Medicine 1st Le

MEDICINE 1st LE 1.

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A positive Auspitz sign is pathognomonic for which of the following scaling disorders: a. Psoriasis vulgaris b. Ichthyosis vulgaris c. Pityriasis rosea d. Tinea versicolor A herald patch is the initial lesion seen in: a. Psoriasis vulgaris b. Pityriasis rosea c. Ichthyosis vulgaris d. Tinea versicolor Pemphigus vulgaris, an autoimmune blistering disease presents with flaccid bullae which easily ruptures. This level of split of the bullae is: a. Subepidermal b. Intradermal c. Subcorneal d. Subcutaneous A 35 year old female is diagnosed to have Stevens-Johnson Syndrome secondary to intake of anticonvulsant. What type of lesion should you look for? a. Discoid lesion b. Purpura c. Target lesion d. AOTA (all of the above) are correct A 65 year old male consults because of a deep ulcer on the medial malleoli area. The diagnosis is: a. Arterial ulcer b. Neurotropic ulcer c. Venous ulcer d. Decubitus ulcer A scar which spreads beyond the initial injury is: a. Hypertropic scar b. Keloid c. Both A and B d. Neither A nor B Scarring alopecia may presentation of a. SLE b. Syphilis c. Both A and B d. Neither A nor B

be

one

of

the

dermatologic

Alopecia in SLE is caused by: a. Telogen effluvium b. Anagen effluvium c. Autoimmune damage to the hair follicle d. AOTA A 25 year old male presents with multiple patches with fine scaling at the periphery on the trunk. Your diagnosis is Pityriasis rosea. Further PE revealed similar lesions on the palms and soles. You will now suspect that the patient has: a. Scabies b. Follicultits c. Secondary syphilis d. Psoriasis

a. b. c. d.

Psoriasis vulgaris Seborrheic dermatitis Allergic contact dermatitis Stasis dermatitis

14. Seborrheic dermatitis characteristically occurs on the a. Flexural areas in children, extensor areas in adults b. Scalp, nasolabial sulci, eyebrows, chest, back c. Sides of fingers and toes d. Elbows, knees, palms and soles 15. A 56 year old consulted because of multiple pruritic, closely grouped erythemaatous vesicles and papules that coalesce into coin-shaped plaques topped with crusts, on both lower extremeties. Your most likely diagnosis is: a. Impetigo b. Nummular eczema c. Folliculitis d. Tinea corporis 16. Satellite lesions are seen in which of the following conditions? a. Tinea corporis b. Pityriasis versicolor c. Onychomycosis d. Candidal intertrigo 17. Which of the following infections can be highly inflammatory and is very common in children? a. Pityriasis versicolor b. Tinea pedis c. Kerion d. Candidal intertrigo 18. A dull green fluorescence on Wood’s light examination can indicate infection with a. Trichophyton schoenleinii b. Microsporum canis c. Microsporum audouinii d. Malassezia furfur 19. The best area to obtain a high yield in KOH preparation of a tinea corporis lesion is in a. The center of the lesion b. The advancing border of the lesion c. A satellite lesion d. The dermis of skin biopsy specimens 20. Dermatophytes are fungi that a. Live in the superficial keratinized areas of the skin, hair and nails b. Cause inapparent systemic infections c. Require complex media for growth d. Invariably invade the subcutaneous tissue 21. The characteristic lesion seen in scabies is the a. Crust b. Burrow c. Nodule d. Excoriation 22. Scabies classically causes a. Daytime itch b. Itch anytime of the day c. Itch on the extensor areas of the body d. Nocturnal itch

10. The most common pattern in cutaneous drug eruption is a. Urticarial b. Pustular c. Exanthematous d. Blistering

23. Cold sores are usually caused by a. Herpes simplex virus 1 b. Herpes simplex virus 2 c. Human papilloma virus d. Pox virus

11. Acute eczema generally presents as a. Scales or crusting b. Hyperpigmentation c. Lichenification d. Vesicles

24. Genital herpes is usually caused by a. Herpes simplex virus 1 b. Herpes simplex virus 2 c. Human papilloma virus d. Pox virus

12. A 19 year old nursing student consults for recurrent very pruritic deep-seated tapioca-like vesicles on the sides of the fingers affecting both hands. Appropriate management include a. Mupirocin ointment b. Ketoconnazole cream c. Zinc oxide cream d. Clobetasol ointment

25. Bullous impetigo is usually caused by a. Staph aureus b. Group B Streptococcus c. Pseudomonas d. Corynebacterium m.

13. Koebner’s phenomenon is seen in which of the following conditions?

26. Hot tub folliculitis is usually caused by a. Staph aureus b. Grp B Streptococcus c. Pseudomonas

d.

