QUESTIONS
1. A 72-year-old presents with confusion and a fever. The urinalysis shows
leukocyte esterase and nitrites. Most likely diagnosis?
A. Dehydration
B. Urinary tract infection (Correct Answer)
C. Renal failure
D. Hyponatremia
Rationale: Positive nitrites and leukocyte esterase indicate bacterial UTI,
especially in elderly patients with confusion.
2. Which physical exam finding suggests right-sided heart failure?
A. Pulmonary crackles
B. Orthopnea
C. Jugular venous distension (Correct Answer)
D. Inspiratory wheezes
Rationale: Right-sided failure leads to systemic congestion, resulting in JVD,
ascites, and edema.
3. Which laboratory test monitors long-term glycemic control in diabetes?
A. Fasting glucose
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, B. Hemoglobin A1c (Correct Answer)
C. Urine glucose
D. Serum ketones
Rationale: HbA1c reflects average glucose levels over 2–3 months and guides
therapy adjustments.
4. A patient on simvastatin reports muscle pain. The most appropriate next step is:
A. Continue the same dose
B. Check creatine kinase (CK) level (Correct Answer)
C. Start a beta blocker
D. Prescribe a corticosteroid
Rationale: Myopathy and rhabdomyolysis are statin complications; CK levels
confirm muscle injury.
5. Which of the following findings is most consistent with chronic kidney disease
(CKD)?
A. Low creatinine
B. Elevated HDL
C. Elevated BUN and creatinine (Correct Answer)
D. Low potassium
Rationale: CKD reduces filtration, leading to retention of nitrogenous waste
products.
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