NATIONAL COUNCIL OF MEDICAL RESIDENCES

AUTONOMOUS UNIVERSITY OF SANTO DOMINGO

FACULTY OF HEALTH SCIENCES
MEDICAL RESIDENCE OFFICE
SINGLE NATIONAL EXAM FOR APPLICANT TO MEDICAL RESIDENCES 2016
(ENURM 2016)
1. Living person or animal, including birds and arthropods, that under natural circumstances allows
the subsistence or accommodation of an infectious agent:

a) Reservoir

b) Vector

c) Causal agent

d) Guest

Module of Principles of Epidemiology for Disease Control (MOPECE) Second Revised Edition. Health and
disease in the population, Pag. 24.

2. Most common disorder in cobalamin deficiency:

a) tropical sprue

b) Pernicious anemia

c) Orotic aciduria

d) Regional ileitis

Jordi San-Sabrafen, Clinical Hematology; 5th edition, chapter 7; p. 132-133. 2006. Spain

3. The etiological agent that causes HIV/AIDS is:

a) Rhinovirus

b) Retrovirus

c) Parvovirus

d) Papillomavirus

Rojas Immunology, XVI edition, Chapter XXII, page. 302

4. Which of these nerves, when stimulated at the cardiac level, can generate a decrease in heart rate
of between 20 to 40 beats per minute?

a) Facial b) Hypoglossal

c) Glossopharyngeal

d) Pneumogastric
Guyton and Hall. Treatise on Medical Physiology; XII edition; p. 111.

5. It is a dose or series of doses that can be administered at the beginning of treatment in order to
achieve the desired concentration.

a) Saturation dose

b) Sustaining dose

c) Distribution volume

d) Bioavailability

Goodman and Gilman. Pharmacological Bases of Therapeutics. Vol. I, X edition; p. 31.

6. Which of these disorders is considered a neural tube defect?

a) Anencephaly

b) Hydrocephalus

c) Gastrochisis

d) Omphaloce

Carey J, White B; Multifactorial inheritance and common diseases. Medical Genetics; 4th edition; Elsevier
Publishing. Spain 2011. Chap. 12; p. 233-234.

7. It is an anomaly that has to do with the formation of the cardiac loop towards the left:

a) Transposition of the great vessels

b) atrioventricular communication

c) Dextrocardia

d) cardiac septa

Langman, TW Sadler. Medical Embryology; 12th Edition; Lippincott Williams & Wilkins. Spain 2012

8. Omega 3 fatty acids are:

a) Metabolized in the body to produce arachidonic acids

b) Acids provided by fish and flax and almond seeds

c) A type of trans fatty acid.

d) Synthesized in the liver and small intestine

Nutrition by Janicel Thompson, Melinda M. Manore, Linda A Vaughan; (2008). P. 199

9. The risk of suffering from cardiovascular disease is lower in patients who have high blood levels of:

a) Triglycerides

b) Very low density lipoproteins

c) Low density lipoproteins

d) High density lipoproteins

Nutrition by Janicel Thompson, Melinda M. Manore, Linda A Vaughan; (2008). P. 208

10. 42-year-old male patient with a long history of gastroesophageal reflux. When performing an
endoscopic biopsy and taking a sample of the esophagus, simple columnar epithelium and gastric
glands were observed. What is the most common cause of this situation?

a) Alcoholism

b) Esophageal candidiasis

c) Hiatal hernia

d) Zenker's diverticulum

Kumar V; Cotran R; Robbins R. Human Pathology, 7th Edition; Saunders, 2004; p. 552.

11. Which of these anatomical structures is located in the posterior mediastinum?

a) Timo

b) Heart

c) Windpipe

d) Esophagus

Moore K; Dalley AF. Anatomy with clinical orientation; 5th edition. Panamericana Medical Editorial.
Mexico 2007. Chap. 1, Page, 179 .

12. Organ that is in close anatomical relationship with the pancreas:

a) Liver

b) Stomach c

c) Duodenum

d) Spleen

Moore K; Dalley AF. Anatomy with clinical orientation; 5th edition. Panamericana Medical Editorial.
Mexico 2007. Chap. 2, Page, 283.

13. On which surface of these structures is the basilar sulcus located?

a) Anterior medulla oblongata

b) Anterior midbrain

c) Posterior pons

d) Anterior of the cerebral bridge

H. Rouviere, A, Delmas. Mason; Human anatomy; 10 edition volume III, pp. 616 and 624.
14. It is the time that passes from infection to the presentation of symptoms:

a) Latency period

b) prodromal period

c) Incubation period

d) Symptomatic period

Module of Principles of Epidemiology for Disease Control (MOPECE) Second Revised Edition. Public health
surveillance, Pag. 21

15. It is the formed element of blood with a bilobed nucleus that rises in intestinal parasitosis.

a) platelets

b) Eosinophil

c) Neutrophil

d) reticulocyte

Ross. Histology: Text and Atlas, Wojciech Pawlina. Lippincott Williams and Wilkins. Wolters Kluwer
Health, 7th edition, chap. X, p. 307. Spain, 2015.

