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Internal Medicine II Practice Test

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  • Which of the following is not among the most frequent manifestations of mixed connective tissue disease?
  • What is the diagnostic criterion for spontaneous bacterial peritonitis and the recommended initial management?
  • Distinguish diabetic ketoacidosis from hyperosmolar hyperglycemic state and outline initial management priorities.
  • Which radiologic finding is commonly seen in rheumatoid arthritis of the hands?
  • If spironolactone alone is insufficient to control cirrhosis-related ascites, which diuretic should be added?
  • Which statement is true regarding physiologic immunology changes during pregnancy
  • For a stable COPD patient with resting SpO2 of 89%, what is the target oxygen saturation range and when is long-term oxygen therapy indicated?
  • What regimens are used for latent TB infection?
  • What is true about methotrexate use in rheumatoid arthritis regarding pregnancy and monitoring?
  • In HIV infection with a CD4 count less than 200 cells/µL, what is the standard prophylaxis against Pneumocystis jirovecii, and what vaccination considerations apply?
  • Generalized osteoporosis is an extra-articular feature of which disease?
  • What is the standard initial therapy for active tuberculosis?
  • What is the diagnostic criterion for spontaneous bacterial peritonitis in ascitic fluid?
  • Vaccination considerations in immunocompromised patients and which vaccines are generally contraindicated?
  • Which HLA allele is associated with ankylosing spondylitis?
  • Which statement about Eosinophilic granulomatosis with polyangiitis (Churg-Strauss) is true?
  • In DKA management, why must potassium be ≥3.3 mEq/L before initiating IV insulin therapy?
  • Which investigations are used in combined T and B cell defects?
  • Which therapy is central to treating myxedema coma?
  • What is the first-line management for nonalcoholic fatty liver disease (NAFLD) and its primary therapeutic goal?
  • Podagra refers to involvement of which joint in gout?
  • Initial management steps for status epilepticus in an adult?
  • Methotrexate is typically prescribed how often?
  • Calcimusc use in allergic diseases is best described by which statement?
  • Which autoantibody is most characteristic of mixed connective tissue disease?
  • Which drug is definitely teratogenic
  • Anti-SSA and anti-SSB positivity is NOT typical in which disease?
  • Which criterion best describes when to transition from IV insulin to subcutaneous insulin in DKA management?
  • Eczemas may be characterized by which of the following?
  • Secunder or associated Sjögren's syndrome is defined as
  • Which autoantibody is associated with limited cutaneous systemic sclerosis (CREST)?
  • In heart failure with reduced ejection fraction, which statement about ARNI use is correct?
  • How do you differentiate upper GI bleed from lower GI bleed and what is the initial diagnostic approach?
  • Which test best assesses humoral immune function by measuring antibody responses to vaccines?
  • In hypercalcemia of malignancy, what is the typical pathophysiology and initial management steps?
  • What class of medication is commonly used to manage hyperlipidemia in nephrotic syndrome?
  • Which combination of manifestations is commonly observed in mixed connective tissue disease?
  • Which radiologic abnormality is not typically seen in rheumatoid arthritis?
  • In a conscious patient with type 1 diabetes experiencing hypoglycemia, the recommended initial treatment is:
  • Which statement about arthrosis is NOT true?
  • Use of Calcimusc in allergic diseases is best described by which statement?
  • The induction regimen for lupus nephritis typically combines corticosteroids with which immunosuppressant?
  • Which statement is true of primary Raynaud's phenomenon?
  • Which of the following is a traditional DMARD used in RA but not typically first-line today?
  • Which statement about ACE inhibitors and ARBs in CKD with albuminuria is correct?
  • Which statement describes the Duke criteria for native valve endocarditis and a common initial empiric regimen?
  • Which statement about Cyclophosphamide is NOT accurate?
  • How many cyclooxygenase isoenzymes are known?
  • Which statement best differentiates latent TB infection from active TB and their initial testing and treatment strategies?
  • Features of distal renal tubular acidosis in Sjögren's syndrome, EXCEPT ONE
  • Which is not used in the active phase of mixed connective tissue disease?
