Final Year Questions for Medicine
These questions are typical of what is expected of a final examination of medical school. It will focus on normal variations, common disorders, and catastrophic illness.
For answers, if underlined, hover mouse over underlined area for three seconds.
- IM
- obs/gyne
- peds
- surgery
- emerg
- psych
- FM
- public/global
- ethics/law
- assessment
Internal Medicine
- clinical case multiple choice questions
- cardiology
- respirology
- gastroenterology
- nephrology
- neurology
- rheumatology
- endocrinology
- dermatology
- infectious disease
- random
Clinical Case Multiple Choice Questions
Your are the attending physician in a small hospital emergency department.
A 82 year-old man with moderate dementia is brought to the emergency department for collapse and severe abdominal pain. He is now semi-conscious. His landlord heard him scream and found him on the floor. No other history available.
When asked about his pain, the patient continues to point to his abdomen.
medical and surgical history
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medications (no allergies)
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social
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Questions
What is your first step? answer
What do you do about this? answer
What next? answer
And then? answer
Anything else? answer
A 70 year old man presents with an irregular pulse. All of the following indicate he is in atrial fibrillation EXCEPT:
- A - Irregularly irregular pulse
- B - Variable first heart sound
- C - Variable systolic blood pressure
- D - Loud fourth heart sound
- E - Absent a wave on JVP
answer more information
Anticoagulation with warfarin is not recommended in atrial fibrillation in which of the following patients:
- A - Previous embolus
- B - CHF
- C - Prior MI
- D - Isolated AF in a 40 yo female
- E - Significant mitral stenosis
answer more information
A 75 year old man with a history of AF and a prior embolic CVA does not want to take “rat poison”. He says it kills people from bleeding. You explain that the relative risk reduction in stroke with warfarin is:
- A - 95%
- B - 68%
- C - 30%
- D - 10%
- E - 1%
answer more information
Cardiology
- what are the physical findings of atrial fibrillation? answer
- what are the indications of warfarin for atrial fibrillation? answer
- what is the relative risk reduction of stroke with warfarin answer
- what are the indications for emergent cardioversion? answer
- what are the important signs and symptoms of aortic stenosis? answer
- what would one see collapsing atrial pulse? answer
- what medication helps relieve CHF symptoms, but not mortality? answer
- what is the RRR of BB in CHF? answer
- what are causes of MI in young, healthy people? answer
- what are the causes of cardiogenic shock immediately and over the days following MI? answer
- what murumur does mitral stenosis cause? answer
- what murmur does pulmonic stenosis cause? answer
- what are the major risk factors of ischemic heart disease? answer
- what are the indications for hospitalization for angina? answer
- what are the functional classes of angina? answer
- what are the signs and symptoms of pericarditis? answer
- what are the routine treatments for an NSTEMI? answer
- what are the contraindications to thrombolysis in MI? answer
- what anticoagulant can cause thrombocytopena? answer
- what are the side effects of BB?
- what are the side effects of amiodarone?
- what are the reversible causes of CHF? answer
- what can cause splenomegaly? answer
- what are the physical findings of endocarditis? answer
- when are S4 sounds heard? answer
- what are the various causes of ST elevation? answer
- what is the presentation of aortic dissection? answer
- what heart rhythms can cause transient loss of consciousness? answer
- what MI is associated with transient heart block? answer
- cause of fixed second heart sound answer
- cause of loud P2 answer
- cause of displaced, enlarged apex beat: answer
- with manual defibrillators, are paddles or pads preferred? Why? answer
- how should medications be given during recuscitation? answer
- what does electerical alternans occur with? answer
Respirology
- what causes tactile fremitus to change? answer
- In what lung region is blood flow highest? answer
- Where does expiratory flow limitation come from? answer
- What are the three types of atelectasis? where does the mediastinum move in each? answer
- What cells are present in hemodynamic pulmonary edema? answer
- Where does fluid accumulate in microvascular injury pulmonary edema? answer
- In congestive heart failure, where does fluid initially collect? answer
- Where is the damage in ARDS? answer
- how does a pleural effusion appear on physical exam? answer
- what causes pleural effusions? answer
- what two mechanisms cause bronchiectasis? answer
Nephrology
- what is the presentation of nephrotic syndrome?