16. When the platelet count is below 150,000 thousand mm3, it indicates:

a) Thrombocytopenia

b) Thrombasthenia

c) Thrombocytosis

d) thrombocytopathy

Jordi San-Sabrafen, Clinical Hematology; 5th edition, chapter 33; p. 520. 2006. Spain

17. The form of drug administration that is useful for drugs in moderate volumes, oily vehicles and
some irritating substances is the route:

a) Intravenous

b) Subcutaneous

c) Intramuscular

d) Oral

Goodman and Gilman. Pharmacological Bases of Therapeutics. Vol. I, X edition; p. 8.

18. The protein enzyme that allows the formation of carbonic acid at the erythrocyte level is:

a) Myosinakinase

b) Elastase

c) Phosphorylase
d) carbonic anhydrase

Guyton and Hall. Treatise on Medical Physiology; XII edition; p. 503.

19. What is the nutrient whose composition is carbon, hydrogen, oxygen and nitrogen?

a) Lipids

b) carbohydrates

c) Proteins

d) omega 3 acids

Nutrition by Janicel Thompson, Melinda M. Manore, Linda A Vaughan; (2008). P. 15

20. Of the following nerves, which supplies the diaphragm muscle?

a) Lazy

b) Phrenic

c) Spinal

d) Halibut

Moore K; Dalley AF. Anatomy with clinical orientation; 5th edition. Panamericana Medical Editorial.
Mexico 2007. Chap. 2, Page 329.

21. Characteristic that identifies cephalhematoma:

a) A subperiosteal hemorrhage that does not exceed the sutures.

b) A subperiosteal hemorrhage that exceeds the sutures.

c) An edema of the subcutaneous cellular tissue that respects sutures

d) An edema of the subcutaneous cellular tissue that does not respect sutures

Nelson Treatise on Pediatrics. 19th edition, Madrid, Spain. Elsevier, 2013. Volume I. Chapter 92, p. 592 .

22. Which of the following pathologies mainly affects premature babies, its main cause being a
deficiency of the surfactant agent?

a) Meconium aspiration syndrome

b) Transient tachypnea of the newborn

c) Neonatal polycythemia

d) Hyaline membrane disease

Nelson Treatise on Pediatrics. 19th edition, Madrid, Spain. Elsevier, 2013. Volume I. Chapter 95, p. 609.

23. A 10-day-old newborn with a history of preterm delivery (33 weeks) was admitted for abdominal
distention, hemorrhagic stools, and septic shock. The x-ray shows pneumatosis intestinalis. The patient
is more likely to present:
a) Intestinal intussusception

b) Congenital hypertrophy of the pylorus

c) Necrotizing enterocolitis

d) Hirschprung's disease

Nelson Treatise on Pediatrics. 19th edition, Madrid, Spain. Elsevier, 2013. Volume I. Chapter 96, p. 630.

24. Rheumatic fever is a condition associated with a history of infection by:

a) Group A beta hemolytic streptococcus

b) Streptococcus agalactiae

c) Staphylococcus aureus

d) Staphylococcus epidermidis

Nelson Treatise on Pediatrics. 19th edition, Madrid, Spain. Elsevier, 2013. Volume I. Chapter 176, p. 955.

25. The main route of infection in the pediatric population for HIV-1 is:

a) Due to an infectious process

b) Vertical transmission from mother to child

c) by saliva

d) sexual contact

Nelson Treatise on Pediatrics. 19th edition, Madrid, Spain. Elsevier, 2013. Volume I. Chapter 268, p.
1213.

26. What vaccine would you recommend giving to a newborn baby?

a) Pentavalent

b) Hepatitis B

c) Hepatitis A

d) DPT

Nelson Treatise on Pediatrics. 19th edition, Madrid, Spain. Elsevier, 2013. Volume II. Chapter 165, Fig,
165 2, p. 927. Standards Expanded Program on Immunization (EPI). Ministry of Public Health and Social
Assistance. Santo Domingo Dominican Republic; 2008.

27. What is the microorganism responsible for producing whooping cough?

a) Streptococcus Pneumoniae

b) Streptococcus pyogenes

c) Corynebacterium diphtheria
d) Bordetella pertussis

Nelson Treatise on Pediatrics. 19th edition, Madrid, Spain. Elsevier, 2013. Volume I. Chapter 189, p. 985.

