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Clinical Medicine - Internal Medicine Flashcards

6 cards from real COMLEX-USA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. Which condition causes an anion gap metabolic acidosis with a normal osmol gap?

    Answer: Lactic acidosis

    Lactic acidosis causes an elevated anion gap metabolic acidosis; isopropanol causes elevated osmol gap without anion gap; methanol and ethylene glycol cause both gaps.

  2. A patient with type 1 diabetes presents with nausea, abdominal pain, Kussmaul breathing, and blood glucose of 450 mg/dL. Treatment priority is:

    Answer: IV fluid resuscitation first

    In DKA, IV fluids are the first priority to restore volume and perfusion; insulin and potassium replacement follow after initial fluid resuscitation.

  3. Chvostek's sign (facial twitching with tapping CN VII) indicates which electrolyte abnormality?

    Answer: Hypocalcemia

    Chvostek's sign and Trousseau's sign (carpal spasm with BP cuff) are clinical signs of hypocalcemia causing neuromuscular hyperexcitability.

  4. A patient with nephrotic syndrome has massive proteinuria, hypoalbuminemia, and pitting edema. The most common cause in adults is:

    Answer: Membranous nephropathy

    Membranous nephropathy is the most common cause of nephrotic syndrome in adults, often idiopathic but associated with anti-PLA2R antibodies.

  5. A patient on warfarin has an INR of 8.0 with no active bleeding. Management should include:

    Answer: Holding warfarin and administering oral vitamin K

    For supratherapeutic INR (>4.5–10) without bleeding, holding warfarin and giving oral vitamin K is appropriate; IV vitamin K and FFP/PCC are reserved for active bleeding.

  6. Which finding on urinalysis is most suggestive of acute glomerulonephritis?

    Answer: Red blood cell (RBC) casts

    RBC casts in the urine are pathognomonic for glomerulonephritis, indicating that red cells have passed through the damaged glomerular basement membrane into the tubular lumen.