Internal Medicine MCQ Credit

  1. Where is the ischemic chest pain (angina pectoris) located?
    • Retrosternal
    • shoulder, neck, right arm
  2. Patients suffering from stenocardia will describe their pain in which ways? (using at least three adjectives)
    • Pressure
    • Squeezing
    • Burning
  3. What are the upper limits of normal blood pressure?
    129/84 mmHg
  4. What is a typical clinical symptom of acute left-sided heart failure?
    Dyspnea (shortness of breath)
  5. Which basic medications are used for the treatment of acute heart failure?
    • Diuretics
    • Vasodilators
  6. What are typical symptoms of acute myocardial infarction?
    • Chest pain
    • Fatigue
    • Dyspnea
  7. What are the three typical directions of stenocardia (angina pectoris) radiation?
    Shoulder, neck, epigastrium (jaw, left arm)
  8. Which basic pharmacological first aid in a patient with stenocardia should be applied?
    Nitroglycerine, asa (acetylsalicylic acid)
  9. Which valvular heart defect should be considered in a young person who experienced syncope during exertion?
    Aortic stenosis
  10. List at least two the most common causes of atrial fibrillation.
    Ht, dm, cad, valvular disease, hf, thyrotoxicosis
  11. What long-term therapeutic measures should be instituted in patient with chronic atrial fibrillation?
    Anticoagulation, antiaggregants, ace-i, arb, rhythm control (amiodarone)
  12. List 4 basic medications which should be used as a secondary prevention in a patient after an acute myocardial infarction.
    Asa, statins, ace-i, sartans, beta blockers
  13. Is ventricular tachycardia life-threatening?
    Yes
  14. What is the first therapeutic approach in a patient with ventricular fibrillation?
    Cpr + defibrillation
  15. What is the basic and first therapeutic approach in a patient with asystolia (cardiac arrest)?
    Cpr
  16. Which severe side-effect can occur during opiates therapy?
    Depression of respiratory centre
  17. Which group of medications is currently considered as a basic pharmacological intervention in hypercholesterolemia?
    Statins
  18. Which is the therapy of choice in a patient with acute myocardial infarction and elevated st?
    1st ptca (percutaneous transluminal coronary angioplasty) + 2nd thrombolysis
  19. What are the acute forms of ischemic heart disease?
    Sudden death, ami, angina pectoris (unstable)
  20. Which two pathological phenomena characterize the morphology of the left heart chamber in mitral insuficiency.
    Hypertrophy + dilation
  21. The laboratory marker, whose negativity excludes the presence of pulmonary embolism is:
    D-dimer
  22. How long lasts the permanent ventricular tachycardia? More than...
    30s
  23. The pulmonary hypertension is characterized by elevated pulmonary artery pressure upper than:
    20-30 mmhg (more than 20)
  24. Which two groups of medication significantly improve the prognosis of patients with congestive heart failure?
    Ace-i or arb + beta blockers
  25. What are the indications for initiation of the cardiopulmonary resuscitation?
    Apnea, asystole, cardiac arrest, ventricular fibrillation
  26. How long after a cardiac arrest is the patient unconscious?
    10-20s (10)
  27. How long after a cardiac arrest does the patient develop a mydriasis?
    60-90s (60)
  28. The first used test (except of resting ecg) in differential diagnosis of chest pain in non-emergent patient should be:
    Exercise stress test
  29. Which proportion (in percentage) of myocardial wall must be destroyed by necrosis to develop a cardiogenic shock?
    40%
  30. What is the most specific laboratory test used to confirm the myocardial necrosis?
    Troponins
  31. What is the most serious arrythmia in the course of myocard infarction?
    Ventricular fibrillation
  32. Ecg record: the hulking st elevation which blends with the t-wave is called:
    Pardee?s sign
  33. What is the consequence of (what follows after) a myocardial free wall rupture?
    Cardac tamponade
  34. How many patients (in percentage) have an asymptomatic course of myocard infarction (silent ischemia)?
    20-30%
  35. How many patients (in percentage) have a secondary cause of hypertension?
    10%
  36. What is the laboratory marker of the congestive heart failure?
    Bnp (brain natriuretic peptide)
  37. Which adverse effect is the most common during the acei treatment?
    Cough
  38. Which adverse effect is the most commonly observed when we treat a patient by furosemide?
    Hypokalemia
  39. So called corrigan pulse (?water-hammer? pulse) is characteristic for...
    Aortic regurgitation
  40. Which imaging method is the best for infective endocarditis diagnosis?
    Tes eco
  41. In how many adult patients (in percentage) persist patent foramen ovale?
    25%
  42. Holosystolic murmur heard over the apex is typical for which valvular heart defect?
    Mitral regurgitation
  43. The systolic murmur heard at the second right intercostal space is typical for which valvular heart defect?
    Aortic stenosis
  44. What disease (from the rank of internal medicine) is nycturia typical for?
    Dm, hf
  45. What dose of furosemide do you choose for treatment of acute heart failure in diuretic naive patient?
    20-40mg
  46. Which antiarrytmic drugs do we use for pharmacological version of atrial fibrilation?
    Amiodarone, beta blocker(sotolol)
  47. What is the ?in-hospital? mortality rate in patients suffering from myocardial infarction treated by pci?
    6-10% (<5%jQuery112405307639723733524_1552851323287)
  48. What is the most common pathophysiology and underlying cause of acute myocardial infarction?
    Atherosclerosis, thrombosis
  49. What is the first choice treatment in patient suffering from st elevation myocardial infarction?
    Ptca
  50. List at least two contraindications for administration of digoxin.
    Decrease heart beat, av blockade (ii, iii), wpw syndrome, decrease k, increase ca, acute mi
  51. What anatomical structures of heart are stimulated in pacing regimen vvi?
    Atria + ventricles
  52. What drug is used as ?the first aid? in patients with significant a-v blockade?
    Atropine (0,5-1mg i.v.)
  53. List the two most common causes of development of aortic stenosis nowadays.
    Age calcification, bicuspide valve
  54. What is the basic treatment of aortic stenosis?
    Statins, beta blockers, aortic valve repair/replacement
  55. List the most common cause of development of mitral stenosis.
    Rheumatic fever
  56. Which valve could we expect to be affected in most cases by infective endocarditis in i.v. Drug users?
    Tricuspid
  57. Which disease do we find osler?s nodes in?
    Rheumatic fever
  58. What auscultation site is used for systolic murmur in patient with ventricular septal defect?
    3rd-4th intercostal space on left
  59. What is the usual daily dose of penicilin in treatment of infective endocarditis?
    12-18 mu
  60. What disease are betablockers contraindicated in?
    Asthma, decreased bp, av block, bradycardia, acute hf
  61. What kind of diuretics could we use in the treatment of hypertension? (list at least two.)
    Furosemide, thiazides, potassium sparing drugs
  62. What drug is ?the first choice? for treatment of hypertension during pregnancy?
    Methyldopa
  63. In which disorder hypertension limited to the upper half of the body is usually observed?
    Coarctation of aorta
  64. Which disorder is characterized by paroxysmal hypertension?
    Pheochromocytoma
  65. Which is the typical finding during physical examination in the case of acute pericarditis sicca? (without effusion)
    Pericardial friction rub
  66. Which cardiomyopathy is genetically determined?
    Hypertrophic
  67. Which imaging method is the best one for cardiac tamponade diagnosis?
    Echo
  68. Which two diagnostic methods are used to prove left ventricle hypertrophy in daily practice?
    Echo + ecg
  69. Which congenital heart disease is the most commonly diagnosed in adulthood?
    Asd
  70. What is the typical auscultation finding in the patient with atrial septal defect?
    Systolic murmur and fixed split of s2 sound over pulmonary artery
  71. List five most common causes of pericardial effusion:
    Infection, ami, iatrogenic, cancer, myxedema
  72. Which imaging method helps us to distinguish left ventricular dysfunction present in dilated cardiomyopathy and coronary heart disease?
    Coronarography
  73. What is the typical clinical presentation of cardiac tamponade?
    Decreased bp and heart sounds, increased jvr, pulsus paradoxus, dyspnea
  74. Do calcium channel blockers belong among the preferred drugs for treatment of heart failure?
    No
  75. What kind of change could we observe on ecg record in patient with hyperkalemia?
    High peak t with narrow base
  76. What is the shape of p pulmonale on an ecg record?
    P>2.5mm in leads ii, ii and avf
  77. What changes do we find on ecg record in patient with acute cor pulmonale?
    Sinus tachycardia, s i, q iii and negative t in iii, negative t in v1-v3, verticalization of cardiac axis and incomplete or complete rbbb
  78. List three symptoms associated with aortic stenosis?
    Exertional dyspnea, syncope, angina pectoris
  79. What diseases cause left ventricle hypertrophy?
    Ht, aortic stenosis, aortic coarctation
  80. In which leads do we observe changes on ecg record in patient with inferior myocardial infarction?
    Ii, ii and avf
  81. What situation should we assume in patients with pathological q wave and persistant st elevation in leads monitoring anterior myocardial wal?
    Aneurysm of the anterior wall
  82. What is the first symptom of valvular regurgitant defects?
    Heart murmur
  83. List at least three causes for development of mitral insufficiency.
    Dilation of lv, myxomatous degeneration, ami, rupture pap. Muscle
  84. What is the basic energetic need of a healthy young person not extremely burdened physically?
    2000 kcal
  85. What is the basic need for liquids in an uncomplicated recumbent patient in ml/kg/day?
    30-40 ml/kg/24h
  86. What is the basic need for full-value proteins for a healthy person?
    0.8 g/kg
  87. What means bmi?
    Body mass index
  88. What is definition of obesity (using bmi value)?
    30-35
  89. What is the upper limit of normal body weight expressed by bmi?
    25
  90. What does the term ?all-in-one parenteral nutrition? mean?
    All components in one formula (fats, sugar, proteins)
  91. What is the effect of the prolonged shock to diuresis?
    Kidney failure
  92. What is the reason for insertion of nasojejunal tube?
    Unable to get food per os, stomach dysfunction, impaired gastric motility, gastric reflux, vomiting
  93. What does antidote mean in toxicology?
    Counteracts the effect os poisoning
  94. Which organ is severely affected and often fails in paracetamol poisoning?
    Liver
  95. What is the definition of sepsis?
    Overall response to infection ? changes of t?, increased hr and rr, alteration of leukocytes
  96. What amount of muscular mass could be catabolised in severe acute critical state per day?
    500g
  97. What is plasmapheresis?
    Blood plasma removed from the body, treated and returned to bloodstream
  98. List all branched essential aminoacids.
    Leucine, isoleucine, valine
  99. List at least five trace elements.
    Iron, iodine, zinc, copper, cobalt, selenium, fluor
  100. In which medium are vitamins d and k soluble?
    Fat
  101. List micronutrients administered for their antioxidative properties.
    Vit. C, vit. E, zinc, selenium, coenzyme q
  102. What purpose does the indirect calorimetry serve?
    Technique that measures utilization of certain nutrients at a certain time
  103. What is the first aid for a patient who is unconscious due to hypoglycemia?
    Glucose (40% 20ml i.v.)
  104. What is a typical clinical sign of diabetes sensitive polyneuropathy in lower extremities?
    Dysesthesia, paresthesia, anesthesia
  105. What is the most significant clinical sign of periphery artery disease?
    Claudication, ischemia
  106. What is characteristic laboratory finding in incipient diabetic nephropathy?
    Microalbuminuria (70-200 microg/min)
  107. What value of fasting glycemia is diagnostic of diabetes? (measured in venous plasma)
    7mmol/l
  108. List at least three basic symptoms of hypoglycemia.
    Tremors, palpitations, perspirations, tachycardia, hunger, loss of consciousness
  109. Which medication is used as a basic treatment for a patient with newly diagnosed type 2 diabetes mellitus?
    Metformin
  110. What is the basic therapetic measure in patient with type 1 diabetes mellitus?
    Insulin therapy
  111. Which two pathophysiological disturbances participate in development of type 2 diabetes mellitus?
    Insulin resistance, decreased secretion
  112. What has to be corrected first in patient with hyperosmolar hyperglycemic state?
    Dehydration
  113. Which severe disorder can be caused by extremely high level of serum triglycerides?
    Acute pancreatitis
  114. Which external factor causes the diabetic foot ulcer in most cases?
    Pressure due to incorrect shoes
  115. What is the most important contra-indication in type 2 diabetic patients to be treated by metformin?
    Renal insufficiency
  116. In patient suffering from obstruction of calf arterial bed where is claudicatory pain localized?
    Plantar area of foot
  117. In patient suffering from obstruction of superficial femoral artery where is claudicatory pain localized?
    Calf
  118. In patient suffering from obstruction of iliac arteries where is claudicatory pain localized?
    Thighs + buttocks
  119. What kind of pain does the patient with ischemic pain in lower limbs in rest describe?
    Burning like pain at night specially in toes, diffuse
  120. What kind of complaints does the patient with claudicatory pain describe?
    Cramping pain (after walking and relieved by rest)
  121. At what time do we observe filling of dorsal veins during the performance of modified ratschow?s test?
    10s
  122. What value of ankle-brachial index (abi) do we consider as diagnostic for periphery artery disease?
    Less or equal to 0.9
  123. .
    • What is necessary to take into the consideration in patient with proven pad? What other diagnostic angiological procedures do you recommend?
    • Atherosclerotic involvement of othe rarteries. Check coronary, carotids
  124. List at least three measures belonging to non-pharmacological intervention in patients with pad?
    Stop smoking, exercise, reduce fat intake, pta + stents
  125. What is the most common cause of acute arterial occlusion in extremities?
    Embolism (af, aortic atherosclerosis, thrombi after mi)
  126. Which clinical stage of pad do we consider angiography in?
    Fontain iib ? pain at rets
  127. What is the most common cause of aortic dissection?
    Arterial ht
  128. What does the term ?abdominal angina? mean?
    Postprandial sharp abd pain due to mesenteric atherosclerosis
  129. What is predisposig factor for development of thrombangiitis obliterans?
    Smoking
  130. List the components of wirchov-rokitanski triad?
    Endothelial damage, hypercoagulation, blood stasis
  131. List at least three inborn hypercoagulable states?
    Leyden mutation, deficiency protein c, protein s, antithrombin iii, prothrombin
  132. List at least three acquired hypercoagulable states?
    Hormonal contraceptives, tumors, pregnancy, immobilization state
  133. What examinations are considered as ?gold-standard? in suspicion for deep venous thrombosis?
    Duplex us (grey scale + doppler)
  134. What basic therapeutic measures do we institute in patient with recently proven dvt in calf venous bed?
    Fraxiparin 0.01 ml/kg s.c.
  135. What does paradoxic embolism mean?
    Emboli that goes from right heart through foramen ovale to arterial circulation
  136. List at least four symptoms of pulmonary embolism.
    Pleural chest pain, tachpnea, dyspnea, cough, hemoptysis
  137. What basic therapeutic measures do we institute in patient with recently proven thromboflebitis?
    Effective compression, venoactive drugs, nsaids
  138. List at least three symptoms of hyperglycemia.
    Polyuria, polydipsia, loss of appetite, dehydration, loss of weight, blurred vision, consciousness changes
  139. What examinations should we performed at least annualy in patients with diabetes? List at least three.
    Fundoscopy, microalbuminuria, extremities examination, lipids, liver tests
  140. What tests do we use for evaluation of metabolic and overall control in patients with diabetes? List at least five.
    Glycated hb, ogtt, cholesterol (ldl, hdl, tags), blood glucose, bp, microalbuminuria
  141. What is the normal range of hba1c in healthy subjects according to ifcc calibration?
    20-45 mmol/mol (4-5.6%)
  142. What does the term ?impaired fasting glucose? mean?
    Increased levels of fasting blood glucose in venous blood (5.6-6.9 mmol/l)
  143. What kind of drugs used in treatment of dm can cause hypoglycemia?
    Insulin and secretagogues (sufunylureas, glinides)
  144. What three features characterize diabetic dyslipidemia?
    Ldl > 2.5, tags >1.7, all cholesterol > 4.5 and decreased hdl145.
  145. What waist circumeference (in cm) is diagnostic for metabolic syndrome according to idf guidelines?
    Women > 94 cm and men > 80 cm
  146. What are two main causes leading to acute pancreatitisjQuery112406846218817247969_1552851569648
    Obstruction, alcohol
  147. Which hepatotropic viruses spread mainly by the orofaecal route?
    Hepatitis a + e
  148. Characterise the typical and general course of hepatitis c acute phase?
    Innapparent, asymptomatic
  149. Which viral hepatitides never become chronic?
    Hepatitis a + e
  150. Which antigen is always present in the blood of patients with chronic hepatitis b?
    Absag
  151. Which laboratory parameter indicates the seriousness of hepatic encephalopathy?
    Ammonia
  152. Which tumour marker is typical of hepatocellular carcinoma?
    Afp
  153. What are two basic types of ileus?
    Obstructive (mechanic) and paralytic
  154. What beam orientation should be applied during x-ray examination in recumbent position of patient to diagnose ileus?
    Horizontal
  155. What is a typical sign of ileus in x-ray examination (plain films of the abdomen)?
    Air fluid levels
  156. List two main causes of hepatic cirrhosis.
    Alcohol, viral
  157. Which kind of disorder could we assume in patients with prolonged prothrombin time and cirrhosis of liver?
    Decreased production of coagulation factors
  158. What is the causal treatment of fulminant liver failure in cases when the complex non-specific treatment fails?
    Liver transplant
  159. Which pharmacological group do we use in treatment of chronic portal hypertension?
    Beta blockers
  160. What does hepatorenal syndrome mean?
    Renal dysfunction due to liver cirrhosis and portal ht, caused by vasoconstriction of renal arteries and impaired renal perfusion that results
  161. Which test serves as a preventitive screening for colon cancer?
    Fob test (fecal occult blood) and colonoscopy
  162. Which patients with cholecystolithiasis are not indicated for cholecystectomy?
    Asymptomatic
  163. What parameters (and what arbitrary value of them) signalize that the patient with acute gastrointenstinal bleeding is hemodynamically unstable?
    Bp < 90/60 mmhg, hr > 100 bmp, colapse state
  164. What two test are important to provide the diagnosis of gastroesophageal reflux disease?
    Ph monitoring (24h) + endoscopy
  165. Which gastric neoplasma is the most frequently observed?
    Adenocarcinoma
  166. What is the definition of diarrhoea?
    Increased frequency of bowel movements, > 3 liquid stools/day
  167. What are three characteristic features of the gastrointestinal lesions occured in patients with crohn disease?
    Skip lesions, granulomas, transmural
  168. What is the time-course and associated characteristics of a colic?
    Wavy course, spontaneous, spasmodic
  169. What is the time-course of pain due to imflammation?
    Persistant
  170. Which laboratory parameter indicates a serious bleeding into gastrointestinal tract at the earliest?
    Leukocytosis with left shift
  171. What changes (in laboratory parameters) could we expect in a serious bleeding into gastrointestinal tract? List at least three.
    Iron, sat. Transferin, leukocytosis, coagulation, anemia
  172. What parameter and signs do we look for during ultrasound examination in patient with suspected cholestasis?
    Bile duct dilation, cholelithiasis, liver size, echogenicity
  173. What is the cause of pseudomembranous enterocolitis?
    Clostridium difficile after atb therapy
  174. Which disease is caused by tropheryma whipplei?
    Whipple?s disease
  175. What diagnostic method do we use in oder to prove achalasia?
    X-ray with swallowing test, esophageal manometry
  176. What is the crucial difference between ercp and mrcp?
    Ercp ? endoscopic cannulation of vater?s pappila (invasive vs non- invasive)
  177. What diagnostic method do we use in oder to prove chronic pancreatitis?
    Amylase, chymotrypsin in stools, elastase in stools + us, ct, mrcp
  178. What should we perform during the diagnostic process for functional disorders of gi tract?
    Exclude organic causes (labs, x-ray, us, endoscopy)
  179. What diet should be instituted in a patient with acute exacerbation of idiopathic proctocolitis?
    Low residue diet with gradual transition to rational diet
  180. What are the risk factors for transformation of ibd into crc?
    Inflammatory activity + disease duration
  181. What acute disease could imitate ?a new case? of crohn?s disease?
    Appendicitis
  182. What kind of drugs is considered as a therapy of choice in a patient with acute exacerbation of idiopathic proctocolitis?
    Methylprednisone 32-48 mg
  183. Which kind of polyp in large intestine is associated with hypokalemia?
    Villous colon adenoma
  184. In which parts of gi tract could we find gastrinoma? List at least two organs.
    Stomach (antrum pylori), duodenum, pancreas
  185. What are pharmacological options for the treatment of pseudomembranous enterocolitis? Be specific.
    Stop previous atbs, replace fluids + electrolytes, metronidazole, vancomycin, stool transplant
  186. What characteristics of antibiotics are considered necessary for successful treatment of cholangitis?
    Atb excreted in bile + against gram + enterococci (pipperacilin + tazobactam)
  187. List drugs used for eradication of helicobacter pylori.
    Metronidazole, clarithromycin, omeprazol, amoxicillin
  188. List three unequivocal indications for eradication of helicobacter pylori.
    Peptic ulcer, malt lymphoma, gastritis, gastric carcinoma
  189. What diagnostic method do we use in oder to evaluate compliance of a patient treated for celiac disease?
    Gliadin abs
  190. What diagnostic method do we use in oder to prove unequivocally celiac disease?
    Endoscopy, histology, biopsy, immunologic (anti-tissue transglutaminase, anti-gliadin, anti-endomysium)
  191. When during the day is the highest cortisol level in plasma?
    Morning (6-8h)
  192. What is an usual hydrocortison dose (range) used for substituion in a patient suffering from addison's disease?
    30 mg/day
  193. What are typical laboratory findings in patients with hyperaldosteronism (conn's syndrome)?
    Serum ? decr. K (hypokalemia), urine ? incr. K, incr. Na, met. Alkalosis
  194. In a patient with addison's crisis one can expect hypertension, hypotension or a patient is normotensive?
    Hypotension
  195. Define the common therapeutic dose of intravenous hydrocortisone administred during an acute situation. In which acute situation this treatment should be applied?
    Addison crisis. 100mg bolus + 100 mg 6-8h (max 300-400 mg/24h). Applied in surgery, pneumonia, sepsis, trauma
  196. What means tetany?
    Increased muscular spasms (decreased ca and mg)
  197. What are typical symptoms of thyreotoxicosis?
    Loss of weght, tachyarrhythmia, increased hr, palpitations, diarrhea, tiredness
  198. What are typical symptoms of hypothyroidism?
    Weight gain, bradycardia, hoarseness, cold intolerance, constipation, myxedema, obstipation, decreased bp199.
  199. What does goitre mean?
    Enlarged thyroid glan
  200. List two main causes of hypercalcemia.
    Increased pth, malignancy, sarcoidosis
  201. Which laboratory parameter is the most useful in patient with hypercalcemia and why?
    Pth to distinguish primary hyperparathyroidism, serum ca + p (ca > 2.75 mmol/l and p< 0.65 mmol/l)
  202. What are the most common signs of primary hyperparathyroidism?
    Nephrolithiasis, polyuria, increased ca, osteodystrophy, bone pain, nephrocalcinosis, pancreatitis, stomach ulcers, weakness, fatigue
  203. What signs and symptoms could tell us about possible hypocalcemia?
    Tetany, decreased bp, arrhytmia, nause, vomiting, anorexia, ecg w/ long qt
  204. Which hormonal deficit is the most important in pituitary insufficiency and why?
    Acth ? risk of addison crisis (decreased glucose, increased k)
  205. How can we differentiate polyuria caused by diabetes insipidus from polyuria in diabetes mellitus or due to hyperparathyroidism?
    Urine osmolarity or vasopressin test
  206. What is the leading sign in a patient with acromegaly?
    Acral enlargement of body parts (hands, feet, skull, tongue, jaw, lips, nose), organomegaly
  207. Why is abrupt interruption of long-term corticosteroid treament (with medium or high doses) dangerous?
    Acute adrenal insufficinecy ? depressin of hpa axis (hypothalamic-pituitary-adrenal axis)
  208. What are clinical signs of hyperaldosteronism?
    Ht, muscular fatigue, paralysis, metabolic alkalosis, increased na, decreased k, polyuria, palpitations
  209. What symptoms could tell us about possible pheochromocytoma?
    Paroxysmal ht with bp crisis (50%), persistent ht (50%), headache, palpitations, pallor, sweating, nausea, dyspnea, nervousness
  210. What treatment should be instituted in a patient with adrenal (addisonian) crisis?
    100mg bolus hydrocortisone + 100mg 6-8h i.v.211.
  211. Which laboratory parameter is the most useful in a patient with primary hypothyroidism in an outpatient office?
    Increased tsh and decreased t4
  212. List other endocrine diseases associated with type 1 diabetes. (at least one)
    Autoimmune thyroiditis, gastritis, celiac desease
  213. What are clinical signs and symptoms telling us about suddenly developed anemia?
    Dyspnea, pallor, tachycardia, weakness
  214. What is the most common cause underlying development of microcytic anaemia?
    Chronic blood loss (gyn, git, uro)
  215. Which morphologic characteristic is important for differentiation of anemias?
    Mcv, mch, rdw, mchc
  216. What is the most frequent and wide-spread type of anemia?
    Sideropenic
  217. What is the most serious complication of pernicious anemia?
    Gastric carcinoma
  218. What is the most notable symptom of haemolytic anemia?
    Icterus
  219. Which laboratory test do we use for confirmation of autoimmune hemolytic anemia?
    Coombs test
  220. There is a necessity to treat a patient with autoimmune hemolytic anemia by blood transfusions. What kind of transfusion preparation would you prefer?
    Washed out rbcs, 37?c
  221. Is hemolytic anemia possible to be observed in a patient after a cardiac surgery (using extracorporal circulation)?
    Yes, mechanical trauma
  222. What is a typical finding in blood count in a patient who suffers from aplastic anemia?
    Pancytopenia, reticulopenia (0.1%), thrombocytopenia
  223. Which examination is necessary to perform in differential diagnosis of aplastic anemia?
    Bone marrow aspiration
  224. What is the most frequent complication of chronic lymphocytic leukemia?
    • Infection
    • Is the primary focus of non-hodgkin lymphoma located always in a lymph-node?
    • No
  225. What is the consequence of the bence-jones protein production?
    Renal failure
  226. What is the typical x-ray finding in kahler?s disease?
    Osteolysis, fractures
  227. What lab test do you use for monitoring the efficacy of low-molecular weight heparin treatment?
    Factor xa (anti xa)
  228. Which preparation is the most effective to normalize protrombin test in a patient who is overdosed by warfarin?
    Fresh frozen plasma
  229. Which preparation is essential to treat a trombocytopenic patient when an emergent surgery is required?
    Platelets
  230. Inr
  231. Which imaging method should be performed to prove the intracerebral haemorrhage?
    Ct
  232. Which imaging method should be performed in patients with stroke before initiation of low-molecular weight heparin treatment?
    Ct
  233. Can brain arteries atherosclerosis lead to the cerebral atrophy?
    Yes
  234. What is the upper limit of normal size of lymph node?
    0.5-1 cm inguinal, 1.5 cm axilla, groin, 1 cm neck
  235. What is the most frequent underlying cause of lymphadenopathy? Benign or malignant?
    Benign
  236. Which imaging method could be used for evaluation of the size of lymph nodes.
    Us
  237. What does sentinel lymph node mean?
    First lymph node draining a tumor, primary site of metastasis
  238. Is lymphadenopathy present in a patient with whipple?s disease?
    Yes
  239. Which test do we use for monitoring of efficacy during warfarin treatment?
    Inr
  240. At what size of a lymph node do we consider lymphadenectomy? > 2.5 cm (depending on location)
  241. What antidote do we use in a serious heparin overdosing?
    Protamine sulfate 1mg/100iu
  242. Is disseminated intaravascular coagulation a dynamic disorder?
    Yes
  243. Could reaction antigen?antibody trigger disseminated intravascular coagulation?
    Yes
  244. What are the most frequent complications after bone marrow transplantation?
    Pancytopenia, infection, gvhd
  245. At what concentration of hemoglobin do we administer blood transfusion?
    70g/l
  246. What is the most frequent type of anemia in pregnant women?
    Sideropenia
  247. At what site do we perform confirmatory determination of blood groups of a patient and prbc?
    Bedside table
  248. List class of drugs used for treatment of immune-mediated adverse reaction to blood transfusion.
    Antihistaminics, cs, antipyretics, antithrombin, heparin, coagulation factors
  249. What is the first therapeutic measure in case of adverse reaction to blood transfusion?
    Stop transfusion
  250. What is mycosis fungoides?
    Skin t-cell lymphoma
  251. Which disease is associated with pel-ebstein fever with?
    Hodgkin lymphoma
  252. What is walderstrom?s disease?
    Lymphoplasmocytic lymphoma with macroglobulinemia
  253. What does uremia (azotemia) mean?
    Syndrome with increased nitrogeneous substances in urine (accompanying renal failure)
  254. Which parameter is crucial for evaluation of renal function in ckd disregarding etiology of nephropathy?
    Gfr
  255. Could we evaluate glomerular filtration rate without performing any clearance methods (clearance of creatinin, inulin, dtpa)?
    Yes, calculated (mdrd)
  256. How many stages of chronic kidney disease according to kidney disease outcome quality initiative (kdoqi) do we distinguish?
    5
  257. What is the parameter used for division into the ckd stages according to kidney disease outcome quality initiative (kdoqi)?
    Calculated gfr
  258. What is diagnostics of urinary tract infection based on?
    Symptoms + bacteriuria > 10^5
  259. Define the therapy of asymptomatic bacteriuria (abu) in various situations.
    Atb therapy if: pregnant, before surgery
  260. What does the term ?complicated infection of urinary tract? mean?
    Cystitis or pyelonephritis in patients with increased risk for utis
  261. List at least two promotors of lithogenesis causing urolithiasis.
    Increased urine concentration of ca, oxalates, phosphates, uric acid, cysteine
  262. Which bacterial phylla are associated with urolithiasis?
    Proteus, klebsiella, pseudomonas
  263. What factors contribute very often to lithogenesis? List at least two of them.
    Decreased fluids intake, increased nacl and proteins intake
  264. What does the term ?ischemic kidney disease? mean?
    Decreased gfr caused by renal ischemia due to atherosclerosis in renal vessels
  265. What is the most frequent form of vascular nephropathy in population?
    Hypertensive nephrosclerosis
  266. What are predisposing factors for vascular nephropathy?
    Genetics, atherosclerosis, cholesterol, endothelium dysfunction, ht, dm, age
  267. What is the definition of microalbuminuria?
    30-300 mg/24h in 3 different measurements over 6m
  268. What is the definition of selective glomerular proteinuria?269.
    Secretion of proteins medium size (69-88kda) ? albumin, transferrin
  269. What does the term ?preglomerular (overflow) proteinuria? mean?
    High plasma concentration of low molecular weight proteins pass into filtrate
  270. What does the term ?tubular proteinuria? mean?
    Proteinuria due to decreased tubular reabsorption of normal proteins
  271. What is the definition of non-selective glomerular proteinuria?
    Excessive secretion of proteins in urine. Loses capacity to distinguish and filter proteins by size. Iggs in urine
  272. What is the definition of nephrotic proteinuria?
    3.5 g/24h
  273. What method does ?hospital?s lab v motole? use for evaluation of erytrocyturia?
    Automated microscopy of native urine without centrifugation
  274. What morphological abnormality of erythrocyte found in urine sediment is indicative of glomerular lesion?
    Acanthocytes
  275. What is the definition of rapidly progressive glomerulonephritis?
    70% impairement of glomeruli progressing to esrd
  276. Which method, used in evaluation of bioptic renal sample, gives us the most important additional information needed for differential diagnosis of rapidly progressive glomerulonephritis?
  277. Which imaging method provides us with enough information about urinary tract? (ureters, urinary bladder) list at least one.
    Us, ct, excretory urography, mri, cystoscopy
  278. What extra benefit has the examination with nuclear nephrography in comparison to other imaging method.
    Can view functional renal changes
  279. Use of iodinated contrast agents (dyes) in imaging methods in patients suffering from decrease of renal function is associated with a risk. Define this risk.
    Iodine contrast nephrotoxicity (with pre-existing risk) ? changes in hemodynamics and direct tubular toxicity
  280. Which kind of examination is considered as the most important in the initial part of differential diagnosis of acute renal failure?
    Excretion fracton of na + us
  281. What is the definition of nephrotic syndrome?
    Proteinuria > 3.5 g/24h, hypercholesterolemia >8, hypoalbuminemia <30 g/l, edema
  282. What is the definition of 1st type of nephrotic syndrome?
    Minimal change disease, selective proteinuria > 5g/24h without erythrocyturia
  283. What is the definition 2nd type of nephrotic syndrome?
    Focal segmental glomerulosclerosis and membranouse gn, non-selective proteinuria > 5g/24h with erythrocytuira (20), mild ht
  284. What is the definition 3rd type of nephrotic syndrome?
    Membranoproliferative gn, non-selective proteinuria > 5g/24h with erythrocyturia (100), moderate ht
  285. Which criterion is used for division of metabolic acidoses into two basic types?
    Anion gap
  286. List the formula for counting fo anion gap.
    (na + k) ? (cl + hco3) 6-16mmol/l
  287. List at least three causes for metabolic acidosis with anion gap.
    Ketoacidosis, lactic acidosis, uremic acidosis, alcoholic acidosis
  288. What does the term ?bence-jones protein? mean?
    Paraprotein composed of monoclonal ig light chain (multiple myeloma). Produce cristals deposited in tubules
  289. What is the most frequent cause of dehydration associated with lab abnormalities: hypokalemia, hypochloremia and metabolic alkalosis?
    Vomiting
  290. What is the name of endocrine abnormality associated with normo or hypocalcemia, hyperphosphatemia and elevated level of parathormon in plasma?
    Secondary hyperparathyroidism
  291. What is the definition of tertiary hyperparathyroidism?
    Resistant pth after long period of secondary with increased ca
  292. List at least three therapeutic measures used for correction of hyperphosphatemia.
    Limit protein intake, phosphate binders (ca acetate + carbonates), furosemide
  293. What is the sodium deficit in patient with body weight = 74 kg and serum concentration of na = 115 mmol/l?
    0.6 x kg x 140 = 0.6 x 74 x 25 = 1110 mmol/l in male
  294. What is volume (in litres) of the whole body water in a patient whose body weight is 75 kg.295.
    75 x 0.6 = 45l in male (60%), 41l in females (55%)
  295. What is the definition of polyuria?
    Increased diuresis per 24h (>2,5l/d)
  296. What is the definition of oliguria?
    Decreased diuresis per 24 h (< 500mg/d)
  297. According to which criterion do we divide polyuria into two basic forms?
    Osmolality of urine
  298. What is the formula for calculation of base deficit?
    Hco3 = 0.3 x kg x (24- hco3) ? 84% hco3
  299. What is the water deficit in patient with body weight = 74 kg and serum concentration of na = 179 mmol/l?
    0.6 x kg x (1- na target/measured na) = 0.6 x 74 x (1-140/179) = 9,63 l
  300. What value of fraction excretion of sodium (fena) would you assume in patient with renal failure of prerenal etiology?
    Low fena < 1%
  301. Ucr/una ratio helps us to differentiate between prerenal and renal cause of oliguria. What value of this ratio is indicative of renal cause of oliguria?
    < 40
  302. What is the treatment of thoracic empyema? List at least two methods.
    Atbs + thoracic drainage
  303. What is the definition of nosocomial pneumonia?
    Pneumonia acquired 2 days after staying in hospital or 14 days after discharge
  304. List the two most frequent locations of the extra-thoracic tuberculosis, occurred in the czech republic.
    Lymph nodes, joints and skeleton
  305. What way of drug administration is preffered in the astma bronchiale treatment?
    Inhaled
  306. How long (how many months) should the patient have a productive cought to consider such disorder to be chronic?
    3 m in 2 consecutive years
  307. What is the main risk factor for development of chronic bronchitis?
    Smoking
  308. What kind of obstructive ventilation disorder is typical of astma bronchiale?
    Reversible3
  309. What oxygen concentrations could be administered during acute astma bronchiale treatment?
    Increased 4 l/min
  310. What kind of obstructive ventilation disorder is typical for copd?
    Irreversible
  311. What is the change of ventilation pattern in a patient with acute exacerbation of copd?
    Shallow, faster, no involvement of acessory muscles
  312. List at least two groups of drugs using in the treatment of patients with copd.
    Beta and sympatomimetics, cs, antimuscarinic agonists
  313. Define parameters of sufficient oxygenation (sao2, pao2) in a patient with copd exacerbation.
    Sao2 90%, pao2 8 kpa
  314. Which type of ventilation change is typically present in idiopathic pulmonary fibrosis?
    Restrictive
  315. Define the possible sources of nosocomial infection. List at least two possible causes.
    Mechanical ventilation, humidifiers, staff, air conditioning
  316. What means multiresistant tuberculosis?
    Tb resistant to at least 2 anti-tb drugs (isoniazid + rifampicim)
  317. Define the indication of corticosteroids in the treatment of extrapulmonary tuberculosis.
    Cns, septic shock, adrenal, pleural
  318. What is the consequence of inadequate adh secretion?
    Nausea, tiredness, haedache, cramps, brain edema, coma, decreased na
  319. Which are the two basic histological types of pulmonary carcinoma?
    Small cell vs non small cell ca
  320. Specify the neurological disease which is frequently observed in patients suffering from thymoma (in 30-50%).
    Myasthenia gravis
  321. Specify the auscultation findings in pneumothorax.
    Reduced breathing, inaudible sounds
  322. What is the most common cause of secondary pneumothorax?
    Rupture of emphysematous bullae in young smokers
  323. Define changes in blood gases caused by alveolar hypoventilation.hypoxemia, hypercapnia
  324. What is the most frequent cause of transsudate in pleural cavity?
    Left heart failure
  325. Which biochemical parameter do we have to examine in young adults with severe form of copd?
    Alfa-1-antitrypsin
  326. What class of drugs is overused in the highest level in patients with copd?
    Cs
  327. What does the abbreviation ?ltot? mean?
    Long term oxygen therapy
  328. Which indication for lung transplant is associated with the best postoperative prognosis of the patients?
    Cystic fibrosis
  329. What hemodynamic parameter precludes the possibility of unilateral lung transplant?
    Pulmonary ht
  330. What is the name for class of drugs used for treatment of unproductive (irritating) cough?
    Antitussics
  331. What is the name for class of drugs used for treatment of productive cough and expectoration of viscous mucus?
    Expectorants/mucolytics
  332. What disease is the cause for chronic cough in most cases?
    Rhinitis in non smokers, smoking (copd)
  333. What is the name of disease characterised by increased resistance in upper respiratory tract and periods of apnea during sleep?
    Obstructive sleep apnea
  334. What extent of pneumothorax (given by distance between the thoracic wall and lung) could be considered as a small rim pno?
    3cm
  335. When performing drainage of pleural cavity by active suction, what is the range of negative pressures used?
    -10 to -30 cmh2o
  336. What countries do we find the highest rate of tuberculosis?
    Developing countries (africa, asia)
  337. What is the term for lean dyspnoic patients with emphysema and no cyanosis?
    Pink puffers
  338. What does the term ?incidence of tbc? mean?
    Number of newly diagnosed tb cases per year per 100 000 people
  339. What is the incidence of tbc in czech republic in recent years and what is the trend of this parameter?
    Incidence is decreasing steadily: < 8/100 000
  340. What does the term ?primary tbc? mean?
    Initial infection in a noninfected individual
  341. What does the term ?postprimary tbc? mean?
    Reactivation or reinfection of previous infection (when health status declines)
  342. What does the term ?latent tbc? (ltb) mean?
    Asymptomatic carriage of tb
  343. What are the tests for ?latent tbc? (ltb)?
    Igras (interferon gamma release assays), quanti-feron-tb test
  344. What is the evaluation of mantoux ii test?
    Evaluates the size of the induration on skin, normal until 5cm, 5-15cm positive, >15cm active infection
  345. What factors increase risk for the transition of ?latent tbc? into active form?
    Immunosupression, contact with symptomatic tb
  346. What examinations is it necessary to perform before the treatment with anti-tnf alfa agents?
    Igras + chest x-ray
  347. What is time is required to perform cultivation of m. Tuberculosis?
    4-6 weeks (up to 8w)
  348. What are the disadvantages of using pcr to diagnose m. Tuberculosis when compared with classic cultivation test?
    False positive results
  349. What material is examined in cases when the patient is unable to expectorate sputum?
    Induce sputum (after inhalation nacl), bronchoaspiration
  350. What is the course of chemoprophylactic treatment of tbc in cr?
    Isoniazid 5mg/kg during 6m
  351. When is the chemoprophylactic treatment of tbc indicated?
    Kids in contact with tb, immunosuppressed in contact with tb, tuberculin reaction >10mm/y
  352. List all five basic antituberculotic drugs.
    Isoniazid, rifampicin, ethambutol, pyrazinamid, streptomycin
  353. Which antituberculotic drugs are used in the initial treatment and how long does the initial phase last?
    Isoniazid, rifampicin, ethambutol/streptomycin, pyrazinamide for 2m
  354. Which antituberculotic drugs are used in the continual treatment and for how long?
    Isoniazid + rifampicin for 4m
  355. What does the abbrevation ?mdr? mean in relation to tbc?
    Multidrug resistant tb (to isoniazid and rifampicin)
  356. List at least 2 of some antituberculotic drugs used for the treatment of mdr tuberculosis?
    Linezolid, amikacin, kanomycin
  357. What is the justification for tbc vaccination?
    Severe forms of tb such as basilar meningitis and miliary tb
  358. Which groups of population are currently vaccinated against tbc in cr?
    Kids > 2.5kg from day 4 to 6w if: 1. House member has or had active tb, 2. Member in country with active tb, 3. Social groups, homeless
  359. Is the phrase ?there is a steady increase of lung cancer incidence in cr in both men and women? true? Please justify.
    No. Only women
  360. What is the difference between pneumonia and bronchopneumonia?
    Pneumonia- 90% streptococcal, 30-40y with underlying chronic disease. Bronchopneumonia- kids and elderly, lighter, spotted consolidations, staph & e. Coli
  361. What is the definition of ?community acquired? pneumonia?
    Pneumonia caught in normal environment, outside hospital
  362. What is the definition of nosocomial pneumonia?
    Pneumonia acquired 2 days after hospitalization or within 14 days after discharge
  363. What is the most common pathogen causing pneumonia?
    Streptococcus pneumoniae
  364. What pathogens cause so-called ?atypical? pneumonia?
    Mycoplasma, chlamydia, francisella, legionella, coxiella
  365. In walking patient where is the aspiration pneumonia localised?
    Right inferior lobe
  366. In lying patient (for example ventilated) where is the aspiration pneumonia localised?
    Posterior segments of lower lobes
  367. What is the detection rate of disease causing pathogens in sputum?
    50%
  368. Finding of gramm positive diplococci in sputum is suspective of what pathogen?
    Strep. Pneumoniae
  369. Which bacterial antigens are commonly examined in a urine sample?
    Strep., legionella
  370. Which class of immunoglobulins is important for diagnosis of acute m. Pneumonii and ch. Pneumonii infections?
    Igm, iga
  371. List at least 2 groups of antibiotics used for the empirical treatment of community acquired pneumonia.
    Amoxicillin, macrolides
  372. List at least 2 groups of antibiotics used for the treatment of atypical pneumonia.
    Macrolides, tetracyclines, fluoroquinilones
  373. Which groups of patients are at increased risk of nosocomial pneumonia?
    Ventiated, surgery (abd, chest), immobilized, immunosupressed
  374. What is the most common pathogen causing nosocomial pneumonia?
    Pseudomonas
  375. List at least 2 groups of antibiotics used for the empirical treatment of nosocomial pneumonia.
    Antipseudomonas penicillin, cabapenems
  376. List at least two of the most common complications of pneumonia.
    Empyema, abscess, fistula, sepsis
  377. What is the most common etiology of pneumonia in immunocompromised patients?
    Bacterial, cmv
  378. What is the most common pathogen causing pneumonia in aids patients?
    Pneumocystis jiroveci
  379. What is a first typical symptom of rheumatoid arthritis manifestation?
    Stiff joints in the morning
  380. What pathogens cause aspiration pneumonia?
    Enterococci, anaerobes, s. Aureus, h. Influenzae
  381. Where is polymyalgia rheumatica pain typically localized?
    Shoulders, hips
  382. What is the basic medication for the treatment of polymyalgia rheumatica?
    Prednison
  383. What is the usual range (min-max dose) of the dose in chronic prednisone therapy?
    5-60mg
  384. Which part of the musculoskeletal system is affected in bechterew's disease (ankylosing spondylitis)?
    Sacroiliac joint, spread proximally along the spine, can affect small peripheral joints
  385. Which extra-articular symptoms in a young man might signalize a presence of bechterew's disease?
    Uveitis, dactylitis
  386. What are the most characteristic deformities in rheumatoid arthritis?
    ?swan neck? fingers on pip and dip joints, ?wander knee? and hallux valgus
  387. What is rheumatoid factor?
    Autoab agains fc fragment of igg molecule
  388. What are rheumatoid nodules?
    Firm, painless, subcutaneous nodules of bone. Extensor parts of limbs
  389. What is the combination of clinical presentation consisting of rheumatoid artritis, splenomegaly and leukopenia called?
    Felty?s syndrome
  390. List at least two of the most common complications of felty?s syndrome?
    Bacterial infection, anemia, splenomegaly
  391. Anti-citrullinated protein antibody are characteristic for which disease?
    Rheumatoid arthritis
  392. What are the clinical manifestations of gout?
    Articular: acute gout attack, chronic gouti trophi. Extra-articular: gouty interstitial nephritis, nephrolithiasis
  393. What is the examination used for detection of urate crystals?
    Polarizing microscope from joint aspiration
  394. Which joint is most commonly affected by hydroxyapatite artritis?
    Shoulder joint395.
  395. Which disease is characterised by gross bridgeing of interverebral spaces by oseous process, especially in obese patients with dm older than 50 years of age?
    Diffuse idiopathic skeletal hyperostosis
  396. What are diagnostic features (clinical + lab and ancillary procedures) for polymyositis?
    Symetrical proximal muscle weakness, 2. Elevated serum levels of muscle enzymes (ck, ldh, alt, ast, mg), 3. Multifocal myopathic emg changes, 4. Biopsy- inflammatory infiltrates in muscle fibers
  397. List at least two skin signs of dermatomyositis.
    ?shawl and face? rash, mechanical hands
  398. List at least two antibodies associated with myositis.
    Anti-jo-1, anti-mi-2, anti-srp, anti-pm-scl
  399. In rheumatology what does the term ?das? mean?
    Disease activity scoop
  400. What is ?antiphospholipid syndrome??
    Autoimmune disease with incresed blood clotting caused by the presence of antiphospholipid ab
  401. What is a fatal complication in patients with systemic sclerosis?
    Pulmonary fibrosis, pulmonary ht, repiratory insufficiency
  402. Which substance is used in the basic treatment of polymyositis and dermatomyositis and what is the dosing of this drug?
    Prednisone 40-80 mg (0.5-1mg/kg)
  403. List at least three major causes of clinically significant hypergammaglobulinemia.
    Multiple myeloma, waldenstrom?s macroglobuminemia, monoclonal gammopathy, sle, sarcoidosis
  404. What is the characteristic feature of diffuse idiopathic skeletal hyperostosis?
    Calcification and skeletal hyperostosis of axial skeleton and peripheries and with larynx problems
  405. List at least five adverse effects of corticosteroid treatment.
    Cushing?s, osteoporosis, hyperglycemia, infection, ht, obesity, hyperlipidemia, hypokalemia
  406. What is the recommended concurrent pharmacotherapy in patients undergoing long-term corticosteroid treatment?
    Ca, vit. D, biphosphonates, ppi, blood glucose monitoring
  407. List at least five adverse effects of nsaid treatment.
    Ulcer bleeding + perforation, hepathopathy, bronchoconstriction, cardiotoxicity, ars, nephropathy
  408. Occupational diseases in the czech republic can be acknowledged solely by...
    Center of occupational diseases
  409. The most frequent occupational disease due to vibrations nad overload of upper extremities is...
    Carpal tunnel
  410. What malignancy can be caused by benzene?
    Leukemia, lymphoma
  411. What cancers can develop uranium miners? (list at least 2)
    Lung carcinoma, leukemia, basal cell ca
  412. What occupational diseases are most frequent in the healthcare workers? (list at least 2)
    Scabies, hepatitis c, allergies
  413. What type of skin tests (and where applied) are used to diagnose contact allergic dermatitis?
    Apicutaneous test, patch test
  414. What examinations are used to diagnose vibrations-induced raynaud syndrome? (at least 2)
    Finger plethysmography, cold test
  415. Which examination can prove vibrations-induced or overload-induced peripheral neuropathy?
    Emg
  416. What antidote is used to treat internal contamination by iodine radionuclide?
    Potassium iodine
  417. What is the correct first aid after ingestion of acids or alkalis?
    Drink milk/water, no vomit, no charcoal
  418. What examination after ingestion of corrosives is considered the gold standard to diagnose the damage and to decide further steps?
    Endoscopy
  419. Which antidotes are used to treat poisoning with lead or mercury - group name (specifically dmsa, dmps)?
    Chelators, dmsa
  420. What antidote can treat intoxication with methemoglobinemia? (at least 1)
    Methylene blue
  421. What are the clinical symptoms of methemogloginemia? (2 signs at least)
    Cyanosis, dyspnea, tachycardia
  422. What is the typical sound on auscultation in asbestosis nad extrinsic allergic alveolitis?
    Inspiratory crepitus
  423. What is the treatment of silicosis and asbestosis?
    No cure
  424. What examination is crucial for the diagnosis of silicosis/ asbestosis?
    Chest x-ray
  425. What tumours may be caused by asbestos? (at least 2 types)
    Lung carcinoma, larynx carcinoma, mesothelioma
  426. What is the common effect of organic solvents?
    Neurotoxicity
  427. To diagnose occupational asthma, following examinations are crucial: (at least 2)
    Spirometry, bronchoprovocation test, allergy skin prick test
  428. Most important information in material safety data sheet of a chemical product is its formula. Where can it be found? (at least 1 possibility)
    Msds, online
  429. What shape have the opacities on the chest radiograph in silicotic patients?
    Eggshell in upper lobes
  430. What organ damage in addition to neurotoxicity causes ethylene glycol (antifreeze, brake fluids)
    Gastrotoxic, nephrotoxic
  431. What typical damage (besides cns effect) causes methylalcohol?
    Gastrotoxic, cyanosis, hypotension
  432. What antidotes are used after ingestion of ethylene glycol and methanol?
    Ethanol, fomepizole
  433. After petroleum distillates ingestion (gasoline, naphta) following procedures are contraindicated in the pre-hospital and hospital care: (2 examples)
    Vomiting, milk
  434. Poisoning with amanita phalloides can be treated with following drugs - ?antidotes?:
    Silibinine, vitamin k
  435. The latency from ingestion to first symptoms of poisoning with amanita phalloides is typically...
    7-13h
  436. Intoxication with morphine and its derivatives can be treated with...
    Naloxon
  437. Decision concerning antidote treatment in paracetamol ingestion is based on... (at least 1 option) amount, time, body weight
  438. Antidote indication in benzodiazepines or morphine derivates poisoning is based on...
    Counsciousness, breathing
Author
Marine
ID
346017
Card Set
Internal Medicine MCQ Credit
Description
MCQ for 6th year Credit Test
Updated