INTERNAL MEDICINE Year 4 Internal Medicine Notes OmpathStudy

INTERNAL MEDICINE Year 4 · Internal Medicine Collection: 4TH YEAR ALL NOTES / IMED / internal medicine revision / papers -- Mount Kenya UNIVERSITY EXAMINATIONS 2018/2019 SCHOOL OF MEDICINE DEPARTMENT OF INTERNAL MEDICINE BACHELOROF MEDICINE AND BACHELOR OF SURGERY (MBChB) DEGREE UNIT CODE: MBIM 4100 UNIT TITLE: INTERNAL MEDICINE (YEAR 4) DATE: WED 14™ AUG, 2019 8.00AM SPECIAL/SUPP TIME: 2 HOURS SECTION A: MCQ'S ONE ANSWER ONLY (ANSWER ALL QUESTIONS) 1. Which of the following drugs is likely to cause a lupus like syndrome? A. Baclofen. B. Insulin. @ Procainamide. —wes% D. Isoniazid. 2. Which antibodies are useful in making a diagnosis of systemic Lupus Erythematosus except? A. ANA. B. DS DNA. Anti-centromere antibodies. @Anti—hismne antibodies. — 3. What is the typical skin lesion in Scleroderma? A. Butterfly rash over the face. { B. Vasculitic ulcers on the legs. ‘/@ Thickened, hard skin D. Pitting oedema. / i 4. In what condition is anti-centromere antibodies found? { § b Page 1 Paper Two\n\nCREST syndrome. B. SLE. C. HIV D. Pneumonia. E. Polymyalgia rheumatica. 5..All the following are features of scleroderma expect A. Dysphagia B. Raynaud's phenomenon ¢ C. Skin contracture D) Calcification in all long hones' ~ &rthsse 6. A 35 years old lady complains dysphagia, Raynaud's phenomenon, sclerodactyly, investigation show antinuclear antibody, diagnosis is A.SLE (B) Systemic sclerosis C. Mixed connective tissue disorder D. Rheumatoid arthritis. 7. Which of the following is NOT a cause of Microcytic Anemia? L ( A. Thalassemia. f B. Anemia of chronic disease’— S < C. Iron deficiency anemia. / 0 v @ Pancytu peni'a.- 2MpP E. Lead poisoning. ek 8. The lab reports fora patient with low. MCV show high serum ferritin and low ;.TIBC. What is the most likely cause for this patient's anemia? A. Fe deficiency. - ko= Y Anemia secondary to inflammation. !. Thalassemia.— Tiee nvmal D. Hemoglobinopathy.\n9. Fe is absorbed in the: A. Stomach. Paper Two\n\n\ «I")I)uorlmmm, C. Jejunum, D. lleum. 10. Bone marrow transplant is indicated in which patien A. 55 years old 34 years old. 76 years old. D. 82 years old. . 67 years old. 11. Hemophilia A is characterised by which of the following feature A Deficiency of factor Viii. Hosr '!"“" = e B. Prolonged INR 3 Prolonged PT. . Deranged Liver function tests. 12. Hemophilia A is inherited by: A. Autosomal dominant. B. Autosomal recessive. X-linked recessive. D. X-linked dominant. 13. The term poikilocytosis means: A.RBCs with a normal content of hemoglobin V@abnurmalfy shaped RBCs C.RBCs that are irregular in size. D. Increased content of hemoglobin. 14. Anisocytosis is the changing in the: Page 3\n\nr:. Ble -~ Aoy;jm/u retener by by rbrareudls ashwho: 5- wygdloha wninoul Sfeafy Localnahe 4 anaes o4 of 1 }aumt Covre A. Shape of RBCs. Size of RBCs. €. Hemoglobin content in RBCs. D. Deposits within the nucleus. 15. Disseminated intravascular coagulation is characterized by all of the following except: A. Prolonged APTT, /- ) Lo PLT (ot s 8. Prolonged PT.—(? 1714 #E s C. Prolonged Thrombin time. D. Reduced fibrinogen levels,, V@lncreased fibrinogen levels. of the following Myelodysplastic syndromes has been found to have the poorest prognosis: A. Refractory anemia. B. Refractory anemia with ringed sideroblasts. C. Refractory anemia with excess blasts. D. Refractory cytopenias with multilineage dysplasias. 17. Bronchial asthma is characterized by all the following, except: A. Hyper active air way (B)Clubbing C. Spasmodic cough D. Bilateral chest wheezes 18. All of the following are common causes of empyema, except: A. Staphylococcal pneumonia B. Lung abscess IMeasles D. Chest injury 19. Wheezing is a hall mark symptom of V@ Asthma. Page 4 Paper Two\n\nB. COPD C. Cystic fibrosis. D. Lung cancer 20.Tree in bud findings and cysts on a High resolution CT scan of the chest are indicative of: a) COPD Bronchiectasis c) Asthma. d) Lung Cancer. 21. All of the following are increase risk of developing lung cancer except: A. Smoking B. Exposure to radon or asbestos C; Exposure to coal products or radioactive substances such as uranium History of seasonal allergies 22. Which of the following is not a recognized manifestation of Tuberculosis: A. Clubbing B. Gibbus C. Pericardial effusion Silicosis 23. What may be heard on thoracic auscultation in a patient with a pneumothorax? A. Increased lung sounds as the patient struggles to breathe B. Increased heart sounds Decreased or absent lung sounds D. Absent heart sounds. 24. What causes a pneumothorax? A. An accumulation of pus in the thoracic cavity Pages Paper Two NN 8. An accumulation of fluid in the thoracic cavity An accumulation of air in the thoracic cavity D. An accumulation of blood in the thoracic cavity. 25. What is the first line management for DVT? A. Aspirin. B. Clopidogrel. C. Warfarin. D. Fondaparinux. \/@ Low molecular weight heparin. 26. What is the target INR for patients on warfarin for the management o' A 1-2. 2-3. C.4-5. D. 5-6. f DVT?