- what are the signs and symptoms of hypercalcemia? answer
- what are the causes of hypercalcemia? answer
Neurology
- where is the oculomotor nucleus? answer
- what nucleus controls pupillary constriction? answer
- which CN has the longest pathway? answer
- what does CN III palsy cause? answer
- what CN problem will cause head tilt? answer
- what are the side effects of Tegretol on the fetus?answer
- what are the two slow adapting and two fast adapting skin receptors? answer
- what two CNs carry taste sensation? answer
- what are the two mechanisms of taste transduction? answer
- how do olfactory receptors transduce? answer
- what does sound push against on the inner ear? answer
- in the ear, where are hair cells sitting on and under? answer
- where is highest frequency best heard? answer
- what sensory information does not pass through thalamus? answer
- what is endolymph high in? answer
- what do vestibular nuclei receive input from? answer
- how does sound localization occur? answer
- what's the good of the middle ear? answer
- what is a life-threatening cause of hearing loss? answer
- what's a type of vertigo induced by certain head positions? answer
- how do you fix it? answer
- what might cause menieres? answer
- what nucleus processes taste, and what else does it do? answer
- what does the thoracic nucleus do? answer
- in the motoneuronal nuclei, are flexors anterior or posterior? answer
- which sensory fibres enter in the medial bundle? answer
- where in the thalamus does the medial lemniscus go? answer
- what are the fibres crossing over at the medial lemniscus? answer
- what cranial nerves emerge where in the medulla? answer
- where do corticopontine fibres go? answer
- where do the vagal parasympathetics come from? answer
- how about vagal motor functions? answer
- what does the inferior peduncle receive information from? answer
- where does the superior colliculus project? answer
- what does the posterior spinocerebellar tract carry, from where to where? answer
- where does the anterior spinocerebellar tract go? answer
- what are the criteria for dementia? answer
- what drugs work well for partial seizures? answer
- how to distinguish complex partial from absence seizures?
- what is is increased in huntingtons's disease? answer
- deep brain stimulation is done where in PD? answer
- what brain structure(s) suggested to be involved in OCD? answer
Rheumatology
What is the clinical scenarios:
- WBC 30,00, negative birefingent needle-shaped crystals answer
- WBC 2000, staw-colour fluid answe
Endocrine
- what are normal calcium levels? answer
- how does calcium
- what are some symptoms of hypocalcemia? answer
- what are some symptoms of hypercalcemia? answer
- what can be done about hypercalcemia? answer
- what does PTH do? answer
- what does it inhibit? answer
- what does vitamin D do? answer
- what is tertiary hyperparathyroidism? answer
- what does calcitonin do? answer
- where is calcitonin produced? answer
- what affects CBG levels? answer
- what stimulates production of testosterone? answer
- how come adrenal insufficiency causes hair loss in women but not men? answer
Dermatology
Infectious Disease
Random
Pediatrics Questions
- cardiology
- behaviour
- congenital
By when should undescended testicles be corrected? answer more information
What heart defect is accompanied by fixed S2 split? answer more information
A healthy man has a brother with cystic fibrosis. What are the chances that he's a carrier? answer more information
An 8 year-old presents to emergency with purple spots on her buttocks and legs, measuring 0.5-1 cm. What is the most likely?
- A - thrombocytopenia
- B - microscopic hematuria
- C - prolonged PT
- D - prolonged PTT
answer more information
When do children sit, supported by their hands?
What should exclusively breastfed infants be supplemented with? answer more information
What is the most effective treatment for ADHD? answer more information
When does handedness typically arise? answer more information
How does the timing of puberty onset of males and females relate? answer
What is the first sign of puberty in females? answer more information
What is the first sign of puberty in males? answer more information
How does Turner's syndrome present?
Presentation of croup
6 week old, staccato cough; bilateral conjunctival erythema? answer more information
A 14 year-old experiences PEA while playing basketball. What is the most likely finding on autopsy? answer more information
Parvovirus B19 signs and symptoms? answer
What best distinguishes Strep pharyngitis from EBV? answer
What are the most common bacteria causing acute otitis media? answer more information
What is the first-line treatment for otitis in someone with no allergy? answer more information
Which is NOT a common cause of pneumonia in pre-school-aged childre?
- A - influenza A
- B - Listeria monocytogenes
- C - Mycoplasma pneumoniae
- D - Streptococcus pneumoniae
- E - Hemophius influenzae
answer more information
A three year-old has vomiting and diarrhea for four days. He is moderately dehydrated. What should management be?
- A - hospitalization - iv therapy and normal diet therafter
- B - hospitalization - iv therapy and bland diet therafter
- C - oral rehydration therapy at home and normal diet therafter
- D - oral rehydration therapy at home and bland diet therafter
answer more information
What is the best treatment for acute salycilate poisoning?
answer more information
What is true regarding foreign body aspiration in preschool-age children?
- A - most children present win 24 hours
- B- small items such as coins or pebbles most most common
- C - classic triad seen in: cough, wheeze, decreased breath sounds seen in most
- D - most objects found in larynx or trachea
answer more information
Septic workup for 2 week-old answer more information
A 6 year-old boy is brought in with vomiting and diarrhea. He is quite dehydrated. What should the treatment be?