28. An 8-year-old female comes to the emergency room due to profuse diarrhea without fever with a
fishy odor. What is your diagnostic impression?

a) Anger

b) Parasitosis

c) Salmonellosis

d) Amebiasis

Nelson Treatise on Pediatrics. 19th edition, Madrid, Spain. Elsevier, 2013. Volume I. Chapter 193, p. 1009

29. What is the microorganism most frequently involved in urinary tract infection in pediatric age ?

a) Pseudomonas aeruginosa

b) Streptococcus pneumoniae

c) Escherichia coli

d) Staphylococcus aureus

Nelson Treatise on Pediatrics. 19th edition, Madrid, Spain. Elsevier, 2013. Volume II. Chapter 532, p.
1901.

30. A 16-year-old male comes to the emergency room presenting: oral temperature of 39.5 °C,
headache, jaundice, myalgia. He also has dark and scant urine. What is the most likely diagnosis?

a) Reyes syndrome

b) infectious mononucleosis

c) Leptospirosis

d) Meningococcemia

Nelson Treatise on Pediatrics. 19th edition, Madrid, Spain. Elsevier, 2013. Volume I. Chapter 214, p. 1070-
1071.

31. At 10 months, children have repetitive consonant sounds in their language:

a) say a few words

b) Forms polysyllabic vowel sounds

c) Dad mom

d) Ta, you

Nelson Treatise on Pediatrics. 19th edition, Madrid, Spain. Elsevier, 2013. Volume I. Chapter 8, p. 30.
32. The second cause of accidental death in children under 5 years of age is:

a) Pneumothorax.

b) Drowning.

c) Trauma.

d) Strange bodies.

Nelson Treatise on Pediatrics. 19th edition, Madrid, Spain. Elsevier, 2013. Volume I. Chapter 62, p. 294.

33. What is the factor that most frequently precipitates cardiac instability in children?

a) Low motor response

b) Low level of consciousness.

c) Respiratory failure.

d) Circulatory insufficiency.

Nelson Treatise on Pediatrics. 19th edition, Madrid, Spain. Elsevier, 2013. Volume I. Chapter 62, p. 296.

34. Through which of these laboratory studies can we diagnose amoebiasis in children?

a) Coprological

b) Fecal occult blood test.

c) Hemogram

d) Urine Test

Nelson Treatise on Pediatrics. 19th edition, Madrid, Spain. Elsevier, 2013. Volume I. Chapter 273, p. 1233.

35. Which of the following is the route of transmission of congenital toxoplasmosis?

a) Caesarean section.

b) Blood transfusion.

c) Transplacental

d) From one fetus to another in the case of a twin pregnancy.

Nelson Treatise on Pediatrics. 19th edition, Madrid, Spain. Elsevier, 2013. Volume I. Chapter 282, p. 1264.

36. The diagnosis of acute pyogenic meningitis in children is confirmed by:

a) Analysis of cerebrospinal fluid.

b) Tomography.

c) A smear of blood.

d) Complete blood count.

Nelson Treatise on Pediatrics. 19th edition, Madrid, Spain. Elsevier, 2013. Volume II. Chapter 595, p.
2165.

37. A one-month-old child comes to the emergency room with a history of progressive and projectile
vomiting; After vomiting, the infant is hungry and wants to feed again. We can think that it is about:

a) Congenital hypertrophy of the pylorus.

b) Intestinal obstruction.

c) Gastrointestinal infection.

d) Lactose intolerance.

Nelson Treatise on Pediatrics. 19th edition, Madrid, Spain. Elsevier, 2013. Volume II. Chapter 321, p.
1329.

38. The major vehicle of transmission of giardia lamblia infections is:

a) urine infections

b) Saliva

c) Contaminated water

d) blood transfusions

Nelson Treatise on Pediatrics. 19th edition, Madrid, Spain. Elsevier, 2013. Volume I. Chapter 274, p. 1235.

39. An 8-year-old boy goes to the doctor's office because of weakness and pain in his legs after
exercise. On physical examination, he has a disparity in blood pressure between his arms and legs. He
is suffering from one of these diseases:

a) Pulmonary stenosis

b) Coarctation of the aorta

c) Mitral regurgitation

d) intraventricular communication

Nelson Treatise on Pediatrics. 19th edition, Madrid, Spain. Elsevier, 2013. Volume II. Chapter 421, p.
1631.

