UNIVERSITY OF SANTO TOMAS

FACULTY OF MEDICINE AND SURGERY

DEPARTMENT OF MEDICAL EDUCATION
MEDICAL BOARD REVIEW 2017

POST TEST: INTERNAL MEDICINE

SATURDAY, JULY 22, 2017
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Name: J J " '

GENERAL INSTRUCTIONS: This questionnaire is composed of 100 items On the box prowded in
the front page of the Examination Answer Sheet, kindly write your student code & name All final
answers should be made On the back page of the EXAMINATION ANSWER SHEET prowded for
SHADE SET A. Only Mongol 1 may be used Do not leave any blanks as this Will be conSidered
incorrect Do NOT detach the name stub Submit your EAS only Please be guided accordingly
TEST I: CHOOSE THE BEST ANSWER:

Choose the best answer.

7, 1. Which vaccine should be administered in splenectomized patients receiving intensive

chemotherapy7
A. 4-Valent meningococcal vaccine C. Hepatitis B
B. 23-Valent pneumococcal polysaccharide D. Measles/mumps/rubella
2. Diagnosis of tetanus is usually based on:
' A. Positive tissue culture growmg C tetani
B. Serum antitoxin levels > 0.01 unit/ml
C. EMG showing continuous discharge of motor units
D. Clinical ndings
r 3. The drug of ch0ice for a 25 year old woman on herLt'drimester of pregnancy suffering from
typhoid fever is:
9 7
A. Chlorampheni'col C. Co-trimoxazole
, it. Awk
B. Ciprooxacin ,..1 D. Ampicillin
i

\i 4. The pathophysiologic mechanism causmg the clinical manifestations in Leptospirosis is

v A. Antibody production C. Leptospiremia
B. Ischemia D. Vasculitis
5. CC and her friends ate fried rice, nido soup, fried chicken and potato salad. Four hours after,
most of them experienced vomiting, abdominal pain and diarrhea. The etiologic agent causing
the above symptoms is:
A. Bacillus cereus C. E coli
B. Cholera vibrio D. Clostridium perfringens
6. The single most important preventive measure to prevent health care associated Infections is:
A. Hand hygicne C. Use of personal protective equipment
8. Isolation of patients D. Proper waste disposal
7. Appropriate interventions for secondary syphills in pregnant patients allergic to penicillin
A. Ceftn'axone 1 gm IM q weekly for 3 doses
:7

B. oxycycline 100 mg BID for 2 weeks

C. Azithromycin 500 mg OD for 1 week
D. Benzathine penicillin G 2.4 M units IM after desensitization
\. 8. Regarding the clinical course of HIV infection:
A. Death is often due to the WHIVinfection itself \.
,. _
B. Opportunistic infections usually appear when CD4 counts are S 500 cells/UL
C. Acute retroviral syndrome occurs w/in 3-6 weeks after primary infection.
4 *0. Viral load is low during the clinical latency/period. F 942
~ 9. Among febrile neutropenic patients, what is the most important laboratory parameter in
monitoring treatment reSponse?
A. Serum creatinine C. Prothrombin time
8. Quantitative platelet count D. Absolute neutrophil count

Page 1 of 8
 10. The hallmark of f.p$l.i is:
,i'
A. dCCTEdSCSVJ in peripheral reSistance and increased in cardiac output
B. increased in peripheral resnstance and decreased in cardiac output
C. stimulation of the coagulation pathway
0. down regulation of the inflammatory mediators
11. The most likely etiologic agent in a patient presenting With generalized erythroderma and sepsis
, lS.
"i

