question
stringlengths 9
1.12k
| opa
stringlengths 1
113
| opb
stringlengths 1
137
| opc
stringlengths 1
126
| opd
stringlengths 1
106
| cop
int64 0
3
| rare disease
sequencelengths 1
4
| input
stringlengths 85
1.46k
|
---|---|---|---|---|---|---|---|
Typhoid oral vaccine is given - | 1, 3, 5 days | 1, 2, 3 days | 1, 2, 4 days | 1, 7, 14 days | 0 | [
"Typhoid"
] | Question: Typhoid oral vaccine is given -
Choices:
A. 1, 3, 5 days
B. 1, 2, 3 days
C. 1, 2, 4 days
D. 1, 7, 14 days
Answer: |
Which of the following Px is true for Typhoid carriers? | Ciprofloxacin + azithromycin | Cotrimoxazole | Amoxicillin + probenecid | None | 2 | [
"Typhoid"
] | Question: Which of the following Px is true for Typhoid carriers?
Choices:
A. Ciprofloxacin + azithromycin
B. Cotrimoxazole
C. Amoxicillin + probenecid
D. None
Answer: |
All of the following statements are about Non Typhoid Salmonella (NTS) are true, EXCEPT: | Humans are the only reservoir | Transmission is most commonly associated with eggs, poultry and undercooked meat | Common in Immunocompromised individuals | Resistance to fluroquinolones has emerged | 0 | [
"Typhoid"
] | Question: All of the following statements are about Non Typhoid Salmonella (NTS) are true, EXCEPT:
Choices:
A. Humans are the only reservoir
B. Transmission is most commonly associated with eggs, poultry and undercooked meat
C. Common in Immunocompromised individuals
D. Resistance to fluroquinolones has emerged
Answer: |
Typhoid intestinal perforation is usually occurs in which week of typhoid fever? | 2nd - 3rd week | 4th - 5th week | 5th - 7th week | 6th - 8th week | 0 | [
"Typhoid"
] | Question: Typhoid intestinal perforation is usually occurs in which week of typhoid fever?
Choices:
A. 2nd - 3rd week
B. 4th - 5th week
C. 5th - 7th week
D. 6th - 8th week
Answer: |
Which of the following is not true regarding Typhoid carrier? | Convalescent carriers excrete the organism for 6 - 8 weeks | Chronic carriers excrete bacilli for many years | Chronic carrier state is associated with presence of bacilli in gall bladder | Urinary carrier is more common than fecal carrier | 3 | [
"Typhoid"
] | Question: Which of the following is not true regarding Typhoid carrier?
Choices:
A. Convalescent carriers excrete the organism for 6 - 8 weeks
B. Chronic carriers excrete bacilli for many years
C. Chronic carrier state is associated with presence of bacilli in gall bladder
D. Urinary carrier is more common than fecal carrier
Answer: |
All are complication of Typhoid ulcer except ? | Perforation | Stricture | Haemorrhage | Sepsis | 1 | [
"Typhoid"
] | Question: All are complication of Typhoid ulcer except ?
Choices:
A. Perforation
B. Stricture
C. Haemorrhage
D. Sepsis
Answer: |
Features of Typhoid Ulcers include all of the following Except: | Bleeding | Perforation | Stricture and obstruction | Longitudinal orientation | 2 | [
"Typhoid"
] | Question: Features of Typhoid Ulcers include all of the following Except:
Choices:
A. Bleeding
B. Perforation
C. Stricture and obstruction
D. Longitudinal orientation
Answer: |
Which of the following is true regarding Typhoid in children : | Leukochyosis is characteristic | Encephalitis is common | Mild splenomegaly is usual | Urine culture is positive in 4 to 6 days | 2 | [
"Typhoid"
] | Question: Which of the following is true regarding Typhoid in children :
Choices:
A. Leukochyosis is characteristic
B. Encephalitis is common
C. Mild splenomegaly is usual
D. Urine culture is positive in 4 to 6 days
Answer: |
Typhoid perforation occurs during | Ist week | 2nd week | 3rd week | 4th week | 2 | [
"Typhoid"
] | Question: Typhoid perforation occurs during
Choices:
A. Ist week
B. 2nd week
C. 3rd week
D. 4th week
Answer: |
Typhoid ulcer perforation mostly occurs in: March 2005, March 2013 | 1 -2 week | 2 -3week | 3-4 week | 4 -5week | 2 | [
"Typhoid"
] | Question: Typhoid ulcer perforation mostly occurs in: March 2005, March 2013
Choices:
A. 1 -2 week
B. 2 -3week
C. 3-4 week
D. 4 -5week
Answer: |
Most common complication of Typhoid: | Paralytic ileus. | Otitis media. | Oophoritis. | Rheumatic fever. | 0 | [
"Typhoid"
] | Question: Most common complication of Typhoid:
Choices:
