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FAMILY MEDICINE (FM-1) MULTIPLE CHOICE QUESTIONS / TYPE I Select the correct answers to the following questions!!! ...each question may have more than one correct answer. FM-1.1. Renal calcification is a possible complication of: A) medullary cystic kidney disease B) renal tuberculosis C) sarcoidosis D) sickle cell anemia E) secondary hyperparathyroidism FM-1.2. Which of the following statements concerning chromosomes are correct? A) their number is normally 46 B) mosaicism is the coexistence of cells with different number of chromosomes within the same organism C) they are always identical in cells of the same phenotype D) nondisjunction must be followed by translocation E) they can be used as tumor markers FM-1.3. Drugs with a bacteriostatic effect in regular doses include: A) tetracyclines B) cephalosporins C) sulfamethoxazole and trimethoprim (Sumetrolim) D) erythromycin E) amoxycillin FM-1.4. Factors causing a susceptibility to urinary tract infect include: A) urinary tract obstruction B) diabetes mellitus C) hyperkalemia D) prolonged tetracycline therapy E) pregnancy FM-1.5. The medical history of a 45-year-old male reveals episodes of vertigo and loss of consciousness associated with sweating. Possible causes of his symptoms include: A) hyperventilation B) hyperglycemia C) Zollinger-Ellison syndrome D) pheochromocytoma E) paroxysmal tachycardia FM-1.6. Possible causes of hematemesis include: A) salicylate administration B) an oral iron supplement overdose C) severe burn injury D) Menetrier's disease (giant hypertrophic gastritis) E) feeding via a nasogastric tube FM-1.7. The use of which of the following should be avoided in patients receiving monoamino-oxidase inhibitor therapy: A) cheese B) imipramine (Melipramin) C) phentolamine (Regitin) D) pethidine (Dolargan) E) sulphonamides FM-1.8. Which of the following conditions are usually associated with purpura? A) Henoch-Schonlein syndrome B) hepatic cirrhosis C) systemic lupus erythematosus D) Addison's disease E) Raynaud's phenomenon FM-1.9. Bone density is markedly increased in: A) osteopetrosis B) Paget's disease of the bone C) following the intake of a large amount of fluoride D) hyperparathyroidism E) renal osteodystrophy FM-1.10 Which of the following conditions is associated with a male-type distribution of hair in females? A) myxedema B) true hermaphroditism C) Laurence-Moon-Biedl syndrome D) Stein-Leventhal.syndrome (polycystic ovary) E) Cushing's syndrome FM-1.11. In which of the following conditions can central cyanosis be detected? A) methemoglobinemia B) ventilation-perfusion mismatch C) pulmonary arteriovenous fistula D) heatstroke E) heavy physical exercise FM-1.12. Which of- the following statements about delirium tremens are correct? A) chlormethiazole (Heminevrin) is suitable for treatment B) acoustic hallucinations are common C) visual hallucinations are common D) elecroshock therapy is indicated in severe cases E) the condition may be fatal FM-1.13. In which of the following conditions can renal failure be fatal? A) hypernephroma B) systemic lupus erythematosus (SLE) C) Weil's disease D) renal tuberculosis E) accelerated hypertension FM-1.14. Penicillin administration is the appropriate therapy in which of the following complications of syphilis? A) meningitis B) aneurysm of the aorta C) interstitial keratitis D) condyloma latum E) the generalized paralysis of psychotic patients FM-1.15. Characteristics of mycoplasma-pneumonia include: A) pleural effusion as a common complication B) the presence of cold agglutinins C) associated renal failure D) a good response to tetracyclines E) patients immunized against mycoplasma are resistant FM-1.16. Which of the following statements about post-traumatic epilepsy are correct? A) it usually follows head trauma within a month B) the CT reveals the causative abnormalities C) it requires surgical therapy in most cases D) it responds poorly to standard anticonvulsive therapy E) the EEG reveals its characteristic changes FM-1.17. Macroglossia is a possible feature of which of the following conditions? A) acromegaly B) Marfan's syndrome C) Hurler's