" A. Acmebacter baumanil C. Streptococcus pneumonia

8. StaphyIOcoccus aureus D. Streptococcus pyogenes
12. An 80-year~old male wrth prostatic enlargement developed oliguria. On PE, the hypogastnc area
i x was noted to be distended and dull on percussion. His serum creatinine lS progressrvely elevating
Which of the followrng is the possible mechanism for the patients acute kidney injury?
A. Extrarenal C. Pre-renal
B. Intra-rena'l D. Post-renal
\ 13. 1nf patients wrth advanced cirrchosis, systemic vascular resistance is markedly reduced because
p 0 .'
A. a primary arterial vasodilatron in the splanchnic Circulation
8. volume depletion and dehydration
C. infections like spontaneous bacterial peritonitis
D. concomitant right heart failure seen in these patients
14. An example or an endogenous toxin that can lead to acute kidney injury is:
A. pentamidine C. uric acrd
B. ethylene glycol D. Tamm~Horsfal| protein
. 5' 15 What histopathologic finding is an ominous sign of irreversibility and progression to renal failure
among patients with glomerular disease?
A. Glomerular crescents ' "*1
B. Interstitial brosis
C. Mesangial hypercellulan'ty ~ e
D. Splitting of the glomerular basement membrane ' 1' t I. "W
" 16. Post-streptococcal glomerulonephritis after an episode of impetigo usually develops after:
A. 1-3 weeks
\ in

B. 2-6 weeks
C. 6-8 weeks
D. 812 weeks
\ 17. What is the most cause of hypothyroidism worldwide"
l \T

~ A. Hashimotos thyroiditis C. Radioactive loadine

B. Iodine deciency D. Thyroidectorny
18. What is the Single best screening test for thyroid dysfunction?
\1. A. T4 C. TSH
B. PM D. TRH
19. What is the marker for recurrent well-differentiated thyroid cancer?
A. Thyroid binding globulin C. Thyroglobulin
B. Anti-TPO antibody D. Calcitonin
.) 20. What are the expected laboratory results in Graves disease?
A. Low TSH and low FT C. High TSH and Low FT4
B. Low TSH and high FT4 D. High TSH and High FM
; 21. Which oral antidiabetic agent has the most potential to cause hypoglycemia?
\'/ A. Biguanides C. Sulfonylureas
B. Thiazolidinediones D. Dipeptidyl peptidase-IV inhibitor
22. Which counterregulatory hormone drives most of the clinical signs and symptoms of
1A hypoglycemia?
A. Epinephrine C. Growth hormone
V y B. Glucagon D. Cortisol
" 1 23. What is the appropriate screening test for a patient with prognatism, macroglossia, coarsening of
" facial features and carpal tunnel syndrome?
'

A. Growth hormone level C. Insulin tolerance test

B. IGF-l level D. ACTH stimulation test
2 24. What is the preferred definitive treatment for most prolactinomas?
A. Dopamine agonist C. External beam irradiation
B. Transcranial surgery D. Transsphenoidal surgery
Page 2 of 8
 25. Which one of the following happens during ventricular diastole?
i. I A. lsovolumetric contraction C. Atrial diastole
' 8. Opening of aortic and pulmonic valves D. Isovolumetric relaxation .
'

726. Which among the following would have a negative Carvallos sign \'- r a). i i) i' "
K
g,

A. Tricuspid stenosrs murmur ' - '"C. Aortic stenosis murmur

_

a B. Pulmonic stenosis murmur D. Tricuspid regurgitation murmur

27. A 58 year old female corporate lawyer known hypertensive but poorly compliant to her
medications, came to the ER because of right sided weakness, accompanied by slurring of
\__ . speech and facial asymmetry. Her initial BP was 210/ 110. She belongs to what stage of
hyperten5ion?
A. Pre-hypertension C. Stage 2
B. Stage 1 D. Isolated systolic hypertension
28. One of the following physical examination ndings signies a hypertensive emergency:
7 A. Papilledema on fundoscopy C. Sustained apical impulse
B. Blot hemorrhages on fundoscopy D. Apical holosytolic murmur
L 29. The ideal maintenance anti-hypertensive drug to start for diabetic patients with nephropathy is:
L A. Centrally acting drugs C. ACE inhibitor
B. Thiazrde diuretics D. Calcium channel blocker
30. Which of the following would most likely suggest an Acute Myocardial Infarction? V." rv
bf, \ i A. CKMB 2x elevated, cardiomegaly by CXR, T-wave inversion by ECG, leukocytosis on CBC
5 j B. Troponin 0.03, normal CXR, 0.5mm ST segment depression leads V1-V3, leukocytosis on CBC
C. Troponin 2x elevated, cardiomegaly by CXR, 2.5 mm ST segment depression; leukocytosis on
CBC
D. Troponin 0.03, cardiomegaly by CXR, 1.5 mm ST segment elevation leads V4oV6 leukocytosis
on CBC
31. Primary mechanism involved in acute coronarysyndrome:
I