A. Paralytic ileus.
B. Otitis media.
C. Oophoritis.
D. Rheumatic fever.
Answer: |
All are true about Typhoid EXCEPT: | Incubation period 10 to 14 days | Most common among males | Carrier are treated by Ampicillin | Highest incidence occurs in 30-40 years age group | 3 | [
"Typhoid"
] | Question: All are true about Typhoid EXCEPT:
Choices:
A. Incubation period 10 to 14 days
B. Most common among males
C. Carrier are treated by Ampicillin
D. Highest incidence occurs in 30-40 years age group
Answer: |
Early surgery is indicated in -a) Amoebiasis peritonitisb) Biliary peritonitisc) Typhoid peritonitisd) All | a | bc | ac | ad | 1 | [
"Typhoid"
] | Question: Early surgery is indicated in -a) Amoebiasis peritonitisb) Biliary peritonitisc) Typhoid peritonitisd) All
Choices:
A. a
B. bc
C. ac
D. ad
Answer: |
Typhoid is treated by all except | Erythromycin | Ceftriaxone | Amikacin | Ciprofloxacin | 0 | [
"Typhoid"
] | Question: Typhoid is treated by all except
Choices:
A. Erythromycin
B. Ceftriaxone
C. Amikacin
D. Ciprofloxacin
Answer: |
All are complication of Typhoid ulcer EXCEPT - | Perforation | Stricture | Haemorrhage | Endocarditis | 1 | [
"Typhoid"
] | Question: All are complication of Typhoid ulcer EXCEPT -
Choices:
A. Perforation
B. Stricture
C. Haemorrhage
D. Endocarditis
Answer: |
Most immunogenic Typhoid antigen | O antigen | H antigen | Vi antigen | Somatic antigen | 1 | [
"Typhoid"
] | Question: Most immunogenic Typhoid antigen
Choices:
A. O antigen
B. H antigen
C. Vi antigen
D. Somatic antigen
Answer: |
Increased Monocytic count is seen in Typhoid and which of the following conditions? | Parasitic infections | Sub-Acute Bacterial Endocarditis | Hodgkin's Lymphoma | None of the above | 1 | [
"Typhoid"
] | Question: Increased Monocytic count is seen in Typhoid and which of the following conditions?
Choices:
A. Parasitic infections
B. Sub-Acute Bacterial Endocarditis
C. Hodgkin's Lymphoma
D. None of the above
Answer: |
Surgery is indicated in Ulcerative Colitis in all except? | Toxic megacolon | Colonic polyp | Colonic obstruction | Refractory fistula | 1 | [
"Ulcerative Colitis"
] | Question: Surgery is indicated in Ulcerative Colitis in all except?
Choices:
A. Toxic megacolon
B. Colonic polyp
C. Colonic obstruction
D. Refractory fistula
Answer: |
Most common Morphological difference between Ulcerative Colitis and Crohn's disease: | Crypt abscess | Diffuse polyps | Mucosal edema | Lymphoid aggregates | 0 | [
"Ulcerative Colitis"
] | Question: Most common Morphological difference between Ulcerative Colitis and Crohn's disease:
Choices:
A. Crypt abscess
B. Diffuse polyps
C. Mucosal edema
D. Lymphoid aggregates
Answer: |
Earliest pathological change is X-ray in Ulcerative Colitis - | Loss of haustration | Aphthous ulcerattions | Mucosal granularity | Skip tensions | 2 | [
"Ulcerative Colitis"
] | Question: Earliest pathological change is X-ray in Ulcerative Colitis -
Choices:
A. Loss of haustration
B. Aphthous ulcerattions
C. Mucosal granularity
D. Skip tensions
Answer: |
Most common Morphological difference between Ulcerative Colitis and Crohn's disease | Mucosal edema | Crypt abscess | Diffuse polyps | Lymphoid aggregates | 1 | [
"Ulcerative Colitis"
] | Question: Most common Morphological difference between Ulcerative Colitis and Crohn's disease
Choices:
A. Mucosal edema
B. Crypt abscess
C. Diffuse polyps
D. Lymphoid aggregates
Answer: |
Not a feature of Ulcerative Colitis? | Fine mucosal granularity | Pseudopolyps | String sign of Kantor | lead Pipe Appearance | 2 | [
"Ulcerative Colitis"
] | Question: Not a feature of Ulcerative Colitis?