Corynebacterium m.

27. Erythrasma is usually caused by a. Staph aureus b. Grp B Streptococcus c. Pseudomonas d. Corynebacterium m. 28. Molluscum contagiosum is caused by a. Herpes simplex virus 1 b. Herpes simplex virus 2 c. Human papilloma virus d. Pox virus 29. Type wart with malignant potential a. Flat wart b. Common wart c. Genital wart d. Subungal wart 30. A simple lab test to support the diagnosis of Herpes Simplex infection is a. KOH stain b. Polymerase reaction test c. Tzanck smear d. Gram stain 31. Which of the following organism produces diarrhea by producing toxins? a. Bacillus cereus b. Rotavirus c. Giardia d. Clostridium difficile 32. Which of the following is an indicator for further work up in a patient with diarrhea? a. Duration >24 hours with improvement of symptoms b. Elderly >70 years old c. Patients with low grade fever d. Watery, mucoid stools 33. Antibiotic prophylaxis is recommended for the following patients travelling to high risk countries a. Elderly b. Patients with mechanical heart valves c. Patients with gastric achlorhydria d. Patients with recent vascular graft 34. A 55 year old male with diabetes was admitted because of respiratory tract infection. A few days after antibiotics was started, patient developed abdominal pain, with fever, vomiting and bloody diarrhea. Most probable cause of the patient’s bloody diarrhea is a. Salmonella typhi b. Shigella sp c. Clostridium difficile d. E. histolytica 35. Diagnostic test that would confirm the diagnosis of the above patient would be a. Blood culture b. Stool exam c. C. difficile toxin assay d. Colonoscopy 36. Treatment for the above patient would be a. Ciprofloxacin b. Ceftriaxone c. Amoxicillin d. Metronidazole 37. A 35 year old missionary from Australia developed abdominal pain with 2-3 episodes of bloody diarrhea for 2 days after arrival to the Philippines. Patient has no signs of dehydration on examination. Most likely etiology of patient’s symptoms is a. Rotavirus b. Escherichia coli c. Entamoebal coli d. Helminthes 38. Aside from hydration, management for the above patient would include a. Viral culture b. Antibiotics c. Admit patient for observation d. Urgent colonoscopy

39. A 20 year old male patient developed diarrhea occurring >10x per day amounting to >1L/episode. Stools were characterized as rice-water appearance. Most likely etiology of diarrhea is a. Vibrio cholera b. Salmonella infection c. Entamoeba histolytica d. Bacillus cereus 40. A 30 year old businessman developed watery stools, 25/hpf; EC < 10/hpf b. WBC > 25/lpf; EC < 10/lpf c. WBC > 25/lpf; EC < 25/hpf d. WBC > 25/lpf; EC < 10/hpf

Fluconazole Rifampicin Clarithromycin

64. Recommended prophylactic antibiotic for high risk afebrile neutropenic patients a. Levofloxacin b. Cotrimoxazole c. Cefixime d. Co-amoxyclav 65. Regarding CMV infections among post-transplant recipients a. Pharyngitis and lymphadenopathy are frequent manifestations b. Splenomegaly is often present c. Fever and leucopenia are the usual findings d. Candidiasis is a common complication 66. In the evaluation of febrile neutropenic patients, the clinician’s most important task is to a. Immediately start on empiric antibiotic therapy b. Identify the most likely source of the infection c. Administer granulocyte colony stimulating factor d. Give prophylactic antibiotic 67. Among febrile neutropenic patients, one of the following increases the risk of complications and mortality a. Outpatient onset of fever b. Presence of solid tumor c. Female sex d. Hypotension