L/ A. Chronic progressive narrowing of the epicardial coronary arteries

8. Leucocyte recruitment and foam cell formation
C. Plaque rupture and resultant thrombus formation
A D. Acute embolic occlusion of an epicardial coronary artery
; 32. What is the denitive treatment of choice for ST elevation MI?
.

" " A. Unfractionated heparin administration C. IV Beta-blockers

B. IV nitroglycerine D. Timely reperfusion using brinolytics or PCI
33. True regarding use of beta-blockers in Acute Myocardial Infarction:
A" A. Improves ischemia but has no role in symptomatic relief of chest pain

.c B. Improve myocardial supplyvdemand mismatch by reducing heart rate

C. By reducing heart rate, may potentially increase serious ventricular arrhythmias
D. Signicantly reduce mortality and morbidity, hence must be given to all patients even those
with advanced heart block
34. If chest pain occur while doing ordinary physical activity, what is the functional classication?
A. Class I C. Class III
B. Class II D. Class IV
35. Which one of the following is preferred for chronic treatment of congestive heart failure due to
.\1
left ventricular systolic dysfunction?
a A. Diuretics
l
B. Digoxin
C. ACE inhibitors
\. D. Hydralazine (Apresoline) plus isosorbidedinitrate (Isordil, Sorbitrate)
I)", 36. Which among the following is part of the major Framingham criteria for heart failure?
/
r A. Positive hepatojugular reux C. Norturnal Cough
B. Ankle edema D. Dyspnea on ordinary exertion
A 37. Most common rhythm in sudden cardiac death:
% C A. Ventricular brillation C. Idioventricular rhythm
B. Junctional rhythm D. Atrial brillation
38. A 21 year old male consulted at the outpatient department because of fever and joint swelling,
. involving the knees, elbows and his wrists. He had history of sore throat 2 weeks ago. What is
\ , the most likely diagnosis?
x A. Post-streptococcal reactive arthritis (PSRA)
B. Post-viral Reactive arthritis
C. Rheumatic Fever
D. Acute Viral Illness
Page 3 of 8
 39. TRUE regarding manifestation of ACUTE Rheumatic Fever (ARF)
A. Sydenham's churea commonly occurs in the absence of other manifestations and IS found,
mainly in males
B. Valvular damage is the hallmark of rheumatic carditis.
C. The typical ARE ]ornt involvement is migratory, moving from one Jomt to another over a
period of hours, it almost always affects the smaller JOIDIS and it is symmetric.
D. Subcutaneous nodules occur as painful, smalleOS2cm), mobile lumps beneath the skin
overlying bony prominences, particulary of the hands, feet, elbows, occiput and occasronally
the vertebrae. They are early manifestations that disappear 2-3 weeks after onset of disease.
40. What PE nding points to impending respiratory failure?
A. Alar aring C. Abdominal paradox
B. Pulsus paradoxus D. Tripod position
41. An anxious patient had a respiratory rate of 26. The rest of the Physrcal Exam was
unremarkable. What do we expect on ABG
A. High pH, high PaCOZ C. High pH, low PaCOZ
B. Low pH, low PaC02 D. low pH, h:gh PaC02
_ 42. A 58 year old patient was diagnosed to have Asthma. She uses her ICS once daily. She has
nightawakening twice a week, and has had to stop Ballroom because of frequent episodes of
shortness of breath. What is expected in the sprrometry of this Asthma patient?
A. Low FVC C. Low FEVl/FVC
B. High FEVl D. High FEVl/FVC
43. What spirometry result best pornts to a COPD?
A. Pre-bronchodilator FEVl < 70 C. Resrdual volume < 140%
B. Post bronchodilator FEVl/FVC < 70 D. Reversrbility > 12%
44. What pathology is expected in a Lung Cancer patient manifesting With the following PE findings
on the right hemrthorax: lagging, decreased tactile fremiti, dullness, decreased breath sounds,
apex beat at 5 LICS parasternal line?
A. Consolidation C. Obstructive atelecta5is