Choices:
A. Fine mucosal granularity
B. Pseudopolyps
C. String sign of Kantor
D. lead Pipe Appearance
Answer: |
Ulcerative Colitis and Crohn's diseases are associated with all EXCEPT? | Wiskott Aldrich Syndrome | Turner's syndrome | Glycogen storage diseases Type III | Hermansky Pudlak Syndrome | 2 | [
"Ulcerative Colitis"
] | Question: Ulcerative Colitis and Crohn's diseases are associated with all EXCEPT?
Choices:
A. Wiskott Aldrich Syndrome
B. Turner's syndrome
C. Glycogen storage diseases Type III
D. Hermansky Pudlak Syndrome
Answer: |
When is surgery not done in cases of Ulcerative Colitis? | Toxic megacolon | Colonic perforation | Colonic obstruction | Refractory fistula | 3 | [
"Ulcerative Colitis"
] | Question: When is surgery not done in cases of Ulcerative Colitis?
Choices:
A. Toxic megacolon
B. Colonic perforation
C. Colonic obstruction
D. Refractory fistula
Answer: |
All the following Vasculitis causes necrotizing inflammation | Polyarteritis nodosa | Wegener's granulomatosis | Kawasaki disease | Microscopic polyangitis | 2 | [
"Vasculitis"
] | Question: All the following Vasculitis causes necrotizing inflammation
Choices:
A. Polyarteritis nodosa
B. Wegener's granulomatosis
C. Kawasaki disease
D. Microscopic polyangitis
Answer: |
Vasculitis involving the Aoic arch is | Takayasu aeritis | Polyaeritis nodosa | Kawasaki disease | Churg-Strauss syndrome | 0 | [
"Vasculitis"
] | Question: Vasculitis involving the Aoic arch is
Choices:
A. Takayasu aeritis
B. Polyaeritis nodosa
C. Kawasaki disease
D. Churg-Strauss syndrome
Answer: |
Vasculitis is seen in-a) Burger's diseaseb) HSPc) Goutd) Reiteres diseasee) Behcets syndrome | abcd | bcde | acde | abde | 3 | [
"Vasculitis"
] | Question: Vasculitis is seen in-a) Burger's diseaseb) HSPc) Goutd) Reiteres diseasee) Behcets syndrome
Choices:
A. abcd
B. bcde
C. acde
D. abde
Answer: |
Which of the following is a 'Small Vessel Vasculitis': | Polyaeritis Nodosa (PAN) | Microscopic polyangitis | Giant cell vasculitis | Takayasu's Disease | 1 | [
"Vasculitis"
] | Question: Which of the following is a 'Small Vessel Vasculitis':
Choices:
A. Polyaeritis Nodosa (PAN)
B. Microscopic polyangitis
C. Giant cell vasculitis
D. Takayasu's Disease
Answer: |
Vasculitis not commonly seen in adults- | Kawasaki disease | Henoch schonlein purpura | Temporal arteritis | PAN | 0 | [
"Vasculitis"
] | Question: Vasculitis not commonly seen in adults-
Choices:
A. Kawasaki disease
B. Henoch schonlein purpura
C. Temporal arteritis
D. PAN
Answer: |
Vasculitis not commonly seen in adults | Kawasaki disease | Henoch schonlein purpura | Temporal aeritis | PAN | 0 | [
"Vasculitis"
] | Question: Vasculitis not commonly seen in adults
Choices:
A. Kawasaki disease
B. Henoch schonlein purpura
C. Temporal aeritis
D. PAN
Answer: |
Which of these doesn't present with granulomatous Vasculitis? | Polyarteritis nodosa | Wegeners | Churg strauss syndrome | Microscopic polyangitis | 3 | [
"Vasculitis"
] | Question: Which of these doesn't present with granulomatous Vasculitis?
Choices:
A. Polyarteritis nodosa
B. Wegeners
C. Churg strauss syndrome
D. Microscopic polyangitis
Answer: |
A young female presents with a history of fever and nodular lesion over the shin. Histopathology reveals foamy histiocytes with neutrophilic infiltration. There is no evidence of Vasculitis. Most probable diagnosis is: | Sweet's Syndrome | Erythema nodosum | Erythema nodosum leprosum | Behcet's syndrome | 1 | [
"Vasculitis"
] | Question: A young female presents with a history of fever and nodular lesion over the shin. Histopathology reveals foamy histiocytes with neutrophilic infiltration. There is no evidence of Vasculitis. Most probable diagnosis is:
Choices:
A. Sweet's Syndrome
B. Erythema nodosum
C. Erythema nodosum leprosum
D. Behcet's syndrome
Answer: |
In Werner Syndrome, most common site of Gastrinoma is? | Pancreas | Stomach | Colon | Small Intestione | 3 | [
"Werner Syndrome"
] | Question: In Werner Syndrome, most common site of Gastrinoma is?
