Internal Medicine — all previous exam questions in one place
196
Total Questions
5
Exam Years
6
Exam Types
Filters
Showing 196 question(s)
A patient with heart failure and diabetes mellitus is receiving standard heart failure therapy. Which medication should be added because it improves outcomes in both conditions?
Which of the following statements regarding ischemic heart disease risk factors is WRONG?
Which of the following statements regarding right ventricular infarction is FALSE?
All of the following are potential causes of acute pulmonary edema EXCEPT:
Which of the following statements regarding aortic stenosis is NOT true?
Which of the following statements regarding aortic regurgitation (aortic valve incompetence) is FALSE?
A 50-year-old woman presents with ascites. Serum albumin is 2.6 g/dL and ascitic fluid albumin is 1.7 g/dL. What is the most likely cause?
Which of the following should NOT be used in the management of hypercalcemia?
A patient presents with hematuria and sensorineural hearing loss. What is the most likely diagnosis?
What is the most common causative organism of infective endocarditis?
A patient presents with hemoptysis and hematuria and is diagnosed with Goodpasture syndrome. What is the target antigen?
A patient with rheumatoid arthritis develops acute kidney injury after taking ibuprofen. What is the mechanism responsible for this complication?
A patient develops acute kidney injury following a crush injury. What is the underlying mechanism?
A patient presents with a serum creatinine of 2.2 mg/dL that improves after intravenous fluid administration. What is the most likely cause of acute kidney injury?
In IgA nephropathy, immunofluorescence microscopy is most likely to demonstrate:
A patient with asthma remains uncontrolled despite treatment with inhaled corticosteroids and SABA. According to GINA guidelines, what should be added next?
A patient diagnosed with bronchiectasis is found to have situs inversus. What is the most likely associated condition?
A patient presents with pleuritic chest pain, and HRCT shows a signet ring sign with bronchial wall thickening. What is the underlying pathophysiology?
Why is peritoneal dialysis preferred over hemodialysis in patients with frequent hypotension?
Why is serum creatinine not an ideal marker for estimating GFR?
Which of the following is considered first-line therapy for pulmonary arterial hypertension?
A 34-year-old woman presents with progressive dyspnea and chest pain. She has a history of pulmonary embolism and multiple spontaneous abortions. Physical exam reveals elevated jugular venous pressure and a prominent second heart sound. What is the most consistent physical finding in this patient?
Which of the following statements regarding Heart Failure (HF) is FALSE?
All of the following can be seen in typical decompensated Heart Failure (HF), EXCEPT:
A woman with Heart Failure and CKD (GFR 45) presents for a check-up. Urinalysis shows proteinuria. Which of the following is the most appropriate next step to slow progression?
A 71-year-old male with HFrEF (EF <30%) presents with acute worsening dyspnea. Which of the following is NOT a typical precipitating factor for acute decompensation?
All of the following are true regarding Heart Failure management, EXCEPT:
Which of the following is not a recognized feature or management approach for hypertrophic obstructive cardiomyopathy (HOCM)?
Which of the following is a characteristic finding in hypertrophic obstructive cardiomyopathy (HOCM)?
All of the following are potential causes of acute pulmonary edema, EXCEPT:
A patient has acromegalic features and a new diagnosis of diabetes. What is the best initial test?
A 25-year-old man reports excessive thirst and large-volume urine output. A water deprivation test reveals persistently low urine osmolality, which remains unchanged after desmopressin administration. What is the most likely diagnosis?
A 67-year-old man presents with dyspnea and hypotension after recent cardiac surgery. He has distended neck veins and muffled heart sounds. Which of the following findings would be least expected in this scenario?
A 70-year-old ICU patient diagnosed with urosepsis is started on empiric broad-spectrum antibiotics. After 48 hours, blood cultures grow E. coli sensitive to ceftriaxone. What is the most appropriate next step?
All of the following can commonly cause Acute Pericarditis, EXCEPT:
What is the primary pathophysiology of hypotension in massive pulmonary embolism?
All of the following statements about Ischemic Heart Disease (IHD) are true, EXCEPT:
A woman complains of shortness of breath (SOB) only after climbing several flights of stairs or significant exertion. She has no symptoms at rest. What is her WHO functional classification for Pulmonary Hypertension?
Which of the following statements regarding Ischemic Heart Disease (IHD) risk factors is FALSE?
Which of the following is the most common pathogen causing infective endocarditis?
Which of the following statements regarding Right Ventricular (RV) Infarction is FALSE?
A 55-year-old woman with known mitral regurgitation and pulmonary edema is diagnosed with pulmonary hypertension on echocardiography. Which of the following best explains the underlying mechanism?
Which of the following is an indication for surgical intervention in a patient with infective endocarditis?