B. Pleural effusion D. Pneumothorax
45. A trauma patient manifests With a Tension Pneumothorax. What PE nding is most diagnostic?
A. HR 110/min C. Altered sensorium
B. BP 80/40 D. Subcutaneous emphysema
46. A 46 year old patient consults for fever, mugh and dyspnea. His daughter says he also seems a
bit confused. BP 110/80, CR 110, RR 31, T40. What is the srte of care for his pneumoniaj
A. Out patient C. In patient ICU
B. In patient non ICU D. We need to see the chest x-ray rst
47. A patient with 3 weeks cough is suspected to have PTB He has never had previous TB treatment.
What test should we request for according to the NTP guidelines?
A. TST C. Sputum AFB
B. Chest xray D. Sputum MTB culture
48. A patient presenting 4 weeks cough is confirmed to have TB. What regimen should be given?
A. RHEZ4/RH2 C. RHEZSZ/RHEZl/RHES
B. RHEZZ/RH4 D. RH9
49. A 43 year old obese patient is assessed tor OSAS. He also has hypoxemia while awake. What
does he most likely have7
A. Primary snoring C. Obstructive sleep apnea
B. Sleep hypopnea syndrome D. Obesity hypoventilation syndrome
50. A female post op patient suspected to have Pulmonary Embolism. What nding is most
diagnostic7
A. Loud 82 B. Pedal edema C. Bibasal rales D. RVH
51. Which statement best describes basic structure of immunoglobulin7
A. All immunoglobulins have basic structure 2 heavy and 2 light chains
B. The f0ur chains are covalently linked by 2 molecules of -OH bonds
C. The variable regions are responsble for the biologic functions of immu.ioglobu|ins
D. The constant regions constitute the antibody binding (Fab) region of the molecule.
52. A 75 year old retired busiriesswoman consulted because of 7 days history of knee 10int pains and
diffi'Culty in walking. On examination, r.ght knee was slightly warm, minimally effused with pain
limited range of motion. A diagnostic arthrocentesrs was done What is the most plausible cause
of knee effusion?
A. Septic arthritis C. Rheurriatoid arthritis
8. Crystal arthropathy D. Reiter's syndrome
Page 4 of 8
 53. The following best describes morning stiffness associated with inammatory disorders.
A. Precipitated by exposure to cold C. Improves With activity
8. Lasts for lSminutes at most D. Exacerbated by activity
54. Which of the following poses a greater likelihood of deveIOping joint abnormalities and disabilities
. .1 ,.\ in a patient with rheumatoid arthritis?
J A. Markedly elevated sedimentation rate
8. Pattern of disease onset
C. Radiographic eVIdence of periarticular osteopenia
D. Symmetric polyarthritis
55. What is the preferred muscle enzyme in myopathies?
A. Gamma-glutamyl transferase C. Aspartate aminotransferase
B. Lactic dehydrogenase D. Creatine kinase
56. What is the optimal goal of drug therapy in osteoarthritis?
g I A. Reverse pathologic changes
- 8. Delay progression
C. Offer palliative treatment
D. Prevent progression
C 57. Which is the major component of the antrlreux barrier?
- A. Acute angle of His C. Lower esophageal sphincter
B. Diaphragmatic crura D. Phrenoesophageal ligaments
58. What is the gold standard for the diagnosis of erosive gastroesophageal reux disease (GERD)
A. Barium swallow
D 8. Continuous intraesophageal pH monitoring
C. Proton pump inhibitor pH monitoring
.i D. UGI endoscopy
' 59. What of the following symptoms is more typical of duodenal than gastric ulcer?
) A. Nausea C. Vomiting
\ B. Night distress D. Weight loss
_._\ 60. What is the most common cause of lower GI bleeding?
A. Hemorrhoids C. Neoplasms
B. Inammatory, bowel disease/juvenile polyps D. Vascular ectasia
_ 61. What is the most common cause of acute pancreatitis?
K" A. Alcohol C. Gallstone
8. Drugs D. Hypertriglyceridemia
,3. 62. What is the best test for hepatocyte injury:
A. Alanine aminotransferase C. Bilirubin