40. The most common cause of lower intestinal obstruction in newborns is due to:

a) Intestinal duplication

b) Hirschsprung's disease

c) meconium plug

d) Adynamic ileus

Nelson Treatise on Pediatrics. 19th edition, Madrid, Spain. Elsevier, 2013. Volume II. Chapter 324, p.
1341.
41. 27-year-old female with 8 weeks of amenorrhea. The uterine height is above the umbilical scar;
Chorionic gonadotropin hormone levels in the blood are elevated.
Blood pressure 130/80 mmHg, HR 88 beats per minute. What is the most likely diagnosis?

a) Gestational hypertension

b) Pseudocyesis

c) Molar pregnancy

d) Unruptured ectopic pregnancy

Gestational Trophoblastic Disease: William Obstetrics, 23rd Edition, 2011, McGraw-Hill, Mexico 2011,
chap. 11, p. 257-263. Ross S Berkowitz, Goldstein Donal P. Chap. 39, pp. 1458-1462. Berek and Novak
Gynecology, 15th Edition, Lippincott Williams & Wilkins, 2013.

42. A 64-year-old female presents with respiratory distress, a distended abdomen, a liquid wave sign
present, and a history of having an elevated CEA 125 marker. What is your diagnosis?

a) Cervical cancer

b) Endometrial cancer

c) Hepatocarcinoma

d) Ovarian cancer

Berex Jonathan, Longacre Teri: Ovarian, uterine tube and peritoneal cancer, Chap. 37, pp.1350;
Berek and Novak Gynecology, 15th Edition, Lippincott Williams & Wilkins, 2013.

43. Procedure of choice for the early detection of cervical cancer in a 25-year-old G3 P3 female with
findings of chronic cervicitis and a previous Pap smear CIN 2:

a) Colposcopy, biopsy and curettage

b) Determine CEA 125

c) Repeat exfoliative cytology

d) Endovaginal sonography

Miller Caela, Elka John: Cervical and vaginal cancer. Chap. 19, pp.593; Berek and Novak Gynecology, 15th
Edition, Lippincott Williams & Wilkins, 2013.

44. A 22-year-old female comes to the emergency room with a history of pain in the lower abdomen
that began 4 days after menstruation, associated with general malaise, a temperature of 38.5 °C;
hemoglobin 12 gr%; leukocytes 18,500/mm, neutrophils equal to 82% and lymphocytes equal to 18%.
Which of these is your diagnosis?

a) Pelvic inflammatory disease

b) twisted ovarian cyst

c) Mittelschmertz syndrome
d) Endometriosis

David E. Soper: Urogenital infections and sexually transmitted diseases, Chap. 18, p. 563-566; Berek and
Novak Gynecology, 15th Edition, Lippincott Williams & Wilkins, 2013.

45. Multiparous, over 40 years of age, who in her third trimester of pregnancy presents with a
sudden onset of vaginal bleeding, pain, sensitivity and persistent uterine hypertonia; What is your
diagnosis?

a) Previous placenta

b) Placenta accreta

c) Uterine rupture

d) Premature abruption of normal placenta

William Obstetrics, 23rd Edition, 2011, McGraw-Hill, Mexico 2011, chap. 35, p. 761-766.

46. Hypertension diagnosed after 20 weeks of gestation but persisting after 12 weeks of delivery is
characteristic of:

a) Preeclampsia

b) Eclampsia

c) Chronic Hypertension

d) Gestational hypertension

William Obstetrics, 23rd Edition, 2011, McGraw-Hill, Mexico 2011, chap. 34, table 34-1, p. 707 .

47. Drug of choice used to prevent and stop seizures during pregnancy.

a) Phenytoin

b) Diazepam

c) Methyldopa

d) Magnesium sulphate

William Obstetricia, 23rd Edition, 2011, McGraw-Hill, Mexico 2011; chap. 34. p. 736,739.

48. It is the most voluminous part of the fetus that makes contact with the upper pelvic outlet,
occupying a large part of it, and which can evolve on its own giving rise to the birth mechanism.

a) Fetal presentation

b) Fetal attitude

c) Fetal status

d) Fetal position

Schwarcz Obstetrics, 6th Edition, Buenos Aires; El Ateneo 2005, p. 38.

49. In the sonographic recognition of pregnancy, the heartbeat should be observed after:

a) Six weeks post conception

b) Six weeks post period

c) Five weeks post period

d) Five weeks post conception

Prenatal Care: William Obstetrics, Cap. 8, p. 193. 23rd Edition, 2011, McGraw-Hill, Mexico 2011.

50. Of the high-risk subtypes of human papillomavirus, which of these are most linked to invasive
cervical cancer?

a) 18 and 35

b) 16 and 18

c) 11 and 15

d) 15 and 35

Miller Caela, Elka John: Cervical and vaginal cancer. Chap. 37, pp.1305; Berek and Novak Gynecology,
15th Edition, Lippincott Williams & Wilkins, 2013.

