Multiple Choice Questions on Internal Medicine | Objective Questions | Internal Medicine Quiz | MCQ
1 >>A 42-year-old man underwent allogeneic bone marrow transplantation from an unrelated donor for acute myeloid leukemia in second remission. He develops hepatomegaly and fever 3 months after the infusion of the allogeneic cells. Radiographic imaging of the abdomen reveals extensive intraabdominal lymphadenopathy as well as an enlarged liver, which appears to be diffusely infiltrated. There is no ascites noted. Which of the following is the likely mechanism for the patient’s current deterioration? ?
- (A) Venoocclusive disease of the liver
- (B) Overgrowth of EBV-infected lymphocytes
- (C) Recurrence of acute myeloid leukemia
- (D) Graft-versus-host disease
2 >>Which statements concerning Acinetobacter is correct ?
- (A) This organism is often confused with Neisseria on Gram stain
- (B) This organism is often mistakenly identified as a diphtheroid on Gram stain.
- (C) This organism is a member of the Enterobacteriaceae family on the basis of its appearance on routine laboratory culture media.
- (D) This organism is usually sensitive to penicillin and ampicillin
3 >>Correct statements concerning melioidosis include which of the following? ?
- (A) Infection is usually caused by person-to-person transmission.
- (B) Patients with pneumonia usually have relatively few organisms in the sputum.
- (C) The diagnosis usually depends on serologic testing.
- (D) Therapy with a combination of two or three antibiotics is recommended for severely ill patients.
4 >>A 43-year-old nurse whose job requires frequent hand washing has noted a small erosive skin lesion between the third interdigital web of the right hand (Plate A). The best therapy for this condition would be ?
- (A) topical 5-fluorouracil
- (B) topical clotrimazole
- (C) oral griseofulvin
- (D) topical clotrimazole
5 >>For the past 2 days, a 24-year-old woman has had fever and pain in the left wrist, right ankle, and left knee. Nine painful skin lesions are present on the distal extremities, predominantly about the jo ?
- (A) herpes simplex
- (B) meningococcemia
- (C) gonococcemia
- (D) erythema multiforme
6 >>A 26-year-old man from Cape Cod sees his physician because of a 3-week history of an expanding, slightly burning ring of redness (as shown in Plate C) that first surrounded a red papule on the posterior neck. He complains of headaches, generalized muscle aches, anorexia, and malaise. On examination, he is noted to be febrile [38.3�C (101�F)]; his rash is slightly raised and slightly tender and displays central clearing but no scaling, even after vigorous scraping. Which of the following vectors has been strongly associated with the type of rash described above? ?
- (A) Kissing bug
- (B) Spider
- (C) Flea
- (D) Tick
7 >>A 24-year-old man is concerned because of the appearance of several light brown spots on his trunk (Plate D). The lesions (limited to the chest, back, abdomen, and upper arms) are flat and sharply marginated and have a fine scale that is easily scraped off. The most appropriate diagnostic study is ?
- (A) Giemsa stain of scraped material (Tzanck preparation)
- (B) bacterial culture of the lesions
- (C) fungal culture of the lesions
- (D) microscopic examination of potassium hydroxide- treated scrapings
8 >>A 67-year-old man presents with a history of headache for 5 days and 2 days of swelling of the right part of the forehead and right eye . A Tzanck preparation of the lesion reveals multinucleate giant cells on Giemsa stain. The patient was admitted to the hospital and begun on intravenous acyclovir. The most important next step would be ?
- (A) ophthalmologic consultation
- (B) administration of systemic glucocorticoids to prevent postherpetic neuralgia
- (C) administration of antistaphylococcal antibiotics to prevent secondary bacterial infection
- (D) application of iodine-containing solution to prevent secondary bacterial infections
9 >>Which statement concerning Klebsiella infections is correct? ?
- (A) Most clinical isolates are obtained from the respiratory tract
- (B) Predisposing factors for Klebsiella pneumonia include alcoholism, diabetes mellitus, and chronic bronchopulmonary disease.
- (C) Klebsiella is closely related to Pseudomonas.
- (D) Detecting Klebsiella growth from a sputum culture obtained from an intubated patient mandates treatment with an aminoglycoside or a third-generation cephalosporin.
10 >>Which statement concerning toxoplasmosis is correct? ?