55. Post influenza bacterial pneumonia is frequently caused by a. Streptococcus pneumonia b. Haemophilus influenza c. Pseudomonas aeruginosa d. Staphylococcus aureus 56. Pneumonia plus extra-pulmonary finding of serous myringitis on tympanoscopy is commonly seen in a. Pneumocystis carinii pneumonia b. Chlamydia pneumoniae pneumonia c. Legionella pneumophila pneumonia d. Mycoplasma pneumoniae pneumonia

68. The inclusion of vancomycin in the initial antimicrobial therapy for febrile neutropenic patients is necessary when the patient manifests with a. Oral ulcers b. Loose stools c. Jaundice d. Oliguria

57. Appropriate therapy for community-acquired purulent meningitis of unknown cause in a previously healthy 20 yo residing in the Phils is a. Vancomycin + ceftriaxone b. Cefotaxime c. Ampicillin+ chloramphenicol d. Aqueous penicillin G

69. The recommended empiric antifungal drug for neutropenic patients, with persistent fever is a. Itraconazole b. Fluconazole c. Amphotericin B d. Flucytosine

58. The recommended initial therapy for suspected methicillinresistant Staphylococcus aureus infection is a. Ceftriaxone b. Clindamycin c. Cotrimoxazole d. Vancomycin

70. In community-acquired native valve endocarditis, the primary site of entry for Streptococcus bovis is the a. Oral cavity b. Skin c. Upper respiratory tract d. Gastrointestinal tract

59. The combination of penicillin and streptomycin recommended against what specific organism a. Streptococcus pneumoniae b. Enterococcus fecalis c. Moraxella catarrhalis d. Pseudomonas aeroginosa

in

71. Severe congestive heart failure to infective endocarditis is primarily due to the dysfunction of which valve a. Mitral valve (eto daw sagot accdg to dr javelosa) b. Tricuspid valve c. Aortic valve (answer key) d. Pulmonic valve

60. For patients with complicated intraabdomnial infections, like ruptured appendicitis or pericholecystic abscess, the most appropriate empiric antibiotic therapy is a. Cefazoline b. Cefuroxime c. Cefoxitin d. Ceftriaxone

72. Which of the following is a vascular phenomenon in infective endocarditis? a. Osler’s nodes b. Janeway lesions c. Roth spots d. Rheumatoid factor

61. The single most important risk factor for infection in patients with hematologic malignancy is a. Anemia b. Leucopenia c. Granulocytopenia d. Thrombocytopenia 62. The recommended form of management of asymptomatic HIV-infected patients, with a CD4 count of more than 500/mm 3 is a. Anti-retroviral therapy (HAART) b. Prophylactic antivirals c. Administration of isoniazid and cotrimoxazole d. Patient education 63. This drug is recommended for the prevention of Mycobacterium avium-intracellulare (MAI) infection in HIV patients with a CD4 count < 50/mm3 a. Cotrimoxazole

73. Appropriate antibiotic for prophylaxis against infective endocarditis for high-risk adults with penicillin-allergy undergoing an oral cavity procedure a. Cotrimoxazole b. Cephalexin c. Clindamycin d. Linezolid 74. The usual etiologic cause of acute bacterial endocarditis is a. Viridians Streptococci b. Enterococcus spp c. Staphylococcus aureus d. Coagulase-negative staphylococcus 75. To enhance its ability to adhere and invade intact endothelium, Staphylococcus aureus require this molecule, leading to infected vegetation a. Catalase b. Lipotechoic acid c. Dextran

d.

Clumping factor

76. Appropriate antimicrobial therapy endocarditis a. Cefazolin + gentamicin b. Ceftriaxone + gentamicin c. Ampicillin + gentamicin d. Vancomycin only