syndrome D) achondroplasia E) amyloidosis FM-1.18. A paradoxically split second heart sound is a feature of., A) severe pulmonary stenosis B) a ventricular septal defect C) severe aortic stenosis D) a patent ductus arteriosus E) complete right bundle branch block FM-1.19. Bilateral parotid gland enlargement is a symptom of A) Mikulicz's syndrome B) infectious mononucleosis C) mumps D) brucellosis E) sarcoidosis FM-1.20. Which of the following statements about Conn's syndrome are correct? A) a high aldosterone level in the serum is a characteristic finding B) the plasma renin activity is elevated C) the associated hypertension is malignant in 10% of cases D) hyperkalemia is a common complication E) operative therapy is usually recommended FM-1.21. Recognized causes of nodular hepatomegaly include: A) postnecrotic cirrhosis B) primary biliary cirrhosis C) syphilis of the liver D) Weil's disease (Leptospira icterohemorrhagica) E) carcinomatous metastases of the liver FM-1.22. Which of the following symptoms are associated with Turner's syndrome? A) infantilism B) congenital abnormalities of the external genitalia C) an atrial septal defect D) retinitis pigmentosa E) a short stature FM-1.23. Symptoms characteristic of an acute exacerbation of ulcerative colitis include: A) the development of anemia B) the occurrence of vertigo following sulfasalazine therapy C) macroscopically detected blood in the feces D) the development of generalized eruptions E) an increased erythrocyte sedimentation rate FM-1.24. The early manifestations of congenital syphilis include: A) oral eczema B) interstitial keratitis C) occipital lymphadenopathy D) Clutton-knee (Clutton's joint) E) chorioretinitis FM-1.25. Which of the following statements about congenital hypertrophic pyloric stenosis are correct? A) it is more frequent in females B) there is an increased likelihood for any offspring to be similarly afflicted C) any vomit almost never contains bile D) the pyloric ring is rarely palpable E) the majority of patients require surgical therapy FM-1.26. Which of the following statements about renal disease are correct? A) a 3000 ml/24 h urine volume is a normal finding B) the severity of proteinuria correlates with the severity of the responsible renal disease C) granular casts are observed exclusively in renal disease D) orthostatic proteinuria, if chronic, is abnormal E) Tamm-Horsfall protein is a normal constituent of the urine FM-1.27. Which of the following conditions is associated with true hematuria? A) urinary tract tuberculosis B) acute pyelonephritis C) acute cystitis D) malignant hypertension E) renal infarction FM-1.28. Which of the following statements about medullary cystic kidney disease are correct? A) the prognosis is usually poor B) it is usually manifested during childhood C) the diagnosis is based on the associated radiological findings D) renal calculi may be present E) renal function is frequently impaired FM-1.29. In the carcinoid syndrome: A) mitral stenosis is a possible complication B) it may be diagnosed by measuring the vanillylmandelic acid (VMA) concentration in the urine C) the application of methysergide (Deseril) is a possible therapeutic intervention D) any associated alcohol intake can induce a facial blushing E) chronic dyspnea is a recognized complication FM-1.30. Primary optic nerve atrophy is a recognized complication of: A) glaucoma B) disseminated sclerosis C) Paget's disease of the skull D) neurosyphilis E) ethambutol (Sural) therapy FM-1.31. Recognized causes of motor neuropathy include: A) diabetes mellitus B) porphyria C) Guillain-Barre syndrome D) Friedrich's ataxia E) diphtheria FM-1.32. Possible causes of hypercholesterolemia include: A) primary biliary cirrhosis B) the nephrotic syndrome C) hyperthyroidism D) hepatocellular jaundice E) Gaucher's disease FM-1.33. Which of the following statements about Charcot's joint are correct? A) it is caused by syringomyelia B) it is caused by diabetes mellitus C) it is more frequent in females than in males D) one of its complications is kyphosis E) penicillin therapy is effective if this alteration is caused by syphilis FM-1.34. Recurrent