Download Mikbaz I - moed A

Mikbaz I - moed A
1. Upon measuring a patient's potassium levels, the following results have been
attained (on repetitive samplings): 4.8, 4.9, 4.8, 4.7, 4.9, 4.8 mEq/L. From this
data we can conclude that:
a. The method has high accuracy
b. The method has low accuracy
c. The method has high precision
d. The method has low precision
e. We cannot conclude about the accuracy and precision of the method
according to the given data
2. Regarding the specificity and sensitivity of a given marker at a given cutoff:
a. When the cutoff is raised the sensitivity rises
b. When the cutoff is raised the sensitivity decreases
c. When the cutoff is raised the sensitivity is unchanged
d. No correct answer
3. In hemolytic blood it is not possible to evaluate:
a. Glucose
b. Sodium
c. Calcium
d. Potassium
4. Which of the following is correct:
a. The sensitivity of a test changes with the incidence of a disease
b. The sensitivity of a test does not change with the incidence of a disease
c. The higher the sensitivity of a test, usually the higher is the specificity
d. Sensitivity of a test reflects the prediction of lack of disease by a
negative result
5. What is the meaning of poor R-wave progression at leads V1-4:
a. Is common in weight lifters
b. Is a sign of significant pulmonary disease
c. Indicates a previous antero-septal MI
d. Indicates a technical problem in the connections of the ECG electrodes
6. What is the electrical axis in the following strip (pic. 1):
a. Minus 45 degrees
b. 0 degrees
c. 30 degrees
d. 90 degrees
7. Which of the following is most effective in prevention of spreading of
pneumonia in the hospital:
a. Giving wide range preventive antibiotics
b. Washing hands
c. Giving a permanent treatment with H2-blockers
d. Lying the artificially respirated patient on his belly
e. Lying the patient in the supine position
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8. All of the following are common causes of hospital acquired pneumonia after
more than 5 days of hospitalization, except:
a. Acinetobacter
b. ESBL type klebsiella
c. Hemophilus
d. MRSA type staphylococcus
e. Pseudomonas
9. One lung atelectasis causes:
a. Pushing the mediastinum to the contra lateral side
b. Pulling the mediastinum to the damaged side
c. Does not influence the mediastinum
d. Rises the mediastinum
10. Which of the following is characteristic to pulmonary embolism:
a. The common symptom is hemoptysis
b. In most cases signs of DVT can be found on physical examination
c. Most patients have arrhythmias with specific changes at the ECG
d. A normal ABG (arterial blood gas) test rejects the diagnosis
11. A usually healthy 52-year old man, a heavy smoker, presents with hemoptysis.
CXR, CT lung and PET CT demonstrate malignancy in the left upper lobe
without nodal enlargement and without metastases. FNA has demonstrated
squamous type cells with keratin pearls. The treatment of choice is:
a. Radiation followed by chemotherapy
b. Chemotherapy followed by radiation
c. Pneumonectomy of the left lung
d. Lobectomy of the LUL
12. Which of the following conditions causes hyper resonance at percussion of the
lungs:
a. Pneumothorax
b. Pneumonia
c. Pleural effusion
d. Atelectasis
e. All of the above
13. Low diffusion rates (DLCO) are probable to be found in all, except:
a. Restrictive parenchymatic diseases
b. Emphysema
c. Vascular diseases
d. Heavy smoking
e. Asthma
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Questions 14-15 refer to the following story:
A usually healthy 33-year old woman was referred to the ER upon acute dyspnea and
pain in the left chest, aggravated by deep inspiration. Denies cough. A day prior to her
admission she's been back from a long flight of about 8-hour duration. Aside oral
contraceptives takes no medications on a regular basis, non-smoker.
Physical examination: 22 breaths per minute, pulse 98 regular, BP 120/60,
temperature 37.5. Exam of lungs, heart, abdomen - no pathology found.
Laboratory: WBC=12300, ABG: pH=7.49, PCO2=28, PO2=70.
14. What is the clinical diagnosis that would explain the complaints:
a. Pneumonia
b. Pneumothorax
c. Pulmonary embolism
d. Pericarditis
e. Stress hyperventilation
15. What is the best imaging study for making the diagnosis:
a. Echocardiogram
b. CXR (chest X-ray)
c. US legs
d. CT angio
16. Slide number 3 - the diagnosis is UIP (a large bronchus is seen, resembling
bronchiectasis, but temporal heterogenicity and UIP characteristic could be
clearly seen).
