Lernkartei Internal Final (Seite 3 von 5)

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81. Iron deficiency-induced anaemia - indicate the false sentence:

a. it may be accompanied by leukopenia and thrombocythemia

b. is a microcytic hypochromic anaemia

c. concentration of ferritin in serum is elevated

d. one of the major causes of iron deficiency is impaired absorption from the digestive tract

e. during pregnancy and lactation prophylactic supplementation with iron is recommend

82. Which neurological disease can occur in the course of systemic lupus?

a. Guillain-Barre syndrome

b. psychosis

c. aseptic meningitis

d. transverse myelitis

e. All of the above

83. Treatment with the method of whole-lung leakage with high amount of saline solution may be applied:

> called whole-lung lavage!

a. in advanced, progressive form of pulmonary sarcoidosis, not responding to corticosteroid treatment

b. in advanced, nodular, progressive form of silicosis

c. in advanced pulmonary histiocytosis with recurrent penumoperitoneum

d. in all of the above

e. in none of the above

84. Radiological features of osteoarthritis are all features listed below except for:

Clinical features of osteoarthritis:

Pain during or after exertion (e.g., at the end of the day) that is relieved with rest
Morning joint stiffness usually lasting < 30 minutes
DIP joints are typically affected
Joints are usually asymmetrically involved

a. bone erosion

b. degenerative geodes

c. subchondral sclerosis

d. osteophytes

e. narrowing of the articular space

85. indicate the contraindication for biological treatment of TNF in a patient suﬀering from rheumatoid arthritis:

Clinical features:

Morning stiffness (often > 30 min) that usually improves with activity
Symmetrical pain and swelling of affected joints (also at rest)
DIP joints are not typically affected in RA.

a. cancer cured 10 years ago

b. stage IV heart failure, according to the NYHA classification

c. methotrexate intolerance

d. pulmonary interstitial changes in the course of RA

e. increased activity of liver enzymes (<2x ULN)

89. Performing kidney biopsy is purposeful:

a. in a 60-years old man in whom microhematuria occurs in urine sediment

b. in a 40-years-old man diagnosed with hypertension and rapid loss of glomerular filtration

c. in a 65-year old patient in whom proteinuria has persisted for at least two years with normal glomerular filtration

d.w hen renal proteinuria occurs in a person in whom diabetes was diagnosed 30 years ago

e. in 50 years old person in whom creatinine concentration in blood serum is equal to 4 mg/dl and in ultrasound examination the size of his or her kidney on longitudinal dimension is equal to approx. 8 cm

87. ECG

A. atrial fibrillation w/ RBBB

B. atrial flutter

C. ventricular tachycardia

d. ventricular fibrillation

e. atrial fibrillation

88: EKG

a. acute anterior wall MI (STEMI)

b. prior anterior wall MI

c. prior lateral wall MI

d. acute inferior wall MI (STEMI)

89. The patient was suspected of celiac disease based on serological tests. In this case, the following should be done:

a. ileocolonoscopy with the collection of specimens from the ileum

b. capsule endoscopy

c. enterography of the intestine

d. duodenoscopy with duodenal biopsy

e. two-balloon enteroscopy

90. Side eﬀects of SGLT-2 inhibitors:

Urinary tract infections, genital infections (vulvovaginal candidiasis, balanitis) due to glucosuria

Dehydration → weight loss, orthostatic hypotension

Severe diabetic ketoacidosis (was mentioned in the q-)

91. Which sentences are correct regarding pancreatic cancer:

a. most often it is an adenoma from pancreatic ductal cells, located in the pancreatic shaft, and 40-50% of patients survive after total surgery for 5 years

b. after complete surgery 40-50% of patients survive 5 years

c. most often located in the body of the pancreas

d. most often it is an adenoma of pancreatic ductal cells, located in the pancreatic body

e. most often it is an adenoma from pancreatic ductal cells

92. Identify the false sentence regarding thrombocytopenia:

a. small petechiae on the skin are typical symptoms of thrombocytopenic bleeding

b. drug induced thrombocytopenia occurs most frequently after the use of heparin

c. splenectomy is the first-line treatment for ITP

d. immune thrombocytopenia may resolve spontaneously in some patients

e. in the diagnosis of thrombocytopenia, it is advisable to determine the number of platelets in a sample collected "on the citrate" in order to exclude pseudo-thrombocytopenia

93. choose the correct statement:

a. autosomal dominant cystic kidney disease in exceptional cases leads to end-stage renal failure

b. nephritic syndrome is characterized by hypertension, moderate edema, decreased urine output, active urine sediment

c. the most common cause of nephrotic syndrome is hypertensive nephropathy, not because of KZN

d. men suﬀer from SLE more often

e. Klebsiella pneumoniae is the most common pathogen causing UTIs

94. What is not a risk factor of progression in diabetic kidney disease (diabetic neuropathy)

a. inhibition of renin-angiotensin-aldosterone system (RAAS)

b. activation of renin-angiotensin-aldosterone system (RAAS)

c. hyperlipidemia

d. smoking

e. Hypertension

95. The following metabolic disturbances are characteristic for tumor lysis syndrome, except for:

HINT:

"PUKE calcium" - phosphate, uric acid, kalium is elevated - calcium is low!

a. Hypercalcemia

b. Hypocalcemia

c. Hyperkalemia

d. Hyperuricemia

e. Metabolic acidosis

96. The causes of chronic pancreatitis:

The TIGAR-O system categorizes etiologies of chronic pancreatitis: Toxic-Metabolic, Idiopathic, Genetic, Autoimmune, Recurrent acute/severe pancreatitis, and Obstructive (cystic fibrosis, stones)

also Severe hypertriglyceridemia (levels > 1,000 mg/dL)

a. Alcohol

b. Smoking

c. Hereditary

d. Hyperparathyroidism

e. All of the above

97. Aterial Blood Gas to analyse:

a. Metabolic acidosis

b. Respiratory acidosis

c. Metabolic alkalosis

d. DIC

e. Metabolic acidosis with respiratory compensation

98. Liver metastasis are the most common in the malignancy of:

a. CNS

b. thyroid gland

c. large intestine

d. ovary

e. testicles

99. Typical leasions in the course of infective endocarditis (IE) found in echocardigraphic examination are:

a. vegetations

b. abscess, pseudo aneurysm, intracardiac fistula

c. valve perforation or aneurysm

d. new partial dehiscence of a prosthetic valve

e. all of above

100. Mark the drug that is not an oral anticoagulant

a. warfarin

b. rivaroxaban

c. ASS (acetylsalicylic acid)

d. dabigatran

c. acenocoumarol

Question 1/100

A 55-year-old man with type 2 diabetes mellitus, hypertension, and hyperlipidemia presented to the Cardiology Outpatient Clinic with complaints of a localized, pinpoint stabbing sensation in the left side of the chest that accompanies physical exertion and occurs especially when lifting heavy objects. There is also tightness in the chest when climbing the 3rd floor, but this is not a concern for the patient. What is the correct follow-up?

a. Electrocardiographic stress test

b. A non-invasive stress test with imaging

c. The patient is referred to the cardiology department for elective coronary angiography

d. patient does not require further diagnostics

e. Refer the patient to the cardiology department to rule out myocardial infarction and perform urgent coronary angiography

Question 2/100

Which of the following diseases can cause anemia of chronic disease?

a. Bacterial infection

b. Condition following gastrectomy

c. Bacterial infection, malignancy, systemic lupus erythematosus

d. Malignant neoplasms

e. Systemic lupus erythematosus

Question 3/100

Tuberculous mycobacteria:

a. is the bronchial dissemination of mycobacteria initially located in the primary focus of Ghona

B. is the blood-borne dissemination of atypical multidrug-resistant mycobacteria

C. is the historical name for bovine two-lung tuberculosis

D. is a blood-borne dissemination of mycobacteria in the lungs, which only occurs in patients with AIDS

E. is the blood-borne spread of acid-fast mycobacteria to the lungs and other organs, including the brain

Question 4/100

An answer is required

In the differential diagnosis of asthma and chronic obstructive pulmonary disease (COPD), the diagnosis of COPD is supported by:

A. The disease usually progresses slowly over years despite treatment, and airflow limitation through the airways is fixed

B. Airflow limitation is permanent.

C. The disease usually progresses slowly over years despite treatment

D. Onset of disease usually in childhood, but can be at any age

E. Onset of disease usually in childhood, but can be at any age and Airway airflow limitation is fixed

Question 5/100

An answer is required

Cardiac death in patients with symptoms suggestive of myocardial ischemia and presumed new ischemic changes on the ECG before cardiac troponin levels were measured or became abnormal meets criteria for myocardial infarction type:

A.1, 2 i 3

B.1

C.1 i 2

D.2

E.3

Question 6/100

In the diagnosis of colorectal cancer, the most important role is played by:

A. cancer-fetal antigen concentration

B. computed tomography

C. PET

D. colonoscopy

E. Ultrasonography

Question 7/100

Indicate the sentence that is true

> Keine AHnung!

Indicate the sentence that is true A.Due to hypernatremia, patients with hypometabolic breakthrough require therapy with a loop diuretic.

B.For hypometabolic breakthrough, levothyroxine and triiodothyronine (LT4 + LT3) preparations are acceptable

C.In a patient with a developed hypometabolic breakthrough, hypoxemia and hypocapnia are usually observed

D.In a hypometabolic coma, active warming of the patient is necessary due to increased hypothermia

E.The use of hydrocortisone in a patient diagnosed with hypometabolic breakthrough is contraindicated because of the potential for increased metabolism and worsening of hypothyroid symptoms

Question 8/100

Which type of stools according to the Bristol Stool Formation Scale occurs in diarrhea?