- (A) A pregnant woman who has acquired Toxoplasma any time before pregnancy is likely to deliver an infected infant
- (B) A woman who develops acute toxoplasmosis during one pregnancy is more likely than are other women to give birth to an infected child in a subsequent pregnancy.
- (C) A woman who acquires toxoplasmosis during the last trimester of pregnancy is more likely to deliver an infected infant than she would be if she acquired the infection during the first trimester
- (D) Toxoplasmosis in a person with Hodgkin’s disease probably is due to newly acquired infection
11 >>A person with liver disease caused by Schistosoma mansoni would be most likely to have ?
- (A) gynecomastia
- (B) jaundice
- (C) esophageal varices
- (D) ascites
12 >>A 25-year-old homosexual man presents with a diffuse maculopapular rash over his trunk, head, neck, palms, and soles. Generalized lymphadenopathy is also present. He has a history of 4 weeks of anal pain. Which of the following tests is likely to identify the etiologic agent? ?
- (A) Antinuclear antibody
- (B) Blood culture
- (C) Serum rapid plasma reagin (RPR)
- (D) Skin biopsy
13 >>An 18-year-old man (pictured in Plate F) presents because of unsightly facial inflammation. Which of the following statements is correct? ?
- (A) Closed comedones (whiteheads) are less commonly associated with the inflammatory lesions than are open comedones (blackheads).
- (B) Glucocorticoids, although not indicated except in the most severe cases, would likely result in improvement.
- (C) Vigorous scrubbing of the face, which will eliminate surface oils, is indicated
- (D) Patients on systemic retinoic acid may experience very dry skin and hypertriglyceridemia.
Internal Medicine Objective Questions | Internal Medicine Quiz
14 >>Which statement concerning the pathogenesis of fever is correct? ?
- (A) Aspirin inhibits the production of endogenous pyrogens
- (B) The major endogenous pyrogens in humans include interleukin 4 (IL-4) and transforming growth factor- ? (TGF-?).
- (C) Endogenous pyrogens are produced by bacteria, protozoa, and fung
- (D) Endogenous pyrogens play a role in the cachexia of chronic infections.
15 >>Which statement concerning pneumococcal infection is correct? ?
- (A) Pneumocococal bacteremia is prevalent in infants and the elderly
- (B) Only patients who have had a splenectomy for a hematologic malignancy should receive pneumococcal vaccine.
- (C) Pneumococcal pharyngitis is the most common precipitating event for pneumococcal meningitis in adults.
- (D) The occurrence of the “crisis” in pneumococcal pneumonia generally corresponds to the time of maximum leukocytosis
16 >>Which statement about the pathogenesis of streptococcal infections is correct? ?
- (A) Streptococcal strains with M protein in the cell wall are nonpathogenic.
- (B) Manifestations of infection with group A streptococci are due primarily to direct invasion.
- (C) Penicillin significantly shortens the clinical course of the pharyngitis produced by group A streptococci.
- (D) Nonenterococcal group D streptococci cause endocarditis.
17 >>Which of the following systemic manifestations is LEAST characteristic of early adult rheumatoid arthritis? ?
- (A) High fever
- (B) Weight loss
- (C) Muscle wasting
- (D) Fatigue
18 >>Neisseria gonorrhoeae infections can be described by which of the following statements? ?
- (A) Gonococci with pili tend to be avirulent
- (B) Strains of N. gonorrhoeae that produce -lactamase are resistant to penicillin but usually are sensitive to “third-generation” cephalosporins such as ceftriaxone
- (C) Gonococcemia occurs infrequently during menstruation
- (D) The skin lesions of gonococcemia usually appears first on the proximal portions of the extremities.
19 >>Which statement concerning infectious mononucleosis is correct? ?
- (A) The most common symptom of infectious mononucleosis is lymphadenopathy.
- (B) In young adults, the incubation period for infectious mononucleosis is 5 to 10 days
- (C) The atypical lymphocytes associated with infectious mononucleosis are B cells.
- (D) Heterophil antibody titers usually decline within 3 to 6 months from the onset of symptoms
20 >>Which statement concerning malaria is correct? ?
- (A) Malaria caused by each of the four plasmodial species can relapse after the initial illness
- (B) Red cells with the Duffy blood group antigen are resistant to Plasmodium vivax.
- (C) Renal impairment is a grave prognostic sign in falciparum malaria.
- (D) Massive splenomegaly can result from repeated bouts of infection.