  • Which initial management steps are appropriate for thyroid storm?
  • In STEMI management, what is the correct action when PCI cannot be performed within 120 minutes?
  • In SLE, which antibody level tends to reflect disease activity?
  • Protein-energy malnutrition contributes to secondary immunodeficiency.
  • In heart failure with reduced ejection fraction, which disease-modifying therapies have mortality/morbidity benefit?
  • Which antibody is not a myositis-specific antibody?
  • Raynaud's phenomenon can involve which areas?
  • NOT a typical feature of mixed connective tissue disease?
  • CURB-65 scoring: which thresholds correspond to outpatient management, hospital admission, and ICU-level care?
  • Typical for arthrosis, EXCEPT?
  • Measurement of chest expansion is important in ..... disease?
  • Which action reduces adverse drug events in older adults?
  • Gout classically presents with acute monoarthritis of which joint?
  • In hypocalcemia presenting with tetany, what is the initial management and evaluation steps?
  • Which disease among the following is not typically associated with RA-like symptoms?
  • Heberden's nodes are enlargements at which joints?
  • Suspected adrenal crisis in a patient with known adrenal insufficiency—what is the immediate treatment?
  • What are the key elements of the Surviving Sepsis Campaign bundle and the recommended time to administer antibiotics?
  • Which clinical feature favors upper gastrointestinal bleeding over lower gastrointestinal bleeding?
  • Which investigation best assesses humoral defects by measuring antibody responses to vaccines?
  • In osteoporosis with a T-score of -2.5 or lower, what is the first-line pharmacologic therapy?
  • Which urinary indices are typical of prerenal AKI?
  • Bouchard arthrosis involves which joints?
  • Which drug is a classic disease-modifying antirheumatic drug used for RA with potential hepatotoxicity requiring monitoring?
  • In cirrhosis with acute variceal bleeding, what management strategy improves survival?
  • Which statement best describes the characteristics of primary immunodeficiency diseases (PID)?
  • Which statement about Azathioprine is true?
  • Which technique is used to examine nutritive capillary arteries in the nail bed?
  • In Sjögren's syndrome, increased risk of lymphoma is associated with which finding
  • Which finding is not typical of arthrosis?
  • What practical strategy helps minimize adverse drug events in elderly patients?
  • In rheumatoid arthritis, which joint is commonly affected among the following?
  • Which autoantibody is specific for Sjögren's syndrome?
  • For Reiter disease, which treatment is NOT typically used?
  • Routine diagnostic method for calcipenia
  • Which of the following is not part of the classic triad of Reiter's disease?
  • Which statement best describes primary Raynaud's phenomenon?
  • For STEMI presenting within 2 hours of chest pain, what is the preferred reperfusion strategy if a PCI-capable cath lab can perform primary PCI within 90 minutes of first medical contact?
  • In diabetic ketoacidosis management, when should insulin therapy be started?
  • Active tuberculosis is characterized by which combination?
  • In cirrhosis with ascites, what is the initial diuretic regimen and the monitoring parameter?
  • Which management steps are appropriate for increased intracranial pressure following head injury?
  • Which statement describes the initial approach to a suspected upper gastrointestinal bleed?
  • Which circumstances are optimal to minimize fetal complications when a patient with lupus is pregnant
  • Heberden's nodes are most commonly located at which joints?
  • Which statement about gout is true?
  • In microcytic anemia workup, what are the initial tests and how is iron deficiency interpreted?
  • Which statement best describes Crohn's disease versus ulcerative colitis in terms of location and pathology?
  • Signs and symptoms of antiphospholipid syndrome are
  • How do you interpret a serum-ascites albumin gradient (SAAG) and what does SAAG ≥1.1 g/dL indicate?
  • Which imaging modality is preferred for early diagnosis of synovitis in RA?
  • Which is the most frequent primary immunodeficiency in adults?
  • Bechterew disease true statement?
  • Which joint is most frequently involved in gout?