- A - ORS
- B - IV, D5 0.45% NS at 1.5 maintenance
- C - IV D5 NS bolus, then re-assess
- D - IV NS
What is acute seziure management? answer more information
Question about neonatal jaundice
What is the primary reason for weight loss in children with Crohn's disease? answer more information
What is least suggestive of Hirschsprung's disease?
- A - delayed meconium
- B - abdominal distension
- C - fecal soiling
- D - acute enterocolitis
- E - failure to thrive
answer more information
A boy has sx and TTG. What next
- A - gluten-free diet
- B - colonoscopy
- C - small bowel biposy
- D - steriods
What is the most common cause of obs
- A PS
- hirschprungs
- malrotation
- duodenal atresia
- gastroschesis
Four yo with tsp of fresh blood with BM. No other sx.
- Meckels s
- juv polyp xx
- IBD
- rectal ulcer
- allergic colitis
What is the typical age of presentation for Meckel's diverticulum? answer more information
What is lactose? answer more information
When do night terrors occur? answer more information
What is the most significant complication of chronic otitis media with effusion? answer more information
What is the most common cause of death for infants in Canada? answer more information
When are febrile seizures most common? answer more information
What is a typical radiological finding of duodenal atresia? answer more information
Twelve-month old with anemia. Most likely cause? answer more information
What is true about breath-holding?
- A - most common between 4-6 years
- B - common cause of SIDS
- C - may be the first signs of seizure
- D - can cause brain damage
- E - may lead to loss of consciousness
When is idiopathic scoliosis most commonly diagnosed? answer
What does drinking kerosene do? answer
Treatment for lice
Laryngomalacia
Presentation of foreign body
In-toeing: metatarsus adduction, then tibial torsion, then femoral anterversion
Continuous murmur: answer
Presentation of Kawasaki: What is the next step?
- A - isolation
- B - IV immunoglobulin
- C - IV antiobiotics
- D - oral antibiotics
- E - oral corticosteroids
How to treat rheumatic fever? answer
Asthma
SCFE: thyroid studies should also be done
When do hemangiomas appear?
How can these be treated? answer
What are the five T's that cause cyanotic heart disease?
truncus
transposition
tricuspid atresia
tetralogy of Fallot
total anomalous venous return
What is the most common regurgitant heart murmur?
Red reflex in a child appears white. What are you MOST concerned about? answer
Abdominal mass in two year-old. Hematuria and hypertension. answer
How to distinguish strabismus from pseudostrabismus? answer
What is delayed puberty? answer
What is the most common cause of ambiguous genitalia? answer more information
What are some causes of basophilia? answer
A premature infant (28 weeks) shows air bronchograms. What is the most likely cause? answer
What are the inheritance patterns for:
- NF 1 answer
- hemophilia A answer
- Huntington's disease answer
- sickle cell anemia answer
- phenylketonuria answer
Infant forceps left arm internaly rotated, forearm extended and pronated: answer
Surgery Questions
- peri-operative
- general surgery
- ear, nose, and throat
- plastics
- orthopedics
peri-operative risk
ear, nose, and throat
- what is a choleastoma? how does it cause hearing loss
- hat are the frequencies most necessary for the understanding of speech? answer more information
- what is the problem causing conductive hearing loss?
- what does the typical audiogram caused by noise-induced hearing loss show? answer more information
- what are acute complications of otitis media?
what are complications of tonsillectomy?
- A - death
- B - secondary hemorrhage
- C - peritonsillar abscess
- D - severe otalgia
Features of bacterial tonsillitis include the following EXCEPT:
- A - fever
- B - cervical lymphadenopathy
- C - otalgia
- D - cough
- E - tonsillar exudate
answer more information
The following will have a Type B tympanogram EXCEPT:
- A - otitis media
- B - TM perforation
- C - patent tympanostomy tube
- D - choleastoma
- E - otosclerosis
answer more information
Following statements regarding otosclerosis are the following EXCEPT:
- A - can be treated surgically
- B - caused conductive hearing loss
- C - is more common in men
- D - shows a Carhart's notch on an audiogram
- E - can be inherited in an autosomal dominant fashion
answer more information
The following are true regarding with congenital sensorineural hearing loss EXCEPT:
- A - can be caused by infections
- B - more common in NICU babies
- C - genetically, most frequently autosomal recessive
- D - usually associated readily identifiable syndrome
- E - most commonly caused by mutations in the Connexin 26 gene
answer more information
What drugs are NOT ototoxic?
- A - salicylates
- B - fluoroquinolones
- C - antimalarials
- D - platinum-based chemotherapy
- E - aminoglycosides
answer more information
How can you test for CSF otorrhea? answer
What is true regarding vocal cord nodules?