Choices:
A. Pancreas
B. Stomach
C. Colon
D. Small Intestione
Answer: |
In Werner Syndrome, the most common site of Gastrinoma is? | Pancreas | Stomach | Small Intestine | Colon | 2 | [
"Werner Syndrome"
] | Question: In Werner Syndrome, the most common site of Gastrinoma is?
Choices:
A. Pancreas
B. Stomach
C. Small Intestine
D. Colon
Answer: |
All are true about Xeroderma Pigmentosum except | It is autosomal dominant inheritance | Due to defective DNA repair | Associated with squamous cell carcinoma | Thymine dimers | 0 | [
"Xeroderma Pigmentosum"
] | Question: All are true about Xeroderma Pigmentosum except
Choices:
A. It is autosomal dominant inheritance
B. Due to defective DNA repair
C. Associated with squamous cell carcinoma
D. Thymine dimers
Answer: |
In Xeroderma Pigmentosum, defect is in? | Base pair defect | Nucleotide Excision Repair | Mismatch repair defect | Protein folding | 1 | [
"Xeroderma Pigmentosum"
] | Question: In Xeroderma Pigmentosum, defect is in?
Choices:
A. Base pair defect
B. Nucleotide Excision Repair
C. Mismatch repair defect
D. Protein folding
Answer: |
Yaws is caused by | T.pallidum | T. Endemicum | T. Peenue | T. Carateum | 2 | [
"Yaws"
] | Question: Yaws is caused by
Choices:
A. T.pallidum
B. T. Endemicum
C. T. Peenue
D. T. Carateum
Answer: |
Causative agent of Yaws is? | Treponema pertenue | Treponema carateum | Treponema pallidum | Treponema endemicum | 0 | [
"Yaws"
] | Question: Causative agent of Yaws is?
Choices:
A. Treponema pertenue
B. Treponema carateum
C. Treponema pallidum
D. Treponema endemicum
Answer: |
Which of the following statements about Yaws is not TRUE? | Spread by sexual transmission | Caused by T. peenue | Has cross immunity with syphilis | Cannot be differentiated serologically from T. pallidum | 0 | [
"Yaws"
] | Question: Which of the following statements about Yaws is not TRUE?
Choices:
A. Spread by sexual transmission
B. Caused by T. peenue
C. Has cross immunity with syphilis
D. Cannot be differentiated serologically from T. pallidum
Answer: |
Causative agent of Yaws is: | Treponema peenue | Treponema carateum | Treponema pallidum | Treponema endemicum | 0 | [
"Yaws"
] | Question: Causative agent of Yaws is:
Choices:
A. Treponema peenue
B. Treponema carateum
C. Treponema pallidum
D. Treponema endemicum
Answer: |
All are true about Yaws except | Caused by Treponema pertenue | Transmitted non-venerally | Later stages involve heart and nerves | Secondary Yaws can involve bones | 2 | [
"Yaws"
] | Question: All are true about Yaws except
Choices:
A. Caused by Treponema pertenue
B. Transmitted non-venerally
C. Later stages involve heart and nerves
D. Secondary Yaws can involve bones
Answer: |
Which of the following is the causative agent of Yaws? | Treponema peenue | Treponema carateum | Treponema pallidum | Treponema endemicum | 0 | [
"Yaws"
] | Question: Which of the following is the causative agent of Yaws?
Choices:
A. Treponema peenue
B. Treponema carateum
C. Treponema pallidum
D. Treponema endemicum
Answer: |
Which is not true about Yaws? | Spread by sexual transmission | Caused by T. peenue | Has cross immunity with syphilis | Cannot be differentiated serologically from T. pallidum | 0 | [
"Yaws"
] | Question: Which is not true about Yaws?