B. Albumin/Globulin ratio D. Gamma glutamyl transferase

._ 63. What is the inherited tubular disorder due to mutations in the thiazide-sensitive Na-Cl co-
\ ( transporter (NCC) in the dilstalLQllectlng'tubule characterized by hypocalciuria, severe
hypomagnesemia, and prominent muscular signs and symptoms?
A. Bartter's syndrome
8. Gitelmans syndrome
C. Gordon syndrome
D. Liddles syndrome
"\ .. 64. True regarding glomerular diseases:
A. Lupus nephritis is an example of an idiopathic glomerular disease because of its autoimmune
\
\\

pathophysiology
B. A crescent is a half-moon-shaped collection of mostly visceral epithelial cells in the Bowmans
space
C. Diffuse lesions signify involvement of almost all of the glomerular tuft as opposed to
segmental lesions " '
D. Fibrosis is commonly a consequence of healing of crescents or tubulointerstitial disease
65. Which is an example of a secondary from of glomerular disease?
A. Crescentic GN C. Diabetic nephropathy
8. Minimal change disease D. Membranoproliferative Gn type II
66. Post-strep GN:
there is a role for immunosuppressive therapy
has the clinical picture occurring a day after the infection
can spontaneously recover
cow

hematuria does not last for a week after the infection

Page 5 of 8
 67. What is the basement membrane syndrome associated with hemajuria, thinning and spiltting ol
the GEMS, mild proteinuna, chronic glomerulosclerosrs and sensgnneurdl hearing deafness7
A. Alpo'rt s syndrome
8. AntiGBM disease
C. Fabrys disease
D. Thin Basement syndrome
DB _ Which of the lollowmg is an absolute indication for hemodialysis7
\ A. Hypervolemia C. Respiratory acidosis
B. Hyperkalemia D. Uremic pencarditrs
69. Pathognomonic clinical feature of vQco_u\re_teral reux:
@ A Asymptomatic u
Q B. Flank pain that occurs only with micturition
C. Pain wrth variable intensity that occurs continuously
D. Pain radiating to the testes or labia
L r). 70. What IS the most appropriate therapy f0r a 20 year-old non-pregnant female presenting wrth
dysuria and suprapubic tenderness?
IV ampicillin for 7 days
8. IV vancomycm for 3 days
C. Oral ciprooxacin for 3 days
0. Oral nitrofurantom for 7 days
A 71. What is the most cause of hypo'thyror'dism in iodine sufcient countnes?
A. Hashimotos thyrorditis C. Radioactive iodine
B. Iatrogenic D. Thyr0idectomy
C 72. What ultrasound feature of a nodule indicates a risk for thyrord malignancy?
A. Peripheral vascularity C. Microcalcication
B. than tall D_ Hyperechoic , ,
I