All of the following are characteristic to the disease, except:
a. Chronic inflammation
b. Interstitial fibrosis
c. Multiple smooth muscle fibers in the connective tissue
d. Widening of the bronchi
17. Slide number 4 - the diagnosis is lobar pneumonia.
18. Foamy exudates in the airways is characteristic of:
a. CMV
b. Pneumocystic carini pneumonia
c. Aspergillus
d. Herpes virus
19. What is characteristic of atypical pneumonia?
a. Acute inflammatory effusion in the alveoli
b. Atypia of the respiratory epithelium
c. Interstitial inflammation
d. Granulomas
20. What is correct regarding tuberculosis?
a. Involvement of hilar lymph nodes is characteristic of secondary TB
b. Military TB is characterized by cavities in the lung
c. Positive Mantoux test indicates an active infection
d. Secondary TB is, in most cases, a result of primary TB reactivation
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21. What is correct regarding BAC?
a. Initiates at a large bronchus
b. Does not invade the stroma
c. The structure is solid
d. There is a wide necrosis
e. A common clinical manifestation is as atelectasis or emphysema
22. What is correct regarding solitary fibrous tumor of the pleura?
a. Related to asbestos
b. Glandular appearance
c. Atypical mesothelial cells
d. In most cases looks like fibrosarcoma
e. None of the above
23. What is the diagnosis of slide number 2?
a. Squamous cell carcinoma
b. Adenocarcinoma
c. Bronchioalveloar carcinoma
d. Carcinoid tumor
In questions 24-27 relate the statements with one of the diagnoses:
a. Bronchitis
b. Asthma
c. Emphysema
24. Rise in the incidence is related to the hygiene theory
25. Allergy tests are positive in a substantial part of the patients
26. The main etiology is not smoking
27. Airway obstruction as a result of elastic recoil loss
28. In a patient with damage to the right oculomotor nerve (3rd cranial nerve) due
to diabetes:
a. The pupil is dilated and not reactive to light
b. The pupil is constricted and not reactive to light
c. The pupil size is normal, it is reactive only to direct light, but not
consensual (light to the other eye)
d. The pupil is dilated and reactive to consensual light, but not to direct
e. None of the above
29. In case of demyelinating polyneuropathy:
a. We can reassure the patient that the damaged nerves would regenerate
and grow at the pace of 3-4 cm/month until the restoration of function
b. The amplitude of conduction motor potentials is lower than normal
c. We can reassure the patient that the damaged nerves would regenerate
and grow at the pace of 1-2 cm/month until the restoration of function
d. Conduction blocks are expected at the EMG test
e. The conduction is normal at the thick fibers, but is slow at the small
fibers
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30. For a patient with pain due to polyneuropathy:
a. The most efficient treatment is anti-inflammatory analgesic
b. The drug elatrol (amitryptilin) is the drug of choice for patients with
acute attacks of pain
c. The drug tegretol (carbamazepine) is the drug of choice for patients
with acute attacks of pain
d. The pain is usually asymmetric
e. The pain disappears from the areas where the skin sensation disappears
31. All of the following are correct regarding tremor, except:
a. Tremor can involve one or several limbs, the head, the lips, or all
together
b. Hand tremor can be at rest or at function
c. The tremor is usually irregular, unlike other involuntary movements,
which are regular
d. Head tremor is common in essential tremor
e. Essential tremor is mostly familial
32. Injections of the botox toxin are used as treatment in all of the following,
except:
a. Focal dystonias
b. Myasthenia gravis
c. Over perspiration
d. Tremor and tics
e. Spasticity
33. Which of the following is correct regarding cervical dystonia?
a. It is a focal dystonia with poor reaction to botox treatment
b. It is a facial dystonia, causing forced closure of jaws
c. It is a segmental dystonia, involving head, neck and thorax
d. It disappears during sleep
e. The most common cause for this dystonia is trauma
34. All of the following are symptoms of Parkinson disease, except:
a. Loss of coordination
b. Rest tremor
c. Slowness
d. Muscle rigidity
e. Mask face
35. Motor side effects can follow treatment with levodopa. In which case are
motor side effects more common?
a. In older patients with no relation to the duration of disease
b. In patients with long duration of disease
c. Motor side effects are unrelated to the drug dosage
d. In patients, who are additionally treated by comtan
e. In women
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36. A 23 year old woman presents to the ER with an attack of extremely intense
headache for 3-4 hours, accompanied by nausea and sensitivity to light and
noise. This is the third attack of the kind during the last 6 month. The
neurological examination is normal. The symptoms are most likely to direct us
to the diagnosis of:
a. Acute sinusitis
b. Subarachnoid hemorrhage
c. Trigeminal neuralgia
d. Migraine attack
e. Intracranial hemorrhage
Suggested answers:
1.
2.
3.
4.
5.
6.
7. b
8. c
9. b
10. b (I think it's a)
11. d
12. a
13. e
14. c
15. d
16. d
17.
18. b
19. c
20. d
21. b
22. e
23. d
24. b
25. b
26. b
27. c
28. e
29. d
30. c
31. c
32. b
33. c, d
34. a
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35. b
36. d
37.
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