Upload internal_medicine.csv

internal_medicine.csv

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+question,answer
+"What will reduce the high incidence of malignant diseases in kidney transplant recipients?
+A. Providing prophylactic treatment with Valganciclovir.
+B. Giving preventive treatment by Aciclovir.
+C. Treatment with mTOR inhibitors instead of Calcineurin inhibitors.
+D. Treatment with mycophenolate mofetil instead of mTOR inhibitors.
+",C
+"What is true about the risks of performing an endoscopy? 
+A. In diagnostic endoscopy, the risk of bleeding is around 5%. 
+B. A patient with a prosthetic valve undergoing EUS and FNA should be given endocarditis prophylaxis. 
+C. The risk of pancreatitis after ERCP is around 5-30%. 
+D. Percutaneous gastrostomy insertion has a 30% risk of infection. 
+
+",C
+"6A. Differences in bacterial resistance between in vitro and in vivo.
+B. Ciprofloxacin blood concentrations are low due to malabsorption.
+C. Ciprofloxacin concentrations in the urinary system are low due to diabetes.
+D. Rapid clearance of Ciprofloxacin due to CYP206 activation.
+",B
+"When can EBV-lymphoproliferative disease develop after a kidney transplant?
+A. Starting two months after the transplant.
+B. Starting 12 months after the transplant.
+C. Starting two weeks after the transplant.
+D. Starting 5 years after the transplant.
+",A
+"What is considered a risk factor for sudden death in a 35-year-old patient with Hypertrophic Cardiomyopathy?
+A. Appearance of atrial fibrillation.
+B. Thickening of the apical parts of the ventricles.
+C. Mitral valve insufficiency.
+D. The absence of blood pressure elevation at the peak of exertion.
+",D
+"A 34-year-old woman is applying for a consultation regarding drug treatment for obesity. She states that she is usually ""full"" and has gained about 15 kg for no reason in the last two years without substantial diet and physical activity changes. Her blood pressure was 167/94, and a purple striae was found on the abdomen and beneath the axilla. What are the next step required for diagnosis?
+A. Cortisol level in the morning. 
+B. Blood cortisol level in the morning. 
+C. Urine collection for cortisol. 
+D. ACTH level in the blood. 
+
+",C
+"75 years old, was admitted to the hospital due to Malena. What would indicate the need for an urgent endoscopy?
+A. 150 ml of blood in the nasogastric tube bag.
+B. Blood pressure 80/60 mmHg.
+C. Treatment with Antiaggregants.
+D. The hemoglobin value is 10 g/dL.
+",B
+"60 years old, with a background of liver cirrhosis, hospitalized due to varicose veins bleeding. What is true about antibiotic treatment in this patient?
+A. Antibiotic treatment should be given for a week.
+B. Antibiotic treatment is not recommended for this patient.
+C. Long-term antibiotic treatment should be given.
+D. Antibiotic treatment should be given if the patient is a candidate for varicose vein ligation.
+",A
+"71 years old, anesthetized, and ventilated, treated with ceftriaxone due to sepsis. In the background: Parkinson's, heart disease ischemic, hypertension, and depression.
+Until hospitalization, he regularly took Levodopa + Carbidopa, Aspirin, Citalopram, Amlodipine, and Valsartan On the third day of hospitalization, there was an aggravation: fever of 40C, rigidity, Labile arterial blood pressure, increased creatinine and increased CPK. What is the most likely reason for the clinical and laboratory worsening?
+A. Ceftriaxone treatment failure.
+B. Discontinuation of Parkinson's disease treatment.
+C. Discontinuation of depression treatment.
+D. Drug fever for Ceftriaxone.
+",B
+"What is true about the treatment of Myelofibrosis?
+A. A JAK inhibitor has curative potential in myelofibrosis.
+B. A common side effect of JAK inhibitors is leukocytosis.
+C. Interferon alpha can reduce fibrosis in the early stage.
+D. Steroids may worsen anemia in myelofibrosis.
+",C
+"Who should be given the medicine Fluticasone + Vilanterol?
+A. For patients with Asthma but not for patients with COPD.
+B. For patients with COPD but not for patients with Asthma.
+C. For patients with COPD and also for patients with Asthma.
+D. For patients with Emphysema but not for patients with Asthma.
+",C
+"When should you try to lower the blood pressure of a patient who is suffering from an acute ischemic stroke and is not intended for thrombolytic therapy?
+A. When blood pressure values are above 220/130.
+B. When blood pressure values are above 180/110.
+C. When blood pressure values are above 160/100.
+D. When blood pressure values are above 140/90.
+",A
+"In which case of NSTEMI, is Prasugrel treatment better than Clopidogrel?
+A. 40 years old with PCI to the bypassed artery.
+B. 64 years old intended for conservative treatment.
+C. 64 years old undergoing PCI to the left main about a month after a stroke.
+D. 80 years old with atrial fibrillation who underwent PCI to the right artery.