51. The most common benign breast tumor is:

a) Fibrosarcoma

b) Adenocarcinoma

c) Fibroadenoma

d) Phyllodes tumor

Lawrence Camelia, Baiba Grube, Armando Giuliano: Benign Breast Disease. Chap. 21, pp. 670. Berek and
Novak Gynecology, 15th Edition, Lippincott Williams & Wilkins, 2013 .

52. 18-year-old woman presenting with primary oligomenorrhea. It has normal female development.
Androgen levels are elevated. The examination revealed hirsutism and obesity and anovulatory
sterility. On sonography, enlarged ovaries with numerous peripheral follicles were found. The
diagnosis to consider is:

a) Corpus luteum cyst

b) Polycystic ovary syndrome

c) Rokitansky syndrome

d) ovarian follicular cyst

Kuzbari Oumar, Dorais Jessie, Peterson Mattew: Endocrine Disturbances., Chap. 31, pp.1075; Berek and
Novak Gynecology, 15th Edition, Lippincott Williams & Wilkins, 2013.
53. The average length of the umbilical cord is:

a) 30-40cm

b) 50-60cm

c) 40-50cm

d) 60-70cm

Implantation, embryogenesis and placental development: Chap. 3, p. 62 and Anomalies of the placenta,
umbilical cord and membranes, chap. 27, p. 581: William Obstetrics, 23rd Edition, 2011, McGraw-Hill .

54. When maternal serum levels reach their maximum, chorionic gonadotrophic hormone (CGH) is
almost completely produced in:

a) Hypophysis

b) hypothalamus

c) Syncytiotrophoblast

d) Cytotrophoblast

Implantation, embryogenesis and placental development: Chap. 3, p. 63, William Obstetrics, 23rd Edition,
2011, McGraw-Hill.

55. The justification for using the date of last menstruation to calculate gestational age is because:

a) The vast majority of women know their last menstrual period.

b) It is equal to the ovulatory age

c) It is more accurate

d) It is equal to the embryonic age

Fetal growth and development: Determination of gestational age; chap. 4, page 78, William Obstetrics,
23rd Edition, 2011, McGraw-Hill.

56. The midpoint of the age of pregnancy calculated from the date of last menstruation corresponds
to:

a) 20 weeks

b) 24 weeks

c) 28 weeks

d) 32 weeks

Fetal growth and development: Determination of gestational age: Chap. 4, page 80, William Obstetrics,
23rd Edition, 2011, McGraw-Hill.

57. The mechanism of action of oral contraceptives consists of:

a) inhibit ovulation
b) Block fertilization

c) Inhibit menstrual flow

d) Reduce menstrual flow

Contraception. Chap. 32, page 673, William Obstetrics, 23rd Edition, 2011, McGraw-Hill.

58. The rupture of membranes that occurs before labor is:

a) Late

b) Tempestive

c) Early

d) Early

Premature Birth, Premature Rupture of Membranes: Chap. 36, pp. 811, William Obstetrics, 23rd Edition,
2011, McGraw-Hill.

59. The microorganism that frequently causes inflammatory damage to the mucosa of the fallopian
tubes in pelvic inflammatory disease is:

a) Trichomonas

b) Neisseria gonorrhoeae

c) Vaginal Gadnerella

d) Streptococci

David E. Soper: Urogenital infections and sexually transmitted diseases, Chap. 18, pp. 564; Berek and
Novak Gynecology, 15th Edition, Lippincott Williams & Wilkins, 2013.

60. The most common age period in which ovarian cancer occurs is around:

a) 40 years

b) 50 years

c) 60 years

d) 70 years

Berek Jonathan S., Longare Teri A., Friedlander Michael: Ovarian, uterine tube and peritoneal cancer,
Chap. 37, pp. 1350. Berek and Novak Gynecology, 15th Edition, Lippincott Williams & Wilkins, 2013.

61. What is the treatment of choice for secondary syphilis?

a) Intravenous aqueous penicillin G for 10-14 days

b) Penicillin V orally for 10 days.

c) 2.4 million units in a single dose of benzathine penicillin G intramuscularly

d) 2.4 million units in a single dose of benzathine penicillin G in continuous intravenous infusion.
Principles of Internal Medicine, Harrison, 18th Ed. McGraw Hill. 2012, chap. 169, table 169-2, Page. 1387.

62. What technique provides the definitive diagnosis of Mycobacterium tuberculosis infection?

a) Ziehl-Neelsen stain

b) Mantoux intradermorreaction

c) Serum quantification of gamma interferon

d) Cultivation in the Middle of Löwenstein-Jensen

Principles of Internal Medicine, Harrison, 18th Ed. McGraw Hill. 2012, chap. 165, Page 1350.

