CM Midterm Practice Quiz

What is Zollinger-Ellison Syndrome?

How is stool for ova and parasites collected?

What bacteria found in uncooked meats can be passed from a pregnant woman to developing baby and cause miscarriage?

T/F: FIT is more specific than gross FOBT?

Ranson's Criteria is used to diagnose what disease?

RUQ tenderness with jaundice indicates perihepatic inflammation is consistent with what dz?

Pertaining to the prior question, due to which disease/infectious process will you see this syndrome?

Serotonin 5HT Enterochromaffin cells in the colon are increased in what IBS form typically?

Constipation associated with poor reflex for feeling the need to have a BM is called what?

What blood marker is the first sign of infection in Hep B?

Pt has a colonic marker study done. 5 days later, markers were found on abdominal X-Ray in the right colon. What does this indicate?

What blood marker in Hep B indicates high viral replication and infectivity?

A patient presents to you for a routine physical exam. For some reason, the patient recently had a CT and there is a thyroid nodule noted on that study; however, the patient does not have any symptoms. What is the next step to do?

Venous outflow from the liver is obstructed and characterized by hepatomegaly, ascites, and abdominal pain is consistent with what disease?

What medication is given for an Acetaminophen OD in relation to acute liver failure?

What lab value is 2-3x higher than the ALT in alcoholic liver disease?

T/F: bright red blood on TP is a sign of an external hemorrhoid?

Which of the following is not a role of calcium?

This organism is responsible for the most common cause of chronic diarrhea in patients with AIDS .

T/F: TIPS creates a connection between the portal and hepatic veins by placing a stent from hepatic vein and portal vein into the liver via the jugular vein.

In which stage of the viral life cycle is the HBsAg still present in the serum for Hepatitis B lab test?

What is the best treatment recommendation for an adult with an immune-active chronic hepatitis B infection?

A patient of yours with a history of chronic renal failure presents today for routine lab work. In his CMP his calcium is low. EKG shows prolonged QT segments. These findings in addition to his recent complaints of feeling “lost” and “confused at times” prompts you to order a PTH, which comes back elevated. What is your diagnosis based on the patient’s symptoms and lab findings?

A 59-year-old white woman presents with complaints of fatigue, pale-colored stools, and itching. She had returned from vacation in Africa one week ago. She had a blood transfusion in 1969 and had one tattoo placed on her left arm that was not done professionally. She denies IV drug use but does drink alcohol excessively (at least a six- pack of beer daily). Her husband died 2 years ago due to liver cancer. Her primary care physician made the diagnosis of acute viral hepatitis. Which one of the following is the most likely mode of transmission for the patient’s acute viral hepatitis?

Where is the most common place for Crohn's to occur?

A 31-year-old Latino woman presents with complaints of fatigue. She returned from a business trip to Mexico 10 days ago. She visits her primary care physician who orders laboratory tests. The results indicate the ALT level is mildly elevated and hepatitis serologies are anti-HAV IgM(+), anti-HAV IgG (−), HBsAg(−), anti-HBc IgG(−), anti-HBc IgM (−) and anti-HCV (−). Which vaccine should be recommended?

A 45 y/o pt presents to you complaining of painful thyroid gland and fatigue, tremor, diarrhea. On radioactive iodine uptake scan, there is diffuse, decreased iodine uptake. What is the next step in terms of management?

Which of the following is not a carbohydrate?

A 37-year-old Asian man presents to the clinic with hepatitis B that is being treated with lamivudine. Today is week 12 of therapy. What laboratory test(s) should be obtained to determine if therapy is effective?

A 60 y/o female with PMH of Graves’ disease and recent URI presents to ED with palpitations, high fever, tremors, and delirium. What is the next step you do as an awesome PA?

A pregnant patient presents to you complaining of GI upset and notes a metallic taste in her mouth. What toxicity are you concerned with?

A 27-year-old Asian woman is due to give birth to a baby boy in 1 month. Prior to becoming pregnant, she drank alcohol occasionally and did not smoke. She never used IV drugs or had a blood transfusion. The HBsAg test is negative. Which vaccination regimen should be recommended for her newborn baby?