+",A
+"A 74-year-old man was hospitalized due to an MI. In the background:  type 2 diabetes was diagnosed about 17 years, treated with Metformin.
+Last HbA1c 7.6%. he has microalbuminuria with preserved renal function, dyslipidemia with an LDL level of 128 mg/dL, and repeated episodes of pancreatitis. What treatment is recommended?
+A. Semaglutide.
+B. Empagliflozin.
+C. Sitagliptin.
+D. Repaglinide.
+",B
+" A 40-year-old man who underwent a gastroscopy due to pain in the abdomen and a decrease of about 5% in his body weight was found an ulcer in the first part of the duodenum measuring 8 mm. What is true about a duodenal ulcer?
+A. A biopsy should be taken to rule out malignancy.
+B. Most duodenal ulcers are associated with Helicobacter pylori.
+C. In most cases, the ulcer in the duodenum is larger than 3 cm.
+D. Duodenal ulcers appear at an older age than stomach ulcers.
+",B
+"What is true about vaccination against S. Pneumoniae in a 50-year-old woman with multiple myeloma? 
+A. The polysaccharide vaccine (PPSV23) should be given every 5 years in this patient. 
+B. The conjugate vaccine (PCV13) effectively prevents invasive infections in this patient. 
+C. Do not give the polysaccharide vaccine (PPSV23) to this patient. 
+D. Vaccinating with the PPSV23 vaccine before the PCV13 vaccine is better. 
+
+",B
+"What is required for laboratory follow-up about 3 months after starting Rosuvastatin treatment?
+A. ALT.
+B. CPK.
+C. LDH.
+D. INR.
+",A
+"What is the most accepted treatment today for patients suffering from HTN due to Atherosclerosis stenosis of one of the renal arteries?
+A. Elastant angioplasty.
+B. Angioplasty with a stent.
+C. ACE inhibitors.
+D. Calcium channel blockers.
+",C
+"A 50-year-old man with obesity and reflux, treated with Proton Pump Inhibitor, came to the ER with Paresthesia and leg cramps. What causes the symptoms?
+A. Hypomagnesemia.
+B. Hypokalemia.
+C. Hyponatremia.
+D. Hypercalcemia.
+",A
+"A 70-year-old man with heart failure and end-stage renal failure treated with hemodialysis, hospitalized, and ventilated due to pulmonary edema. He was hospitalized 3 weeks ago due to an infection from the dialysis catheter and was treated with antibiotics. 10 days later, he developed a fever, with purulent discharge from the tube and a new filtrate on a chest x-ray. What is the empiric antibiotic treatment in this case? 
+A. Ceftazidime + Azithromycin. 
+B. Meropenem + Clarithromycin. 
+C. Piperacillin-Tazobactam + Levofloxacin. 
+D. Piperacillin-Tazobactam + Azithromycin. 
+
+",C
+"What is the most important prognostic factor in AML at the time of diagnosis?
+A. The size of the spleen.
+B. The height of the WBC count.
+C. The percentage of blasts in the bone marrow.
+D. The chromosomal changes.
+",D
+"A 55 was admitted due to pain and swelling in the proximal interphalangeal joints (PIP) with morning stiffness.
+Her grandmother had arthritis. The patient denies psoriasis abdominal pain and diarrhea. What is the best course of action at this point?
+A. ANA test.
+B. ANCA test.
+C. Ultrasound examination.
+D. Photo of the hands.
+",C
+"What will reduce the high incidence of malignant diseases in kidney transplant recipients?
+A. Providing prophylactic treatment with Valganciclovir.
+B. Giving preventive treatment by Aciclovir.
+C. Treatment with m-TOR inhibitors instead of Calcineurin inhibitors.
+D. Treatment with mycophenolate mofetil instead of m-TOR inhibitors.
+",
+"Which drug can cause acute renal failure in the mechanism of acute tubular necrosis (ATN).? 
+A. Cisplatin.
+B. Aciclovir.
+C. Rifampin.
+D. Ciprofloxacin.
+","A,C"
+"19 years old, usually healthy, was admitted to the cardiac intensive care unit with a diagnosis of Acute Viral Myocarditis.
+The echocardiogram showed left ventricular enlargement with a 40% ejection fraction. Which drug is most recommended at this stage of the disease?
+A. Ibuprofen.
+B. Ramipril.
+C. Prednisone.
+D. Oseltamivir.
+",B
+"42 years old, generally healthy. Due to neck discomfort, he underwent a neck US examination, which showed a normal thyroid gland and a 7 mm oval structure suspicious for a parathyroid adenoma. In the laboratory, PTH is increased 1.5 times the upper value of the norm, calcium 8.7 mg/dL, phosphorus 3.5 mg/dL, albumin 4 g/d ""L. What is the next step in managing the case? 
+A. Parathyroidectomy. 
+B. FNA guided by the US. 
+C. Vitamin D levels. 
+D. CT head and neck with contrast material.
