Internal Medicine Exam Guide Questions and Answers (Revised & Verified) 2024.

Internal Medicine Exam Guide Questions and Answers (Revised & Verified) 2024.  Cardiology OXF. I. Common Cardiac Presentations. 1. Chest Pain. ***) Young medical student complains of chest pain, palpitation, dyspnea, and feeling of impending death. The symptoms occur every time when he is studying. The most likely diagnosis is: Q2012 A. Conversion disorder B. Panic attack C. Somatoform disorder D. Hypochondriasis E. Syncope Answer: B* Panic attack ***) All of the following can cause chest pain, except: A. Angina B. Myocardial infarction C. Hypertrophic cardiomyopathy D. Pericarditis E. Dissecting aortic aneurysm Answer: C* Hypertrophic cardiomyopathy 2. Syncope. ***) Which of the following is classical feature of cardiac syncope: A. Gradual onset B. Warning symptoms C. Rapid recovery D. Residual neurological deficit E. Precipitated by sudden turning of the head Answer: C* Rapid recovery 3. Postural Hypotension. ***) All of the following are causes of postural hypotension, except: A. Diabetes B. Hypovolemia C. Prolonged bed rest D. Addison's disease E. Hyperthyroidism Answer: E* Hyperthyroidism 4. Pulses. ***) Collapsing pulse is found in all of the following, except: A. Aortic regurgitation B. Patent ductus arteriosus C. Mitral stenosis D. Pregnancy E. Anemia Answer: C* Mitral stenosis 5. Heart Murmurs. ***) One of the following can cause pansystolic murmur: Q2012 A. Coarctation of the aorta B. Aortic regurgitation C. Mitral regurgitation D. Atrial septal defect E. Aortic stenosis Answer: C* Mitral regurgitation ***) Diastolic murmur occurs in all of the following conditions, except: A. Mitral stenosis B. Aortic stenosis C. Austin Flint murmur D. Graham-Steel murmur E. Aortic regurgitation Answer: B* Aortic stenosis ***) All of the following can cause systolic murmur, except: A. Aortic regurgitation B. Aortic stenosis C. Pulmonary stenosis D. Ventricular septal defect E. Mitral regurgitation Answer: A* Aortic regurgitation 6. Cardiac Arrest. ***) In cardiac arrest all of the following drugs may be used, except: A. Adrenaline B. Neostigmine C. Calcium chloride D. Isoprenaline E. Lignocaine Answer: B* Neostigmine II. Cardiac Investigations. 1. ECG Abnormalities. ***) All of the following are causes of sinus tachycardia, except: A. Fever B. Hypothyroidism C. Pregnancy D. Anemia E. Cardiac failure Answer: B* Hypothyroidism ***) All of the following may cause bradycardia, except: A. Myxedema B. Atenolol C. Raised intracranial pressure D. Jaundice E. Salbutamol Answer: E* Salbutamol ***) Bradycardia can be caused by all of the following, except: A. Digoxin B. Obstructive jaundice C. Anticholinergic drug D. Hypothyroidism E. Heart block Answer: C* Anticholinergic drug ***) The characteristic ECG finding in ventricular aneurysm is: A. Persistent ST depression B. Left bundle branch block C. Lack of Q waves D. First degree AV Block E. Persistent ST elevation Answer: E* Persistent ST elevation 2. ECG Additional Points. ***) Concerning right ventricular hypertrophy all are true, except: A. It is a characteristic feature of transposition of great vessels B. It is a characteristic feature of tetralogy of Fallot C. It is a characteristic feature of tricuspid atresia D. It is diagnosed when R in V1 exceeds 20mm E. It is associated with plethoric lung fields Answer: C* It is a characteristic feature of tricuspid atresia 3. Exercise ECG Test. ***) All of the following are contraindications of exercise electrocardiography, except: A. Recent myocardial infarction B. Unstable angina C. Diagnosis of chest pain D. Uncompensated heart failure E. Malignant hypertension Answer: C* Diagnosis of chest pain 4. Cardiac Anatomy. ***) The heart chamber that is situated most posterior is the: A. Right atrium B. Right ventricle C. Left atrium D. Left ventricle E. A+D Answer: C* Left atrium III. Cardiovascular Drugs. 