Internal-Medicine
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280 14: Comprehensive Review<br />
38. A 65-year-old man presents with hemoptysis.<br />
His sputum cytology is positive for malignant<br />
cells, but the CXR is normal. Which of the following<br />
is the next best step in management?<br />
(A)<br />
(B)<br />
(C)<br />
(D)<br />
(E)<br />
annual CXR<br />
unilateral pneumonectomy<br />
blind percutaneous needle biopsies<br />
bronchoscopic brushings and biopsies<br />
mediastinoscopy and biopsy<br />
39. A 34-year-old man presents with dyspnea and<br />
increasing peripheral edema. He recently had<br />
a “flu like” illness with intermittent sharp leftsided<br />
chest pain. On examination, his jugular<br />
venous pressure (JVP) is elevated at 8 cm, heart<br />
sounds are soft and the blood pressure (BP) is<br />
125/80 mm Hg with a 20 mm Hg decrease in<br />
systolic arterial pressure during slow inspiration.<br />
Which of the following is the most likely<br />
diagnosis?<br />
(A)<br />
(B)<br />
(C)<br />
(D)<br />
(E)<br />
cardiac tamponade<br />
pulmonary hypertension<br />
ventricular septal defect<br />
coarctation of the aorta<br />
malignant hypertension<br />
40. A 45-year-old man develops end-stage renal<br />
disease due to diabetic nephropathy. He undergoes<br />
a renal transplant with a kidney donated<br />
from his sister. Which of the following immune<br />
suppression therapies are usually used to prevent<br />
rejection in renal transplant patients?<br />
(A)<br />
(B)<br />
(C)<br />
(D)<br />
(E)<br />
splenectomy and irradiation<br />
plasmapheresis and steroids<br />
cyclosporine and steroids<br />
azathioprine and plasmapheresis<br />
steroids and thymectomy<br />
41. A 42-year-old woman has a prior history of left<br />
eye pain and visual loss that resolved spontaneously.<br />
She now has diplopia and weakness<br />
with spasticity in her right leg. Which of the following<br />
is the most likely diagnosis?<br />
(A)<br />
(B)<br />
(C)<br />
cerebral emboli<br />
subclavian steal syndrome<br />
Guillain-Barré syndrome<br />
(D)<br />
(E)<br />
recurrent transient ischemic attacks<br />
(TIAs)<br />
multiple sclerosis<br />
42. A 16-year-old female presents with abdominal<br />
pain, joint discomfort, and purpuric spots on<br />
the skin. On examination, the abdomen is<br />
tender, but there is no rigidity or rebound tenderness.<br />
There are multiple palpable purpuric<br />
lesions on her skin, and there are no acute<br />
joints. Laboratory investigation reveals a<br />
normal CBC, but an abnormal urinalysis with<br />
hematuria and proteinuria. Which of the following<br />
is the most likely diagnosis?<br />
(A)<br />
(B)<br />
(C)<br />
(D)<br />
(E)<br />
hemolytic-uremic syndrome<br />
thrombotic thrombocytopenic purpura<br />
heavy metal poisoning<br />
subacute bacterial endocarditis (SBE)<br />
Henoch-Schönlein purpura (HSP)<br />
43. Which of the following drugs causes an<br />
increase in the effective refractory period of the<br />
atrioventricular (AV) node?<br />
(A)<br />
(B)<br />
(C)<br />
(D)<br />
(E)<br />
bretylium<br />
amiodarone<br />
procainamide<br />
quinidine<br />
disopyramide<br />
44. A 74-year-old postmenopausal woman is<br />
found to have hypercalcemia due to hyperparathyroidism.<br />
She has multiple medical<br />
comorbidities and decides against having surgery.<br />
Which of the following treatments might<br />
she benefit from?<br />
(A)<br />
(B)<br />
(C)<br />
(D)<br />
(E)<br />
estrogen therapy<br />
androgen therapy<br />
calcium therapy<br />
radioiodine<br />
IV phosphate<br />
45. A 23-year-old man of African descent is treated<br />
for malaria contracted on a recent trip. He<br />
develops anemia due to hemolysis after treatment<br />
is started. Which of the following is the<br />
most likely diagnosis?
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