MD Medical Doctor General 2

Question 1

A 55-year-old male presents with sudden-onset tearing chest pain radiating to the back. BP is 180/100 mmHg in the right arm and 150/90 mmHg in the left arm. What is the most likely diagnosis?

Accepted Answer

Aortic dissection

Answer

Aortic dissection classically presents with tearing chest pain radiating to the back and a blood pressure differential between arms due to involvement of subclavian artery origins.

Question 2

Which electrolyte abnormality is most commonly associated with prolonged QT interval and increased risk of torsades de pointes?

Accepted Answer

Hypomagnesemia

Answer

Hypomagnesemia prolongs the QT interval and is the most common electrolyte cause of torsades de pointes, often treated with IV magnesium sulfate.

Question 3

A 30-year-old woman with SLE presents with a butterfly rash, joint pain, and a new serositis. Her anti-dsDNA titers are rising. Which complement levels would you expect?

Accepted Answer

Low C3 and C4

Answer

Active SLE consumes complement via immune complex deposition, leading to low C3 and C4 levels that correlate with disease activity.

Question 4

Which mechanism best explains why metformin is the preferred first-line agent for type 2 diabetes in most patients?

Accepted Answer

Decreases hepatic glucose production and improves insulin sensitivity

Answer

Metformin primarily reduces hepatic gluconeogenesis and improves peripheral insulin sensitivity without causing hypoglycemia or weight gain.

Question 5

A patient with chronic kidney disease has a GFR of 20 mL/min. Which acid-base disorder is most expected?

Accepted Answer

High anion gap metabolic acidosis

Answer

Chronic kidney disease causes accumulation of unmeasured anions (sulfate, phosphate, organic acids) leading to high anion gap metabolic acidosis.

MD - Doctor of Medicine Practice Test

MD - Doctor of Medicine Practice Test

MD Medical Doctor General 2