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Question 1. Which of the following is the most common cause of dilated cardiomyopathy in young adults? A) Ischemic heart disease B) Viral myocarditis C) Hypertension D) Alcohol abuse Answer: B Explanation: Viral myocarditis is a frequent cause of dilated cardiomyopathy in young adults, leading to myocardial inflammation and dilation of the ventricles. Question 2. In atrial fibrillation, which of the following is the primary abnormality? A) Absent P waves and irregularly irregular QRS complexes B) Prolonged PR interval C) Re-entry at the AV node D) Sheath of QRS complex widening Answer: A Explanation: Atrial fibrillation is characterized by the absence of P waves and an irregularly irregular ventricular rhythm due to disorganized atrial activity. Question 3. Which congenital heart defect is most commonly associated with a systolic ejection murmur at the right second intercostal space? A) Atrial septal defect B) Coarctation of the aorta C) Aortic stenosis D) Patent ductus arteriosus Answer: C Explanation: Aortic stenosis typically presents with a systolic ejection murmur heard best at the right second intercostal space. Question 4. Which of the following is a hallmark feature of hypertrophic cardiomyopathy on echocardiogram?
A) Diffuse ventricular dilation B) Asymmetric septal hypertrophy C) Dilated aortic root D) Normal wall thickness with impaired relaxation Answer: B Explanation: Hypertrophic cardiomyopathy commonly shows asymmetric septal hypertrophy on echocardiogram, often leading to outflow obstruction. Question 5. Which of the following is the most typical presentation of stable angina? A) Chest pain at rest lasting more than 20 minutes B) Chest pain precipitated by exertion and relieved by rest C) Sharp chest pain worse with inspiration D) Chest pain associated with diaphoresis and nausea only during sleep Answer: B Explanation: Stable angina occurs with exertion and alleviates with rest, reflecting fixed coronary artery narrowing. Question 6. Which of the following best describes systolic heart failure? A) Impaired ventricular relaxation and filling B) Reduced ejection fraction with decreased contractility C) Increased ventricular compliance D) Normal ejection fraction with diastolic dysfunction Answer: B Explanation: Systolic heart failure involves decreased contractility leading to reduced ejection fraction and impaired systolic function. Question 7. Which laboratory finding is most indicative of a hypertensive emergency? A) Blood pressure >180/120 mm Hg with evidence of end-organ damage B) Blood pressure >140/90 mm Hg with no symptoms C) Isolated systolic hypertension in elderly patients
Explanation: Streptococcus viridans is a common causative organism of subacute infective endocarditis, especially involving damaged valves. Question 11. Which valvular disorder is most commonly associated with a "click" followed by a systolic murmur? A) Mitral valve prolapse B) Aortic stenosis C) Mitral stenosis D) Tricuspid regurgitation Answer: A Explanation: Mitral valve prolapse often produces a mid-systolic click due to leaflet prolapse, sometimes followed by a murmur. Question 12. Which of the following vascular conditions is characterized by a dilatation of the aorta greater than 1.5 times normal size? A) Aortic aneurysm B) Arterial embolism C) Atherosclerosis D) Aortic dissection Answer: A Explanation: An aortic aneurysm is a localized dilatation of the aorta exceeding 1.5 times its normal diameter. Question 13. Which dermatologic condition presents with erythema, telangiectasias, and flushing predominantly on the face? A) Rosacea B) Psoriasis C) Seborrheic dermatitis D) Acne vulgaris Answer: A
Explanation: Rosacea manifests with facial erythema, telangiectasias, and flushing, often exacerbated by triggers. Question 14. Which of the following is a common trigger for Stevens-Johnson syndrome? A) Antibiotics, especially sulfonamides B) Viral infections only C) Ultraviolet light exposure D) Bacterial skin infections Answer: A Explanation: Stevens-Johnson syndrome is often drug-induced, with antibiotics like sulfonamides being common triggers. Question 15. Which fungal infection typically causes a "ring-shaped" lesion with central clearing? A) Dermatophyte infection (tinea corporis) B) Candidiasis C) Aspergillosis D) Cryptococcosis Answer: A Explanation: Tinea corporis presents as ring-shaped, erythematous, scaly lesions with central clearing caused by dermatophyte fungi. Question 16. Which skin neoplasm is most commonly associated with chronic sun exposure and presents as a pearly, telangiectatic papule? A) Basal cell carcinoma B) Melanoma C) Squamous cell carcinoma D) Actinic keratosis Answer: A Explanation: Basal cell carcinoma typically appears as a pearly papule with telangiectasias, often on sun- exposed skin.