A 45-year-old man presents with weight gain, moon face, and hypertension. Labs show elevated cortisol and ACTH not suppressed by high-dose dexamethasone. What is the most likely cause?
Which of the following is the recommended screening test to detect early diabetic nephropathy?
A 65-year-old patient with no current symptoms presents for routine follow-up. He has a history of hypertension and mild chronic kidney disease. What is the most appropriate step regarding his ongoing NSAID use?
Which of the following is NOT a variable used to calculate the estimated glomerular filtration rate (eGFR) using the CKD-EPI equation?
A patient is diagnosed with infective endocarditis following positive blood cultures. What is the next most appropriate step in management?
A female patient presents to the ER in distress. ABG results: pH 7.45, PaCO2 24 mmHg, HCO3 18 mEq/L. Which of the following best describes her acid-base status?
Which of the following is LEAST likely to be associated with a high anion gap metabolic acidosis?
A patient being treated with trimethoprim is noted to have an increase in serum creatinine without oliguria or other signs of renal dysfunction. What is the most likely explanation?
According to WHO classification, what is the most common cause of pulmonary hypertension in adults?
Which of the following statements regarding the QT interval or related syndromes is FALSE?
What is the primary mechanism responsible for anemia in patients with chronic kidney disease (CKD)?
Which of the following best defines chronic kidney disease (CKD) according to established diagnostic criteria?
A patient with stage 4 chronic kidney disease is noted to have persistently elevated parathyroid hormone levels and low serum calcium. Which of the following mechanisms best explains these findings?
In hemodialysis, why does the dialysate flow in the opposite direction to the blood (countercurrent flow)?
In a patient with an arteriovenous (AV) fistula for hemodialysis, which of the following changes occurs in the vein?
A 29-year-old woman presents with episodes of palpitations. ECG reveals a regular narrow-complex tachycardia with no visible P waves. The rhythm converts to sinus with carotid sinus massage. What is the most likely underlying mechanism?
A young patient develops a skin rash two days after starting antibiotics for an upper respiratory tract infection (URTI). Urinalysis shows WBCs and eosinophils, but no bacteria. What is the most likely diagnosis?
A patient undergoes cardiac catheterization with normal renal function initially. One month later, the patient experiences sudden loss of consciousness and cardiac arrest requiring CPR. Two days later, creatinine is severely elevated. What is the most likely cause of the acute kidney injury?
A 50-year-old female with Chronic Kidney Disease (CKD) and a GFR of 9 mL/min presents with nausea, vomiting, and arthralgia. What is the primary indication for initiating dialysis in this patient?
A patient presents with elevated serum creatinine and hyponatremia. Which of the following is the most likely underlying condition?
A woman with Heart Failure and CKD (GFR 45) presents for a check-up. Urinalysis shows proteinuria. Which of the following is the most appropriate next step to slow progression?
Which of the following is NOT a common symptom or sign of heart failure?
A 14-year-old boy presents with fever, migratory polyarthritis, and a new systolic murmur. Which of the following provides the diagnostic framework for confirming acute rheumatic fever?
A 55-year-old woman with known mitral regurgitation and pulmonary edema is diagnosed with pulmonary hypertension on echocardiography. Which of the following best explains the underlying mechanism?
A 71-year-old man with congestive heart failure presents with dyspnea. Chest X-ray shows bilateral pleural effusions. Which of the following is the primary pathophysiological mechanism causing the effusions?
Which of the following statements is false regarding modifiable risk factors for acute coronary syndrome (ACS)?
Which lipid-lowering agent is most effective at lowering LDL cholesterol?
A 34-year-old woman reports episodes of sudden-onset palpitations. ECG shows a regular narrow-complex tachycardia with no visible P waves. The episodes terminate with vagal maneuvers. What is the most likely underlying mechanism?
Which of the following is NOT a defined criterion for diagnosing Metabolic Syndrome?
A 19-year-old male presents with microscopic hematuria and mild proteinuria on urinalysis. There are no visible clots, and he is otherwise asymptomatic. What is the most likely underlying condition?
A 27-year-old man is found to have multiple bilateral renal cysts on ultrasound. He has a positive family history of kidney disease but normal renal function. What is the most likely diagnosis?
A 68-year-old man with chronic atrial fibrillation presents for routine follow-up. Which of the following findings would be LEAST consistent with this arrhythmia?
Which of the following types of glomerulonephritis is most characterized by a positive antineutrophil cytoplasmic antibody (ANCA) test?
Which urinalysis finding helps differentiate Glomerulonephritis (GN) from other causes of hematuria?