+",C
+"What is true about inflammatory bowel diseases, CD (Crohn's disease), and UC (Ulcerative colitis)?
+A. Smoking is a risk factor for UC.
+B. The incidence of diseases has been increasing in recent decades.
+C. Appendectomy is a risk factor for UC.
+D. UC has a stronger genetic basis than CD.
+",B
+"A 60-year-old man with hyperlipidemia and hypertension is hospitalized for chest pain during hospitalization.
+Fever and phlebitis appear near a peripheral infusion without other abnormal findings on physical examination. During the hospitalization, the patient undergoes a TTE echocardiogram demonstrating a calcified aortic valve. In blood culture, growth of Staphylococcus aureus in a single flask without additional growths. What is the right approach now?
+A. Start treatment and perform a TEE as soon as possible to rule out endocarditis.
+B. Start treatment and repeat the TTE echocardiogram later.
+C. Start treatment and repeat TTE echocardiography if the condition worsens.
+D. Start treatment and perform a PET-CT as soon as possible to rule out an abscess.
+",B
+"39 years old, with epilepsy and regular treatment with Phenytoin 300 mg per day, hospitalized due to pneumonia and treated with Ceftriaxone and Azithromycin. After a day, horizontal nystagmus and instability in walking developed. In the laboratory: leukocytosis 13,000 mm3, albumin 2.9 g/dL, BUN 19 mg/dL, triglycerides 112 mg/dL, blood phenytoin level 17 ng/L (norm 10- 20 ng/l). What is the most likely cause of the patient's neurological symptoms?
+A. Involvement of the central nervous system in pulmonary infection.
+B. Reduction in phenytoin clearance.
+C. A decrease in the concentration of albumin in the blood.
+D. Interaction between phenytoin and antibiotic treatment.
+",C
+"50 years old, complaining about abdominal pain. In the laboratory: hemoglobin 9 g/dL, MCV 98, leukocytes 2,900 in mcm, platelets 100,00 in mcm, LDH 800, bilirubin 2.7 mg/dL, and direct 0.7. CT Angio shows mesenteric vein thrombosis. What is the test of choice that will lead to a diagnosis?
+A. BCR: ABL.
+B. Osmotic Fragility.
+C. JAK2.
+D. Flow Cytometry.
+",D
+"In which of the patients suffering from Rheumatoid arthritis is the use of Methotrexate permitted?
+A. 35 years old pregnant.
+B. 65 years old with interstitial lung disease.
+C. 55 years old with chronic kidney failure (creatinine 2.2 mg/dL).
+D. 80 years old with hypertension and AFIB.
+",D
+"A 30-year-old with moderately severe asthma comes to the emergency room with a picture suitable for an asthma attack. She says she has been treated with Ventolin only as needed for the past two years. What treatment should she receive after completing the treatment for the acute attack? 
+A. ICS+LABA inhaler.
+B. LABA regularly by inhaler. 
+C. LAMA regularly in the inhaler. 
+D. Low-dose oral prednisone.
+
+",A
+"Which drug can cause kidney damage in the mechanism of Thrombotic Microangiopathy (TMA)?
+A. NSAIDs.
+B. Bevacizumab.
+C. Gentamicin.
+D. Trimethoprim-Sulfamethoxazole.
+",B
+"In which situation should beta blockers be avoided as part of the treatment of a 60-year-old with NSTEMI?
+A. When the systolic blood pressure is 110 mmHg.
+B. With a pulse of 66 beats per minute.
+C. When the patient has pulmonary edema.
+D. When there is an interstitial lung disease.
+",C
+"22 years old, who, due to diarrhea and rectal bleeding, underwent a colonoscopy, and treatment with 5ASA was recommended.
+What is the possible side effect of the drug?
+A. Pancreatitis.
+B. Acute Tubular Necrosis.
+C. Aphthous Stomatitis.
+D. Reactivation of hepatitis B.
+",A
+"80 years old, comes to the ER due to confusion when on examination, blood pressure is 220/110 mmHg in the right hand and 100/60 mmHg in the left hand. What is the next immediate step in this situation?
+A. Immediate lowering of systolic blood pressure below 120 mmHg.
+B. Lowered blood pressure to 160/100 mmHg within two hours.
+C. Performing brain CT.
+D. Fundus examination.
+",A
+"What is true about the side effects of Azathioprine?
+A. Pancreatitis is irreversible.
+B. Leukopenia is idiosyncratic.
+C. There is a genetic predisposition to the development of side effects.
+D. Acute Interstitial Nephritis is a very common phenomenon.
+",C
+"60 years old with endocarditis on a native valve and growth of C. albicans in the blood, receiving treatment with appropriate antibiotics. The patient has vegetation on a 7 mm aortic valve. Under adequate treatment, he is without fever. What is true about the indications for surgery in this patient?
+A. This patient must be operated on within 24-48 hours.
+B. Even if he responds well to treatment, this patient should be operated on.
+C. There is no indication to operate on this patient if the cultures are sterile after 48 hours.