63. People with the following blood group are known as universal recipients:

a) AB Rh positive

b) AB Rh negative

c) Rh positive

d) Rh negative

Principles of Internal Medicine, Harrison, 18th Ed. McGraw Hill. 2012, chap. 113, Page 951.

64. Most common cause of upper gastrointestinal bleeding:

a) Gastroesophageal reflux

b) Esophageal varices

c) Peptic ulcer

d) Mallory Weiss Tears

Principles of Internal Medicine, Harrison, 18th Ed. McGraw Hill. 2012, chap. 293, Page 2445.

65. Type of compensatory breathing in a diabetic patient in a coma, with blood glucose levels of 350
mg% and presence of ketone bodies in urine.

a) Biot

b) Reynolds

c) Cheyne-Stokes
d) Kussmaul
Principles of Internal Medicine, Harrison, 18th Ed. McGraw Hill. 2012, Chap. 344, Page 2976.
66. 22-year-old male, Cabinetmaker; He went to the emergency room presenting: fever, headache,
multiple arthralgias and fatigue. Clear amber urine, negative peripheral blood smear. What is your
print diagnosis?

a) Anger

b) Chikungunya
c) Dengue

d) Malaria

Principles of Internal Medicine, Harrison, 18th Ed. McGraw Hill. 2012, Chap. 196, Page 1627.

67. A free trade zone worker presents to the emergency room with a clinical picture of unquantified
fever, asthenia, stiffness and pain in the cervical region that makes chewing impossible. Three weeks
ago he had suffered a cut wound on a finger on his right hand for which he was prescribed antibiotics;
currently the wound looks infected. Your print diagnosis is:

a) Botulism

b) Guillain Barre syndrome

c) Soft tissue sepsis

d) Tetanus

Principles of Internal Medicine, Harrison, 18th Ed. McGraw Hill. 2012, Chap. 140, Page 1198.

68. Thiamine deficiency is common in:

a) Chronic liver disease

b) Renal insufficiency

c) Alcoholism

d) Heroinmania

Principles of Internal Medicine, Harrison, 18th Ed. McGraw Hill. 2012, Chap. 74, table 71-1, Page. 594.
69. A 68-year-old woman comes to the clinic complaining of acute epigastric pain radiating to her
back that has been going on for several hours. He has a history of cholelithiasis and habitual alcohol
consumption; The laboratory results highlighted: leukocytosis, increased serum amylase and lipase.
What should be your first diagnostic suspicion?

a) Acute hepatitis

b) Acute pyelonephritis

c) Peptic ulcer

d) Acute pancreatitis

Principles of Internal Medicine, Harrison, 18th Ed. McGraw Hill. 2012, Chap. 313, table 313-1, Page.
2635.

70. In the treatment of an acute and severe asthma attack, the following are used:

a) Aminophylline EV.

b) Oral antibiotics.

c) Oral prednisone.

d) Beta 2 agonist, EV.

Principles of Internal Medicine, Harrison, 18th Ed. McGraw Hill. 2012, Chap. 254, Page 2113

71. Where in the body is extrapulmonary tuberculosis most frequently located?

a) Osseous system

b) genitourinary system

c) Uvea

d) Lymph nodes

Principles of Internal Medicine, Harrison, 18th Ed. McGraw Hill. 2012, Chapter 165, p. 1346 72.

72. To differentiate an acute thrombotic cerebrovascular event from a hemorrhagic one. Which
imaging procedure would be most used?

a) CT scan of the skull

b) skull x-ray

c) Magnetic resonance

d) Cerebral angiography

Principles of Internal Medicine, Harrison, 18th Ed. McGraw Hill. 2012, Chap. 370, p. 3271
73. They are linear and angular erosions that are sometimes covered with crust and are caused by
scratching.

a) Papule

b) Bump

c) Excoriation

d) Plate

Principles of Internal Medicine, Harrison, 18th Ed. McGraw Hill. 2012, Chap. 51 page 390

74. The most common acute complication of type 1 diabetic patients is?

a) Diabetic cetoacidosis

b) Infections

c) Hyperosmolar Coma

d) Hypoglycemia

Principles of Internal Medicine, Harrison, 18th Ed. McGraw Hill. 2012, Chap. 344, p. 2976

75. The most common cause of death in hypertensive patients is?

a) Strokes

b) Pheochromocytoma

c) Heart disease

d) Nephropathies

Principles of Internal Medicine, Harrison, 18th Ed. McGraw Hill. 2012, Chap. 247, page 2046