  • Which statement best describes the initial management priorities for diabetic ketoacidosis and hyperglycemic hyperosmolar state?
  • Which HLA allele is associated with prognosis in rheumatoid arthritis?
  • What is the standard initial treatment for active tuberculosis?
  • Which is the biomarker of osteoclast activity (bone resorption)?
  • Hyponatremia with euvolemia due to SIADH—what is the recommended initial management and the safe rate of correction?
  • Anti-dsDNA antibodies are characteristic of which disease?
  • IVIG is not indicated in myositis when there is which condition?
  • Which cell type is considered the principal pathogenic driver in systemic sclerosis?
  • Which feature is most characteristic of CREST syndrome?
  • What are the components of the classic triad seen in Reiter's syndrome?
  • Smoking has what effect on Raynaud's symptoms?
  • In polyarteritis nodosa, the following organs could be affected, except:
  • Which combination best describes nephrotic syndrome?
  • In Sjögren's syndrome, which finding is NOT associated with an increased risk of lymphoma
  • Which joint is most commonly affected by an initial gout attack?
  • An adult with which finding would raise suspicion for immunodeficiency?
  • What is the most important advantage of selective COX-2 inhibitors?
  • Characteristic features for SNSA, EXCEPT:
  • In immunocompromised patients, what is the general vaccination approach?
  • What are the key differences between Crohn's disease and ulcerative colitis in terms of location, pathology, and typical treatments?
  • Which clinical feature best differentiates thyroid storm from myxedema coma?
  • In heart failure with reduced ejection fraction, which drug classes have proven mortality/morbidity benefit, and what is the role of ARNI?
  • Which examination is recommended for a patient suspected of systemic sclerosis?
  • In lupus nephritis, what is the standard induction therapy and maintenance therapy?
  • Which factor worsens hyperuricemia?
  • What is the recommended antithyroid drug strategy in pregnancy?
  • Defects of B cells are most commonly associated with which infection pattern?
  • What is the general principle for initiating antiretroviral therapy in patients newly diagnosed with HIV?
  • How do you interpret a serum-ascites albumin gradient (SAAG) and what does SAAG ≥1.1 g/dL indicate?
  • In systemic sclerosis, which organ systems can be involved?
  • Immediate treatment for suspected adrenal crisis in known adrenal insufficiency?
  • The following diseases are primary vasculitides, except:
  • Anti-SSA and anti-SSB antibodies are most characteristic of which condition?
  • Which statement best describes Crohn's disease?
  • Which feature is NOT characteristic of pathogenic autoantibodies?
  • Regarding Methotrexate administration, which statement is incorrect?
  • What is the recommended modality and interval for HCC surveillance in cirrhosis?
  • Which antithyroid drug is used in thyroid storm as part of the treatment?
  • In case of suspicion of bacterial arthritis, the most important procedure:
  • The following diseases are secondary vasculitides, except
  • In osteoarthritis, the initial analgesic of choice is what?
  • For a hemodynamically stable patient with suspected DVT or PE, what is the initial diagnostic approach and treatment plan?
  • Which condition is the most common musculoskeletal problem after age 50?
  • Which regimen is appropriate for latent tuberculosis infection?
  • Which statement is NOT a characteristic feature of Felty syndrome?
  • When do we not use intravenous immunoglobulin treatment in myositis patients?
  • In a pregnant patient with antiphospholipid antibodies, what is the recommended management if persistence is confirmed
  • Which therapy is considered hyperosmolar for intracranial pressure management?
  • The absolute indication of venom immunotherapy is which statement?
  • After benzodiazepine failure in status epilepticus, which agent is commonly given?
  • Which of the following is considered a primary vasculitis?
  • First-line therapy for hepatic encephalopathy is:
  • In spontaneous bacterial peritonitis, IV albumin is used to prevent renal dysfunction in selected patients. Which option represents this adjunct therapy?
  • What is first-line therapy for hepatic encephalopathy?
  • “Basic therapy" in osteoporosis
  • Hyponatremia with euvolemia due to SIADH—what is the recommended initial management and the safe rate of correction?