+D. There is no indication to operate on this patient due to the size of the vegetation.
+",B
+"47 years old, diagnosed with polycythemia vera. In the laboratory: hemoglobin 19 g/dL, hematocrit 58%, Leukocytes 14,000 per cubic meter, platelets 670,000 per cubic meter, and uric acid 9.5 mg/dL. What is the treatment policy for this patient?
+A. Keep the hemoglobin 15-16 g/dL.
+B. Keep the hematocrit below 45%.
+C. To start treatment with Anagrelide.
+D. Start treatment with Allopurinol.
+",B
+"72 years old, with sepsis due to a urinary tract infection, accompanied by acute kidney failure. In the laboratory: creatinine 2.5 mg/dL (base: 1 mg/dL) and BUN 70 mg/dL. His urine output during the first 6 hours of his hospitalization is 20 ml. His weight is 80 kg. What is his estimated GFR?
+A. About 1 m/min.
+B. About 20 ml per minute.
+C. About 30 ml per minute.
+D. About 40 ml per minute.
+",A
+"What is true about antibiotics in inflammatory bowel disease (IBD)?
+A. Constitute the first line in the treatment of exacerbation of ulcerative colitis.
+B. Constitute the first line in the treatment of Pauchitis.
+C. Are not effective in the treatment of fistular Crohn's disease.
+D. Are not effective in the treatment of peri-anal Crohn's disease.
+",B
+"A 50-year-old diabetic was hospitalized due to fever and severe pain in her right leg. On examination low blood pressure,.
+and in the laboratory high inflammation indices and elevated CPK. Gram + cocci in blood cultures. What is the preferred antibiotic treatment?
+A. IV Clindamycin + IV Penicillin.
+B. IV Metronidazole + IV Penicillin.
+C. IV Clindamycin + IV Amoxycillin-Clavulanate.
+D. IV Azithromycin + IV Ceftriaxone.
+",A
+"What is true about the treatment of metabolic acidosis in chronic renal failure?
+A. NaHCO3 should be treated only when the bicarbonate value is lower than 15 mAq/liter due to the high sodium content in the drug.
+B. There is no need to treat acidosis because most patients in grade IV have acidosis with a normal anion gap.
+C. Continuous chronic treatment with NaHCO3 may slow down the progression of kidney failure.
+D. Treatment with KHCO3 is the treatment of choice for acidosis due to advanced renal failure.
+",C
+"77 years old, with worsening shortness of breath, and on auscultation: holosystolic murmur at the left sternal border.
+Which increases during inhalation. What is the most likely valvular disorder?
+A. Insufficiency of the tricuspid valve.
+B. Mitral valve insufficiency.
+C. Aortic valve stenosis.
+D. Insufficiency of the pulmonary valve.
+",A
+"What is true about the risk of colon cancer in patients with ulcerative colitis (UC)?
+A. The risk of development in patients with UC is twice that of the general population.
+B. In patients with extensive and prolonged disease, a colonoscopy is recommended every 5 years.
+C. Treatment with ASA-5 for more than 5 years increases the risk of cancer.
+D. The presence of stricture does not predict colon cancer in patients with UC.
+",A
+"40 years old with Rheumatoid Arthritis, treated with Infliximab, hospitalized due to fever, pain, swelling, and redness in the knee for several weeks. Knee puncture demonstrated a cloudy fluid, direct surface for pathogens smear was negative, sterile culture.
+What is the correct approach in this case?
+A. Send liquid to culture for fungi.
+B. Send a synovium culture for mycobacteria.
+C. Start treatment for gonococcal arthritis.
+D. Inject corticosteroids into the knee.
+",B
+"A 39-year-old woman diagnosed with primary biliary cholangitis was hospitalized due to spontaneous peritonitis. In the hospital, a nosebleed appears, while in the laboratory PTT, 3.7 INR 64 seconds, factor VII level 20%, factor V 80%, and fibrinogen 280 mg/dL. What is the treatment of choice to correct the coagulation disorder in the patient?
+A. Intravenous vitamin K.
+B. Intravenous factor VIII concentrate.
+C. Activated factor VII.
+D. Activated prothrombin concentrate complex.
+",A
+"A 70-year-old woman with metabolic syndrome, after catheterization with the opening of the LAD. So far, she has taken Atorvastatin at a dose of 10 mg per day. In the laboratory: HDL 38 mg/dl, LDL 150 mg/dl, and triglycerides 140 mg/dl. What would be recommended as treatment at this stage?
+A. Increasing the dose of Atorvastatin to 80 mg.
+B. Adding Bezafibrate 200 mg per day.
+C. Replacing Atorvastatin with Ezetimibe.
+D. Adding a PCSK9 inhibitor.
+",A
+"A 40-year-old woman complains about the swelling of her fingers and a cough for about six months and notes a change in the color of her fingers.
+Hands exposed to cold: turn white and then turn blue. What is the most important index for follow-up during the initial investigation of her illness?