1. Beta-blockers. ***) Indications for the use of Beta-blockers include all of the following, except: A. Hypothyroidism B. Angina C. Hypertension D. After myocardial infarction E. Congestive heart failure Answer: A* Hypothyroidism ***) Indications for the use of Beta-blockers include all of the following, except: A. Hypertension B. Ischemic heart disease C. Migraine D. Bronchial asthma E. Anxiety Answer: D* Bronchial asthma ***) Side effects of propranolol include all of the following, except: A. Cold extremities B. Depression C. Nightmares D. Bronchospasm E. Tremors Answer: E* Tremors 2. Digoxin. ***) The treatment of digitalis-induced arrhythmia may include all of the following, except: A. Withdrawal of digitalis B. Phenytoin administration C. Calcium gluconate administration D. Potassium supplements E. Xylocaine administration Answer: C* Calcium gluconate administration ***) All of the following are side effects of digoxin therapy, except: A. Nausea and vomiting B. Yellow vision C. AV block D. Ventricular extrasystole E. Insomnia Answer: E* Insomnia 3. ACE inhibitors. ***) All of the following are side effects of ACE-inhibitors, except: Q2012 A. Hypokalemia B. Angioneurotic edema C. Hyperkalemia D. Dry cough E. Hypotension Answer: A* Hypokalemia IV. Cardiac Diseases and Conditions. 1. Angina Pectoris. ***) A 65 year old male, presented complaining of retrosternal chest pain of 4 months duration, the pain precipitated with walking uphill, last 5 minutes, relieved with rest. Clinical examination was normal, and electrocardiogram was normal sinus rhythm. The most likely diagnosis is: A. Stable angina pectoris B. Unstable angina C. Chronic pericarditis D. Musculoskeletal E. Reflux esophagitis Answer: A* Stable angina pectoris ***) Which of the following drug is useful in the treatment of angina pectoris: A. Salbutamol B. Propranolol C. Digoxin D. Quinidine E. Phenytoin Answer: B* Propranolol 2. Acute Coronary Syndrome (ACS). ***) 50 years old male presented with 1 hour retrosternal chest pain, BP 85/62, JVP is 10 cm, ECG shows 3 mm ST elevation in II, III, aVF and ST depression in V1, V4, and troponin is positive. The most likely diagnosis is: Q2012 A. Unstable angina B. Stable angina C. Anterior wall MI D. Inferior wall and right ventricular MI E. Stroke Answer: D* Inferior wall and right ventricular MI ***) All the following can cause false positive troponin except: Q2012 A. Septic shock B. Pulmonary embolism C. Pulmonary edema D. Uncontrolled HTN E. Renal failure Answer: D* Uncontrolled HTN ***) All the following can cause increased in troponin except: Q2012 A. Pulmonary edema B. MI C. Pneumonia D. Congestive heart failure E. Myocarditis Answer: C* Pneumonia ***) All the following are features of metabolic syndrome except: Q2012 A. BP over than 135/85 B. LDL over than 160 C. FBS over than 110 D. HDL less than 50 in females E. Waist circumference over than 40 inches in males Answer: B* LDL over than 160 ***) Risk factors for ischemic heart disease include all the following, except: A. Hypertension B. Smoking C. Obesity D. High cholesterol level E. High level of high density lipoproteins (HDL) Answer: E* High level of high density lipoproteins (HDL) ***) Risk factors for ischemic heart disease include all the following, except: A. Excessive exercise B. Positive family history C. Cigarette smoking D. Hypertension E. Hyperlipidemia Answer: A* Excessive exercise.