- A - pre-malignant
- B - caused by HPV
- C - typically unilateral
- D - hoarseness typically constant
- E - excessive voice used contributes
answer more information
What is the most common benign salivary gland tumour? answer more information
What is the most common cause of a painless, midline, 3cm neck mass in a five-year old?
- A - branchial cleft cyst
- B - infected delphian lymph node
- C - thyroglossal duct cyst
- D - cystic hygroma
- E - lymphoma
answer more information
What is true regarding nasopharyngeal carcinoma?
- A -south-east African?
- B - primary surgery excision primary treatment
- C - commonly assoc with CMV
- D - common presenting complaints include neck mass and/or hearing loss
- E - adenocarcinoma is the most common tumour
answer more information
All of the following are true regarding oral cavity cancer EXCEPT:
- A - SCC is most common
- dip
- leukoplakia and erythroplakia
- distant mets common
- lymphatic spread is frequently early
answer more information
What is the response to radiotherapy and chemotherapy for HNC? answer
The most common thyroid malignancy is
- A - papillary
- B - follicular
- C - medullary
- D - anaplastic
- E - lymphoma
answer more information
What the following statements regarding a thyroid nodule is true?
- A - most palpable nodules are malignant
- B - a 'hot' nodule on technitium-99 scanning rules out malignancy
- C - cycstic nodules are less likely than solid nodules
- D - TSH is usually deregulated in malignancy
- E - FNAB showing malignancy should be followed by treatment with radioactive I-131
answer more information
The following are risk factors for AOM EXCEPT:
- A - exposure to second-hand smoke
- B - breastfeeding
- C - daycares
- D - family history
- E - craniofacial abnormalites
answer more information
What of the following is TRUE regarding group A strep?
- A - rapid antigen test is excellent at ruling out GAS
- B - cough is typical
- C -
The following causes loss of smell EXCEPT:
- A - diabetes
- B - Azlheimer's disease
- C - schizophrenia
- D - hyperthyroidism
- E - viral illness
answer more information
What thyroid carcinoma is associated with MEN? answer more information
The following statements regarding tinnitus is TRUE:
- A -tinnitus is never ext audible
- B- most pychogenic
- C - degree correlates to with degree of hearing loss
- D - audiogram is recommended
- E - frequently successfully treated with meds
answer more information
- how is Meniere's disease diagnosed?
- how long does vertigo last with Meniere's disease? answer more information
- two month mild inspiratory stridor in an three-month old infant? answer more information
What is true re: epiglottitis:
- A - rare in childre
- B - post vessels
- C -
general surgery
30-yo sudden onset leg pain. Cold, pulseless, mottled cyanosis. Motor and sensory function impairment. Hx rheumatic fever and atrial fibrillation.
- A - thrombophlebitis
- B - embolus to femoral artery
- C - thrombosis of femoral artery
- D - Raynaud's pnenomenon
answer more information
62 iron deficiency anemia; recent change in bowel pattern, loarge obstruction. Most worrying concern after initial resuscitation?
- A - electrolyte imbalance
- B - strangulation obstruction
- C - metastatic disease
- D - cecal perforation
answer more information
A 25 year-old with ITP has a peristently low platelet count after high-dose prednisone. What of the following is best management?
- A - cyclosporin
- B - tacrolimus
- C - splenectomy
45 year-old female, sudden, severe RLQ pain. Leukocytosis. Most likely:
- ischemic bowel
- appendicitis
- gastroenteritis
- bowel obstruction
- cholecystitis
answer more information
Most common cause of fever during RBC transfusion? minor WBC antigens
49 yo woman, asympomatic spontaneous bloody nipple discharge from right side. Most likely? answer
Presentation and treatment of bacterial cholangitis?
Post-op repair of small bowel obstruction develops leakage of enteric contents from abdominal wound. No fever or pain. Management? answer
Following microcalcifations on mammography, core biopsy shows atpical ductal hyperplasia. What next? answer
Treatment of Paget's disease? answer
Woman, peritonitis, obstipation. Imaging - volvulus.
Barrett's esophagus: metaplasia (71%)
What is the most common cause of liver abscess? cholangitis
What is normal thickness of gallbladder wall? answer
Symptoms of insulinoma
Most common indication for surgery for diverticulosis answer
Fever during administration of pRBCs, otherwise asymptomatic. Treatment? answer
Woman, OTC, sudden onset abdominal pain and hypotension. U/S shows free abdominal fluid and a liver mass. Likely diagnosis? answer
Self-discovered breast lump. Next treatment? answer
Incidental gallbladder adenocarcinoma extending into submucosa discovered following cholecystectomy for gallstones. Treatment? answer
Gunshot, hypotensive. Most likely cause?