+A. Pulse.
+B. Oxygen saturation.
+C. Sugar values.
+D. Blood Pressure.
+",D
+"What can cause peripheral jaundice?
+A. Decreased cardiac output.
+B. Pulmonary arteriovenous fistula.
+C. Acquired methemoglobinemia.
+D. Climbing to high altitude.
+",A
+"What is the accompanying phenomenon of secondary hyperparathyroidism in patients with chronic renal failure?
+A. A dynamic bone disease.
+B. Erythropoietin resistance.
+C. Cardiac calcification.
+D. Tumoral calcinosis.
+","B,D"
+"What is included in the calculation of the Child-Pugh Classification for cirrhosis?
+A. Sodium level.
+B. Fibrinogen level.
+C. Bilirubin level.
+D. PTT level.
+",C
+"What is the correct approach in suspected osteomyelitis of the spine?
+A. The start of antibiotic treatment should not be delayed under any circumstances.
+B. Surgical intervention is required mainly if the source is hematogenous spread.
+C. The recommended duration of antibiotic treatment is 8-12 weeks.
+D. It is possible to treat with oral medications while adjusting to the sensitivity profile.
+",D
+"Which drug has demonstrated superiority over others in reducing proteinuria in renal failure patients.
+Chronic?
+A. Amlodipine.
+B. Tamsulosin.
+C. Clonidine.
+D. Verapamil.
+",D
+"In which of the following conditions may ""paradoxical splitting"" of the second heart sound be found?
+A. Stenosis of the aortic valve.
+B. Mitral valve stenosis.
+C. Hypertrophic cardiomyopathy.
+D. Diastolic dysfunction of the heart.
+",A
+"In which of the following situations would a liver biopsy be recommended?
+A. Assessment of fibrosis in a patient with hepatitis C.
+B. Assessment of disease severity in hepatitis B.
+C. Evidence of fatty liver seen in US.
+D. Suspected autoimmune hepatitis.
+",D
+"A young man complained of purulent diarrhea and abdominal pain on the last day, which appeared about two hours later. He was eating in a restaurant, which indicates eating a suspicious potato salad the day before receiving it. What is reasonable to assume about his condition? 
+A. This is about ingesting enterotoxin in food from the restaurant. 
+B. This is a Shigella infection from spoiled food. 
+C. This is an E. coli O157:H7 infection. 
+D. This is an infection with Bacillus cereus. 
+
+",B
+"What constitutes a good prognostic factor in a patient with IgA nephropathy?
+A. Recurrent events of macrohematuria.
+B. Male gender.
+C. Older age at the time of diagnosis.
+D. Biopsy findings consistent with RPGN.
+",A
+"What are the considerations regarding the treatment of fever and neutropenia (neutropenic fever) after chemotherapy treatment.?
+A. Aminoglycoside monotherapy is an accepted treatment for fever and neutropenia.
+B. Addition of an aminoglycoside plus a beta-lactam is the recommended treatment.
+C. Empirical fluconazole should be given if an Aspergillus infection is suspected.
+D. Quinolone prophylaxis in anticipation of prolonged neutropenia reduces mortality.
+",D
+"For how long after myocardial infarction, troponin levels may remain higher than normal in the presence of normal kidney function?
+A. Up to 48 hours.
+B. Up to four days.
+C. 7-10 days.
+D. 14 days.
+",C
+"45 years old, with a background of obesity and diabetes for the past year.
+She is treated with metformin and a type of preparation weekly GLP1 (Dulaglutide). Glycated hemoglobin 8.5%. What is the contraindication to administering a drug from the SGLT2 inhibitor group in this patient?
+A. Moderate-severe decrease in left ventricular systolic function.
+B. Eurospsis in the past on a background of unquarried stones.
+C. Body Mass Index below 32.
+D. 5 CKD not on dialysis.
+",D
+"A 70-year-old man with heart failure and COPD is hospitalized due to respiratory exacerbation, treated with inhalations and Azithromycin. currently, he has a fever, tachycardia, low blood pressure, and noticeable diffuse tenderness on palpation of the abdomen.
+What is true about the preferred treatment?
+A. Oral Fidaxomicin.
+B. Oral Vancomycin and Intravenous Metronidazole.
+C. Oral Fidaxomicin and Intravenous Metronidazole.
+D. A combination of oral and intravenous Vancomycin.
+",B
+"A 66-year-old woman with no history of smoking but with asthma in the past. A chest x-ray was performed due to suspicion of inflammation in the lung. A lump was found in the left lung. What is the most likely histology of this tumor? 
+A. Adenocarcinoma. 
+B. Small Cell Carcinoma. 
+C. Squamous Cell Carcinoma. 
+D. Neuroendocrine tumor. 
+
+",A
+"According to the result of the urine albumin/creatinine ratio, who has microalbuminuria?
+A. 15 mg/mg.
+B. 15 mg/g.
+C. 45 mg/mg.