Choices:
A. Spread by sexual transmission
B. Caused by T. peenue
C. Has cross immunity with syphilis
D. Cannot be differentiated serologically from T. pallidum
Answer: |
Yaws is caused by - | Treponema pallidum | Treponema carateum | Treponema refringens | Treponema pertenue | 3 | [
"Yaws"
] | Question: Yaws is caused by -
Choices:
A. Treponema pallidum
B. Treponema carateum
C. Treponema refringens
D. Treponema pertenue
Answer: |
Yellow Fever vaccination stas protection after how many days of injection - | 5 days | 10 days | 15 days | 20 days | 1 | [
"Yellow Fever"
] | Question: Yellow Fever vaccination stas protection after how many days of injection -
Choices:
A. 5 days
B. 10 days
C. 15 days
D. 20 days
Answer: |
Ceificate of vaccination of Yellow Fever is valid for how many years: September 2010 | 1 year | 2 years | 5 years | 10 years | 3 | [
"Yellow Fever"
] | Question: Ceificate of vaccination of Yellow Fever is valid for how many years: September 2010
Choices:
A. 1 year
B. 2 years
C. 5 years
D. 10 years
Answer: |
To prevent Yellow Fever Aedes aegypti index should be less than? | 0.50% | 1% | 2% | 5% | 1 | [
"Yellow Fever"
] | Question: To prevent Yellow Fever Aedes aegypti index should be less than?
Choices:
A. 0.50%
B. 1%
C. 2%
D. 5%
Answer: |
To prevent Yellow Fever Aedes aegypti index should be less than | 0.50% | 1% | 2% | 5% | 1 | [
"Yellow Fever"
] | Question: To prevent Yellow Fever Aedes aegypti index should be less than
Choices:
A. 0.50%
B. 1%
C. 2%
D. 5%
Answer: |
All are true about Yellow Fever except | Incubation period is 3-6 days | Validity of Int’l certificate of Vaccination lasts up to 10 years | Urban form is controlled by 17 D vaccine | Aedes aegypti index should not be more than 10% to ensure freedom from yellow Fever | 3 | [
"Yellow Fever"
] | Question: All are true about Yellow Fever except
Choices:
A. Incubation period is 3-6 days
B. Validity of Int’l certificate of Vaccination lasts up to 10 years
C. Urban form is controlled by 17 D vaccine
D. Aedes aegypti index should not be more than 10% to ensure freedom from yellow Fever
Answer: |
A 67-year-old man is hospitalized after several days of fever and increasing shortness of breath. Respiratory viral panel returns positive for influenza A and the patient is started on a standard five day course of oseltamivir. Despite therapy, his shortness of breath continues to worsen and his oxygen saturation decreases to the point where ICU transfer and intubation are required. Chest radiograph shows bilateral infiltrates. Clinical criteria are consistent with development of Acute Respiratory Distress Syndrome (ARDS). After several weeks of supportive therapy, the patient improves with lung function returning to near normal. Which of the following processes is involved in the regeneration of alveolar lining after damage to alveoli occurs? | Squamous cell proliferation. | Sweeping of debris out of the alveoli by ciliated cells. | Excess mucus production by goblet cells. | Proliferation of surfactant-secreting cells. | 3 | [
"Acute Respiratory Distress Syndrome"
] | Question: A 67-year-old man is hospitalized after several days of fever and increasing shortness of breath. Respiratory viral panel returns positive for influenza A and the patient is started on a standard five day course of oseltamivir. Despite therapy, his shortness of breath continues to worsen and his oxygen saturation decreases to the point where ICU transfer and intubation are required. Chest radiograph shows bilateral infiltrates. Clinical criteria are consistent with development of Acute Respiratory Distress Syndrome (ARDS). After several weeks of supportive therapy, the patient improves with lung function returning to near normal. Which of the following processes is involved in the regeneration of alveolar lining after damage to alveoli occurs?
Choices:
A. Squamous cell proliferation.
B. Sweeping of debris out of the alveoli by ciliated cells.
C. Excess mucus production by goblet cells.
D. Proliferation of surfactant-secreting cells.
Answer: |
A newlywed couple comes to your office for genetic counseling. Both potential parents are known to be carriers of the same Cystic Fibrosis (CF) mutation. What is the probability that at least one of their next three children will have CF if they are all single births? | 0. | 1/64. | 27/64. | 37/64. | 3 | [
"Cystic Fibrosis"
] | Question: A newlywed couple comes to your office for genetic counseling. Both potential parents are known to be carriers of the same Cystic Fibrosis (CF) mutation. What is the probability that at least one of their next three children will have CF if they are all single births?