- A - reduced cardiac contractility
- B - decreased systemic vadcular resistance
- C - reduced left atrial filling pressure
- D - ineffective heart rate
answer more information
A 54 year-old has decreased persistent urine output 48 hours after following large volume blood loss. What is most consistent with ATN?
- A - creat
- B - BUN
- C - increased urine Na
- D - increased urine K
answer more information
A 58 year-old has hematemesis and melena. BP 100/70 and pulse 110. Next step?
- A - IV ocreotide
- B - endoscopy
- C - placement of Sangston-Breakmore tube
- D - IV fluids
answer more information
34-year-old post-splenectomy. Most common cause of sepsis?
- A - meningiococcus
- B - pneumococus
- C - Pseudomonas
- D - Staphylococcus
answer more information
Appendectomy, misdiagnosed. CT - fluid, air bubbles. Tx?
- A - appendectomy
- B - ileocecal resection
- C - percutaneous drainage
- D - IV antibiotics
answer more information
MVC. Flail chest management
- A - administer O2
- B - chest tube
- C - CXR
- D - FAST ultrasound
answer more information
Elevated in:
- A - AFP hepatocellular carcinoma
- B - CEA colon cancer
- C - CA 19-9 pancreatic cancer
- D - CA-125 ovarian cancer
MVC, hypotension, responds to fluid. Stable Management?
- A - splenectomy
- B - splenic repair
- C - laproscopic evaluation
- D - observation
answer more information
When to use adj chemo?
- A - location in rectum
- B - LN involvement
- C - submucosal infiltration
- D - association with bleeding
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What colonic polyp is most associated with malignancy? answer more information
A 68 year-old man presents with progressive abdominal pain, distention and obstipation x2d. No med/sx history.
- A - neoplasm
- B - volvulus
- C - intussusception
- D - internal hernia
answer more information
Acute chole, AMI 2 days ago
- A - IV antibiotics
- B - percutaneous cholecystostomy
- C - laproscopic cholecystectomy
- D - open cholecystectomy
answer more information
A 3cm cessile polyp in ascending colon that cannot be removed endoscopically. Biopsy shows villious adenoma with no evidence of malignancy. Which of the following is the best management?
- A - repeat biopsy in one month
- B - repeat biopsy in six months
- C - laparoscopic trans-colonic polypectomy
- D - right hemicolectomy
answer more information
MVC: femur # and liver laceration. Develops dyspnea 5 days following. O2 Sat 86% on RA. poor air entry to lung bases. CXR: bilateral basal atelectasis.
- A - ET intubation
- B - 1L fluid bolus
- C - IV heparin
- D - chest CT scan
answer more information
A 64 yo man has endoscopy and dilation; acute onset pain...
Three days after cholecystectomy, a 45 yo woman develops foul, non-bloody diarrhea. Endoscopy shows grey patches on mucosa. Best treatment?
- A - IV vanco
- B - metronidazole
- C - Lactobacillus
- D - amphotericin B
answer more information
A 68 year-old man presents with empyema. What is best management?
- A - long term antibiotics
- B - chest tube
- C - lobectomy
- D - pneumonectomy
answer more information
Fall from ladder, sx of tension. Treatment after 02:
- CXR
- ET
- chest tube
progressive weight loss after stroke. What to provide?
- A - enteric feeding via NG
- B - enteric feeding jejunostomy tube
- C - peripheral TPN
- D - parenteral nutrition via central venous catheter
answer more information
Tachycardia and hypotension following difficult cholecystectomy. Numerous cardiovascular risk factors. Most likely cause:
- A - MI
- B - arterial bleeding
- C - pulmonary embolism
- D -
What is a resp rate that is sustainable over time? 30/min
What is the hemodynamic profile suggesting sepsis? answer more information
Progressive pain, redness, swelling on right thigh. Temp 39.2 and wbc 19. Area shows tissue crepitus. Best management?
- A - IV metronidazole
- B - clostridial anti-toxin
- C - incision and drainage
- D - surgical debridement
answer more information
Question for hyperparathyroidism vs
Post-op pneumonia?