35 year old Caucasian male presents to the office complaining of RUQ abd pain. Upon PE the patient’s skin is jaundice, hepatomegaly and splenomegaly present. Labs show an increased alkaline phosphatase, GGT, AST/ALT, bilirubin and a positive P-ANCA. The patient has a history if IBD. What condition is most likely for this patient?

A 28 year old woman presents with amenorrhea, galactorrhea, and vision changes. You performed visual field confrontation testing and observed some problems in your patient’s peripheral vision. You do a pregnancy test, and it comes back negative. What are the next steps you would take?

In the prior question, the patient was confirmed to have a prolactinoma. What is the correct treatment?

A 44-year-old man will be traveling to Africa on a medical mission in 2 weeks. His hepatitis serologies are as follows: anti-HAV IgM (−), anti-HAV IgG (+), anti-HBs (−), HBsAg (+), HBeAg (−), anti- HBcIgG (+), anti-HBcIgM (−), and anti-HBe (−). Which one of the following prophylaxis regimens should be recommended prior to his departure to Africa?

Which of the following is the only inhibitory hormone secreted by the hypothalamus to the pituitary?

A 56 year old patient with a PMH of a blood transfusion (1981) for sickle cell disease is a most risk for what disease?

Which of the following is an inorganic cause of being underweight?

A 33-year-old white woman developed acute viral hepatitis 5 days ago. Her hepatitis serologies are as follows: anti-HAV IgM(+), anti-HAV IgG (−), anti-HCV (−), HBsAg (−), and anti-HBsAb (+). Which one of the following options is best to treat her acute viral hepatitis?

What labs/PE findings would you expect to diagnose Wilsons Disease?

Which virus infects only people with hepatitis B infection?

Which vitamin is not an antioxidant?

29 year old Caucasian female present to the office complaining of fatigue and pruritus. Upon PE you note hepatomegaly, splenomegaly and spider angiomas. You order lab tests and see elevated aminotransferase, bilirubin, and a positive anti-nuclear antibody. This patient most likely has what condition?

In reference to the prior patient, what is the recommended treatment?

Which vitamin is recommend in management of NAFLD and NASH to reduce oxidative stress?

The anti-Saccharomyces cerevisiae antibody (ASCA) is typically used to support the diagnosis of what condition?

Which one of the following is the most common cause of gastroenteritis worldwide?

Which of the following components is not included in TLC diet?

T/F: Fecal blood/WBCs and mucus are found in inflammatory diarrheas and are absent with non-inflammatory diarrhea.

Which one of the following is the most common cause of travelers’ diarrhea?

What is the most common cause of upper GI bleeding?

Orthostatic hypotension is common in Parkinson’s Disease?

What is the most common cause of Lower GI bleeding after an Upper GI bleed has been ruled out?

Which of the following tumors leads to acromegaly?

All of the following are ways to diagnose diabetes except:

A 45 yo M patient presents to the ED with complaints of hearing loss in his left ear x 1 month. On exam, the patient has an absent corneal reflex and facial numbness. Which is the best test to confirm your diagnosis?

The goggles worn by the patient during an electronystagmography (ENG) are specifically designed...

You are examining a patient who complains of dizziness when they changed poses at yoga class. When you perform the Dix-Hallpike maneuver on the patient's right side, this elicits nystagmus and vertigo. The direction of the nystagmus will be _________, which means the cause of their vertigo is _______.

Describe the mechanism of action of intra-TM gentamicin in the treatment of Meniere's disease.

A patient with a PMH of DM, asthma, and cold sores presents to your office complaining of a sudden attack of vertigo which was severe for the first few days, but has been gradually getting better. Exam shows + horizontal nystagmus suppressed by visual fixation with no hearing loss or tinnitus. What is the likely diagnosis?

T/F: Inflammatory bowel disease can cause growth retardation in children.

Which of the following is a major symptom of preformed enterotoxins (ie. S. aureus)?

Which sign or symptom is NOT associated with IBS?

A patient with Crohn’s disease comes to your office complaining of pneumaturia (passage of gas mixed with urine). What is this a sign of?

55 year old Caucasian male presents to your office complaining of “the room spinning.” Upon PE the patient reveals unilateral hearing loss with his right ear and also has facial numbness on the right side of the face. What condition most likely is the patient presenting with and what testing would be the best to confirm your suspicion?