syncopes are possible complications: A) in narcolepsy B) during the Valsalva maneuver C) in children suffering from whooping cough D) of the Shy-Drager syndrome E) in Adams-Stokes syncope FM-1.35. Which of the following symptoms are associated with chronic alcoholism? A) acoustic hallucinations B) amnestic syndromes C) severe pruritus D) degeneration of the corpus callosum E) multiple mononeuritis FM-1.36. Which of the following signs can be attributed to an iron deficiency anemia? A) a pale color of the sclera B) hepatosplenomegaly C) glossodynia (pain in the tongue) D) menorrhagia E) neurologic abnormalities FM-1.37. Which of the following statements about lymphogranuloma inguinale are correct? A) its causative agent is Chlamydia B) it is associated with painful primary genital lesions C) it causes painless inguinal lymphadenopathy D) it is frequently associated with suppuration of the inguinal lymph nodes E) rectal stenosis is a possible complication FM-1.38. Which of the following statements about hallucinations are correct? A) acoustic hallucinations are a common complication of amphetamine psychosis B) paranoid symptoms are characteristic of "cocaine psychosis" C) amphetamines can induce hallucinations D) hallucinations are inevitable symptoms of schizophrenia E) purely visual hallucinations suggest a functional abnormality FM-1.39. In encephalitis lethargica: A) choreoathetoid movements are seen in the acute phase B) an oculogyric crisis develops following therapy C) endogenic depression is a common complication D) mental retardation can develop E) Argyll-Robertson pupils are detected FM-1.40. Which of the following conditions are related to psychosomatic disorders? A) systemic lupus erythematosus B) vasomotor rhinitis C) peptic ulcer D) diabetes mellitus E) Bartter's syndrome FM-1.41. Which of the following compounds are well known antidotes? A) naloxone - morphine overdose B) pralidoxime - parathione intoxication C) dimercaptol - cyanide intoxication D) orphenadrine - pyridostigmine intoxication E) cobalt-EDTA - haloperidol overdose FM-1.42. HLA B8-linked diseases include: A) multiple sclerosis B) dermatitis herpetiformis C) celiac disease D) ankylosing spondylitis E) myasthenia gravis FM-1.43. Factors stimulating gastrin secretion include: A) gastric wall distension B) acid in the lumen of the stomach C) glucagon D) calcium E) secretin FM-1.44. Hyperparathyroidism is associated with: A) hypocalcemia B) psychosis C) constipation D) Trousseau's sign E) renal stones with the risk of urinary obstruction FM-1.45. Brucellosis is usually associated with: A) bilateral hilar lymphadenopathy which can be observed on the chest x-ray B) jaundice C) spontaneous remissions of several weeks to months in length D) splenomegaly E) marked sweating FM-1.46. Which of the following statements about anthrax are correct? A) it is an occupational disease B) Woolsorter's disease develops following the inhalation of the causative microorganism C) more than 90% of patients exhibit skin lesions D) the malignant pustula is very painful E) any associated regional lymphadenopathy is very unusual FM-1.47. Nephroblastoma (Wilms' tumor): A) is a malignancy of childhood B) distant metastases develop rapidly C) it may present with systemic hypertension D) if the tumor is localized to the kidney, a nephrectomy is indicated E) it causes hypercalcemia FM-1.48. Recognized causes of the nephrotic syndrome include: A) constrictive pericarditis B) malaria C) Goodpasture's syndrome D) Hodgkin's disease E) excessive use of acetaminophen (Rubophen) FM-1.49. The ECG abnormalities characteristic for acute rheumatic fever include: A) a short QT interval B) nonparoxysmal AV nodal tachycardia C) prominent U waves D) second degree AV block E) delta waves FM-1.50. Non-cardiogenic pulmonary edema is associated with: A) an acetaminophen (Rubophen) overdose B) nitrofurantoin therapy C) oxygen toxicity D) head trauma E) ketoacidosis FM-1.51 Hypoglycemia is a recognized symptom or complication of: A) Addison's disease B) the Zollinger-Ellison syndrome C) chlorpropamide therapy D) high dose penicillin therapy E) chlorpromazine therapy FM-1.52. Which of the