Internal-Medicine

276 14: Comprehensive Review
6. A 30-year-old woman develops acute onset of
erythema nodosum, fever, malaise, and
anorexia. The chest x-ray (CXR) reveals bilateral
hilar lymphadenopathy and a left paratracheal
lymph node. Which of the following is
the most likely diagnosis?
(A)
(B)
(C)
(D)
(E)
acquired immune deficiency syndrome
(AIDS)
rheumatic fever
sarcoidosis
tuberculosis
bronchogenic carcinoma
7. Which of the following imaging techniques is
best able to measure regional brain substrate
uptake and metabolic kinetics?
(A)
(B)
(C)
(D)
(E)
magnetic resonance imaging (MRI)
computed tomography (CT)
positron emission tomography (PET)
serial thallium scintigrams
Doppler ultrasound
8. A 47-year-old man suddenly develops high
fever and hypotension. He has a generalized
erythematous macular rash, and over the next
day, develops gangrene of his left leg. Which of
the following is the most likely organism?
(A)
(B)
(C)
(D)
(E)
Corynebacterium diphtheriae
Streptococcus group C
Neisseria gonorrhoeae
Streptococcus group A
Salmonella enteritidis
9. A 56-year-old woman presents to the hospital
because of symptoms of dyspnea, blurry
vision, and headaches. On examination, her
blood pressure is 210/130 mm Hg, heart rate
100 beats/min, and oxygen saturation 95%.
Her fundi reveal retinal hemorrhages and
papilledema. The heart sounds are normal
expect for an S 4
, and the lungs have lower
lobe crackles. Which of the following is the
most appropriate agent to reduce her blood
pressure?
(A)
(B)
IV hydralazine
IV labetalol
(C)
(D)
(E)
oral methyldopa
IV diazoxide
sublingual nifedipine
10. A 56-year-old man complains of increased
thirst and increased urinary volume and frequency.
He has also noticed new symptoms of
constipation and generalized aches and pains.
He has no significant past medical problems
and his physical examination is normal. Initial
investigations consist of a normal complete
blood count (CBC) fasting blood glucose and
urinalysis. His sodium, urea, and creatinine are
normal, but calcium is 12.4 mg/dL (8.4–10.2
mg/dL). Further testing reveals an elevated
PTH level. Which of the following is the most
likely mechanism for the polyuria in this
condition?
(A) direct effect of PTH on the kidney
(B) hypercalcemia-induced renal tubular
acidosis (RTA)
(C) hypercalcemia-induced chronic renal
failure
(D) hypercalcemia-induced defect in renal
concentrating ability (nephrogenic diabetes
insipidus)
(E) hypercalcemia-induced defect in renal
glucose handling
11. A 13-year-old boy has periods when he seems
to be unresponsive, associated with blinking
of his eyes. These are momentary, and he seems
normal thereafter. Which of the following is
the most effective treatment?
(A)
(B)
(C)
(D)
(E)
phenytoin
carbamazepine
phenobarbital
gabapentin
ethosuximide
12. Which of the following lymphoid malignancies
is invariably of B-cell origin?
(A)
(B)
(C)
(D)
(E)
chronic lymphocytic leukemia (CLL)
hairy cell leukemia
Burkitt’s lymphoma
mycosis fungoides
angioimmunoblastic lymphadenopathy