Choices:
A. 0.
B. 1/64.
C. 27/64.
D. 37/64.
Answer: |
Two days after delivery, a 4300-g (9-lb 8-oz) newborn has difficulty feeding and has become increasingly lethargic. His cry has become weak. He was born at term. His mother has a history of intravenous drug use. His temperature is 36.4°C (96.5°F), pulse is 170/min, respirations are 62/min, and blood pressure is 70/48 mm Hg. Examination shows midfacial hypoplasia, diaphoresis, and tremor of the lower extremities. Macroglossia is present. There are folds in the posterior auricular cartilage. The left lower extremity is larger than the right lower extremity. Abdominal examination shows an umbilical hernia. The liver is palpated 4 cm below the right costal margin. Neurological examination shows decreased tone in all extremities. Which of the following is the most appropriate intervention? | Administer thyroxine. | Administer 3% saline. | Administer glucose. | Administer ampicillin and gentamicin. | 2 | [
"Macroglossia"
] | Question: Two days after delivery, a 4300-g (9-lb 8-oz) newborn has difficulty feeding and has become increasingly lethargic. His cry has become weak. He was born at term. His mother has a history of intravenous drug use. His temperature is 36.4°C (96.5°F), pulse is 170/min, respirations are 62/min, and blood pressure is 70/48 mm Hg. Examination shows midfacial hypoplasia, diaphoresis, and tremor of the lower extremities. Macroglossia is present. There are folds in the posterior auricular cartilage. The left lower extremity is larger than the right lower extremity. Abdominal examination shows an umbilical hernia. The liver is palpated 4 cm below the right costal margin. Neurological examination shows decreased tone in all extremities. Which of the following is the most appropriate intervention?
Choices:
A. Administer thyroxine.
B. Administer 3% saline.
C. Administer glucose.
D. Administer ampicillin and gentamicin.
Answer: |
A 27-year-old G3P2002 presents to the clinic for follow up after her initial prenatal visit. Her last period was 8 weeks ago. Her medical history is notable for obesity, hypertension, type 2 diabetes, and eczema. Her current two children are healthy. Her current pregnancy is with a new partner after she separated from her previous partner. Her vaccinations are up to date since the delivery of her second child. Her temperature is 98°F (37°C), blood pressure is 110/60 mmHg, pulse is 85/min, and respirations are 18/min. Her physical exam is unremarkable. Laboratory results are shown below:
Hemoglobin: 14 g/dL
Hematocrit: 41%
Leukocyte count: 9,000/mm^3 with normal differential
Platelet count: 210,000/mm^3
Blood type: O
Rh status: Negative
Urine:
Epithelial cells: Rare
Glucose: Positive
WBC: 5/hpf
Bacterial: None
Rapid plasma reagin: Negative
Rubella titer: > 1:8
HIV-1/HIV-2 antibody screen: Negative
Gonorrhea and Chlamydia NAAT: negative
Pap smear: High-grade squamous intraepithelial lesion (HGSIL)
What is the best next step in management? | Colposcopy and biopsy after delivery. | Colposcopy and biopsy now. | Cryosurgical excision. | Loop electrosurgical excision procedure (LEEP). | 1 | [
"Rubella"
] | Question: A 27-year-old G3P2002 presents to the clinic for follow up after her initial prenatal visit. Her last period was 8 weeks ago. Her medical history is notable for obesity, hypertension, type 2 diabetes, and eczema. Her current two children are healthy. Her current pregnancy is with a new partner after she separated from her previous partner. Her vaccinations are up to date since the delivery of her second child. Her temperature is 98°F (37°C), blood pressure is 110/60 mmHg, pulse is 85/min, and respirations are 18/min. Her physical exam is unremarkable. Laboratory results are shown below:
Hemoglobin: 14 g/dL
Hematocrit: 41%
Leukocyte count: 9,000/mm^3 with normal differential
Platelet count: 210,000/mm^3
Blood type: O
Rh status: Negative
Urine:
Epithelial cells: Rare
Glucose: Positive
WBC: 5/hpf
Bacterial: None
Rapid plasma reagin: Negative
Rubella titer: > 1:8
HIV-1/HIV-2 antibody screen: Negative
Gonorrhea and Chlamydia NAAT: negative
Pap smear: High-grade squamous intraepithelial lesion (HGSIL)
What is the best next step in management?
