Free Internal Medicine Board Review Trivia Questions and Answers — Questions and Answers
Question 1: Differential cell count, total protein, pH, glucose, amylase, triglycerides, microbiology, and cytology. Effusions must meet a minimum of one requirement (Light's requirement). <br>
1) Pleural/serum protein: >0.5 <br>
2) > 0.6 LDH (pleural/serum) <br>
3) LDH above three times the average serum LDH
- What is the difference between Transudative effusion and Exudative effusions?
- If exudative effusion is suspected, what should be performed on fluid? (Correct answer)
- What laboratory findings are consistent with PBC? Treatment?
- What test is used to differentiate between sarcoidosis and Berylliosis?
Correct answer: If exudative effusion is suspected, what should be performed on fluid?
The provided text explicitly lists the various components of fluid analysis—such as differential cell count, total protein, pH, glucose, amylase, triglycerides, microbiology, and cytology—that are performed to characterize an effusion. It also includes Light's criteria, which are used to differentiate between transudative and exudative effusions. Therefore, the question asking what should be performed on fluid if an exudative effusion is suspected directly aligns with the given information.
Question 2: 1) RVH <br>
2) VSF <br>
3) Overriding Aorta <br>
4) Pulmonary Artery Stenosis
- What are causes of severely elevated LFTs?
- What are the 4 features of tetrology of fallot? (Correct answer)
- What is the treatment for Goodpasture's Syndrome?
- What are causes of mildly elevated LFTs?
Correct answer: What are the 4 features of tetrology of fallot?
The four features listed—Right Ventricular Hypertrophy (RVH), Ventricular Septal Defect (VSF), Overriding Aorta, and Pulmonary Artery Stenosis—are the classic anatomical defects that collectively define Tetralogy of Fallot. This is a well-known congenital heart condition characterized by these specific structural abnormalities. The question directly asks for the condition described by these four features.
Question 3: 1) Cardiac enzymes to rule out MI <br>
2) Echocardiogram to estimate EF <br>
3) Chest x-ray to look for cardiomegaly, and pulmonary edema and rule out COPD <br>
4) EKG <br>
5) CBC (anemia)
- What is the treatment for bleed varices?
- What is the Child-Pugh rating system?
- What is the 2012 Berlin Definition of ARDS?
- Tests to order for patient with suspected CHF (Correct answer)
Correct answer: Tests to order for patient with suspected CHF
The listed tests—cardiac enzymes, echocardiogram, chest x-ray, EKG, and CBC—are all standard and essential diagnostic evaluations for a patient presenting with suspected Congestive Heart Failure (CHF). These tests help to rule out acute myocardial infarction, assess cardiac function (ejection fraction), identify cardiomegaly or pulmonary edema, detect arrhythmias, and check for contributing factors like anemia, all crucial for diagnosing and managing CHF.
Question 4: When symptoms persist despite receiving the best care possible from b-blockers, ACEI, diuretics, and aldosterone antagonists in patients with EF 40%, digoxin should be given.
- When is surgery indicated for AAA?
- What is the treatment for cholangitis?
- When should digoxin be used in CHF patients (Correct answer)
- What are the two pathological types of HCC?
Correct answer: When should digoxin be used in CHF patients
The provided text directly states the indication for digoxin use in CHF patients: 'When symptoms persist despite receiving the best care possible from b-blockers, ACEI, diuretics, and aldosterone antagonists in patients with EF 40%, digoxin should be given.' This clearly outlines that digoxin is reserved for symptomatic patients with reduced ejection fraction who remain symptomatic despite optimal guideline-directed medical therapy.
Question 5: 1) Both IV antibiotics and IV hydration <br>
2) Monitor blood pressure and urine output; once symptoms have subsided for 48 hours, perform an ERCP to determine the cause <br>
3) The most significant consequence is a liver abscess.
- What is the triad of symptoms indicating a ruptured AAA?
- What is the treatment for cholangitis? (Correct answer)
- What is the cause of Goodpasture's syndrome?
- What is Crigler-Nijjar Syndrome?
Correct answer: What is the treatment for cholangitis?
The provided information details the standard management for acute cholangitis, which involves immediate broad-spectrum intravenous antibiotics and fluid resuscitation to stabilize the patient. Subsequently, an ERCP (Endoscopic Retrograde Cholangiopancreatography) is performed to relieve biliary obstruction once the patient's condition has improved. The text also correctly identifies a liver abscess as a significant potential consequence of cholangitis.
Question 6: It was shown for patients with A. Rate control outperformed rhythm control.
- What treatment is required for TOF
- How does USA differ from NSTEMI?
- What is Churg-Strauss syndrome?
- What did the AFFIRM trial show? (Correct answer)
Correct answer: What did the AFFIRM trial show?
The provided text states, 'It was shown for patients with A. Rate control outperformed rhythm control.' This is a direct summary of a key finding from the AFFIRM (Atrial Fibrillation Follow-up Investigation of Rhythm Management) trial. The AFFIRM trial was a landmark study that compared rate control versus rhythm control strategies in patients with atrial fibrillation, concluding that a rate control strategy was not inferior to rhythm control.
Question 7: It was shown for patients with A. Rate control outperformed rhythm control.
- What treatment is required for TOF
- How does USA differ from NSTEMI?
- What is Churg-Strauss syndrome?
- What did the AFFIRM trial show? (Correct answer)
Correct answer: What did the AFFIRM trial show?
The provided text states, 'It was shown for patients with A. Rate control outperformed rhythm control.' This is a direct summary of a key finding from the AFFIRM (Atrial Fibrillation Follow-up Investigation of Rhythm Management) trial. The AFFIRM trial was a landmark study that compared rate control versus rhythm control strategies in patients with atrial fibrillation, concluding that a rate control strategy was not inferior to rhythm control.