Which of these is not characteristic for C. Diff?

MJ is a 39y/o female who presents with sudden onset severe RUQ pain after eating lunch that has happened under similar circumstances 5 times in the past month with associated jaundice. ECRP demonstrates a dilated bile duct with stones. What is her most likely diagnosis?

A patient presents to the ED with slurred speech, double vision, and gait disturbances. The test of choice for this "do not miss" diagnosis is

With regard to the patient above, what is the best initial management?

Which of these is not a secondary cause of constipation?

What test is indicated to look for free air in the abdomen?

Which is true of Zollinger-Ellison Syndrome?

What is the most likely source of bleeding if you find maroon colored stools?

Which of the following tests is the most important lab test to order when you suspect a GI bleed?

What is the primary manifestation of gastroenteritis?

Which lab value would you see in acute HBV?

Bradyarrhythmias are more likely to cause syncope than tachyarrhythmias

T/F: Infratentorial lesions may cause a coma abruptly.

High values of what lab value are characteristic of Paget's Disease?

T/F: Patients infected with Norovirus have long-lasting immunity.

A stone less than ___ mm will pass spontaneously.

An elevation in which of the following suggests EtOH ingestion?

This is helpful to quantify the severity of pancreatitis. It depends on patient factors at time of admission and things that develop with the first 48 hours of hospitalization. Mortality correlates with its findings. This description defines which of the following?

Which of the following is most consistent with Cholecystitis?

A 75 y/o male pt reports “passing out” while shaving. This syncope is best categorized as:

Which of the following is true about the norovirus?

A 25 yo female complains of diarrhea x 1 week while traveling in the Philippines and eating some of the street food. She says that she has about 12 unformed stools per day. She also experienced nausea, vomiting, and abdominal cramping. Which of the following is the pathogenic cause of her diagnosis?

Which is diagnostic of an ectopic pregnancy?

What is the preferred diagnostic test for lower GI bleeds?

Which symptom of GERD would indicate an endoscopy?

At what age are colon cancer screening tests encouraged?

Which of the following is an indication for an ERCP?

69 year old Caucasian male has come into the ER complaining of vertigo, diplopia, hemiparesis and dysarthria. After consulting with your medical team you suspect the patient has suffered from vestibular ischemia. Which test would be best to confirm this diagnosis?

47 year old female Caucasian patient presents to your office with sensation of “the room spinning around her when she wakes up in the morning.” The patient also states anytime she changes the position of her head quickly the “room spins around her again.” The spinning only lasts about a minute. On physical exam there is no hearing loss bilaterally but is positive for the Dix-Hallpike test. What is most likely the condition that she is presenting with?

In regards to the previous patient what is the best treatment regimen?

A 55 y/o male patient with a 30 pack year smoking history comes into your office complaining of episodic epigastric pain that is worse at night and relieved with eating x 1 month. He also admits to diarrhea x 1 week. Patient denies chronic use of NSAIDs. You suspect PUD and perform a urease breath test which comes back negative. You go ahead and start your patient on pantoprazole and counsel on smoking cessation. Despite optimal therapy, your patient continues to return to your office with recurrent, non-healing ulcers. What is the next best step for this patient?

Which of these is not included in the non-pharm tx for IBS?

T/F: Peripheral vestibular causes of vertigo have nystagmus that is relieved by visual fixation.

Which is a contraindication for an upper GI series?

PMHx includes multiple abdominal surgeries. Pt presents with crampy, intermittent abdominal pain, abdominal distention, vomiting, and obstipation (absence of stool/flatus). An abdominal radiograph reveals dilated bowel loops. Which of the following PE findings is consistent with this presentation?

Which is true of gastric ulcers?

Which of the following is found on a hepatic function panel?

Which of the following puts a patient at significant risk for a colonoscopy?

T/F: Automatisms such as humming or lip smacking may be seen in a complex partial seizure.

What type of thyroid CA has the highest mortality rate?

Which of the following will cause hearing loss and poor speech discrimination?

Vomiting is the most prominent symptom when infected with which of the following pathogens?

Pt presents with severe poorly localized abdominal pain that is out of proportion to PE findings. Pt has elevated serum lactate. Which of the following will confirm diagnosis?

