FREE Internal Medicine Board Review MCQ Questions and Answers

Question 1

A 68-year-old man who is a patient in the emergency room woke up with palpitations, chest pain, dyspnea, and vertigo.
He claims his heart is "beating," but he has no history of heart disease or high blood pressure.
His pulse is quick and erratic, his blood pressure is 85/60 mmHg, and crackles can be heard at the bases of his lungs.
His standard laboratory tests, including a troponin level, are expected.
His EKG reveals atrial fibrillation with a 130-beat-per-minute ventricular response.
Which course of action is ideal?

Accepted Answer

Intravenous digoxin

Answer

Delayed cardioversion after anticoagulation

Answer

Immediate cardioversion

Answer

Intravenous beta-blocker

Question 2

An intermittent, mid-sternal chest ache that typically lasts 5 to 10 minutes affects a 57-year-old male. Both when we are working and when we are not. His throat also feels sore, which occasionally gets better with antacids. He stopped smoking around the age of 50. He denies having other serious medical issues. His type 2 diabetes and hypertension run in the family. His height is 70 inches, weight is 210 pounds, blood pressure is 135/85 mmHg, and pulse is regular at 76. Auscultation reveals his chest is clean and free of cardiac rubs or murmurs. The overall evaluation is unfavorable. He has a normal electrocardiogram. What logical step would result in the best chance of a diagnosis?

Accepted Answer

Technetium Tc99m Sestamibi stress test

Answer

Troponin Level

Answer

EGD Endoscopy

Answer

Coronary Angiography

Question 3

A 52-year-old guy with Type 2 diabetes attends the clinic for his yearly checkup. The only drug he takes is metformin. His serum creatinine level was 1.8 mg/dL, and his most recent hemoglobin A1C result was 6.5%. Despite having a high blood pressure of 170–175 mm/Hg, the remainder of his evaluation is negative. Although his chest x-ray is normal, left ventricular hypertrophy is suggested by his EKG. Which medication would be best for treating his hypertension?

Accepted Answer

Angiotensin receptor blocker (ARB)

Answer

Thiazide diuretic

Answer

Beta-blocker

Answer

Calcium channel blocker (CCB)

Question 4

You are meeting a 20-year-old male who has complained for the previous two months about "puffy eyes" and "swollen ankles." Additionally, he says that his pee "sort of looks frothy and foamy." His vital signs during the examination are within normal ranges, and the funduscopy is uneventful save for minor bilateral edema 2+ in the bilateral feet to the ankle. He has never experienced any health issues or operations. His tests show an average serum creatinine level; a considerable 4-plus protein level without blood or bacteria is found in the urine. He has had a kidney biopsy, which on light microscopy appears normal but, on electron microscopy, reveals diffuse podocyte effacement. Negative immunofluorescence results. Which medical intervention is ideal for this patient?

Accepted Answer

Corticosteroids

Answer

Cyclophosphamide

Answer

Tacrolimus

Answer

Rituximab

Question 5

A 25-year-old lady who has been experiencing lethargy and polyuria for the past nine months comes into your office for an examination. She also had anorexia and a mysterious 12-pound weight drop. She has also experienced nocturnal sweats for a few months. She exhibited minor hypercalcemia upon evaluation of her lab results from her yearly visit roughly nine months prior, while all other tests, including glucose, were normal. She has been playing tennis outside more frequently and anticipated feeling better as a result of the increased exercise. She doesn't have a history of fractures or nephrolithiasis. No history of hypercalcemia in the family. She doesn't use any prescription drugs.
Physical exam:
Weight 125 pounds, height 5’2”, blood pressure 102/74 mmHg, heart rate 94 bpm
She has dry mucous membranes and delayed deep tendon reflexes. Otherwise unremarkable.
You send her to the lab to evaluate her symptoms and history of mild hypercalcemia. Her lab results are remarkable for Calcium = 13.1 mg/dL (8.9-10.1 mg/dL)
Phosphorus = 5.0 mg/dL (2.5-4.5 mg/dL)
Creatinine = 1.4 mg/dL (0.6-1.1 mg/dL)
Serum urea nitrogen = 22 mg/dL (6-21 mg/dL)
Intact PTH = 4 pg/mL (10-65 pg/mL)
25-Hydroxyvitamin D = 24 ng/mL (25-80 ng/mL)
1,25-Hydroxyvitamin D = 90 pg/mL (16-65 pg/mL)
Alkaline phosphatase = 99 U/L (37-98 U/L)

Accepted Answer

Prednisone

Answer

Calcitonin

Answer

Zolendronic acid

Answer

Cinacalcet

Question 6

A middle-aged man who was experiencing chest problems went to the emergency room. Results from the lab and the EKG showed a non-ST elevation of myocardial infarction (NSTEMI). His left anterior descending artery had a significant branch that was 95% blocked, according to an angiography (LAD). Less than 40% of his other streets seemed to be stopped. The highly clogged vessel underwent balloon angioplasty, and a drug-eluting stent was implanted. The patient claims that following the treatment, he is pain-free. Now that his resting EKG is normal, ischemia cannot be detected by an isotope stress test. With the exception of which drug the patient should be released on all the following medications?

Accepted Answer

Warfarin

Answer

ACE inhibitor

Answer

Clopidogrel

Answer

Statin

Question 7

Which of the following statements about a ventilator with volume control is false?

Accepted Answer

Pressure is controlled

Answer

lung injury may occur at high pressures

Answer

Minute ventilation volume can be preset

Answer

Tidal volume is preset and fixed