- A - cloxacillin
- B - levofloxacin
- C - meropenem
- D - heparin
answer more information
avascular necrosis of hip 7 y o: Legg-Calve-Perthes
SCFE: males 13-18, growing, heavier
most common cause of limping in children: trauma
most common cause in absence of trauma: transient synovitis
brittle bones and short stature: osteogenesis imperfecta
most common cause of tall stature:
Marfan: long extremeties, reduced vision, aortic aneurysm
leading cause of death in children
skeletal maturity is evaluated by X-ray at: wrist
how many bones in the wrist? eight
most common presentation of cerebral palsy: spasticity
14 yo boy complaining of aching on front of knee after exercise: Osgood-Sclatter disease
most common paralysis in polio: one leg
arthritis and black urine: alkaptonuria
most common complication of knee dislocation: poplitieal artery
most common glenohumeral dislocation: anterioinferior
most common bones for avascular necrosis: scaphoid, talar, femoral head
most common wrist fracture in young adults: scaphoid (navicular)
fat embolism syndrome: petechiae (50-60%) ARDS, CNS involvement
incidence with DVT is highest with total hip replacement
De Querevain's test: Finkelsteins test
shortened, internally rotated, adducted leg: posterior hip dislocation
fracture of distal third humerus causes injury to which nerve: radial
flexion deformity of distal IP joint: mallet deformity
62 yo man: unable to fully extend finger: Dupetryen's
dinner fork deformity: Colles'
ulnar nerve derives mainly from which nerve root?: C8
quad weakness with absent reflex - which nerve root? L4
inability to extend knee with depressed knee reflex: due to lesion in disc: L3-L4
weakness of plantar flexion and depressed ankle jerk lesion:
bunions are also known as: halux valgus
femoral nerve originates from:
lateral cutaneous nerve of the thigh:
carpal tunnel - which nerve: median
evaluation of meniscal tears: McMurray's test
when do wound infections tend to arise: 4-7 days
most likelt cause of joint infection: S. aureus
most common benign MSK tumour: osteochondroma
most common soft tissue malignant tumour in children: rhabdomyosarcoma
most common soft tissue malignant tumour in adults: liposarcoma
most common site of prostate mets: pelvis and spine
hemophilic arthritis: knee
most common indication for hip replacement: osteoarthritis
pseudogout: blue coffin crystals
pencil in cup on X-ray: psoriatic arthritis
Emergency Medicine Questions
- stabilization
- altered consciousness
- chest pain
- dyspnea
- abdominal and pelvic symptoms
- trauma
Altered Consciousness
A woman comes to the emergency department poorly responsive. She attempts to push the nurse away from starting an IV, opening her eyes to the pain and mumbling incomprehensibly. What is her Glasgow Coma Scale (GCS)?
- A - 7
- B - 8
- C - 9
- D - 10
answer more information
A woman arrives in the emergency room unresponsive. Over 30 minutes she gradually becomes wakes up returns to normal functioning. Which is the most likely cause?
- A - seizure
- B - arrhythmia
- C - overdose
- D - hypoglycemia
answer more information
A woman has a glucometer reading of 60 mmol. Which of the following would most likely describe the cause of her poor responsiveness?
- A - stroke
- B - heroin overdose
- C - hyperosmolar state
- D - alcohol overdose
answer more information
A woman has an ischemic stroke and is poorly reponsive. Where is the lesion most likely?
- A - parietal cortex
- B - occipital cortex
- C - brainstem
- D - cerebellum
answer more information
A man presents to the ED with symptomiatic ventricular tachycardia. What area of the heart is most likely infarcted?
- A - inferior MI
- B - anterior MI
- C - posterior MI
- D - right ventricular MI
answer more information
An EKG shows a delta wave. What is the most likely?
- A - Wolff-Parkinson-White syndrome
- B - atrial fibrillation
- C - atrial flutter
- D - Brugada syndrome
- E - third degree heart block
answer more information
Loss of consciousness immediately following which event would be NOT worrying?
- A - exercise
- B - immunization
- C - supper
- D - waking
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An alcoholic man is brought in unresponsive. His osmotic gap is 40, and ethanol level is 0. What to give?
- A - N-acetyl cysteine
- B - ethanol infusion
- C - naloxone
- D - flumazenil
answer more information
What is a normal anion gap? answer more information
What is the LEAST likely cause of metabolic acidosis?
- A - methanol
- B - acetaminophen
- C - iron
- D - isoniazid
answer more information
Electrolytes on a poorly responsive patient return as Na 145, K 4.1, Cl 110, Bicarb 10. What is the anion gap?
- A -
- B -
- C -
- D -
answer more information
A patient on dialysis, who has missed dialysis for the past three days due to a large snowstorm, is brought into the emergency department acutely short of breath. He is intubated using succinylcholine (as relaxant) and goes into PEA. What is treatment?
- A - begin CPR, arrange for immediate dialysis
- B - begin CPR, treat hyperkalemia
- C - begin CPR, treat with epinephrine and atropine
- D - begin CPR, give antidote for succinylcholine
answer more information
A patient with hemophelia A comes into emergency with severe headace and a subdural hematoma on CT. What treatment is recommended?