+D. 45 mg/g.
+",D
+"What is the most common cause of SA node dysfunction?
+A. Medicines.
+B. Hypoxemia.
+C. Hypothyroidism.
+D. Hypothermia.
+",A
+"55 years old, was hospitalized due to acute hepatitis. According to his wife, he has been drinking alcohol for many years daily, but the patient strongly denies it and claims that he drinks once a month. Which test combiner will support the patient's statement? 
+A. Bilirubin mg/dL 3, mg/dL ALT 175, AST mg/dL 350. 
+B. Bilirubin mg/dL 4, mg/dL ALT 380, AST mg/dL 170. 
+C. Bilirubin mg/dL 1.8, mg/dL ALT 5000, AST mg/dL 9000. 
+D. Bilirubin mg/dL 8, mg/dL ALT 670, AST mg/dL normal level. 
+
+",B
+"A 60-year-old woman is being ventilated in the intensive care unit due to sepsis, the patient has a GI tube and a urinary catheter. In urine culture growth Candida. What is true about Candida?
+A. The presence of neutropenia will strengthen the decision to treat.
+B. Candida overgrowth is rare.
+C. Fluconazole is not a relevant treatment option.
+D. It should be treated even if there are no symptoms at all.
+",A
+"In which kidney disease is steroid treatment beneficial?
+A. Acute renal failure on the background of cholesterol emboli.
+B. Focal segmental glomerulosclerosis on the background of hepatitis B.
+C. Membranous interstitial nephritis on the background of lung malignancy.
+D. Acute interstitial nephritis due to the use of PPI.
+",D
+"A 55-year-old man who was hospitalized due to STEMI underwent PCI within an hour with a stent for the blocked artery without complications. Before discharge, when the patient is in good condition, he asks how soon it will be possible to return to regular sexual activity. What is your answer? 
+A. After 6 months. 
+B. After a week. 
+C. After a month. 
+D. After two months. 
+
+",B
+"Which of the following is the factor with the lowest rate as a reason for the development of liver cirrhosis?
+A. Hepatitis C.
+B. Cardiac cirrhosis.
+C. Hepatitis B.
+D. Fatty live.
+",B
+"A 30-year-old man complains of burning and discharge from the urethra for the first time in his life. he used to have unprotected relations with a permanent partner. What is true about treatment?
+A. A combination of Amoxicillin and Levofloxacin should be treated.
+B. Doxycycline should also be included in the treatment for M. genitalium.
+C. The treatment includes oral Azithromycin at a dose of 1,000 mg.
+D. Azithromycin has no significance in the treatment of N. gonorrhea.
+",C
+"What is the renal damage that can be caused by both hypercalcemia and hypokalemia?
+A. Decreased ability to concentrate urine.
+B. Acute renal failure.
+C. A decrease in the production capacity of ammonium.
+D. RTA type II.
+",A
+"A 34-year-old man with HIV was diagnosed as suffering from PCP and, after 3 days of treatment with Trimethoprim Sulfamethoxazole, developed weakness and jaundice in the skin and conjunctiva. In the laboratory: hemoglobin 6 g/dL, MCV 96, platelets, and leukocytes are normal, Bilirubin 3.2 mg/dL, of which 0.5 is direct, the liver enzymes are normal, LDH 1,000 blood smear without cell fragments. Normal coagulation functions. The COOMBS test is negative.
+What is the most likely diagnosis?
+A. DIC as part of severe sepsis.
+B. Autoimmune hemolytic anemia.
+C. Microangiopathic hemolytic anemia.
+D. Hemolytic anemia secondary to PD6G deficiency.
+",D
+"What is a possible side effect after successful treatment with adenosine in a patient with SVT?
+A. Transient atrial fibrillation.
+B. Hypotension.
+C. Torsades de pointes.
+D. Pericarditis.
+",A
+"A 40-year-old woman was admitted due to spasmodic abdominal pain. A CT stone protocol scan demonstrates an adrenal mass on the left side with a diameter of 1.3 cm and a density of 5 HU. On examination after analgesia, blood pressure was 105/70 mmHg and regular pulse with 80 bpm. What is the next step in case management?
+A. Synacthen test (ACTH).
+B. Test for blood metanephrine levels.
+C. Test for aldosterone and renin levels.
+D. Test for hydroxyprogesterone17 levels in the blood.
+",B
+"A 60-year-old woman with cirrhosis of the liver due to fatty liver was hospitalized due to fever, abdominal pain, and ascites. The blood sample showed leukocytosis and a paracentesis from the ascites showed 350 neutrophils in µL and culture from the liquid E. coli, Enterococcus and s. viridans. What is true about her condition? 
+A. This is a typical culture for SBP. 
+B. The albumin concentration in the ascites fluid is likely lower than one g/dL. 
+C. The bacteria cultured from the liquid will most likely be cultured in the blood. 
+D. Abdominal imaging is necessary as part of the investigation. 
