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Question 1 of 20
1. Question
Component therapy is encouraged in transfusion medicine to avoid volume overload most especially in elderly patients. In a male patient with a current hemoglobin level of 96 g/L, how many units of packed red blood cell (PRBC) is needed to be transfused to raise the hematocrit level to 0.38?
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Question 2 of 20
2. Question
Which seronegative spondyloarthropathies associated with Human Leukocyte Antigen B27 most likely presents in a young man complaining of chronic lower back pain with morning stiffness for more than an hour which improves with exercise?
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Question 3 of 20
3. Question
The following miscellaneous cardiac “pathognomonisms” are correctly matched; except,
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Question 4 of 20
4. Question
A 20 y/o male complained of chest pains and difficulty in breathing. He was seen in the ED, and his vital signs were as follows: T = 37OC; PR = 88 bpm, regular; BP = 110/70 mmHg, RR = 20 cpm; and O2 sat on room air = 94%. PE revealed a rather anxious patient with no pallor, icterus, or cyanosis. JVP was normal. The apical pulse was in the 5th ICS MCL, and a murmur was heard that extended throughout the cardiac cycle. The most likely cause for this murmur is which of the following?
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Question 5 of 20
5. Question
A 69 y/o man with a history of coronary artery disease and hypertension presents with acute onset of right facial weakness and numbness. On examination, his speech and extremity strength are normal, but he has significant weakness of the right side of the face, including the orbicularis oculi. In addition, he complains of roaring in the right ear, and his taste sensation is absent on the right side of the anterior tongue. Sensation is normal to pinprick. Which of the following would best explain these findings?
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Question 6 of 20
6. Question
A 34 y/o man comes to your clinic complaining of “crushing” chest discomfort for 1 hour. He has no significant medical history. The ECG is normal but you still give sublingual nitroglycerin which immediately improves the pain. What is the next step in the management?
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Question 7 of 20
7. Question
A 60 y/o known diabetic patient was rushed to the ER for unresponsiveness. On physical examination, she was noted to have dry skin and oral mucosa with BP 100/70mmHg, HR 100 bpm, RR 28 cpm. RBS = 600mg/dL, urine – negative for ketones. What is the initial step in the management of this patient?
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Question 8 of 20
8. Question
A 30 y/o female is brought to the ER for lethargy. You noted dry skin and hair, periorbital edema and sparse hair on the armpit. Serum TSH and FT4 levels are low. What is your most probable diagnosis?
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Question 9 of 20
9. Question
A 35 y/o patient is brought for evaluation of confusion for a day. You find that she has an elevated BP, decreased air entry on right lung base with dullness to percussion, and symmetrical joint swelling of the wrists. Chemistry profile shows elevated creatinine with proteinuria on urinalysis. What is your diagnosis?
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Question 10 of 20
10. Question
Characteristic of Obstructive Lung Disease:
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Question 11 of 20
11. Question
Which of the following is characteristic of a transient ischemic attack?
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Question 12 of 20
12. Question
An 80-year-old male previously diagnosed to have duodenal bulb ulcer was admitted because of repeated bouts of vomiting previously ingested food of 2 months duration associated with weight loss and weakness. On PE, he was noted to have poor skin turgor and succussion splash. What is the probable diagnosis?
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Question 13 of 20
13. Question
A significant amount of pleural effusion accompanying pneumonia is an indication for:
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Question 14 of 20
14. Question
A 60-year-old female with known coronary heart disease was recently diagnosed to have hyperthyroidism probably due to Grave’s. The best treatment option for this patient is:
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Question 15 of 20
15. Question
An acute myocardial infarction that is transmural produces dramatic and characteristic electrocardiographic changes. The earliest change on ECG with an acute transmural infarction is:
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Question 16 of 20
16. Question
The patient is a 43-year-old male. He is anemic with a hemoglobin of 12.2 g/dl an MCV of 120 fL. Which of the following is the least likely diagnosis?
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Question 17 of 20
17. Question
The ECG of a 66-year-old male with a history of atherosclerotic heart disease reveals an irregular but rapid heart rate. The QRS complexes are normal but no P waves can be seen. The most likely reason for this finding is:
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Question 18 of 20
18. Question
One of your diabetic patient has a blood glucose level of 200 mg/dl. Surprisingly, a dipstick test is negative for urinary glucose. How could this finding be explained?
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Question 19 of 20
19. Question
A 67-year-old woman complains of gradually increasing fatigue. On physical examination, she is found to be anemic and has peripheral neuropathy characterized by loss of position and vibratory sense. Labs show macrocytic anemia and low WBC and platelet counts. Your impression is:
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Question 20 of 20
20. Question
Calcium and aluminum-containing antacids should not be given to patients taking which of the following?
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