Choices:
A. Colposcopy and biopsy after delivery.
B. Colposcopy and biopsy now.
C. Cryosurgical excision.
D. Loop electrosurgical excision procedure (LEEP).
Answer: |
A 22-year-old gravida 1 presents to her physician at 15 weeks gestation for a prenatal appointment. She complains of a rash involving her chest, face, and arms, a watery nasal discharge, and mild bilateral knee pain. She has had these symptoms for about 5 days. The symptoms do not seem to bother her too much, but she is concerned for the baby. She had contact with her younger sister, who also had a rash and was diagnosed with rubella infection about 10 days ago at a family gathering. She cannot confirm her vaccination history. Her vital signs are as follows: blood pressure, 110/70 mmHg; heart rate, 89/min; respiratory rate, 12/min; and temperature, 37.6℃ (99.7℉). Examination shows a moderately dense maculopapular lacy rash spread over the patient’s trunk, extremities, and face. No lymph node, liver, or spleen enlargement is noted. The knee joints appear normal.
Serology performed 1 year ago Current serology
Rubella IgM - negative Rubella IgM - negative
Rubella IgG - 1:128 Rubella IgG - 1:64
Rubella IgG avidity - high Rubella IgG avidity - high
What is the proper next step in the management of this woman? | Reassure and recommend vaccination against rubella postpartum. | Recommend pregnancy termination. | Arrange a chorionic villus sampling. | Recommend additional serologic testing for parvovirus B19. | 3 | [
"Rubella"
] | Question: A 22-year-old gravida 1 presents to her physician at 15 weeks gestation for a prenatal appointment. She complains of a rash involving her chest, face, and arms, a watery nasal discharge, and mild bilateral knee pain. She has had these symptoms for about 5 days. The symptoms do not seem to bother her too much, but she is concerned for the baby. She had contact with her younger sister, who also had a rash and was diagnosed with rubella infection about 10 days ago at a family gathering. She cannot confirm her vaccination history. Her vital signs are as follows: blood pressure, 110/70 mmHg; heart rate, 89/min; respiratory rate, 12/min; and temperature, 37.6℃ (99.7℉). Examination shows a moderately dense maculopapular lacy rash spread over the patient’s trunk, extremities, and face. No lymph node, liver, or spleen enlargement is noted. The knee joints appear normal.
Serology performed 1 year ago Current serology
Rubella IgM - negative Rubella IgM - negative
Rubella IgG - 1:128 Rubella IgG - 1:64
Rubella IgG avidity - high Rubella IgG avidity - high
What is the proper next step in the management of this woman?
Choices:
A. Reassure and recommend vaccination against rubella postpartum.
B. Recommend pregnancy termination.
C. Arrange a chorionic villus sampling.
D. Recommend additional serologic testing for parvovirus B19.
Answer: |
A 23-year-old woman, gravida 2, para 1, at 20 weeks of gestation comes to the physician for a routine prenatal exam. Her last pregnancy was unremarkable and she gave birth to a healthy rhesus (RhD) positive girl. Her past medical history is notable for a blood transfusion after a car accident with a complex femur fracture about 3 years ago. Her temperature is 37.2°C (99°F), pulse is 92/min, and blood pressure is 138/82 mm Hg. Examination shows that the uterus is at the umbilicus. Ultrasound examination reveals normal fetal heart rate, movement, and anatomy. Routine prenatal labs show the following:
Blood type A Rh-
Leukocyte count 11,000/mm3
Hemoglobin 12.5 g/dL
Platelet count 345,000/mm3
Serum
Anti-D antibody screen Negative
Rubella IgM Negative
Rubella IgG Negative
Varicella IgM Negative
Varicella IgG Positive
STD panel Negative
Urine
Protein Trace
Culture No growth
Cervical cytology Normal
Which of the following is the best next step in management of this patient?" | Administer anti-D immunoglobulin now and repeat antibody screening shortly before delivery.. | Repeat antibody screening at 28 weeks. Administer anti-D immunoglobulin at 28 weeks and after delivery if the newborn is Rh(D) positive.. | Repeat antibody screening at 28 weeks and administer anti-D immunoglobulin at 28 weeks. No further management is needed.. | No further screening is needed. Administer anti-D immunoglobulin shortly after delivery. | 1 | [
"Rubella"
] | Question: A 23-year-old woman, gravida 2, para 1, at 20 weeks of gestation comes to the physician for a routine prenatal exam. Her last pregnancy was unremarkable and she gave birth to a healthy rhesus (RhD) positive girl. Her past medical history is notable for a blood transfusion after a car accident with a complex femur fracture about 3 years ago. Her temperature is 37.2°C (99°F), pulse is 92/min, and blood pressure is 138/82 mm Hg. Examination shows that the uterus is at the umbilicus. Ultrasound examination reveals normal fetal heart rate, movement, and anatomy. Routine prenatal labs show the following:
Blood type A Rh-
Leukocyte count 11,000/mm3
Hemoglobin 12.5 g/dL
Platelet count 345,000/mm3
Serum
Anti-D antibody screen Negative
Rubella IgM Negative
Rubella IgG Negative
Varicella IgM Negative
Varicella IgG Positive
STD panel Negative
Urine
Protein Trace
Culture No growth
Cervical cytology Normal
Which of the following is the best next step in management of this patient?"