+
+",D
+"A 30-year-old man with a BMI of 30 and a family history of gout was referred for the first time due to severe pain and swelling in the 1MTP. In the laboratory: c1HBA, 6.6% LDL cholesterol 140 mg/dL, triglycerides 270 mg/dL. In addition. Uric acid 8.1 mg/dL, which he has had for several years. The current attack was treated with an NSAID in review. Routinely, after 6 months, there have been no further attacks, and the blood tests are stable. What is the recommendation now? 
+A. Colchicine treatment. 
+B. Appropriate diet and drinking a lot. 
+C. Allopurinol treatment. 
+D. If the patient has tophi, the treatment of choice is Probencid. 
+
+",B
+"40 years old, generally healthy, admitted due to fever, severe headache, and vomiting for two days. In his examination, the patient was confused with a purpuric rash on the limbs. In a lumbar puncture, 80 cells, most of them mononuclear, increased protein, and normal glucose were detected. What is true about his condition?
+A. Prednisone should also be added to the treatment.
+B. Prophylactic antibiotic treatment should be given immediately to the family members.
+C. Doxycycline should also be added to the empiric treatment.
+D. Aciclovir should be treated.
+",C
+"What is the treatment for obstructive sleep apnea?
+A. CPAP with mouth and nose mask.
+B. BiPAP with mouth and nose mask.
+C. BiPAP with nasal mask only.
+D. CPAP with mouth mask only.
+",A
+"What are the considerations in giving intravenous potassium?
+A. The maximum intravenous rate is 40 mcg per hour.
+B. It is better to treat through a jugular infusion when a central vein is required.
+C. To correct from 2 to 4 mcg/liter, 400-800 mcg of potassium should be given.
+D. The maximum concentration of potassium through a central vein is 10 meq/dL.
+",C
+"What is true about Chronic Myelogenous Leukemia (CML?).
+A. Interferon treatment significantly improved the course and survival.
+B. Acceptable first-line treatment is the administration of Tyrosine Kinase Inhibitors.
+C. It is recommended to refer patients in remission from their disease to an allogeneic bone marrow transplant.
+D. The long-term survival (8 years) of CML patients is about 40-20%.
+",B
+"Which of the tests does not diagnose myocardial ischemia?
+A. CT calcium scoring.
+B. CT coronary angiography.
+C. PET.
+D. Cardiac MRI.
+","A,B"
+"A 38-year-old woman was diagnosed with Graves' disease and was treated with Mercaptizol. Three weeks After starting the treatment, a temperature of 38.3ֲC was measured, and a sore throat appeared. Blood count showed leukocytosis with left shift deviation. Throat swab positive for Streptococcus. Empirical treatment with penicillin was initiated. What. The therapeutic approach at this stage? 
+A. Continue Mercaptizol simultaneously as antibiotics. 
+B. Immediately suspend treatment with Mercaptizol. 
+C. Add oral steroids. 
+D. Change the Mercaptizol to PTU. 
+
+",A
+"What is true about the treatment of patients suffering from fatty liver disease (NAFLD)?
+A. Metformin is recommended as a treatment for NAFLD.
+B. NAFLD can be used after a liver transplant.
+C. There is a contraindication to the treatment with statins.
+D. Bariatric surgery reduces fibrosis.
+",B
+"50 years old woman with asthma. is arriving with purpura, weakness in the right hand, and paraesthesia in the left leg. In the Blood: 5,000 Eosinophils in cubic millimeters. What is the test with the best ability to determine the prognosis?
+A. CT chest in thin sections.
+B. Nerve biopsy.
+C. Echocardiography.
+D. ANCA.
+",C
+"A 35-year-old woman, with a kidney transplanted two months ago, was hospitalized due to fever and confusion. Known allergy to penicillin.
+In lumbar puncture: 700 mononuclear cells, glucose 30 mg/dL (in blood 100 mgdL), high protein, and in blood smear:  positive gram rods. What is true about treatment?
+A. Doxycycline IV should be added to the treatment.
+B. Empirical coverage with ceftriaxone is sufficient in this case.
+C. Dexamethasone treatment will improve the prognosis.
+D. The treatment of choice is Sulfamethoxazole-Trimethoprim IV.
+",D
+"58 years old with a DVT event about 6 years ago that appeared after a flight. Now comes to the emergency room with a short breathing that started suddenly. On examination: 21 breaths per minute, pulse 110 regular, temperature 36.8, and oxygen saturation 95% in the chest x-ray a small amount of pleural fluid at the right base. What is the best test for the diagnosis of PE? 
+A. CT-angio. 
+B. Echocardiography. 
+C. Ventilation/perfusion scan. 
+D. Check dimer-D and decide on imaging. 
+
+",A
+"What is the most likely etiology for hypokalemia in a patient whose blood potassium levels are 2.2 Maq/liter, sodium 140 maq/l, chlorine 114 maq/l, creatinine 1.2 mg/dL, and in the gas test pH 
+7.25, bicarbonate 18 mq/l, 2PCO 33 mq/l. In the urine test: potassium 10 mAq/liter and creatinine 50 mg/dL?