- A - transfusion packed red blood cells
- B - transfusion fresh frozen plasma
- C - infusion Factor VIII
- D - infusion Factor IX
answer more information
An 80kg man with burns: 5% 1st degree, 20% 2nd degree, 20%
What most adequaltely reflects adequacy of recuscitation in burn patient? urine output (0.5-1 cc/kg/hr)
Most characteristic feature of 2nd degree burn? blistering
First stage of skin graft healing?
- A - inosculation
- B - revascularization
- C - re-epithelialization
- D - plasmatic imbibition
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What describes tissue from another species? answer
Most common pattern of melanoma growth? answer
Most important prognostic feature of melanoma: Breslow thickness
Most common skin cancer: answer
Most common skin cancer in immunosuppressed patient: answer
When do fibroblasts first appear during wound healing? proliferation
most common hand fractures: distal phalanx
median nerve muscles: LOAF
Kanaval's cardinal signs of flexor tenosynovitis? answer
where does the ulnar nerve pass into the hand? answer
most common tumour of hand? answer
missed septal hematoma? answer
What is the max of lidocaine? answer
What is Cushing's reflex? answer
How do you calculate cerebral perfusion pressure? answer
What are the grades of spleen laceration?
What are treatments for hyperkalemia? answer more information
Trauma
Welder has severe eye pain after striking metal pin with a hammer. What is the most appropriate next step?
- A - antibiotics
- B - NSAIDs
- C - CT orbit
- D - patch the eye
answer more information
What are the treatments for acute-angle glaucoma?
A man has burns over his anterior chest, anterior abdomen, and anterior left arm. What percentage is burned?
- A - 17%
- B - 20%
- C - 23%
- D - 25%
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A 50 kg male has 2nd degree burns to 50% of his body. What are his fluid requirements for the first eight hours?
- A - 2L
- B - 5L
- C - 10L
- D - 15L
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What are the standard radiographic imaging in multitrauma patients?
- A - neck, chest, pelvis
- B - neck, abdomen, pelvis
- C - chest, abdomen, pelvis
- D - chest, neck, abdomen
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How many views on X-ray do you need to clear a C-spine?
- A - 1
- B - 2
- C - 3
- D - 4
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An MVC pt comes in with HR 130 and BP 80/60. Which of the following identified injuries should be treated LAST?
- A - large scalp laceration
- B - compound femur fracture
- C - aortic dissection
- D - spleen laceration
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What % of blood loss is required in trauma to consistently produce a drop in systolic blood pressure?
- A - 10%
- B - 20%
- C - 30%
- D - 40%
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What is the most sensitive for blood loss in a young person?
- A - heart rate
- B - skin tone
- C - postural blood pressure
- D - respiratory rate
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What can make pneumothorax worse?
- A - ascent while diving
- B - flying
- C - intubation
- D - all of the above
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What is the treatment of flail chest?
- A - analgesia and positive pressure ventilation
- B - needle decompression
- C - chest tube
- D - CPR
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What is LEAST likely to cause shock?
- A - isolated pelvic injury
- B - penetrating chest injury
- C - C-spine
- D - isolated head injury
- E - blunt abdominal trauma
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What is the shape and source of an epidural hematoma? answer
What is the shape and source of a subdural hematoma? answer
What is the IV fluid of choice for major trauma recuscitation? answer
What are the zones of the neck? answer
What are the findings with fat embolism syndrome? answer
What is the first test to be done for foreign body aspiration? answer
What treatments should be given for community-acquired pneumonia? answer
Fractures
Clavicle fracture: what other potential complications? answer
What is a Colles' fracture?
What is a Smiths fracture?
What is a Chance fracture? answer
What X-ray finding implies supracondylar fracture? answer
What other injuries are associated with calcaneal fractures? answer
What are the Ottawa ankle rules? answer
Psychiatry Questions
- anxiety
- depression
- psychosis
- child and adolescent
- medications
When do alcohol withdrawal seizures occur? answer more information
When does delerium tremens occur? answer more information
What is NOT common in conversion disorder?
- A - non-physiological symptoms
- B - la belle indifference
- C - blindness
- D - pseudoseizures
answer more information
What are the diagnostic criteria for somatoform disorder? answer
What is the management strategy for somatoform disorder? answer more information
What are the common side effects of haldol? answer
What antipsychotic medication has the highest risk of agranulocytosis? answer
What is NOT a diagnostic criteria of anorexia nervosa?
- A - refusal to eat
- B - distorted body image
- C - body weight <85%
- D - recurrent
answer more information
What is a physical finding with anorexia nervosa?
