INTERNAL MED PAST PAPER Year 4 Internal Medicine Notes

INTERNAL MED PAST PAPER Year 4 · Internal Medicine Collection: 4TH YEAR ALL NOTES / IMED / internal medicine revision / papers -- 6Immunological evidence of immunity to hepatitis B is the presence of A. hepatitis B core antibodies i é hepatitis B core antigen hepatitis B surface antibodies D. hepatitis B surface antigen E. any of the above 7 The most correct statement regarding the Child-Pugh score for liver disease is that A. a high-risk score is not possible with normal aminotransferase levels% B. a high-risk score is possible without encephalopathy 4 prothrombin time greater than 10 seconds above normal confers extra points to the raw score D. it has not heen validated for non-shunt and non-transplant laparotomies # E. it was originally developed for patients undergoing hepatic transplantation 4 8. A patient with a third episode of gastrointestinal hacmorrhage from an unknown site should first be offered: A .Early endoscopy B.Barium radiology C.Laparatomy @Imravenousacid-suppres s' there E. A sengstaken tube\n\ntement is fajse? g in infancy with severe chronic constipation s growth faltering abdominal distension persist. of life with feed inlDleLancBL/ ration in acute gastroenteritis are the following except? A‘months Tue to decreased surface afea to volume‘gflc/ el tic load of an exclusive milk diet ) F A P “Bottle fex predaminamlyvd Lk 7 R 'D. Frequent stools ( 5 day) and vomiting ( twice a day). ~~ /19, Cardinal signs that indicate hypovolaemic shock are include all except? A. Weak/absent pulse;v” E Lz B/-AVPU < A gr any alteration in the level of conciusness C. Cold hands Temperature gradient D. Capillary refill 3 s€cs A-sunken eyes: 20. The common presentation for acute pancreatitis is? A, right hypochondria pain that radiates to the back/. B ? severe abdominal pain that is initially epigastric and later generalized with tebound tenderness and guarding - ) C. left hypochondrial pain with radiation to the neck” Dr severe abdominal pain predominantly in the umbilical quadrant with generalization and rebound tenderness. g /f none of the above. 21, All of the following statements are TRUE about gastroesophageal reflux disease (GERD) e ) # EXCEPT: P. ERD is a benign illness without any life-threatening complications / BMany infants with GERD can be treated successfully with conservative measures alone C. Symptoms are frequently non-specific, such as failure to thrive and irritability D. H2-blocking drugs (e.g., ranitidine) have a role. e E. Surgery should be done for severe cases with life th reatening aspirations. 22. A 2-month-old, otherwise healthy boy presents with several episodes of %'fing’\ and no bowel movement for 4 days. His parents state that he has had difficulty pa/ssi ng,hMe birth. His abdomen is distended, and stool is palpable in the suprapubic region. His r@@'fimmfian reveals no fissures, and no stool is palpable on digital examination. He has a bowel movement remOVEyour finger, Which of fhe Tollowing statements 15 PRUE about the most likely etiology™of this patient’s constipation? ~ g A). Caused by neurotoxins elaborated by bacteria in the GI tract 5\n\n¥. N M‘anse:’. by an absence of parasympathetic ganglion cells in the intcstinc\/ C). Likely due to a combination of behavieral and environmental factors D). Caused by poorly functioning endocrine glands et 23. A 3-year-old girl presents to the ED with fever, vomiting, and abdominal pain. She has right upper quadrant tenderness and hepatomegaly. Her serum fransaminases are elevated, but her total and direct bilirubin are only slightly above normal. Several other children in her day care are sick with similar symptoms. Which of the following statements is FALFS E; ~ A. Most patients with this illness do not develop fulminant or chronic disease B. Jaundice is common in young children with this illnessA- ) @ Highly effective vaccines exist against this discase « E/[& D. Most commonly transmitted by fecal-oral contact « A None of the above. 24. A S-year-old boy presents with abdominal pain. Potential causes of his abdominal pain include: A. Pneumonia e B. Streptococal throat infection ©7 Testicular torsion D). Diabetic ketoacidosis 7 All of the above” 25. Among the hepatitis viruses, the hepatitis B virus (HBV) is unique becausg: A) liver injury is mediated through the immune system i é B) the presence of antibodies to HBV indicates protective immunity &‘i’t has similarities to human retroviruses because it is a DNA virus which replicates through an RNA intermediate D. itis the only agent to cause fulminant hepatic failure J. it has a glycoprotein coat enclosing a viral nucleocapsid 26. Recognized complications of acute hepatitis A include all of the following except: fulminant hepatic failure./” atic adenocarcino; G ) chronic hepatitis cholestatic hepatitis . triggering autoimmune hepatitis . Common causes of secretory diarrhea in children include all of the following except vibrio cholerae infection . chlostridium hominis D C. giardia lamblia