A patient with weight gain and hypertension is evaluated for secondary hypertension. A low-dose dexamethasone suppression test fails to suppress cortisol, and 24-hour urinary cortisol is elevated. Plasma ACTH levels are undetectable. What is the most appropriate next step?
Which of the following is considered a MAJOR Duke criterion for Infective Endocarditis?
Which of the following is TRUE regarding the anatomy and physiology of the pituitary gland?
A 58-year-old woman with long-standing rheumatoid arthritis presents with progressive tongue enlargement, bilateral leg edema, and frothy urine. Laboratory testing confirms nephrotic-range proteinuria. What is the most likely renal complication?
Which electrolyte abnormality is most likely to cause QT interval prolongation on ECG?
In hospitalized patients, which of the following is the most common cause of acute hypercalcemia?
A 72-year-old man with severe COPD and resting hypoxemia (PaO₂ = 52 mmHg) presents with worsening shortness of breath. Which intervention is proven to improve both survival and quality of life?
Which electrolyte abnormality is most likely to cause QT interval prolongation on ECG?
An elderly patient (60s) with a history of recurrent respiratory symptoms and yellow sputum has a CT scan showing bronchiectasis. What is the most likely causative microorganism?
A patient with well-controlled asthma who plays basketball presents with cough and shortness of breath two hours AFTER exercise. What is the most appropriate management?
A spirometry test reveals a ≥12% and ≥200 mL increase in FEV₁ following bronchodilator administration. Which of the following is the most likely diagnosis?
Which statement about the pituitary gland is true?
Which statement is NOT true about stable angina?
Regarding anginal chest pain with normal cardiac catheterization, all of the following are potential causes EXCEPT:
A patient with retrosternal pain and ECG showing anteroseptal STEMI has low blood pressure. Which statement is true?
Which statement is FALSE regarding cardiovascular risk factors?
Which heart sound is associated with heart failure and volume overload?
All of the following are classic signs of heart failure EXCEPT:
All of the following can cause acute pulmonary edema EXCEPT:
Which drug improves the prognosis/mortality in a patient with heart failure with reduced ejection fraction (HFrEF) presenting with PND and orthopnea?
A patient with congestive heart failure presents with sudden shortness of breath, low BP, and elevated creatinine. What is the most adequate treatment?
Gold standard diagnosis for Myocarditis:
Regarding pericarditis, which of the following is correct?
Kussmaul sign (JVP increase on inspiration) is seen in:
All of the following can cause acute pericarditis EXCEPT:
Which of the following is NOT a typical presentation of acute pericarditis?
Therapeutic range for INR in a patient with a mechanical heart valve:
Which valve is most commonly affected in Rheumatic Fever?
Which finding is NOT included in the minor criteria of infective endocarditis?
Which renal disease classically causes "muddy brown" granular casts in the urine sediment?
What is the most common underlying condition associated with Libman-Sacks endocarditis?
What is the primary role of ACE inhibitors in diabetic patients with microalbuminuria?
A patient treated for severe pyelonephritis develops acute renal failure. Which medication class most likely caused this complication?
A 24-year-old with a history of URTI presents with hematuria and proteinuria. There is a strong family history of CKD and deafness. What is the most likely diagnosis?
Hyperkalemia ECG changes include all of the following, EXCEPT:
Most common cause of nephrotic syndrome in children:
A patient has nephrotic syndrome with no changes seen on light microscopy. What is the next diagnostic step?
Hyperkalemia ECG changes include all EXCEPT:
Which electrolyte imbalance causes shortened QT interval?
A patient presents with SVT and is hemodynamically unstable (BP 70/50). What is the appropriate treatment?
Which of the following rhythms cannot be shocked (non-shockable)?
Painless hematuria in an elderly smoker is:
Lab results: Na 133, Cl 118, HCO3 5. What is the primary acid-base disorder?
Osler nodes and Janeway lesions are signs of:
Which is a potassium-sparing diuretic?
Which of the following is NOT a cause of hypokalemia and hypertension?
A patient presents with severe hypertension, hypokalemia, and metabolic alkalosis. What is the likely diagnosis?
Which electrolyte imbalance causes a shortened QT interval?
Which of the following findings is NOT typically seen in an uncomplicated severe asthma attack?
A 38-year-old female dies from life-threatening asthma. Which pathologic finding is LEAST likely to be seen at autopsy?
Which of the following is the major risk factor for asthma?
Which of the following patients is most appropriately diagnosed with asthma?
Which of the following is NOT an obstructive lung disease?
A 45-year-old smoker has chronic cough and increased AP diameter. Which statement is TRUE regarding his condition (COPD)?
Best initial test for suspected acromegaly:
Which of the following drugs used in the treatment of CHF has been shown to increase survival?
A patient has angina but catheterization reveals no stenosis. What is the likely cause?
