NCCPA Internal Medicine 2

Question 1

A 58-year-old man with chronic kidney disease has a serum potassium of 6.2 mEq/L. Which ECG finding is most characteristic of hyperkalemia?

Accepted Answer

Peaked T waves

Answer

Prolonged QT interval

Answer

ST depression

Answer

P wave inversion

Question 2

A 45-year-old woman presents with fatigue, constipation, and a serum calcium of 11.8 mg/dL. PTH is elevated. Which is the most likely diagnosis?

Accepted Answer

Primary hyperparathyroidism

Answer

Malignancy-associated hypercalcemia

Answer

Vitamin D toxicity

Answer

Familial hypocalciuric hypercalcemia

Question 3

A patient with COPD exacerbation has an ABG showing pH 7.30, PaCO2 62 mmHg, HCO3 29 mEq/L. Which acid-base disorder is present?

Accepted Answer

Acute-on-chronic respiratory acidosis

Answer

Pure acute respiratory acidosis

Answer

Metabolic alkalosis with respiratory compensation

Answer

Mixed metabolic and respiratory acidosis

Question 4

A 62-year-old man with diabetes and hypertension develops proteinuria >300 mg/day and creatinine 2.1 mg/dL. Which medication class best slows progression of diabetic nephropathy?

Accepted Answer

ACE inhibitors or ARBs

Answer

Calcium channel blockers

Answer

Beta-blockers

Answer

Thiazide diuretics

Question 5

Which finding best differentiates restrictive cardiomyopathy from constrictive pericarditis on echocardiography?

Accepted Answer

Septal bounce and respiratory variation in mitral inflow

Answer

Elevated BNP levels

Answer

Peripheral edema

Answer

Elevated JVP

Question 6

A 50-year-old woman with rheumatoid arthritis on methotrexate presents with macrocytic anemia and oral ulcers. Which supplement is indicated?

Accepted Answer

Folic acid

Answer

Vitamin B12

Answer

Iron

Answer

Pyridoxine

Question 7

A 70-year-old man has a serum sodium of 122 mEq/L, urine osmolality 600 mOsm/kg, and urine sodium 45 mEq/L. He takes a thiazide diuretic. What is the most likely cause?

Accepted Answer

Thiazide-induced hyponatremia

Answer

SIADH

Answer

Psychogenic polydipsia

Answer

Adrenal insufficiency