following statements about Crohn's disease are correct? A) the prevalence of ulcerative colitis is lower in relatives of patients suffering from Crohn's disease B) pyrexia of unknown etiology is a characteristic finding C) any intestinal manifestation might be preceded by ankylosing spondylitis D) a risk of developing colonic carcinoma is increased after 10 years of the presence of Crohn's disease E) the first detected symptom of the disease is usually diarrhea without blood in the feces FM-1.53. Neuropsychiatric symptoms of hepatic insufficiency include: A) a reverse sleep pattern B) Argyll-Robertson pupils C) myelopathy with paraplegia D) perseveration signs E) diagnostic EEG abnormalities FM-1.54. Which of the following statements about psoriatic arthropathy are correct? A) it affects 20% of psoriatic patients B) all joints are symmetrically affected C) sacroileitis is a characteristic finding D) the joints of the hand frequently exhibit minimal destructive abnormalities E) the application of steroids is usually contraindicated FM-1.55. Which of the following statements about gastric secretion are correct? A) approximately 250 ml gastric juice is secreted daily B) gelatinase is a normal constituent of gastric juice C) the stomach is capable of producing both acidic or alkaline secretions D) if the rate of production is slow, the Na+ concentration is high E) only the glands of the pyloric region are capable of secreting mucus FM-1.56. Characteristics of mediastinal emphysema include: A) marked suprasternal pulsation B) Hamman's sign (a crackling sound synchronous with cardiac systole) C) pain in the throat D) gas under the diaphragm E) cyanosis FM-1.57. Transient amnesia is possible: A) following head trauma B) in patients suffering from epilepsy C) in cerebrovascular insufficiency D) in Alzheimer's disease E) in patients with a temporal lobe tumor FM-1.58. Paresthesia associated with pruritus is characteristic for which of the following conditions? A) multiple sclerosis B) temporal lobe epilepsy C) Raynaud's phenomenon D) acromegaly E) hypoventilation FM-1.59. An abnormality of speech is a recognized complication of. A) dementia paralitica (a generalized paralysis of the psychotic patient) B) congenital diplegia C) Friedrich's ataxia D) amyotrophic lateral sclerosis E) severe glossitis FM-1.60. In which of the following conditions does palpation reveal uneven, rough liver edges? A) alcoholic cirrhosis after the withdrawal of alcohol B) secondary syphilis C) hepatic actinomycosis D) Wilson's disease E) an amebic hepatic abscess FM-1.61. In polycythemia rubra vera: A) the reticulocyte count is typically elevated B) the leukocyte alkaline phosphatase activity is low C) 30% of patients exhibit hyperuricosuria D) the vitamin B binding capacity in the serum is elevated 12 E) the serum total iron level is typically elevated FM-1.62. Which of the following statements about methemoglobinemia are correct? A) it is caused by a cytochrome B reductase deficiency 5 B) the color of the blood is chocolate brown C) the family history is usually positive D) if treatment is indicated, the intravenous administration of methylene blue is a possible intervention E) cyanosis is a characteristic finding FM-1.63. In eczema of infancy: A) eruptions are characteristically present at birth B) the papules cause itching C) cold weather relieves the symptoms D) in 70% of cases the family history reveals data indicative of the disease E) the presence of dermographism excludes the diagnosis FM-1.64. Which of the following statements about Letterer-Siwe disease are correct? A) this is a slowly progressing disease of childhood B) a generalized lymphadenopathy is characteristic C) severe hemorrhagic eruptions occur D) the reaction to corticosteroids is usually positive E) a "honeycomb lung" on the x-ray film is of diagnostic value FM-1.65 Tetralogy of Fallot: A) pulmonary stenosis in most cases is due to an obstruction of the valve B) cyanosis might be absent in the first few months of life C) can be associated with convulsions D) the second pulmonary sound becomes widely split E) the pulmonary fields are typically flooded on the chest x-ray