A patient with heart failure, paroxysmal nocturnal dyspnea, and orthopnea with EF=30%. Which drug improves the prognosis?
In diabetics, which drug causes fluid retention and worsens heart failure?
An asthmatic patient who is pregnant is asking about her asthma medications. What should she stop?
A patient is now asymptomatic with normal spirometry after a cough/dyspnea episode. What is the next step?
A patient presents with enlarged hands, feet, and tongue. What is the diagnosis?
Which type of AV block is characterized by consistent PR interval prolongation but ALL impulses reaching the ventricles?
Which of the following is NOT found in nephrotic syndrome?
Prolongation of PR with all beats transmitted — fixed?
A hypertensive and diabetic patient has an irregular heart rate of 120-140 bpm. What is the most likely diagnosis?
A renal biopsy from a patient with severe acute nephritic syndrome (likely post-streptococcal glomerulonephritis) would most likely demonstrate which histological finding?
What indicates poor prognosis in glomerulonephritis (GN)?
Regarding hypercholesterolemia in an extremely high-risk patient, what is the target LDL level?
How do you differentiate Acute Tubular Necrosis (ATN) from a pre-renal cause of AKI?
An electrocardiogram (ECG) demonstrates ST-segment elevation in leads I, III, and aVF. Which coronary artery is most likely occluded?
Which of the following findings supports a diagnosis of COPD?
Which of the following cardiac rhythms is non-shockable?
A patient presents with unstable atrial fibrillation (BP 70/50). What is the treatment?
All of the following are correct about renin, EXCEPT:
All of the following are true about aminoglycosides, EXCEPT:
Which acid-base disturbance is most commonly associated with advanced renal failure?
Anginal chest pain with normal cardiac catheterization — all of the following are potential causes EXCEPT:
Which of the following is a Major Criterion in the Modified Duke Criteria for infective endocarditis?
What is a hallmark symptom pattern of COPD?
Which organism causing infective endocarditis is most likely associated with colorectal cancer?
All true about cardiac tamponade except?
Which physical exam finding is classically associated with constrictive pericarditis (and distinguishes it from cardiac tamponade)?
Acute pericarditis causes include all of the following EXCEPT:
False about dilated cardiomyopathy?
Which malignancy is most associated with ectopic ACTH secretion?
In a COPD exacerbation, after SABA, oxygen, and systemic steroids, what is the next step?
Which of the following statements about spironolactone is FALSE?
Which of the following is INCORRECT about spironolactone?
What is the most appropriate maintenance therapy after a severe COPD attack?
What are the most suggestive features for COPD in the clinical history?
What are the characteristic electrolyte findings in Addison's disease?
A patient presents with renal failure, back pain, and hypercalcemia. What is the most likely cause?
Which statement about Myocardial Infarction (MI) is FALSE?
A patient presents with constipation and muscle weakness. Labs show hypercalcemia. What tests should be ordered next?
All are heart failure symptoms except?
PFTs: TLC = 100%, DLCO = 80%, FEV₁ = 55%, FVC = 87%. What pattern do you expect in this patient?
Which of the following is NOT true regarding Prinzmetal's (variant) angina?
What is the mechanism of polyuria in Diabetes Insipidus (DI)?
An anteroseptal MI patient 4 hours after pain onset. Most appropriate management if PCI is not available?
Which of the following conditions does NOT cause tubular basement membrane deposits?
Which of the following statements is incorrect about Eplerenone?
All of these seen in restrictive cardiomyopathy except:
All of the following are true about renin release, EXCEPT:
All of the following are true statements about the loop of Henle in renal tubules, EXCEPT:
All the following statements are true about HOCM, EXCEPT:
All of the following statements are true about the loop of Henle in renal tubules, EXCEPT:
Choose the wrong answer regarding bradycardia and antiarrhythmic drugs:
All of the following are properties that make an ideal GFR tracer, EXCEPT:
Which of the following drugs is NOT used in the treatment of acute coronary syndrome?
All of these seen in restrictive cardiomyopathy EXCEPT:
Which of the following organisms is the most common cause of infective endocarditis in patients with a history of intravenous drug use?
A patient who returns several weeks after surgery with fever, malaise, and new-onset heart murmur is most likely suffering from:
Major criteria of Duke criteria for Infective Endocarditis:
A female with hypercalcemia, osteopenia, and elevated PTH — what is the next investigation?
A patient with normal spirometry does not respond to drugs. What is the next step?
Spirometry (Pre/Post bronchodilation: FEV₁ 55% → 65%, FVC 85% → 86%). What is the diagnosis?
Spirometry with obstructive pattern is seen in which of the following?
All of the following are TRUE regarding renin release, EXCEPT: