no more a loser
Forum Guru
Topics: 140
Posts: 580
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INTERNAL MEDICINE QUESTIONS
1) 35 yr female with double vision at the end of the day, dysphagia, nasal voice, upp ext weakness, her sx improve after a night’s sleep. Dx?
2) What is MG?
3) Best initial test for MG?
4) What is the specific test for MG?
5) What is the sensitive test for MG?
6) Most accurate test for MG?
7) Tx for MG?
8) If primary tx fails, what to use (initial choice) for MG?
9) If initial tx after primary tx fails, what tx for MG?
10) Tx for acute MG crisis?
11) Surgical tx for post puberty till age 55 yrs for MG pts?
12) 46 yr male w/ rubbery legs for 2 days, loss of reflexes bilaterally and weakness in lower ext. Hx of diarrhea 3 wks ago. Dx?
13) What is Gullian-Barre Syndrome?
14) Pattern of sensory distribution loss w/GBS?
15) When to take GBS pt to ICU?
16) What % of GBS pt have prior hx of infection 1-3 wks ago?
17) Best initial test for GBS?
18) Most accurate test for GBS?
19) Tx for GBS?
20) Acute abortive tx for migraine? If contraindicated, alternative tx?
21) Prophylactic tx for migraine when to start n what tx?
22) Pt w/ severe, infrequent migraine unresponsive to any tx?
23) Initial tx for tension H/A, what if refractory?
24) Prophylactic tx for cluster H/A?
25) Most effective tx for acute cluster H/A, alternative?
26) Central vertigo a)onset b)tinitis,HL c)diplopia,blindness,dysarthria,weakness d)nystagmus
27) Peripheral vertigo a)onset b)tinitis,HL c)diplopia,blindness,dysarthria,weakness d)nystagmus
28) Triad of Meniere’s disease?
29) Two most common causes of Meniere’s dis?
30) Peripheral vertigo associated w/ blunt ear trauma, air flight, scuba diving?
31) Symptomatic tx for peripheral vertigo? If severe?
32) Medical tx for Meniere’s dis? If fails?
33) Symptomatic tx for vertigo secondary to labyrinthitis? If severe?
34) Examples of reversible causes of dementia?
35) Examples of irreversible causes of dementia?
36) Early presentation of Pick’s dis?
37) Presentation of Creutzfeldt-Jakob dis?
38) Binswagner dis?
39) Tx for mild-moderate dementia? Other tx?
40) 32 yr female w/numbness & tingling of R hand began several days ago. Hx of seeing double 3 yrs ago for 2 days. Hyperactive reflexes bilaterally and inc spasticity in lower extremities. Dx?
41) What is Multiple sclerosis?
42) Triggers that exacerbate MS?
43) Most accurate test for MS?
44) Best initial test for MS?
45) Most sensitive test for MS?
46) If MRI is nonconfirmatory but MS suspicion still high, what test?
47) Tx for relapsing-remitting dis of MS?
48) Tx for secondary progressive dis of MS?
49) If cant tolerate IFN B1b, IFN B1a or glatiramer acetate?
50) Tx for primary progressive disease of MS?
51) Tx for acute exacerbation of MS?
52) Tx for MS pt w/ spasticity?
53) Tx for MS pt w/ nocturnal spasticity?
54) Tx for MS pt w/ bladder hyperactivity?
55) Tx for MS pt w/ Urinary retention?
56) Tx for MS pt w/ fatigue?
57) Tx for MS pt w/ erectile dysfunction?
58) What is Parkinson’s disease?
59) Parkinsonism + vertical gaze palsy?
60) Parkinsonism + prominent ataxia?
61) Parkinsonism + prominent orthostatic hypotension?
62) Parkinson pt w/ intact functional status (less bradykinesia) < 60 yrs, initial tx?
63) Parkinson pt w/ intact functional status (less bradykinesia)> 60 yrs, initial tx?
64) Parkinson pt w/ compromised function, initial tx?
65) Tx for late complications of carbidopa/levodopa (response fluctuations)?
66) Only drug that can arrest progression of Parkinson dis?
67) Surgical TX for Parkinson pt, when? Procedure?
68) Test of choice for diagnosing epilepsy?
69) Tx of status epilepticus?
70) When are first time seizures treated with long-term anticonvulsants?
71) First line tx for generalized tonic clonic seizure? If not a choice?
72) First line tx for absence seizures? If not a choice?
73) First line tx for partial seizures (complete/partial)? Acceptable alternatives?
74) Tx of choice for myoclonic and atonic seizures?
75) CNS SE of phenytoin?
76) Systemic SE of phenytoin?
77) SE of phenobarbitol?
78) SE of valproic acid?
79) SE of lamotrigine?
80) Presentation of occlusion of anterior cerebral artery?
81) Presentation of occlusion of middle cerebral artery? If dominant hemisphere is involved? If non-dominant hemisphere is involved?
82) Presentation of posterior cerebral artery? Involvement of penetrating branches/CN III palsy?
83) Presentation of occlusion of basilar artery branches? Involvement of post inferior cerebellar artery?
84) Presentation of occlusion of major cerebellar artery?
85) Initial test of choice for cerebrovascular disease?
86) Most sensitive test to detect blood in brain?
87) Most accurate test for detecting cerebral ischemia?
88) Diagnostic workup for pt w/acute ischemic stroke?
89) Tx for pt who present w/in 3 hrs of onset of stroke?
90) When is heparin given in acute ischemic stroke?
91) First line tx for secondary prevention of ischemic stroke?
92) If aspirin allergic or continue to have recurrent CVA on aspirin alone?
93) When to recommend carotid endarterectomy?
94) Most common site of spinal cord compression?
95) Dx test of choice for SC compression? When contraindicated?
96) Plain X-ray abn in what % of SCC?
97) Tx of choice for herniated disc, epidural abscess, hematoma?
98) Tx of SCC?
99) Px of SCC depends on what factor?
100) E.g., of communicating syringomyelia?
101) E.g., of non-communicating syringomyelia?
102) Most common site of syringomyelia?
103) Pattern of subacute combined degeneration (B12 related)
104) Pattern of ant spinal art infarction?
105) Overall 5 yr survival for small cell CA of lung?
106) Overall 5 yr survival for non-small cell CA of lung?
107) Smoking hx of 40 pack/yr increases lung CA risk how many times compared to normal non-smoker individual?
108) Asbestos exposure increases bronchiogenic CA risk by how many times?
109) Centrally located lung CA types?
110) Peripherally located lung CA types?
111) Which lung CA type is associated w/ pleural effusion (w/increase hylauronidase) Dx?
112) Most common sx of lung CA at time of dx?
113) What % of squamous cell CA dx is made by sputum cytology?
114) Best dx procedure for centrally located lung CA?
115) Best dx procedure for peripherally located lung CA?
116) Bull’s eye lesion?
117) What % of lung tumors w/ malignant effusion is unresectable?
118) Sx that suggest unresectable lesion of lung CA?
119) Tx of choice for resectable small cell lung CA?
120) Tx of choice for resectable non-small cell lung CA?
121) Tx of effusion associated w/lung CA?
122) Px after surgical resection of squamous cell lung CA? If large cell CA & adenoCA?
123) Define sleep apnea?
124) Tx for obstructive sleep apnea?
125) Tx for central sleep apnea?
126) Dx of sleep apnea?
127) ABGs in ARDS?
128) Swan Ganz catheter findings in ARDS?
129) Tx for ARDS?
130) Mortality rates for ARDS?
131) Most common cause of thrombophilia?
132) Pts at inc risk for post op venous thromboembolism?
133) EKG changes of pulmonary embolism?
134) First test when PE is suspected?
135) Gold stand to dx PE?
136) Gold stand to dx DVT?
137) Pts w/ PE who don’t req angiogram for dx?
138) Tx for PE?
139) Tx for PE pts who r hemodynamically unstable? If contraindicated?
140) Tx for hemodynamically stable PE pt w/contraindication to anticoagulation or recurrent PE on anticoagulant?
141) Tx for pregnant pt w/PE or DVT?
142) Epidemiology of silicosis?
143) Epidemiology of asbestosis?
144) Epidemiology of coal miner’s lung?
145) PFT pattern of pneumoconiosis?
146) Most common CA associated w/ asbestosis?
147) Dx of asbestosis?
148) Main difference b/w asbestosis & acute silicosis?
149) How to evaluate silicosis associated w/TB?
150) CXR findings of asbestosis?
151) CXR findings of silicosis?
152) CXR findings of coal miner’s lung (CWP)?
153) Associated immunolgoical abn in CWP?
154) What is Caplan synd?
155) What is Lofgren synd?
156) What is Heerfordt-Waldenstrom synd?
157) Lab findings of sarcoidosis?
158) Definitive dx of sarcoidosis?
159) Px of sarcoidosis?
160) In which sarcoidosis pt, steroids r mandatory for tx?
161) 55 yr male w/exercise intolerance over 6 mos. No significant past hx. Over past wk, he gets dyspnea on walking across room. Never smoked. RR 24, JVD 8cm, coarse crackles, clubbing, trace pedal edema (both legs), CXR: diffuse reticular disease. Dx? Tx?
162) Etiology of bronchiectasis (permanent dilation of small-med bronchi)?
163) Best non-invasive test for bronchiectasis?
164) Tx for bronchiectasis?
165) When are IV antibiotics (aminoglycosides, ceftazidime, or quinolones) used in bronchiectasis?
166) When is surgical tx considered in bronciectasis?
167) What % of smokers develops COPD?
168) What % of COPD pts are smokers?
169) Dx test of choice for COPD?
170) First line tx for COPD?
171) Second line tx for COPD?
172) 2 modalities that decease mortality in COPD pt?
173) COPD + cor pulmonale will benefit from home O2 tx?
174) When are antibiotics used in COPD?
175) First line tx for acute exacerbation of COPD?
176) Best predictor of survival in COPD?
177) When is dyspnea at rest noted?
178) When is dyspnea on exercise noted?
179) Vaccine for COPD pt?
180) Which B agonist used for nocturnal & exercise induced asthma?
181) Asthmatic pt w/HD in whom B agonist & theophylline may be dangerous so what tx?
182) Tx of choice for spontaneous atelectasis?
183) What 3 criteria have to be present for transudative effusion?
184) How to proceed in low risk pt w/ pulmonary nodule?
185) How to proceed in high-risk pt w/ pulmonary nodule?
186) How to maintain O2 content (O2 to vital organs) in critically ill pt?
187) Formula for alveolar-arterial gradient (useful in assessment of oxygenation)?
188) 60 yr male w/chronic bronchitis develop persist diarrhea, what acid base disorder?
189) Markedly obese 24 yr male, what acid base disorder?
190) 14 yr female w/ severe asthmatic attack, what acid base disorder?
191) 56 yr female w/ chronic bronchitis is started on diuretic tx for peripheral edema resulting in 3kg wt loss, what acid base disorder?
192) Best initial screening test for renal artery stenosis?
193) Best noninvasive method to confirm renal art stenosis?
194) Best invasive method to confirm renal art stenosis?
195) Best initial tx for renal art stenosis?
196) Dx of primary hyperaldosternosim (Conn synd)?
197) Tx for Conn synd?
198) Tx for simple kidney cysts?
199) Dx of RTA type I (distal)?
200) Tx for RTA type I (distal)?
201) Dx of RTA type II (proximal)?
202) Tx for RTA type II (proximal)?
203) Dx of RTA type IV (hyporenin/hypoaldosteronism)?
204) Tx for RTA type IV?
205) EKG in hyperkalemia?
206) Tx of hyperkalemia?
207) What is Bartter synd?
208) EKG findings of hypokalemia?
209) Tx of hypokalemia?
210) Tx for hypernatremia? For CDI? For NDI?
211) Dx of hyponatremia?
212) Tx of hyponatremia? Mild (approx 120-130)? Moderate (approx 110-120)? Severe (<110 w/sx)? Chronic?
213) Tx of anemia in ESRD?
214) Tx of osteodystrophy (secondary hyperparathyroidism) in ESRD?
215) General tx of ESRD?
216) Indications of dialysis in ESRD?
217) Helpful in dx of post infectious GN?
218) Tx for Goodpasture synd?
219) Which nephritic synd is associated w/ Hep C?
220) Tx for Hemolytic Uremic Synd?
221) Tx for TTP?
222) TX for cryoglobulins IgM & IgG deposits?
223) Tx for HSP?
224) Tx for Wegner’s granulomatosis?
225) Dx of analgesic nephropathies?
226) Tx of choice for TSS?
227) Dx of blastomycosis?
228) Tx for blastomycosis? Severe? Mild?
229) Best dx test for toxoplasmosis?
230) Best initial test for CNS toxo lesion in AIDS pt?
231) Dx of RMSF? Tx?
232) When to start triple tx for HIV pt?
233) When to give AIDS pt prophylaxis for PCP? What? When to discontinue?
234) When to give MAI px to AIDS pt? What? How to dx MAI in HIV pt? Tx?
235) Prophylaxis for toxo in AIDS?
236) Tx for cryptococcus in AIDS?
237) Best dx test /specific dx for myocarditis?
238) Ultimate dx for gas gangrene?
239) Tx of gas gangrene?
240) Initial dx test for brain abscess?
241) Most accurate test for brain abscess?
242) Most common cause of encephalitis?
243) Most specific & sensitive test for HSV encephalitis?
244) What type of meningitits in pt w/hx of neurosurgery?
245) Best initial test for meningitis?
246) DIC associated w/ which leukemia type?
247) Tx for DIC?
248) Tx for hemophilia A?
249) Most common cause of congenital disorder of hemostasis?
250) Dx of vWD?
251) Tx for vWD?
252) Dx of ITP?
253) Tx of ITP?
254) Virus/bacteria associated w/ Non Hodgkin lymphoma?
255) % Location of cervical/supraclavicular nodes in NHL?
256) Initial dx for NHL & HL?
257) Tx for stage I A & II A of HL & NHL?
258) Tx for stages IB, IIB, III & IV of NHL?
259) Tx of relapses of NHL?
260) % Location to cervical/supraclavicular nodes in HL?
261) Tx for stages IB, IIB, III & IV of HL?
262) Which HL has good prognosis?
263) Dx of CML?
264) Tx of CML?
265) Confirmatory dx of acute leukemia?
266) Differentiation b/w different types of acute leukemia?
267) Tx of acute leukemia?
268) Common causes of death in PNH?
269) Defect in PNH?
270) Dx of PNH?
271) TX of PNH?
272) Defect in hereditary spherocytosis?
273) Dx of heredietary spherocytosis?
274) Tx of heredietary spherocytosis?
275) Specific dx for autoimmune, cold-agglutinin & drug induced hemolytic anemia?
276) Staging for HL & NHL?
277) Etiology of MGUS?
278) Dx of MGUS?
279) Sx of hyperviscosity synd associated w/MM?
280) Confirmatory dx for MM?
281) Tx for MM? Young pt? Old pt?
282) Staging & survival for CLL?
283) Dx of CLL?
284) TX of CLL?
285) Dx of aplastic anemia?
286) Tx of aplastic anemia?
287) Genetic association of CML?
288) Earliest tests to detect osteomyelitis?
289) Usually initial test for osteomyelitis?
290) Best dx test for osteomyelitis?
291) Dx of granuloma inguinale (calymmatobacterium granulomatis)?
292) Tx of granuloma inguinale?
293) Dx of lymphogranuloma venereum (chlamydia trachomatis)?
294) Tx of lymphogranuloma venereum?
295) Dx of chancroid (H ducreyi)?
296) Tx of chancroid?
297) When there is no blood in stool, best initial test to dx diarrhea?
298) What is scrombroid diarrhea, tx?
299) Most common extra pulmonary site involved in TB?
300) Best initial test for TB workup?
301) Most specific test for TB?
302) Single most sensitive test for TB?
303) TB meds + steroids given in which conditions?
304) Most common initial test for any pneumonia?
305) Most specific dx test for pneumonia?
306) Most specific dx for mycoplasma?
307) Major determinants of severity of pneumonia?
308) Confirmation dx of bronchitis?
309) Tx of mild/uncomplicated sinusitis?
310) Tx of severe autoimmune hemolysis?
311) Tx of cold agglutinin disease? Mild? Severe?
312) Most specific test for sickle cell?
313) What is sickle prep (sickledex)?
314) Conditions associated w/round macrocytes?
315) Conditions associated w/oval macrocytes?
316) Most specific test for B12 def?
317) Dx of thalasemia?
318) Tx of B thalasemia major?
319) Dx of sideroblastic anemia?
320) Dx of anemia of chronic disease?
321) Most specific test for Fe def anemia?
322) When is exercise treadmill test used?
323) When is treadmill w/thallium used?
324) Contraindications to stress test?
325) When to use cardiac cath?
326) Pt w/ CAD & LDL< 130, Goal?
327) If no definite CAD w/> 1 R.f., LDL>130?
328) If no definite CAD w/> 1 R.f., LDL>160?
329) If no definite CAD w/no or 1 R.f., LDL>160?
330) If no definite CAD w/no or 1 R.f., LDL>190?
331) Indications for intraaortic balloon counter pulsation in MI?
332) Post infarction management?
333) Toxic effects of digitalis?
334) Tx for digitalis intoxication?
335) Tx of pulm edema?
336) Valsalva maneuver decreases what?
337) Squatting decreases what?
338) Factors that affect severity of bite?
339) Electrical inj when dry skin?
340) Electrical inj when wet skin?
341) Inj from AC current?
342) Inj from DC current?
343) Cataracts in what % of electrical inj?
344) Tx of electrical inj?
345) Mortality w/ radiation inj?
346) Mortality almost 100% w/ radiation inj?
347) Bone marrow failure w/ radiation inj?
348) Effect of radiation inj on gonads?
349) Sx of heat cramps?
350) Tx of heat cramps?
351) Sx of heat exhausation?
352) Sx of heat stroke?
353) Tx of heat stroke?
354) Gold standard for GERD?
355) What % esophagitis heal (EGD) by H2 blockers? PPI?
356) What dx test done initially in dx of achalasia?
357) What % of botox effective in blocking cholinergic nerves in achalasia?
358) Definitive tx for achalasia?
359) Tx for scleroderma causing dysphagia?
360) Diffuse esophageal spasm presentation on barium swallow?
361) How to confirm dx of DES?
362) Tx for DES?
363) Same presentation & tx as DES but different disease, how to differentiate?
364) Young pt w/episodic dysphagia to solids & sometimes liquids?
365) Plummer Vinson association w/ malignancy?
366) Dx for Schatzki ring & Plummer Vinson?
367) Tx for Schatzki ring & Plummer Vinson?
368) What % of GERD pts progress to Barrett’s esophagus?
369) AdenoCA after Barrett most likely when?
370) Barrett’s (EGD) how to follow up if shows no dysphagia? Low-grade dysphagia? High-grade dysphagia?
371) Prognosis for esophageal CA?
372) Tx for esophageal CA?
373) Presentation of Zenker’s diverticulum?
374) Tx for Zenker’s diverticulum?
375) Procedure of choice for Mallory Weiss?
376) Tx for refractory cases of Mallory Weiss?
377) Gold stand dx for type B/H pylori associated gastritis?
378) Most widely used test to confirm or R/O H pylori gastritis (very sensitive & specific)?
379) Initial dx of H pylori in gastritis & PUD? How to follow?
380) What % of NSAID induced PUD in stomach? Duodenum?
381) Curative resection is possible in what % of ZES?
382) Dx of gastroparesis?
383) Tx for gastroparesis?
384) Basic tx for crohn’s dis? If small bowel inv? Immunosupp tx? For fistulas? Surgical tx?
385) Surgery for UC?
386) Dx of secretory vs osmotic D based on stool elec?
387) Fecal leukocytes are present in all enteroinvasive diarrhea except?
388) How to confirm fat malabsorption (steatorrhea)?
389) Disease w/malabsorption but no steatorrhea?
390) How to confirm cause of malabsorption?
391) Tx for tropical sprue?
392) Ab related to celiac sprue?
393) Most important complication of celiac sprue?
394) Extraintestinal manifestation of Whipple’s dis?
395) Confirm dx of Whipple’s dis?
396) Tx for Whipple’s dis?
397) Prevalence of diverticulosis?
398) What is painful diverticular synd?
399) Dx of diverticuli?
400) Procedure of choice if dx of diverticulitis in doubt?
401) Dx of carcinoid?
402) Tx of carcinoid?
403) Genetic association w/ AD familial colonic polyposis?
404) What is Lynch synd?
405) Dx test more sensitive for screening colon CA?
406) Tx for stages A & B of colon CA?
407) Tx for stage C of colon CA?
408) Tx of upp GI bleeding?
409) Tx for angiodysplasia (AVMs)?
410) Dx for Meckel’s diverticulum?
411) Tx for lower GI bleed?
412) Enzymes more specific in acute pancreatitis?
413) Enzymes more sensitive in early acute pancreatitis?
414) When to surgically remove pancreatic pseudocyst?
415) Dx of chronic pancreatitis?
416) Sensitivity of US for cholelithiasis dx?
417) Dx test preferred for common bile duct stones (Ca bilirubinate & pigmented stones)?
418) Serum ascites gradient (SAAG) >1.1 g/dl suggests?
419) SAAG <1 g/dl suggests?
420) Most common cause of unconjugated bilirubinemia?
421) Disease w/ severe deficiency of enzyme glucuronosyl transferase (GT)?
422) What is Dubin Johnson synd?
423) Tx of primary biliary cirrhosis (destruction of intrahepatic bile ducts)?
424) What % of primary sclerosing cholangitis (PSC) develops cholangioCA?
425) ERCP presentation of PSC?
426) Incidence of hepatocellular CA in hemochromatosis?
427) Dx of hemochromatosis?
428) Tx of hemochromatosis?
429) Alpha antitrypsin def is responsible for what % of liver disease in neonates?
430) Dx of alpha antitrypsin def?
431) Three causes of high transaminase>1000?
432) What % chance that adult acute Hep B converts to chronic Hep B?
433) What % chance that neonate acute Hep B converts to chronic Hep B?
434) Tx of chronic Hep B?
435) How many pts w/ acute Hep C are symptomatic?
436) Most sensitive way to detect Hep C?
437) Tx for chronic Hep C?
438) Drugs that can cause hyperprolactinemia?
439) Dx of acromegaly?
440) What % of acromegaly pts responds to bromocriptine?
441) What % of acromegaly pts dec GH values w/octreotide & % of tumor regression?
442) Transphenoidal surg for acromegaly pts result in hypopituitarism in what %?
443) RT for acromegaly cause hypopituitarism in what %?
444) Most common cause of death in acromegaly?
445) What is pituitary apoplexy?
446) Etiology of hypopituitarism?
447) Dx of hypopituitarism?
448) What is empty sella synd?
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| jb00727
Forum Elite
Topics: 82
Posts: 190
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Thats an awesome collection of questions. THANKS for being so helpful
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| helpful
Forum Junior
Topics: 4
Posts: 49
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Thanks for this help please tell me what % you got in actual exam from these questions?
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| no more a loser
Forum Guru
Topics: 140
Posts: 580
|
listen as i said these are NOT usmle style questions, these are facts that u need to know. so i cant tell u what % i got on the real exam. They are made out of kaplan internal medicine book. Plus when u r giving the exam, u can hardly finish your blocks, let alone sit there and wonder how many % u got from where  please if u want, use them or if u dont, dont bother with them but please dont ask me stuff thats quite hard to answer
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| akshra_verma
Forum Newbie
Topics: 1
Posts: 3
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hey this is really useful information... thanks a lot for posting your collection
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mle 2003
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