P\ 73. What is the marker for recurrent medullary therId cancer? 1' ' " ' z. i
j A. Thyroid binding globulin C. Thyroglobulin
B. Anti-TPO antibody D. Calcrtonin
74. What is the appropriate test for a patient with buffalo hump, wide purple abdominal istmriae, moon
face and easy brwsability7
A. ACTH level C. InSulin tolerance test
B. 24hur urine free cortisol D. ACl'H stimulation test
0 75. What are the expected laboratOry tests in postsmgical hypoparathyroidism7
A. High calcrum and low phosphate Clow calcrumand low phosphate
\\

8. High calcium and high phosphate D. Low calcium and high phosphate
4 76. What parameter in the GOLD gurdelines sh0uld make the physician prescribe an ICS to a patient
y with Emphysema7
.

A. Frequent exacerbation C. Symptoms score

8. Severity of airway obstruction D. Oxygen saturation
/ /77. What PE nding wrll make the physicran prescribe home ___02 inhalation?
L// A. Increased AP diameter of the chest C. NP 4cm at 30 angle
8. Left parasternal heave D. Bipedal edema
R 78. A patient had an arterial blood gas drawn while on 02 inhalation at 2 LPM.
) pH 7.33 PaCoZ 68 Pa02 105 HCO3 29. OZsat 98% - What is the acrd base status?

.1 A. Partially compensated metabolic alkalosis

B. Uncompensated respiratory alkalosrs
C. Uncompensated metabolic acidosis
D. Partially compensated respiratory acidosis
3 79. A patient was diagnosed to have Community Acquired Pneumonia RML, moderate risk", What is
1) the most probable organism involved"
\\ A. Gram (-) coccobacilli C. Gram (+) cocci in clusters
8. Gram (v) diplocococ D. Gram (-) bacilli
r 80. A 40 year old teacher was diagnosed to have Asthma in December 2013, and was maintained
~

j on 1C5. She also undewvent Spirometry, but the results were "normal". How can we best conrm
a diagnose of Bronchial Asthma?
A. Wait for her to have symptoms and then do the spirometry
B. Let her come to your clinic every week so you can measure her PEFR
C. Request f0r an artenal blood gas
D. Do methachoiine challenge test

Page 6 of 8
 81. What IS the rst Wowutic step in all patients diagnosed to have Bronchial Asthma, regardless
of classification7 &
A. Envronmental control/education C. Inhaled certicosterOid
8. Short acting 8 agonist as rescue med D. Long acting 8 agonist
82. What is usually seen in the ultrasound of patients with deep venous Uiromboss"
A. Non compressrble C. Vrsrble clot
8. Pulseless D. Smaller vessel
83. What PE finding IS most compatible with 3 Pulmonary embolism?
A. Palpable pulse in 2"" [CS synchronous With the apex beat
_ \ B. Diffuse and sustained apex beat
C. JVP 4 cm at 30 angle
D. Loud 52 at base
84. A 47 year old chef con5ults because of excessive daytime sleepiness. A sleep disorder is
suspected. What is TRUE about Obstructive Sleep Apnea?
A. His chest and abdomen are seen to move even if there is no airow
B. His snoring Suddenly stops when he goes to REM
C. There is absence of chest and abdomen movement synchronous with hypoxemia
D. Hypoxemla occurs even during the daytime
85. What IS the best test for Helicobacter pylori in a patient who IS on PPI"
A. Histology C. Stool antigen
8. Rapid urease test D. Urea breath test
86. A 70 year old male, hypertensive, presents wrth muelena and later hematochezra. After stabilizing
\

a the patient, gagstroscopy and colonoscopy were done which showed [18935]):results. What is the
next most appropriate step to do7
A. Angiography
B. CT scan
C. Enteroscopy
D. Tagged RBC scintigraphy
87. Which eSOphageal lesion is the most common risk fact0r adenocarcinoma of the esophagus?
s

