Internal Medicine MCQ II

Question 1 of 49

1. Question

Pain of angina pectoris: Which of the statements below is incorrect?

It is precipitated by exercise.
It is a tight chest pain.
It is precipitated by a recent heavy meal.
It classically affects the left side of the chest below the breast.

Question 2 of 49

2. Question

Manifestations of pyramidal lesions do not include which of the following?

Extensor plantar response.
Paralysis of voluntary movement.
Muscle hypotonia.
Increased tendon reflexes.

Question 3 of 49

3. Question

Features of anemia do not include which of the following?

Tiredness.
Headache.
Shortness of breath.
Bradycardia.

Question 4 of 49

4. Question

Which of the following statements about diabetes mellitus is correct?

Type 1 diabetes mellitus usually starts in at least a 45-year-old.
Ketoacidosis is a complication of Type 1 diabetes mellitus only.
Sulfonylureas should not be given to obese Type 2 diabetics.
Hyperosmolar hyperglycemic state (HHS) is a complication of Type 2 diabetes mellitus.

Question 5 of 49

5. Question

Which of the following statements about myocardial infarction is incorrect?

The patient presents with severe chest pain.
Positive Troponin-C is indicative of myocardial infarction.
The presence of a third heart sound indicates mild myocardial damage.
In patients who present early, ECG findings may be absent.

Question 6 of 49

6. Question

Features of Parkinsonism do not include which of the following?

Intention tremor.
Bradykinesia.
Cogwheel rigidity.
Choreoathetosis.

Question 7 of 49

7. Question

Anemia due to chronic blood loss is seen in which of the following?

Motor vehicle accident.
Burkitt’s lymphoma.
Massive upper gastrointestinal hemorrhage.
Menorrhagia.

Question 8 of 49

8. Question

Which of these statements about cardiac arrhythmias is incorrect?

An atrial rate of 200/min. indicates atrial flutter.
Patients with atrial fibrillation present with atrial rates in excess of 350/min.
P-waves are absent in atrial fibrillation.
Ventricular fibrillation may result from electrocution.

Question 9 of 49

9. Question

Pontine lesions do not result in which of the following?

Internal squint.
Persistent tinnitus and vertigo.
Dysphagia.
Ipsilateral facial anesthesia.

Question 10 of 49

10. Question

Relevant cost-effective investigations in patients with anemia do not include which of the following?

Hemoglobin estimation.
Urine microscopy.
Stool microscopy.
Magnetic resonance imaging.

Question 11 of 49

11. Question

Which of the following statements about blood pressure measurements is incorrect?

The sphygmomanometer cuff should be wrapped snugly around the forearm.
In the lying position the cuff should be at the level of the patient’s heart.
A suspected falsely high blood pressure should be rechecked in the consulting room when the patient will have become relaxed.
Where mercury sphygmomanometer is still used, a break in the mercury column gives a false blood pressure.

Question 12 of 49

12. Question

Which of the following is not expected in cerebellar disease?

Ataxia.
Nystagmus.
Tremors at rest.
Dysarthria.

Question 13 of 49

13. Question

Which of the following is unusual in the leukemias?

Hepatosplenomegaly.
Bone marrow hypocellularity.
Anemia.
Lymphadenopathy.

Question 14 of 49

14. Question

Hypertension: Which of the statements below is correct?

It frequently has an apparent cause.
It frequently causes severe headache.
It is frequently diagnosed in symptomless patients.
It should be treated with long courses of benzodiazepines.

Question 15 of 49

15. Question

Which of the following is not recommended for mitigation of HIV/AIDS?

Involuntary counseling and testing.
Use of male and female condoms.
Reduction of stigma and discrimination.
Improved access to treatment and antiretroviral drugs (ARVs).

Question 16 of 49

16. Question

Which of the following statements about leukemia is correct?

Acute lymphoblastic leukemia is commonest in middle age.
Chronic granulocytic leukemia is rare in young adults.
In acute myeloblastic leukemia anemia is mild.
Thrombocytopenia is expected in chronic lymphocytic leukemia.

Question 17 of 49

17. Question

Which of the following is not a complication of hypertension?