Choices:
A. Administer anti-D immunoglobulin now and repeat antibody screening shortly before delivery..
B. Repeat antibody screening at 28 weeks. Administer anti-D immunoglobulin at 28 weeks and after delivery if the newborn is Rh(D) positive..
C. Repeat antibody screening at 28 weeks and administer anti-D immunoglobulin at 28 weeks. No further management is needed..
D. No further screening is needed. Administer anti-D immunoglobulin shortly after delivery.
Answer: |
An infectious disease investigator is evaluating the diagnostic accuracy of a new interferon-gamma-based assay for diagnosing tuberculosis in patients who have previously received a Bacillus Calmette-Guérin (BCG) vaccine. Consenting participants with a history of BCG vaccination received an interferon-gamma assay and were subsequently evaluated for tuberculosis by sputum culture. Results of the study are summarized in the table below.
Tuberculosis, confirmed by culture No tuberculosis Total
Positive interferon-gamma assay 90 6 96
Negative interferon-gamma assay 10 194 204
Total 100 200 300
Based on these results, what is the sensitivity of the interferon-gamma-based assay for the diagnosis of tuberculosis in this study?" | 194/200. | 90/100. | 90/96. | 100/300. | 1 | [
"Tuberculosis"
] | Question: An infectious disease investigator is evaluating the diagnostic accuracy of a new interferon-gamma-based assay for diagnosing tuberculosis in patients who have previously received a Bacillus Calmette-Guérin (BCG) vaccine. Consenting participants with a history of BCG vaccination received an interferon-gamma assay and were subsequently evaluated for tuberculosis by sputum culture. Results of the study are summarized in the table below.
Tuberculosis, confirmed by culture No tuberculosis Total
Positive interferon-gamma assay 90 6 96
Negative interferon-gamma assay 10 194 204
Total 100 200 300
Based on these results, what is the sensitivity of the interferon-gamma-based assay for the diagnosis of tuberculosis in this study?"
Choices:
A. 194/200.
B. 90/100.
C. 90/96.
D. 100/300.
Answer: |
Acute Myeloid Leukemia is a malignant cancer in which myeloid progenitor cells become rapidly dividing and retain their semi-stem cell state. Under normal circumstances, which of the following cell types would arise from this stem cell?? | NK cell | Platelet | T cell | Lymphoid progenitor | 1 | [
"Acute Myeloid Leukemia"
] | Question: Acute Myeloid Leukemia is a malignant cancer in which myeloid progenitor cells become rapidly dividing and retain their semi-stem cell state. Under normal circumstances, which of the following cell types would arise from this stem cell??
Choices:
A. NK cell
B. Platelet
C. T cell
D. Lymphoid progenitor
Answer: |
Chikungunya has spread widely from Asia and Africa into the Caribbean in recent years. This has been mainly facilitated by:? | Mutation in the virus allowing replication in the mosquito Aedes albopictus | Air Travel | Climate change | Poor mosquito control and the absence of DTT | 0 | [
"Chikungunya"
] | Question: Chikungunya has spread widely from Asia and Africa into the Caribbean in recent years. This has been mainly facilitated by:?
Choices:
A. Mutation in the virus allowing replication in the mosquito Aedes albopictus
B. Air Travel
C. Climate change
D. Poor mosquito control and the absence of DTT
Answer: |
Measles has been controlled in many countries by which of the following?? | By hygiene | By MMR vaccine | By new molecular peptide vaccines | By humanised monoclonal antibodies to F protein | 1 | [
"Measles"
] | Question: Measles has been controlled in many countries by which of the following??
Choices:
A. By hygiene
B. By MMR vaccine
C. By new molecular peptide vaccines
D. By humanised monoclonal antibodies to F protein
Answer: |
Ulcerative Colitis
? | Carries a risk of colonic cancer | Can be treated with a LOFFLEX diet | Can be caused by small intestinal bacterial overgrowth | Can be caused by milk intolerance | 0 | [
"Ulcerative Colitis"
] | Question: Ulcerative Colitis
?
Choices:
A. Carries a risk of colonic cancer
B. Can be treated with a LOFFLEX diet
C. Can be caused by small intestinal bacterial overgrowth
D. Can be caused by milk intolerance
Answer: |