Question 20. Which parathyroid disorder causes hypercalcemia and elevated parathyroid hormone levels? A) Primary hyperparathyroidism B) Hypoparathyroidism C) Pseudohypoparathyroidism D) Vitamin D deficiency Answer: A Explanation: Primary hyperparathyroidism involves overproduction of PTH, leading to hypercalcemia. Question 21. Which ocular condition is characterized by increased intraocular pressure leading to optic nerve damage? A) Glaucoma B) Cataract C) Macular degeneration D) Conjunctivitis Answer: A Explanation: Glaucoma involves increased intraocular pressure causing optic nerve damage and potential vision loss. Question 22. Which of the following describes a common cause of conductive hearing loss? A) Otosclerosis B) Presbycusis C) Meniere's disease D) Acoustic neuroma Answer: A Explanation: Otosclerosis causes fixation of the stapes bone, leading to conductive hearing loss. Question 23. Which sinus is most commonly involved in acute sinusitis? A) Maxillary sinus B) Frontal sinus
C) Ethmoid sinus D) Sphenoid sinus Answer: A Explanation: Maxillary sinusitis is the most common form of acute sinusitis due to its drainage pathway. Question 24. Which oropharyngeal infection is characterized by a "hot potato" voice and muffled speech? A) Peritonsillar abscess B) Pharyngitis C) Laryngitis D) Epiglottitis Answer: A Explanation: Peritonsillar abscess causes swelling that displaces the soft palate, resulting in a muffled voice. Question 25. Which gastrointestinal disorder is characterized by inflammation of the gallbladder often associated with gallstones? A) Cholecystitis B) Cholangitis C) Pancreatitis D) Gastroenteritis Answer: A Explanation: Cholecystitis involves inflammation of the gallbladder, frequently caused by gallstones obstructing the cystic duct. Question 26. Which of the following best describes the clinical feature of peptic ulcer disease? A) Burning epigastric pain relieved by food or antacids B) Sudden, severe chest pain radiating to the back C) Intermittent lower abdominal cramping worsened by meals D) Chronic diarrhea with weight loss
Question 30. Which of the following is a common cause of primary amenorrhea? A) Congenital absence of the uterus (Müllerian agenesis) B) Polycystic ovary syndrome C) Uterine fibroids D) Endometriosis Answer: A Explanation: Congenital absence of the uterus is a primary cause of amenorrhea, as the menstrual pathway is absent. Question 31. Which is the most common benign prostatic hyperplasia (BPH) presenting symptom? A) Urinary frequency and hesitancy B) Hematuria C) Fever and chills D) Painful urination with dysuria Answer: A Explanation: BPH commonly causes obstructive symptoms such as hesitancy, weak stream, and urinary frequency. Question 32. Which test is most useful in diagnosing testicular torsion? A) Doppler ultrasound showing absent blood flow B) Serum alpha-fetoprotein C) Urinalysis D) CT scan of the pelvis Answer: A Explanation: Doppler ultrasound can detect decreased or absent blood flow in torsion, confirming the diagnosis. Question 33. Which hematologic disorder is characterized by a deficiency of hemoglobin due to iron deficiency?
A) Iron deficiency anemia B) Sickle cell anemia C) Thalassemia D) Hemolytic anemia Answer: A Explanation: Iron deficiency anemia results from insufficient iron, leading to decreased hemoglobin synthesis. Question 34. Which infectious disease is most frequently transmitted via tick bites and causes erythema migrans? A) Lyme disease B) Rocky Mountain spotted fever C) Ehrlichiosis D) Babesiosis Answer: A Explanation: Lyme disease, caused by Borrelia burgdorferi, is transmitted by ticks and features erythema migrans rash. Question 35. Which of the following is a hallmark feature of multiple sclerosis on MRI? A) Multiple hyperintense lesions in the white matter B) Single large lesion in the brainstem C) Diffuse cortical atrophy D) Hemorrhagic infarcts Answer: A Explanation: Multiple sclerosis shows multiple hyperintense plaques in the white matter on MRI due to demyelination. Question 36. Which neurological disorder is characterized by resting tremor, rigidity, bradykinesia, and postural instability? A) Parkinson's disease
C) Tobacco use disorder D) Stimulant use disorder Answer: B Explanation: Alcohol use disorder involves compulsive consumption, inability to stop, and withdrawal symptoms. Question 40. Which is a common physical sign of child abuse? A) Unexplained bruises in various stages of healing B) Consistent well-developed social skills C) Regular attendance at school with good grades D) No physical findings despite behavioral concerns Answer: A Explanation: Unexplained bruises, especially in various healing stages, are suspicious for abuse. Question 41. Which substance is most often involved in stimulant use disorder? A) Cocaine and methamphetamine B) Alcohol C) Opioids D) Benzodiazepines Answer: A Explanation: Cocaine and methamphetamine are primary stimulants associated with stimulant use disorder. Question 42. Which mood disorder involves episodes of mania and depression? A) Bipolar I disorder B) Major depressive disorder C) Schizophrenia D) Generalized anxiety disorder Answer: A
Explanation: Bipolar I disorder features alternating episodes of mania and depression. Question 43. Which of the following is a typical feature of anorexia nervosa? A) Restriction of caloric intake leading to significantly low body weight B) Binge eating followed by purging C) Preoccupation with weight gain and food intake D) Overeating with no concern for weight Answer: A Explanation: Anorexia nervosa involves severe caloric restriction and low body weight, often with an intense fear of gaining weight. Question 44. Which of the following is a primary goal in managing a patient with schizophrenia? A) Symptom stabilization with antipsychotic medication B) Complete eradication of symptoms within a week C) Antibiotic therapy D) Surgical intervention Answer: A Explanation: Treatment focuses on symptom management, often with antipsychotics, to stabilize the patient. Question 45. Which is a common cause of secondary hypertension? A) Renal artery stenosis B) Essential hypertension C) Primary hyperaldosteronism D) Both A and C Answer: D Explanation: Renal artery stenosis and hyperaldosteronism are secondary causes of hypertension. Question 46. Which respiratory condition is characterized by airway inflammation, mucus production, and airflow obstruction primarily in children?