T/F: A Urinalysis may show microscopic hematuria in 25% of patients with appendicitis?

Using the Glasgow coma scale, moderate brain injury is classified as which of the following?

Corneal reflex tests the intactness of which of the following?

T/F: the most common arrhythmogenic cause of syncope is Ventricular tachycardia

Which drug class is used for empiric treatment of diarrhea?

Which of the following clinical features is most consistent with a non-inflammatory infectious diarrhea?

GT is a 60 yo male who presents with malaise, myalgia, and fatigue that started 1 week ago. He used to smoke but developed a distaste for it since the onset of his symptoms. On PE, you find mild hepatomegaly and epitrochlear lymphadenopathy. His labs show elevated transaminases. Which of the following is the most likely diagnosis?

A 2 yo female comes in with poor capillary refill, sunken eyes, depressed fontanelles, dry diapers and an absence of tears. Her mother noticed that she started having these symptoms after a week attending her new daycare. Which pathogen is the most likely cause of her diagnosis?

Which of the following treatments is not appropriate for the previous patient?

Which of the following is an indication for a small bowel barium study?

A 64 yo female with a history of diverticulitis x 10 years presents to the ED complaining of severe abdominal pain and tenderness. You suspect she may have a bowel perforation. Which of the following would be the best imaging test?

A pt comes into the office with episodic epigastric pain that is relieved with food. He admits to chronic use of aspirin after he had a heart attack 5 years ago. He is anemic and has a positive FOBT, leukocytosis, and increased amylase. Which of the following is a complication of his diagnosis?

AD comes into the ED with an altered mental status and in distress. Her BP is 88/60 and her HR is 108. Which of the following is true for this patient?

A pt comes in with a suspected significant GI bleed so you decide to place a nasogastric tube. Which of the following aspirate results could suggest a duodenal bleed?

What characteristic is true of referred pain?

What is the only medication currently recommended for an ectopic pregnancy?

Which of the following is a pathogen that causes non-inflammatory infectious diarrhea?

Which of the following is associated with the highest mortality of all the different types of syncope?

Which type of posturing suggests a lesion that is above the midbrain or in other words the midbrain is intact?

Pt presents with vague, colicky periumbilical pain that localizes to the RLQ. Which of the following maneuvers will reproduce the pt’s abdominal pain through certain movements of the right hip?

What is the initial diagnostic test (and gold standard) ordered for a pt with suspected ureterolithiasis?

Which of the following clinical features is most consistent with inflammatory infectious diarrhea?

What is the best modality for imaging the thyroid?

What hormone stimulates prolactin?

What are the lab values in sick euthyroid syndrome?

What is the diagnostic test of choice for pancreatitis?

What differentiates a surgical acute abdomen from a medical acute abdomen?

On PE of a comatose pt, the pupils are fixed at mid position and there is pronation and extension of the arms and legs. Which of the following lesion/dysfunction best describes these physical findings?

Which of the following is more likely to cause pre-syncope and palpitations than true syncope?

Which of the following drugs would be first line treatment for peptic ulcer disease?

A 60 yo male comes in with steady epigastric abdominal pain that radiates into the back. He also feels nauseous and has been vomiting for the last 3 hours. Labs show an elevated amylase and lipase 3x the normal. What is the best management for this patient’s diagnosis?

Which of the following is appropriate for the management of ureterolithiasis?

Which of the following best describes Vasovagal syncope:

Which of the following is NOT a common prodromal symptom of vasovagal syncope?

Which of the following is conservative management for diverticulitis?

An absent or abnormal oculocephalic reflex (Doll’s Eyes) suggests brainstem damage. Which of the following indicates a normal finding?

T/F: Conn syndrome is a type of primary hyperaldosteronism characterized by spontaneous hypokalemia and a unilateral adenoma.

What is Sheehan's syndrome?

45 y/o pt's labs show: low serum Vit D and increased alk phos. Milkman's fx are seen on X-Ray. What is the suspected diagnosis based on these findings?

Which of the following is not one of the three most common precipitants to DKA or HHS?

Pt's labs show: increased PTH, increased Ca, and decreased phosphate. Based on these values, what is the suspected diagnosis?