusual in which of the following?

Peritonitis.
Intra-abdominal abscess.
Urinary tract infections.
Tubo-ovarian abscess.