for

enterococcal

77. Antibiotic prophylaxis before dental procedures is recommended in the following cardiac conditions to prevent infective endocarditis a. Aortic stenosis b. Previous coronary artery bypass graft c. Mitral valve prolapsed with mitral regurgitation d. Previous history of endocarditis 78. For culture-negative IE, the recommended antibiotic is a. Penicillin b. Ampicillin c. Ampicillin-sulbactam d. Vancomycin 79. The most frequent clinical manifestation of patients with IE is a. Fever b. Heart murmur c. Joint pains d. Splenomegaly 80. Which of the following sites of intravascular lines poses the highest risk of IV catheter-related infection a. Jugular vein b. Subclavian vein c. Femoral vein d. Antecubital vein 81. Effective measures in preventing ventilator-associated pneumonia include a. Selective gut decontamination with non-absorbable antibiotics b. Replacement of ventilator tubings every 48 hours c. Elevation of the patient’s head to 30-45o d. Administration of sucralfate as stress ulcer prophylaxis 82. The mechanism of common cold transmission under conditions which results in a high percentage of cases is a. Large particles of respiratory secretions transported in air b. Hand contamination c. Direct contact with infectious secretions or environmental surfaces d. Infectious droplet nuclei suspended in the air 83. To prevent outbreaks of Varicella, aside from the usual standard precautionary measures, this form of transmissionbased precautions should be included in the management of patients with chicken pox in the hospital? a. Airborne only b. Droplet only c. Contact only d. Airborne and contact 84. One of the following measures target the removal of sources of pathogenic organisms a. Adequate immunization b. Antibiotic prophylaxis for high risk procedures c. Appropriate antimicrobial treatment of patients with infections d. Isolation procedures, including appropriate barrier procedures in handling patients 85. What is the most likely organism involved in vascular devise infections? a. Aspergillus b. Streptococci c. Haemophilus spp d. Coagulase-negative staphylococci 86. After the administration of lipid-containing fluids intravenously, the fluid infusion set should be changed a. 24 hours after completing the infusion b. 48 hours after completing the infusion c. Immediately once the infusion is completed d. No change of infusion aet is necessary 87. Nosocomial pneumonia frequently develops because of what mechanism

a. b. c. d.

Inhalation Aspiration Hematogenous dissemination Gastrointestinal translocation

88. The recommended prophylactic antibiotic for clean cardiac, orthopedic or neurologic surgery is a. Cefazoline b. Cefuroxime c. Ceftriaxone d. Ampicillin-sulbactam 89. The most common point of entry for infection related to intravascular devices a. Contaminated infusate b. Insertion site c. Leaking connections d. Contaminated tubings 90. Hygienic hand rubbing, using alcohol-based gel, is necessary in which of the following situations a. Before handling every patient in the ward b. Before any major surgical procedure c. During outbreaks of infection d. When performing routine tasks in the general ward 91. Which of the following does correctly applies to the etiology of sepsis? a. Gram negative and gram positive including fungi accounts for the majority of cases b. Microbiologic data is positive in the majority of cases with a clinical picture of severe sepsis and shock c. Microbial invasion of the bloodstream is not essential for the development of severe sepsis d. Blood culture yield is higher in severe sepsis than septic shock 92. Which of the following is considered a sign of organ dysfunction in sepsis? a. Central venous pressure of 12,000/UL c. Urine output 80cc in 1 hour of a 50kg individual d. Arterial systolic BP of 4.5 c. Homogenous vaginal discharge d. Strawberry-like appearance of the cervix 112. A 24 year old male with urethral discharge of 7 days onset after sexual contact with the infected partner associated with slight dysuria that reveal the following: Gram stain >5 pus cells/OIF and absence of gram negative diplococcic a. Chlamydia trachomatis b. Ureaplasma urealyticum c. Neisseria gonorrheae d. Trichomonas vaginalis 113. The method of diagnosis for Neisseria gonorrheae that determines drug sensitivity a. Antigen detection b. DNA hybridization c. Culture and isolation d. Nucleic acid amplification 114. Which of the following is a live attenuated vaccine a. Hepatitis B b. Pneumococcal c. Influenza d. Oral polio 115. Which of the following is true regarding inactivated vaccine a. Minimal interference with antibody production b. Immune response is similar to natural infection c. Replicate within the recipient’s immune system to be effective d. Effective with just a single dose 116. A vaccine that is contraindicated to be given and administered simultaneously with other vaccines a. Meningococcal vaccine b. Typhoid vaccine c. Yellow fever vaccine d. Influenza virus vaccine 117. The most common systemic adverse effect of a live attenuated vaccine a. Pain and swelling at site of administration b. Redness and induration c. Rash and angioedema d. Fever and malaise 118. Contraindicated to be given in severely immunocompromised individual a. Oral polio vaccine b. Pneumococcal vaccine c. Influenza virus vaccine d. Hepatits B vaccine Sorry kung ung iba walang sagot kasi di ko tlga maintindihan sa audio eh... mejo malabo kasi.. hehehe =) Happy aral and good luck!