  • In suspected acute pancreatitis, which test is typically performed to evaluate gallstone etiology?
  • In cirrhosis with acute variceal bleeding, which management strategy improves survival?
  • Lyme disease skin lesion hallmark.
  • Most specific routine laboratory antibody marker in RA?
  • List the common etiologies of acute pancreatitis and the initial management priorities.
  • In a stable COPD patient with resting SpO2 of 89%, what is the recommended target oxygen saturation range and when is long-term oxygen therapy indicated?
  • In rheumatoid arthritis, which joint is NOT typically involved?
  • In a patient with STEMI presenting within two hours of chest pain, what is the preferred reperfusion strategy when a PCI-capable cath lab can perform primary PCI within 90 minutes of first medical contact?
  • Using CURB-65, which score thresholds correspond to outpatient management, hospital admission, and ICU-level care?
  • Which statement describes a side effect NOT associated with steroids?
  • Venom immunotherapy is indicated when which condition is proven?
  • What is the first-line disease-modifying antirheumatic drug (DMARD) for rheumatoid arthritis and what monitoring is required?
  • Which drug is not a DMARD used for rheumatoid arthritis?
  • NSTEMI risk stratification: Which risk scores are used and what threshold indicates high risk?
  • Which of the following is NOT a cause of secondary osteoporosis?
  • Which immune cell plays an important role in the pathogenesis of rheumatoid arthritis synovitis?
  • Which imaging modality is used to measure bone mineral density in osteoporosis?
  • Atopic dermatitis may be characterized by which statement?
  • In suspected primary adrenal crisis, what is the initial emergency management?
  • What is a common presenting symptom of Sjögren's syndrome
  • The most characteristic skin symptom in Lyme-disease
  • Which antibody is a classic antiphospholipid antibody associated with thrombosis?
  • What is a commonly used empiric antibiotic for spontaneous bacterial peritonitis?
  • Which statement about arthrosis is NOT true?
  • Which of the following is NOT a clinical feature of osteoporosis?
  • Which constellation is considered a red flag in suspected systemic sclerosis?
  • Which monitoring parameter is essential to avoid hyperkalemia when initiating spironolactone for cirrhosis-related ascites?
  • Which radiographic finding is typical of rheumatoid arthritis in the hands?
  • What is the recommended window for IV alteplase in acute ischemic stroke, and what is a key exclusion?
  • RA typically begins in which age range?
  • Which feature is commonly seen with defects in B cells?
  • Defects of innate immunity are associated with which infections?
  • Which feature is NOT typically associated with spondyloarthropathies?
  • What is the correct preoperative management sequence for pheochromocytoma?
  • Which statement about gout is true?
  • Which symptom is not characteristic of anti-Jo-1 syndrome?
  • In prerenal AKI, which combination best describes expected urinary indices?
  • Gout arthritis is characterized by which of the following features? EXCEPT DIP pain.
  • Which drug is the first-line disease-modifying antirheumatic drug for rheumatoid arthritis?
  • Raynaud's syndrome description includes which of the following?
  • What is the characteristic first symptom in ankylosing spondylitis?
  • Which HBV serologic pattern distinguishes acute HBV infection from chronic infection?
  • Which HLA allele is most strongly associated with ankylosing spondylitis?
  • Which drug is a COX-2 selective inhibitor?
  • Which drug can cause Raynaud's phenomenon?
  • Which HLA type is a prognostic factor in rheumatoid arthritis?
  • Which HLA type is most strongly associated with reactive arthritis?
  • Which joint is most frequently involved in osteoarthritis?
  • Which patterns differentiate intravascular vs extravascular hemolysis on laboratory findings?
  • What is the mechanism and initial management for hypercalcemia of malignancy?
  • For NSTEMI, which risk stratification tool guides an early invasive strategy, and what thresholds indicate high risk?
  • Which internal organ changes are included in the 2013 classification criteria for systemic sclerosis?
  • Skin symptoms in anaphylaxis are characterized by which statement?