A. type 1 or 2 or 3

B. type 6 or 7

C. type 3

D. type 1 or 2

E. stool consistency is assessed according to the Boston Stool Formation Scale

Question 9/100

Which of the following statements is true:

A. anemia may occur in sarcoidosis, hypercalcemia is sometimes present, and most patients have elevated serum angiotensin-converting enzyme activity

B. sarcoidosis is a disease of known etiology

C.On chest computed tomography, cavities, infiltrates, and matted glass are characteristic of sarcoidosis

D. acute onset of sarcoidosis with erythema nodosum or with bilateral hilar enlargement generally has a poor prognosis

E. only hilar lymph nodes are enlarged in stage III sarcoidosis

Question 10/100

We should perform a renal biopsy in a patient with acute kidney injury when:

A. use of oral anticoagulants

B. Nephrotic proteinuria with erythrocyturia in the absence of concomitant diseases and signs of infection

C. normalization of creatinine concentration after placement of urinary catheter

D. fever with positive Goldflam's sign on the left side

E. diarrhea and concomitant use of angiotensin inhibitors within the first 48 h after admission

Question 11/100

The most common cause of superior vena cava syndrome is:

A.Compression of the vessel wall by malignant tumors (usually in the setting of lung cancer).

B.Compression of the vessel wall by an aortic aneurysm

C.Tumor of the right atrium

D.Congenital stenosis of the superior vena cava

E.Superior vena cava thrombosis associated with intravenous catheterization

Question 12/100

A 55-year-old man reporting a weight loss of 5 kg over the past month has an incidental blood glucose of 360 mg/dL. The patient reports polyuria and drinks approximately 7 liters of fluids daily. He is in very good general condition. The first step in treatment should be

A.Begin treatment with metformin with a gradual increase in dose

B.Determine TSH, FT3 and FT4

C.Refer patient to urgent care

D.Diagnose diabetes and administer NPH insulin

E.Determine glycated hemoglobin level

Question 13/100

Risk factors for contracting tuberculosis do not include:

A. drug use

B. silicosis

C. biological treatment with anti-inflammatory effects

D.dialysis therapy

E.BMI >35 kg/m2

Question 14/100

The most common causes of chronic kidney disease are:

A. amyloidosis, inflammatory uropathy, lupus nephropathy

B. sarcoidosis, HIV nephropathy, renal cystic degeneration

C.Systemic connective tissue inflammation, Alport syndrome, IgG4-related disease

D. hemolytic uremic syndrome, multiple myeloma, cANCA(+) systemic vasculitis

E. diabetic nephropathy, acute kidney injury, glomerulonephritis

Question 15/100

The most important screening test for diabetic kidney disease is:

A. urine leukocyte rollers

B. glomerular filtration rate (GFR)

C. glycated hemoglobin (HbA1C)

D. albumin/creatinine ratio in urine sample

E.serum creatinine concentration

Question 16/100

Hypertension is defined as resistant when:

A. despite maximal doses of 3 hypotensive drugs for 3 months, target blood pressure values are not achieved.

B. organ complications of hypertension occur despite normal ABP values.

C. despite taking at least 3 hypotensive medications, including a diuretic, in optimal doses and in appropriate combinations, blood pressure targets are not achieved.

D. there are elevated BP values measured by a physician or nurse practitioner and normal BP values measured at home.

E. it is not possible to select the appropriate antihypertensive treatment for the patient because of the side effects of the hypotensive medications used.

Question 17/100

Indicate the true statement regarding chronic lymphocytic leukemia:

A. there is no transformation to acute leukemia

B. is an indolent malignancy of morphologically mature B lymphocytes that are found in the blood, bone marrow, lymphoid tissue, and other organs

C. the least common form of leukemia in Europe and North America

D. mainly affects young adults

E. mainly originates from T lymphocytes

Question 18/100

Cancers of the esophagus:

A. are >90% squamous cell carcinoma and adenocarcinoma

B. are increasingly recognized benign tumors associated with Barrett's esophagus

C. all answers are correct

D. cause characteristic symptoms suggesting the presence of a lesion in the esophagus

E. are most commonly located in the proximal part of the esophagus

Question 19/100

A contraindication to starting renal replacement therapy is:

A.A sustained eGFR < 15 ml/min/m2

B.Severe nonresponsive acidosis resulting from ethylene glycol intoxication

C.Severe hyperkalemia with no response to conservative treatment

D.Disseminated malignancy with the presence of metastases

E.Pulmonary edema

Question 20/100

Which symptom is not included in the major diagnostic criteria (Rome IV) for irritable bowel syndrome?

A. abdominal pain

B. mucus in the stool and bloating

C. association of pain with bowel movements

D. Flatulence

E. mucus in stool

Internal Final

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