C) Pyelonephritis D) Acute tubular necrosis from nephrotoxins Answer: A Explanation: Hypoperfusion leading to prerenal azotemia is the most common cause of AKI in hospitalized individuals. Question 50. Which reproductive disorder is characterized by enlarged, cystic ovaries, irregular menses, and hyperandrogenism? A) Polycystic ovary syndrome (PCOS) B) Ovarian torsion C) Endometriosis D) Ovarian cancer Answer: A Explanation: PCOS features enlarged cystic ovaries, irregular menses, and excess androgens. Question 51. Which benign prostatic condition often presents with urinary hesitancy, weak stream, and nocturia? A) Benign prostatic hyperplasia B) Prostate cancer C) Prostatitis D) Urethral stricture Answer: A Explanation: BPH causes bladder outlet obstruction leading to these obstructive urinary symptoms. Question 52. Which of the following is the most characteristic finding in testicular torsion? A) Sudden, severe testicular pain with absent cremasteric reflex B) Painless testicular lump C) Chronic dull ache D) Fever and dysuria Answer: A
Explanation: Testicular torsion presents with sudden severe pain and loss of cremasteric reflex, requiring urgent diagnosis. Question 53. Which type of anemia is caused by autoimmune destruction of red blood cells? A) Hemolytic anemia B) Iron deficiency anemia C) Aplastic anemia D) Megaloblastic anemia Answer: A Explanation: Hemolytic anemia involves immune-mediated destruction of RBCs, leading to anemia. Question 54. Which infectious disease is characterized by a bull's-eye rash and flu-like symptoms, transmitted by ticks? A) Lyme disease B) Rocky Mountain spotted fever C) Ehrlichiosis D) Babesiosis Answer: A Explanation: Lyme disease presents with erythema migrans rash and flu-like symptoms after tick exposure. Question 55. Which MRI finding is most characteristic of multiple sclerosis? A) Multiple periventricular plaques in white matter B) Single large mass lesion C) Diffuse cortical atrophy D) Hemorrhagic infarcts Answer: A Explanation: Multiple sclerosis shows multiple hyperintense plaques in the periventricular white matter due to demyelination.
D) Benzodiazepines Answer: A Explanation: Cocaine and methamphetamine are primary stimulants linked to stimulant use disorder. Question 60. Which of the following signs raises suspicion for physical child abuse? A) Multiple bruises at different healing stages B) Well-cared-for appearance C) Consistent explanation matching injury pattern D) No physical findings despite behavioral concerns Answer: A Explanation: Multiple bruises at various healing stages are suspicious for inflicted injury. Question 61. Which substance is most commonly involved in stimulant use disorder? A) Cocaine and methamphetamine B) Alcohol C) Opioids D) Benzodiazepines Answer: A Explanation: Stimulant drugs like cocaine and methamphetamine are common causes. Question 62. Which mood disorder involves episodes of both mania and depression? A) Bipolar I disorder B) Major depressive disorder C) Schizophrenia D) Generalized anxiety disorder Answer: A Explanation: Bipolar I disorder is characterized by alternating manic and depressive episodes. Question 63. Which feature is typical of anorexia nervosa?
A) Restriction of caloric intake leading to very low body weight B) Binge eating with purging C) Overconcern with gaining weight D) Excessive exercise without caloric restriction Answer: A Explanation: Anorexia involves severe caloric restriction and significantly low weight. Question 64. Which medication class is first-line for treating schizophrenia? A) Antipsychotics (e.g., risperidone) B) SSRIs C) Benzodiazepines D) Mood stabilizers Answer: A Explanation: Antipsychotics are the primary treatment for schizophrenia to control psychotic symptoms. Question 65. Which secondary cause of hypertension involves excess aldosterone secretion? A) Primary hyperaldosteronism B) Renal artery stenosis C) Cushing syndrome D) Pheochromocytoma Answer: A Explanation: Primary hyperaldosteronism causes secondary hypertension via aldosterone overproduction. Question 66. Which respiratory condition presents with airway inflammation, mucus hypersecretion, and recurrent infections primarily in children? A) Bronchiectasis B) Asthma C) COPD
