MARCH BATCH MEDICINE 1

FIRST LONG EXAMINATION

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Points: 0/46

Question *
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B
 C

Question *
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Question *
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 A

A 40-year-male presents to the office with complaints of multiple

reddish lesions on the chest. He is a chronic alcoholic. On
examination, there are multiple spider angioma on the chest and
:
 examination, there are multiple spider angioma on the chest and
face. An abdominal examination reveals tenderness in the right
upper quadrant region. Which of the following condition is most
likely associated with this patient? *
(-/1 Points)

Cirrhosis

Diabetes mellitus

A feminizing tumor

.Hypothyroidism

Question *
(-/1 Points)

D
:
 6

Question *
(-/1 Points)

A 42-year-old retail manager is sitting in your clinic exam room,

waiting for a routine checkup for hypertension. You enter the room
and sit down, making eye contact, and move your body slightly
toward the patient. You nod your head as the patient begins to bring
you up to date on his life since his last appointment. This
interviewing technique is an example of: *
(-/1 Points)
:
 (-/1 Points)

Echoing

Adaptive questioning

Nonverbal communication

Empathic responses

Question *
(-/1 Points)

D
:
 9

Identify the type of skin lesion. *

(-/1 Points)

wheal

patches

macule

plaques

10

Question *
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:
 A

11

Which is inappropriate for blood pressure screening? *

(-/1 Points)

Blood pressure in each arm will be the same

Avoid drugs such as pseudoephedrine or caffeine prior to evaluation

Position arm at chest level for evaluation

Rest in a chair prior to evaluation

12

A 28-year-old man who recently emigrated from Mexico visits your

clinic with a history of 4 months of cough. He has lost 15 to 20 lbs
unintentionally and has occasional fevers and night sweats. The
cough is dry, and he has coughed up a moderate amount of blood
on 3 occasions. He has been a smoker for 2 years. He smokes 1
1/2 pack of cigarettes per day. Compute the number of pack/years. *

(-/1 Points)
:
 1

13

Question *
(-/1 Points)

D
:
 14

A 65-year-old man visits a clinic for a routine check-up visit. A nurse

is taking the blood pressure recording of the client using a
sphygmomanometer and a stethoscope. What would be the correct
interpretation of the sounds heard during the procedure? *
(-/1 Points)

First Korotkoff sound with diastolic blood pressure

First Korotkoff sound with systolic blood pressure

Second Korotkoff sound with diastolic blood pressure

Second Korotkoff sound with systolic blood pressure

15

A 49-year-old male comes to a surgical practice for repair of an

incisional hernia. His height is 160 cm. His weight is 100 kg. What
weight category does he fall into given his BMI calculation? *
(-/1 Points)

Normal weight

Overweight

Obese class I

Obese class II

16

A patient presents with hair loss in a well-defined area that started 3

weeks ago. The patient has no other complaints or significant
medical history. On the exam, there is a 2 x 2-centimeter area
without hair in the parietal area. The skin is smooth and without
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 without hair in the parietal area. The skin is smooth and without
erythema. The hairs at the borders of the lesion come out with
minimal traction. What is the most probable diagnosis? *
(-/1 Points)

Tinea capitis

Alopecia areata

Lichen planopilaris

Telogen effluvium

17

Question *
(-/1 Points)

B
:
 B

18

A patient on the ward has a nodule-like rash and you are asked by
your registrar to define the meaning of a nodule. From the list below,
select the most appropriate definition of a nodule. *
(-/1 Points)

A well-defined flat area of altered pigmentation

A raised well-defined lesion usually less than 0.5 cm in diameter

A raised flat-topped lesion which is usually greater than 2 cm in diameter

A solid lump greater than 0.5 cm in diameter which may be subcutaneous or

intradermal

A well-defined pus-filled lesion

19

Question *
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:
 A

20

Question *
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:
 A

21

A 20-old homeless man presents with itching. He denies any

exposure to new perfumes, soaps or detergents. On physical
examinations, there are small papules, pustules and excoriations.
Burrows on the finger webs were also identified. What is the most
likely diagnosis *
(-/1 Points)

Acne

Allergic dermatitis

Scabies

Chicken pox

22

Question *
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:
 A

23

The yellowish color of some persons skin is due to _____. *

(-/1 Points)

lack of blood supply

low melanin levels

carotene

hemoglobin

24
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 24

Question *
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25

Question *
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:
 A

26

A medical resident is preparing the patient for physical examination.

Which of the following event need improvement on the part of the
resident? *
(-/1 Points)

The resident adjusts the light to accommodate the examination accordingly

The resident asks the client for consent and positions the client comfortably on the
examining table

The resident begins checking the general appearance and then takes the vital signs

The resident enters the room with the client and goes out to gather supplies

27

During history taking, the patient tells you "I didn't even have a wink
:
 During history taking, the patient tells you "I didn't even have a wink
last night". You replied "Do you mean you had trouble sleeping last
night?". This is an example of which communication technique? *

(-/1 Points)

summarizing

Clarification

Focusing

Paraphrasing

28

Which pair of hormones may be responsible for these clinical

condition? *
(-/1 Points)

Follicle stimulating hormone and human chorionic gonadotropin

Growth hormone and growth hormone–releasing hormone

Dopamine and growth hormone

Prolactin and adrenocorticotropic hormone

:
 29

You are performing a medical interview with a patient and having

some difficulty obtaining accurate information regarding the events
that brought him into the office. Which of the following physician
communication tactics leads to the collection of the most accurate
information? *
(-/1 Points)

Controlling the interview with more directive questions

Using medical terms that the physician feels the patient can understand c. Redirecting
the patient if he/she strays from the relevant points