.4
A. Barrett's
B. Web
C. Papilloma
D. Stricture
\
88. What is the Philadelphia chromosome?
." T A. Translocation between chromosome 9 & 22
B. Translocation between chromosome 11 & 22
C. Deletion of short arm of chromosome 9
D. Deletion of long arm of chromosome 9 8t 22
89. Which of the followmg is used to rapidly reduce the WBC count?
A. Hydroxyurea C. Busulfan
B. lmantinib D. Cytarabine
\
.\ 90. Most common proceeding infection associated with the development of aplastic anemia is:
I)
A. Parvovirus B 19 C. Chlammydia
B. Schistosoma D. Hepatitis
91. A 49 year old female presents with left Uppewr/Quagdrant discomfort. Physical examination showed
the spleen to be enlarged measuring 20cm below the left subcostal margin. CBC: hgb 110 G/L
\
.l
Hct 0.36 WBC: 32x109/L promyelocytes 15% metamyelocytes 20% myelocytes 10% bands 8%
segmenters 37% lymphocyte 10% platelets 650000. Peripheral smear showed presence of tear-
lgdro shaped cells and nucleated red blood cells. What is the most probable diagnosis of the
above patien't.7
A. Acute Myelogenous Leukemia C. Chronic Idiopathic myelobrosis
8. Chronic Myelogenous Leukemia D. Hairy Cell Leukemia
92. What is the blood smear picture of extramedullary hematopoiesis?
.,
\, A. Absence of myelocytes and promyelowtes
B. Increased number of Howell Jolly bodies
C. Presence of tear drop shaped cells
D. Absence of nucleated RBCs
\3'. 93. Which of the following is a cause of megaloblastic anernia from cobalamin deciency?
l C. Pregnancy
A. Acute Hemolysis
8. Infancy D. Veganism

Page 1 of 8
 L. 94. Tyrosine Kinase inhibitor used in Chronic Myelogenous Leukemia
A. Cytarabine C. Imatinib
B. Doxorubicin D. Tretinoin
95. A 55 year old male, hypertensive and diabetic, has been expereincing anginal pains for a year
now. He was awakened an hour earlier by a constricting chest pain that lasted for 20 minutes,
. p accompanied by shortness of breath. Although it has disappeared, she decrded to go to the
C 9 emergency room. What is the most likely diagnosis?
A. Costochondritis C. Acute Myocardial Infarction
B. Unstable Angina D. Biliairy Tract Disease
\ 96. A 26 year old female consulted because of passage of tea-colored urine and pedal edema. Her
, 3 BP is 150/ 100.Which of the following urinalysis casts lS most likely to be present in the patient7
\ ,2 A. hyaline C. WBC
~ B. RBC 0. waxy
'

r 97. A 40 year old female is complaining of pain on her fingers. PE revealed a bony enlargement on
k the PIP joint. This is known as node.
A. Heberden's node C. Bouchards node
B. Virchow's node D. Bunyard's node
98. A 55 year old male, hypertensive and diabetic, came in due to chest pain and leftsided
weakness. BP was 200/ 100, PR 90 bpm, regular, RR 20 cpm, regular, T 36.6C. MMT Left Upper
& (Lower extremities: 2/5, Right Upper and Lower extremities 5/5. Which of the following
neurologic findings would be compatible in this case7
A. Asterexis C. Hypoactive Deep tendon reex
B. Dorsiexuon of the big toe D. Neck immobility
I)" 99. A 23 year-old male medical student with diabetes mellitus has altered sensorium. At the ER, he
was noted to be moaniingincohercntly. Upon painful stimulation, he withdrew his extremities but
there was no eye opening. What is his Glasgow Coma Scale score7
A. 7 C. 11
B. 9 D. 13
i , 100. A 48 year old male presented with abdominal pain, jaundice. The patient has hepatomegaly
L if the liver span is more than 12cm in the right
A. midaxillary line C. midclavicular line *
B. anterior axlllary line D. midsternal

' ' End of Exam * *

Page 8 ol 8