Internal-Medicine

278 14: Comprehensive Review
21. Which of the following features best characterizes
CLL?
following features is characteristic of muscle
weakness in RA?
(A)
(B)
(C)
(D)
(E)
usually a T-cell disorder
a disease of children
responsive to splenectomy
frequently asymptomatic
most common in Asians
22. A 69-year-old man with alcoholic cirrhosis
develops confusion and sleep disturbance.
Which of the following is the most likely cause?
(A)
(B)
(C)
(D)
(E)
occurring after several months of pain
and immobility
showing a neutrophilic infiltrate on
muscle biopsy
secondary to vasculitis
showing heavy mononuclear cell
infiltrate on muscle biopsy
showing type II fiber atrophy and
muscle fiber necrosis on muscle biopsy
(A)
(B)
(C)
(D)
(E)
digoxin
furosemide
penicillin
gastrointestinal (GI) bleeding
stroke
23. An asymptomatic patient has proteinuria and
hematuria that is glomerular in origin on a routine
urinalysis. Which of the following is the
most likely diagnosis?
(A) diabetes mellitus (DM)
(B) amyloidosis
(C) immunoglobulin A (IgA) nephropathy
(Berger’s disease)
(D) focal glomerulosclerosis
(E) thalassemia minor
24. A 63-year-old man with a 60-pack-per-year history
of smoking has been previously diagnosed
as having emphysema. Which of the following
features is most characteristic of this diagnosis?
(A) mild dyspnea
(B) copious purulent sputum
(C) hematocrit over 55%
(D) severe pulmonary hypertension at rest
(E) decreasing diffusing capacity
25. A 26-year-old man with a recent diagnosis of
rheumatoid arthritis (RA) complains of muscle
weakness in his hands. On examination, he has
multiple active joints in his hands and wrists.
Strength in the hand muscles and wrist flexors
and extensors is reduced (graded 4 out of 5).
Strength in his legs is normal. Which of the
26. An 18-year-old woman with a microcytic
anemia is diagnosed with alpha-thalassemia.
Formation of which of the following hemoglobins
is increased in alpha-thalassemia?
(A)
(B)
(C)
(D)
(E)
H
A
F
A2
C
27. Which of the following is most characteristic of
diabetic neuropathy?
(A)
(B)
(C)
(D)
(E)
it is usually bilateral
pain is not a feature
it most commonly affects the brain
it spares the autonomic system
it responds to meticulous control of
blood glucose
28. A 57-year-old man, previously asymptomatic
and on no medications, develops a painful left
big toe. It is so painful that even the weight of
his sheets is excruciating. On examination,
there is a swollen red toe. Which of the following
medications is relatively contraindicated?
(A)
(B)
(C)
(D)
(E)
indomethacin
colchicine
ibuprofen
allopurinol
naproxen
29. A 73-year-old woman is admitted to hospital
with right-sided hemiparesis and expressive
aphasia. CT scan of the brain reveals a stroke in