Involving the patient in his/her treatment plan

Using open-ended questions

30

Establishing rapport with the patient happens in which phase of the

interview? *
(-/1 Points)

pre-interview

introduction

working

termination

31

By pinching the forearm of the patient and observing the skin spring
back, you are assessing which parameter? *
(-/1 Points)
:
 (-/1 Points)

Mobility and turgor

Presence of edema

Observing for blanching of the skin

Checking for petechiae

32

A 22-year-old man, diagnosed with psoriasis, presents in the clinic

with nail changes and joint pain for the last three months. Physical
examination reveals swelling of the distal interphalangeal joints of
the right middle and index fingers with punctate depressions of the
nail plate. Which of the following are the common nail matrix
changes present in this condition? *
(-/1 Points)

Nail pitting

Onycholysis

Subungual hyperkeratosis

.Oil drop discoloration

33

A 35-year-old male visits a wellness clinic. He visits the provider two

times every year for routine checkups. He lives an active life and
has no medical history. A nurse notes the client's blood pressure in
the supine position. The nurse is taking the client's blood pressure
in an erect position now. What change in the blood pressure
compared to the supine position, would the nurse normally expect in
this position? *
:
 this position? *

Increase in the systolic and diastolic pressures

Decrease in the systolic and diastolic pressures

Increase in the diastolic and slight decrease in the systolic pressure

Increase in the systolic and a slight decrease in the diastolic pressure

34

Which of the following set of questions can be used to elicit parts of

the patient's past medical history *
(-/1 Points)

Have you had your MMR shots? How many DTaP shots did you receive in all?

Do you use or have you ever used marijuana, cocaine heroin or other recreational
drugs?

Has anyone in you family been diagnosed with hypertension? cancer?

Are you taking any herbal supplements?

35

A 66-year-old male patient accompanied by his wife is seen in the

clinic because he failed to recognize his son. When asked about the
present year, the answered, “I’m sure it’s 1975.” Which of the
following is the best action you should take with regards to history
taking? *
(-/1 Points)

Ask about his health condition around 1975

:
 Ask the client if he has experienced memory loss before

Let the client rest for 30 minutes and proceed to ask information from the client

Proceed to obtain information from the wife

36

What is the most common cause of this condition? *

Adrenocortical adenoma

Exogenous corticosteroids

Pituitary microadenoma

Ectopic adrenocorticotropic hormone (ACTH) secretion

37

Which of the following goals is important when expanding the cuff of

a sphygmomanometer? *
(-/1 Points)
:
 (-/1 Points)

Collapsing the brachial vein

Transiently collapsing the brachial artery

Monitoring the antecubital vein

Simultaneously monitoring the oxygen saturation

38

Question *
(-/1 Points)

C
:
 D

39

A 25-year-old graduate student presents to your clinic. As she was

telling you about the death of her father, she started to cry. You
placing your hand on the patient’s arm and offer her tissues. Which
type of interviewing technique have you demonstrated? *
(-/1 Points)

Echoing

Adaptive questioning

Nonverbal communication

Empathic responses

40

A 40-year-old man is brought to the hospital with sudden onset low

backache and weakness of the legs over the past 12 hours. On
examination, he is having bladder retention and grade 0 power in
both lower limbs. A magnetic resonance imaging scan of the whole
spine shows a disc prolapse at the T10-11 level compressing the
cord. He undergoes emergency costotransversectomy and
discectomy. He stays in the hospital for 2 weeks and is managed by
the physiotherapy team, following which his power improves to
grade 4- in both lower limbs. After he is discharged, the
physiotherapy team sends a survey to the patient containing open-
ended questions. Which of the following questions is most
appropriate to be included in the survey? *

"What were the results of your physical therapy?"

"Did your symptoms improve after physical therapy?"

:
 "Did your symptoms improve after physical therapy?"

"Was physical therapy beneficial for you?"

"Was physical therapy a good experience for you?"

41

You understand that there are 7 attributes of symptoms. Which

attribute are you referring to when you ask the patient "What is it
like?" *
(-/1 Points)

onset

quality

severity

remitting factors

42

What is the medical term for male pattern baldness? *

(-/1 Points)

alopecia

alopecia areata

androgenic alopecia

acne vulgaris

43
:
 43

Hairs arise from which layer of the skin? *

(-/1 Points)

dermis

stratum basale of the epidermis

subcutaneous layer

connective tissue

44

ou hear the patient says “I had measles and chickenpox at age 12.”
What part of the health history do you document this information?v *

History of Present Illness

Past medical history

Family history

Personal/social history

Review of systems

45
:
 Identify the type of skin lesion. *
(-/1 Points)

papule

vesicle

bullae

pustule

46

At what angle between the nail bed and the cuticula is considered
clubbing of the fingernail? *
(-/1 Points)

90

120

160

180

47

What is the normal blood pressure for those who are 18 years of
age or greater? *
(-/1 Points)

Less than 120 mmHg systolic blood pressure (SBP) and less than 90 mmHg diastolic
:
 blood pressure (DBP)

Less than 120 mmHg SBP and less than 80 mmHg DBP

.Less than 130 mmHg SBP and less than 80 mmHg DBP

Less than 130 mmHg SBP and less than 90 mmHg DBP

48

A 39-year-old male presents for a new patient visit. He has not been
to the doctor since he was a child and takes no medications. His
height is 200 cm. His weight is 115 kg. What weight category does
he fall into given his BMI calculation? *
(-/1 Points)

Underweight

Normal weight

Overweight

Obese

49

A 35-year-old female comes into the office for her annual wellness
exam. Her height is recorded as 165 cm. Her weight is recorded at
80 kg. What is her BMI? *
(-/1 Points)

25

27

29
:
 32

50

What is the optimal lighting for inspecting the apical impulse of the
heart? *
(-/1 Points)

tangential

perpendicular

parallel

oblique

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