Retinopathy.
Renal failure.
Peripheral arterial disease.
Papilloedema.

Question 18 of 49

18. Question

Which of the following statements about HIV/AIDS is incorrect?

Globally, less than 25% of adults living with HIV/AIDS are women.
In sub-Saharan Africa more than half of the adults living with HIV/AIDS are females.
Antiretroviral drugs (ARVs) have transformed the treatment of HIV/AIDS.
Various classes of ARVs act on different stages of the life-cycle of HIV.

Question 19 of 49

19. Question

Autosomal abnormalities do not include which of the following?

Down’s syndrome.
Turner syndrome.
Patau’s syndrome.
Edward’s syndrome.

Question 20 of 49

20. Question

Cardiomyopathy: Which of the statements below is incorrect?

It usually has a definable cause.
It presents as left ventricular dilatation.
It is a known cause of mitral regurgitation.
It may benefit from diuretics and digoxin.

Question 21 of 49

21. Question

Tropical ataxic neuropathy is characterized by which of the following?

A0ge of onset early third decade.
Sudden onset.
Patient ingesting cassava diet.
Impaired two-point discrimination.

Question 22 of 49

22. Question

Which of the following statements about genetic abnormalities is correct?

In sex-linkage the mutation is related to the Y-chromosome.
Heterozygosity and homozygosity refer to dominant genes.
An individual with a recessive condition has only one parent as a carrier.
Sex-linked diseases are not expressed in females.

Question 23 of 49

23. Question

Which of the following statements about heart failure is correct?

With a figure of 60% there is reduced ejection fraction.
Myocardial infarction is a cause of heart failure with reduced ejection fraction (HF-REF).
Stable heart failure is when symptoms are responsive to treatment, with no deterioration, for two weeks.
Ejection fraction >50% is indicative of systolic failure.

Question 24 of 49

24. Question

Which of the following statements about neurological diseases is correct?

A sudden severe headache associated with neck pain in a healthy young adult is suggestive of cerebral thrombosis.
Sudden onset of neurological deficit in a young adult with rheumatic heart disease is likely to be due to subarachnoid hemorrhage.
A thirty-year-old sickle cell anemia patient is unlikely to develop cerebral thrombosis.
Brain-stem infarction or bleeding resulting in focal neurological deficit exceeding 24 hours is cerebrovascular accident.

Question 25 of 49

25. Question

Recessive genetic diseases include which of the following?

Neurofibromatosis.
G6PD deficiency.
Albinism.
Achondroplasia.

Question 26 of 49

26. Question

There is heart failure with preserved ejection fraction (HF-PEF) in which of the following diseases?

Coronary artery disease.
Constrictive pericarditis.
Myocardial infarction.
Cardiomyopathy.

Question 27 of 49

27. Question

In a comatose patient which of the under-listed features is not a pointer to the associated diagnosis?

Acidotic breathing – Renal failure.
Jaundice – Hypertensive encephalopathy.
Heart murmurs – Cerebral embolism.
Hepatosplenomagaly – Hepatic encephalopathy.

Question 28 of 49

28. Question

Which of the following is not a feature of nephrotic syndrome?

Ascites.
Sparse, brittle hair.
Hypocholesterolemia.
Hypoalbuminemia.

Question 29 of 49

29. Question

Left ventricular failure presents with which of the following?

Cardiac asthma.
Anorexia.
Ascites.
Peripheral edema.

Question 30 of 49

30. Question

Which of the under-listed neurological signs is an indicator of the associated disease in a comatose patient?

Bilateral pin-point pupils – Horner’s syndrome.
Neck stiffness – Subarachnoid hemorrhage.
Paraplegia – Cerebrovascular accident.
Unilateral, dilated, fixed pupil – Contralateral expanding intracranial lesion.

Question 31 of 49

31. Question

Which of the following is not a feature of acute kidney injury?

Oliguria.
Highly concentrated urine.
Uremia.
Pedal and facial edema.

Question 32 of 49

32. Question

Which of the following is a high cardiac output state that causes heart failure?

Aortic stenosis.
Tachyarrhythmias.
Thyrotoxicosis.
Hypertension.