76. Between 80 to 95% of cases, the etiology of arterial hypertension is due to:

a) Isolated hypertension

b) Secondary hypertension

c) White coat hypertension

d) Essential hypertension

Principles of Internal Medicine, Harrison, 18th Ed. McGraw Hill. 2012, Ch.247, p. 2047
77. A young female patient arrives at the emergency room with edema in her right leg, fever and
pain that makes it difficult for her to walk. She uses contraceptives. Of these, what is your diagnosis?

a) Thrombophlebitis

b) Nephrotic syndrome c) Erysipelas

d) Heart failure

Principles of Internal Medicine, Harrison, 18th Ed. McGraw Hill. 2012, Chap. 36, page 290

78. Transient loss of consciousness of rapid onset, short duration and spontaneous and complete
recovery, caused by an acute global insufficiency of flow to the brain, is called:

a) Syncope

b) Vertigo

c) Dizziness

d) Cerebral haemorrhage

Principles of Internal Medicine, Harrison, 18th Ed. McGraw Hill. 2012, Chap. 20, p. 171

79- What is the disease that produces liquid stool-type stools in rice water?

a) Shiguellosis

b) Giardiasis

c) Amebiasis

d) Anger

Principles of Internal Medicine, Harrison, 18th Ed. McGraw Hill. 2012, Chap. 156, page 1291

80- To which nosological entity does this clinical picture correspond: sudden-onset fever, retro-orbital
pain, intense myalgia and sometimes a macular rash on the first day?

a) Chikungunya

b) Malaria

c) Leptospirosis

d) Dengue

Principles of Internal Medicine, Harrison, 18th Ed. McGraw Hill. 2012, Chap. 156, Page
1622
81. Most predominant causal factor in the development of acute appendicitis in adult patients:

a) Vegetable and fruit seeds

b) Increased peristalsis

c) Obstruction of the lumen by fecaliths

d) Intestinal parasites, mainly roundworms

Schwartz Principles of Surgery 9th Ed. Mexico; Mac-Graw Hill, 2010. Chapter 30, p. 1075.

82. A well-nourished 2-year-old infant comes to us with a history of sudden colicky pain and bloody
stools; On abdominal palpation there was a sausage-shaped mass in the right lower quadrant. Which
of these conditions is your impression diagnosis?

a) Acute gastroenteritis

b) Intussusception

c) Appendicitis

d) Mesenteric adenitis

Schwartz Principles of Surgery 9th Ed. Mexico; Mac-Graw Hill, 2010. Chapter 39, p. 1433.

83. When the vascularity of the protruding organ is compromised in a hernia, it is called:

a) strangled

b) Imprisoned

c) Reduced

d) Internal

Schwartz Principles of Surgery 9th Ed. Mexico; Mac-Graw Hill, 2010. Chapter 37, p. 1332.

84. Which of the following statements is correct about Hashimoto's thyroiditis?

a) The most common cause is bacteria such as streptococcus.

b) It is of autoimmune origin and causes hypothyroidism.

c) Acute inflammation, thought to be triggered by a viral infection

d) Dense fibrosis caused by fibrosclerosis

Schwartz Principles of Surgery 9th Ed. Mexico; Mac-Graw Hill, 2010. Chapter 38, p. 1357.

85. Procedure of choice to maintain a patent airway that you would recommend to manage a 31-
year-old patient who comes to us in the emergency room after a motorcycle accident. He has a
Glasgow score of 13/15, multiple facial fractures and manifests respiratory distress:

a) Cricothyroidotomy
b) Endotracheal intubation

c) Continuous Airway Pressure (CPAP)

d) Tracheostomy

Schwartz Principles of Surgery 9th Ed. Mexico; Mac-Graw Hill, 2010. Chapter 7, Fig. 7-1; p. 137.

86. 28-year-old female patient, who visits the emergency room due to sudden pain starting in the
right flank, temperature 39.4 °C, fist percussion sign (+), peristalsis present; Blood pressure of 125/70
mmHg; heart rate of 94 beats per minute. Which of these is your diagnosis?

a) Perforated peptic ulcer

b) Acute pyelonephritis

c) Acute cholecystitis

d) Pelvic inflammatory disease.

Schwartz Principles of Surgery 9th Ed. Mexico; Mac-Graw Hill, 2010. Chapter 40; p. 1471.

87. A 72-year-old male presents with crampy abdominal pain, constipation for 4 days, and
asymmetrical abdominal distention. It has never been operated on, it presents a radiographic image
with stair-level fluid and air levels. Tell your diagnosis.

a) internal hernia

b) Intestinal volvulus

c) Adynamic ileus

d) Diverticulosis

Schwartz Principles of Surgery 9th Ed. Mexico; Mac-Graw Hill, 2010. Chapter 29; p. 1054.