  • Which symptom profile best differentiates thyroid storm from myxedema coma?
  • In gout management, what is the approach to acute treatment and long-term urate-lowering therapy?
  • Which is the first-line drug used to treat osteoarthritis-related pain?
  • Which is a commonly used empiric antibiotic for suspected spontaneous bacterial peritonitis?
  • Differentiate thyroid storm from myxedema coma and identify initial management steps for each.
  • Which electrolyte abnormalities are commonly seen in primary adrenal insufficiency?
  • Gout is associated with deposition of which crystals?
  • Which is the biomarker of osteoblast activity?
  • What is the typical age range for onset of Sjögren's syndrome
  • Which statement about Azathioprine is NOT accurate?
  • Gout is a syndrome caused by deposition of which type of crystals in tissues?
  • What are the two most common etiologies of acute pancreatitis, and what is the initial management priority?
  • Which are the three most frequent sites for osteoporotic fractures?
  • Which enzyme is inhibited by allopurinol in the treatment of gout?
  • Which is the deforming arthrosis of the distal interphalangeal joints?
  • Which could be the typical onset scenario for Sjögren's syndrome
  • In rheumatoid arthritis, which cervical spine complication can occur?
  • What best describes pharmacotherapy for NAFLD?
  • Which substance is NOT an approved biological therapy for SLE?
  • Nephrotic range proteinuria is defined as protein excretion greater than:
  • Which method is commonly used for detection of autoantibodies in serum?
  • Which statement about antiphospholipid syndrome is true?
  • In acute kidney injury, prerenal azotemia due to hypoperfusion is best managed by:
  • What is the standard long-term pharmacologic treatment for chronic hepatitis B?
  • The laboratory values Na 140, Cl 110, HCO3 8 yield what anion gap, and what is the most likely class of metabolic acidosis?
  • What is considered the most serious organ involvement in SLE?
  • Not a characteristic autoantibody for mixed connective tissue disease?
  • Arthropathia can occur in.... EXCEPT:
  • Anti-SSA (Ro) antibodies are most associated with which condition?
  • Which method is NOT used for the detection of autoantibodies in serum?
  • In diffuse cutaneous systemic sclerosis, which autoantibody is most characteristic?
  • Among osteoporotic fractures, which site is most commonly fractured?
  • DMARD therapies of rheumatoid arthritis are true except which?
  • Which agents are used for maintenance therapy in lupus nephritis?
  • The following statement about Polymyalgia Rheumatica is false?
  • RA onset age again: which range is most characteristic?
  • Which feature is NOT typical of adult-onset Still's disease?
  • Which statement correctly distinguishes celiac disease and inflammatory bowel disease?
  • Characteristic symptoms of Eosinophilic granulomatosis with polyangiitis (Churg-Strauss), except:
  • Which of the following is NOT a treatment for arthrosis?
  • Which cell types may participate in the pathogenesis of systemic lupus erythematosus (SLE)?
  • Which of the following is NOT typical for psoriatic arthritis?
  • Which statement best distinguishes latent tuberculosis infection from active tuberculosis?
  • Extraarticular features in RA, EXCEPT:
  • Alpha-adrenergic blockade in pheochromocytoma is used before beta-blockade because:
  • Which biological treatment has the best effect in myositis?
  • Which biological therapy is approved for SLE?
  • What is the most common cause of secondary immunodeficiency?
  • Which radiographic finding is typical of osteoarthritis?
  • Heberden nodes are associated with osteoarthritis of which joints?
  • Given Na 140, Cl 110, HCO3 8, what is the anion gap and the most likely class of metabolic acidosis?
  • Which set of investigations is used to evaluate combined T and B cell defects?
  • In cirrhosis with ascites, what is the initial diuretic regimen and the key monitoring parameter?
  • Which of the following is a lupus-specific cutaneous manifestation?
  • A 34-year-old woman with two prior abortions and antiphospholipid antibodies detected; she is pregnant again. What is the recommended thinking according to the material?
  • Which finding would generally exclude using IV thrombolysis in suspected ischemic stroke?
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