Question 33 of 49

33. Question

Ascites is not a feature of which of the following diseases?

Appendiceal mass.
Liver cirrhosis.
Nephrotic syndrome.
Meig’s syndrome.

Question 34 of 49

34. Question

Hyperthyroidism is not a feature of which of the following?

Toxic adenoma of the thyroid.
Toxic diffuse goiter.
Subacute thyroiditis.
Endemic goiter.

Question 35 of 49

35. Question

Cardiac arrest: Which of the statements below is correct?

It presents as unconsciousness and non-palpable radial pulse.
It results in apnea and constricted pupils.
It is a known result of ventricular fibrillation.
It benefits from cardio-pulmonary resuscitation seven minutes after it occurs.

Question 36 of 49

36. Question

Malabsorption: Which of the statements below is incorrect?

It presents as steatorrhea.
It is a cause of anorexia, weight loss and finger clubbing.
It causes abdominal discomfort and distension.
It is unexpected in chronic pancreatitis.

Question 37 of 49

37. Question

Which of the following is a feature of Graves’ disease?

Bradycardia.
Cold intolerance.
Lid lag.
Narrow pulse pressure.

Question 38 of 49

38. Question

Which of the following statements about cerebrospinal fluid is incorrect?

It is produced by both active secretion and dialysis at the choroid plexus.
Obtaining it from a morbidly obese meningitis patient should be easy.
Markedly reduced sugar level is indicative of bacterial meningitis.
Xanthochromia indicates presence of altered blood pigments.

Question 39 of 49

39. Question

Which of the following statements about jaundice is incorrect?

It presents as yellow discoloration of the sclerae.
When in association with dark urine and conjugated hyperbilirubinemia, excessive hemolysis is the cause.
Hepatoma is likely in jaundice associated with hard, nodular liver in a cachexic patient.
The cause is likely to be hepatitis if there is elevation of serum aminotransferase (transaminase) levels.

Question 40 of 49

40. Question

Which of the following statements about hypopituitarism is incorrect?

Craniopharyngioma is a cause.
It may result from Sheehan’s syndrome.
Infertility in males or females is a sequela.
Panhypopituitarism usually manifests first as ACTH deficiency.

Question 41 of 49

41. Question

Aphasia: Which of the statements below is correct?

When motor, it affects speech comprehension.
Disturbance of reading is dysgraphia.
It may manifest initially as anomia.
It is unlikely in damage to Broca’s area.

Question 42 of 49

42. Question

Which of the following statements about liver cirrhosis is correct?

There is patchy fibrosis and nodule formation in the liver.
Drug-induced hepatitis is a usual cause.
When there are ascites and splenomegaly, portal hypertension has occurred.
The liver is usually firm, tender and with a large hard nodule.

Question 43 of 49

43. Question

Alcoholism does not result in which of the following?

Severe hyperglycemia.
Ketoacidosis.
Wernicke’s encephalopathy.
Confabulation.

Question 44 of 49

44. Question

In apraxia: Which of the statements below is correct?

There is in-coordination.
The patient does not understand what is expected of them.
There is inability to imitate movements, if ideamotor.
The disturbance is mild if ideational.

Question 45 of 49

45. Question

Which of the following is expected in cirrhosis?

Gynecomastia and weight loss.
Reduced prothrombin time.
Abnormally high serum albumin levels.
Lower gastro-intestinal bleeding.

Question 46 of 49

46. Question

Which of the following statements about snake bites is correct?

In most cases they are venomous.
Poisonous snakes always inject venom when they bite.
Antibiotic therapy is superfluous.
Specific antivenom should be administered when the offending snake is identified.

Question 47 of 49

47. Question

Which of the following is not expected in frontal lobe damage?

Blindness.
Poor concentration.
Impulsiveness.
Anterograde amnesia.

Question 48 of 49

48. Question

Anemia due to bone marrow invasion or dysfunction is seen in which of the following diseases?

Septicemia.
Iron deficiency.
Leukemia.
Schistosomiasis.

Question 49 of 49

49. Question

Snake bite with envenomation does not result in which of the following?

Vesicular and bullous eruptions.
Hypotension.
Hematuria.
Reduced bleeding and clotting times.