- A -
- B - dry skin
- C - chipped nails
- D - lanugo hair
answer more information
Can you diagnose personality disorder in adolesence? answer more information
Are factitious disorder aware of their motivations? answer more information
Lamotrigine - Stevens-Johnson syndrome
Family Medicine Questions
- hypertension
- pain
- periodic health care
Hypertension
What proportion of the arm circumference should be covered by the bladder cuff? answer
How many blood pressure readings should be taken if making a diagnosis? answer
What is the auscultory gap? How common is it? answer
who should beta-blockers not be used in as first-line therapy for hypertension?
- first-line over age 60, reactive airway disease
What is required for the diagnosis of PCOS?
What is the most sensitive test to confirm PCOS? free testosterone
What may be used to improve chances of pregnancy in PCOS? clomiphine
Where should an infant below one year of age be vaccinated?
What supplementation should be given to formula-fed babies? answer
What is the recommendation for folate supplementation prior to prenancy in women with no risk factors? answer more information
What is the treatment of choice for trigeminal neuralgia? carbamazepine
How does polymyalgia rheumatica present?
low-grade fever, fatigue, difficulty getting in and out of a chair
A 34 year-old man comes to the clinic with a two-day history of facial pain, concerned about sinusitis. more information
- What are some of the signs and symptoms suggestive of bacterial sinusitis? answer
- What are the most common bacterial pathogens in adults? answer
- What are the most common bacterial pathogens in children? answer
- What are first-line treatments for adults and children? answer
A 17 year-old man comes to you with a two day, intense headache and vomiting, worsened with lights. more information
- what are the criteria for common migraine? answer
- what are common triggers of migraine? answer
- what is the likely pathogenesis of migraine? answer
- what are the first-line treatments for migraine? answer
- second-line treatments? answer
- third-line treatments? answer
- what are prophylactic options for migraine? answer
A 72 year-old man discharged from hospital one week ago develops acute urinary retention. more information
- what would a common cause for his condition be? answer
- what medications can cause urinary retention? answer
A 54 year-old woman has not had a period for 6 months and wonders if she is in menopause. more information
- what is the definition of menopause? answer
- what are the most common symptoms of menopause? answer
- what are the risks and benefits of hormone replacement therapy? answer
- what are the recommendations for hormone replacement therapy? answer
A 44 year-old woman has irregular periods and spotting throughout her cycles.
- what is the most likely diagnosis? answer
- what are her treatment options? answer
A 20 year-old woman comes to you with a positive pregnancy test. Her last menstrual period was 10 weeks ago. more information
- what initial bloodwork should be carried out? answer
Public and Global Health
Burden of Disease and Death
What are the top three causes of death for the following populations:
- fetus
- infants
- children (5-18)
- adult men (19-60)
- adult women (19-60)
- senior men
- senior women
average life expectancy in the following countries (2009 data from CIA world factbook)
- Macau
- Canada
- United States
- the world
- Haiti
- Rwanda
- Uganda
- Mozambique
- Zambia
- Angola
Statistics
A study was carried out of a random sampling of adults a family practice, with five questions to screen for anxiety disorder. Of a group of 1000 adults, 500 reported three or more symptoms of anxiety, much of the time.
From this information, you can determine calculate if possible:
- A - rough incidence of anxiety
- B - rough prevalence of anxiety
- C - rough incidence and prevalence of anxiety
- D - neither incidence nor prevalence of anxiety
answer more information
All patients were more formally assessed, and diagnosis of anxiety disorder was made in 450 of these.
screen positive |
screen negative |
|
anxiety disorder |
445 |
5 |
no anxiety disorder |
55 |
495 |
How sensitive is the screening test?
How specific is it?
What is the positive predictive value of the screen?
What is the negative predictive value of the screen?
The family physican decides to screen his entire population of 5000 patients, in which the actual prevalence is 500. Given the above sensitivity, specificity, PPV, and NPV:
How many false positives would occur in this massive screen?
How many false negatives would occur?
The screen's ability to correctly diagnose those who actually have anxiety disorder is:
violence as a child |
no violence as a child |
|
anxiety disorder |
300 |
150 |
no anxiety disorder |
200 |
350 |
- what is the prevalence of anxiety disorder? answer more information
- what is the statistic used in this situation to evaluate possible statistical significance? answer more information
- what are the odds of developing an anxiety disorder if the adult experienced violence as a child? answer more information
- what are the odds of developing an anxiety disorder if the adult did not experience violence as a child? answer more information
- what is the odds ratio? answer more information
random questions
- a screening test for depression has a sensitivity of 0.90 and a specificity of 0.82. To derive the positive predictive value, you would also need to know: answer more information
- what is relative risk?
Of this series: 4,4,5,5,6,6,7,7,20
What is the mean?
What is the median?
What is the mode?
What is the range?
What is type I error?
What is type II error?
How do you calculate power of a study?
Given a variance of 25, what is the standard deviation? answer more information
Ethics and Law
Core Biology
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