88. A 60-year-old female, a known heart patient undergoing treatment for chronic atrial fibrillation,
went to the emergency room complaining of intense and continuous periumbilical pain radiating to
the epigastrium and beginning suddenly about 2 hours ago. On examination, the patient is stable and
feels a lot of abdominal pain, although the abdomen appears soft, depressible, and without signs of
peritoneal irritation. What is the most likely diagnosis for this patient?

a) Mesenteric embolism

b) Perforated peptic ulcer

c) Acute diverticulitis

d) Acute myocardial infarction with inferior surface involvement

Schwartz Principles of Surgery 9th Ed. Mexico; Mac-Graw Hill, 2010. Chapter 23; p. 731.

89. Regarding direct inguinal hernias, choose the correct answer:

a) Surgery is unnecessary
b) It manifests through the transversalis fascia

c) Descends to the scrotum

d) It is the most common hernia of the newborn.

Sabiston's treatise on surgery 19th edition. Chapter 46, p. 1114

90. A 45-year-old female patient arrived at the emergency room at 3:00 am with abdominal pain;
previously treated with NSAIDs for rheumatoid pathologies. On physical examination, he presents
clinical signs of peritoneal irritation; if suspected as a diagnosis, perforated peptic ulcer. Which of
these studies would be ideal to confirm the diagnosis?

a) abdominal sonography

b) Abdominal tomography with double contrast

c) standing chest x-ray

d) Magnetic resonance

Sabiston's treatise on surgery 19th edition. Chapter 47, p. 1149.

91. It is a congenital pathology that is generally observed in newborns until the second year of life
and is due to an abnormal development of the lymphatic system that prevents it from draining its
contents into the venous system.

a) Cystic hygroma

b) Thyroid cyst

c) Necrotizing enterocolitis

d) Chronic lymphadenopathy

Sabiston's treatise on surgery 19th edition. Chapter 67, p. 1832.

92. It is the ideal topical antibiotic for the management of burned patients in the first hours of burns,
which has a therapeutic action of between 12 to 24 hours.

a) Nitrofurazone

b) Fusidic acid

c) Bacitracin

d) Silver sulfadiazine

Sabiston's treatise on surgery 19th edition. Chapter 21, table 21-5; p. 533.

93. Disease that is most frequently confused with acute appendicitis in children:

a) Stomach flu

b) Meckel's diverticulosis

c) Mesenteric adenitis

d) Acute cholecystitis

Schwartz Principles of Surgery 9th Ed. Mexico; Mac-Graw Hill, 2010. Chapter 30; p. 1080.

94. The most common anomaly as a consequence of non-obliteration of the omphalomenenteric

duct is:

a) Enterochisis

b) Omphalomesenteric fistula

c) Meckel's diverticulum

d) indirect inguinal hernia

Schwartz Principles of Surgery 9th Ed. Mexico; Mac-Graw Hill, 2010. Chapter 28; p. 1003.

95. Most common malignant condition of the digestive tract:

a) hodgkin lymphoma

b) non-hodgkin lymphoma

c) Colorectal carcinoma

d) Leiomyoma

Schwartz Principles of Surgery 9th Ed. Mexico; Mac-Graw Hill, 2010. Chapter 29; p. 1041.
96. The anomalous communication between two epithelialized surfaces is one:

a) Fistula

b) Ileostomy

c) Anastomosis

d) Colostomy

Schwartz Principles of Surgery 9th Ed. Mexico; Mac-Graw Hill, 2010. Chapter 28; p. 997.

97. It is the most common cause of insufficient peripheral vascular circulation:

a) Post phlebitic syndrome

b) Raynaud's syndrome.

c) Acute thrombophlebitis

d) Arteriosclerosis

Schwartz Principles of Surgery 9th Ed. Mexico; Mac-Graw Hill, 2010. Chapter 63; p. 1726.

98. Which of these neoplasms are the most common malignant tumors of the chest wall?

a) Sarcomas

b) Adenocarcinomas

c) AC. Epidermoids

d) Malignant melanoma.

Sabiston's treatise on surgery 19th edition. Elsevier-Saunders, Barcelona Spain, 2013. Chapter 58, p.
1593.

99. The most common hernia in children is:

a) direct inguinal

b) Umbilical

c) Epigastric

d) indirect inguinal

Sabiston's treatise on surgery 19th edition. Elsevier-Saunders, Barcelona Spain, 2013. Chapter 67, p.
1856.
100. Internal hemorrhoids that have a prolapse component and are manually reduced after
defecation are considered:

a) First grade

b) Second grade

c) Third degree

d) Fourth grade.

Sabiston's treatise on surgery 19th edition. Elsevier-Saunders, Barcelona Spain, 2013. Chapter 53, p.
1388