+A. Diarrhea.
+B. RTA type 1.
+C. Using variables.
+D. Eating licorice.
+","A,B"
+"What could be the appering of cardiac myxoma?
+A. Ventricular ascending conduction block.
+B. Aortic stenosis.
+C. Right heart failure.
+D. Intracardiac thrombus.
+",D
+"A 50-year-old man, known to have hepatitis C, comes to the ER due to bloody vomiting on the last day. In his examination, there is ascites, and in the laboratory, hemoglobin 10 g/dL. Three large varicose veins were found in the gastroscopy. What is true about Endoscopic variceal ligation? 
+A. The development of an ulcer in the ligament area is common in half of the patients. 
+B. Ligation is recommended for large bleeding varices in the fundus of the stomach. 
+C. After tying the varicose veins, there is no need for further tying. 
+D. Varicose vein ligation is effective in most patients as a treatment for active bleeding. 
+
+",D
+"What is the strategy to reduce urinary catheter-related infections (CAUTI?).
+A. Intermittent catheterization in patients with spinal cord injury.
+B. A silver-coated catheter is better than a regular catheter.
+C. A Nitrafurazone-coated catheter is better than a regular catheter.
+D. Supra pubic catheter is better than a permanent catheter in preventing bacteriuria.
+",A
+"All of the following patients, whose weight is the same, suffer from hyperkalemia with a blood potassium concentration of 5.8. Which of them has the lowest potassium body total?
+A. A patient suffering from oliguric renal failure.
+B. A patient suffering from Addison's disease.
+C. A patient suffering from IV type RTA.
+D. A patient suffering from digoxin poisoning.
+",D
+"What is true about Hodgkin's lymphoma?
+A. This lymphoma represents about 50% of all lymphomas.
+B. Subdiaphragmatic lymphadenopathy is characteristic mainly in young women.
+C. This lymphoma can present as erythema nodosum.
+D. This lymphoma can present with hypocalcemia.
+",C
+"A 66-year-old man with hypertension underwent ablation about 3 months ago for the treatment of paroxysmal atrial fibrillation. he complain about shortness of breath and hemoptysis that have worsened since the procedure. What is the most likely diagnosis that will lead to this identification?
+A. Esophageal tear.
+B. Pulmonary embolism.
+C. Pulmonary valve stenosis.
+D. Mitral valve stenosis.
+","A,B,C,D"
+"What is true regarding  GERD (Gastroesophageal Reflux Disease).
+A. The most sensitive test for diagnosis is pH monitoring for 24 hours.
+B. A normal gastroscopy rules out the possibility of GERD.
+C. Proton Pump Inhibitor treatment is only recommended for people aged 50 and over.
+D. Gastroscopic follow-up is designed to rule out the development of Lymphoma M.
+",A
+"A 30-year-old man, after a respiratory infection, has been suffering from pain in the joints of the fingers and a palpable purpura rash for about a week on the calves and abdomen. What test will indicate the severity of his illness?
+A. Serum immunoglobulins test.
+B. Periodic urine and kidney function test.
+C. Periodic hemoglobin and fecal occult blood tests.
+D. Skin biopsy.
+",B
+"What is the recommended dose of Albuterol (Salbutamol) for the treatment of hyperkalemia?
+A. 2.5 mg.
+B. 5 mg.
+C. 10 mg.
+D. 25 mg.
+",C
+"A 77 years old man with heart failure (EF 30%), was treated with beta-blockers. Received due to shortness of breath and aggravation in peripheral edema. On examination: blood pressure 85/50 mmHg and heart rate 90 per minute. Intravenous Furosemide treatment did not improve his respiratory condition. What is the possible treatment?
+A. Noradrenaline.
+B. Dobutamine.
+C. Levosimendan.
+D. Dopamine.
+",B
+"65 years old, was diagnosed about 5 years ago in an endoscopy as suffering from 4 cm long Barrett's Esophagus.
+In a recent biopsy, more than one focus of high-grade dysplasia was found.
+What is the best management?
+A. Endoscopic follow-up and repeat biopsies every year.
+B. Complete resection of the esophagus.
+C. Radiofrequency Ablation.
+D. Proton Pump Inhibitor treatment only.
+",C
+"30 years old with pain in the buttock that worsens at night and wakes him up from sleep. In the morning, the back is stiff for about an hour, when exerting.
+There is considerable relief. Which test would be most likely to be diagnostic?
+A. HLAB27
+B. Bone scans.
+C. CT of the lumbar spine.
+D. MRI targeting the Sacroiliac joints.
+",D
+"The 66-year-old suffers from arthritis, ischemic heart disease, hypertension, and heart failure. He underwent a puncture of Pleural fluid that appeared in the last few days, mainly on the right. The liquid is straw-colored. Due to a checked error, The liquid is only for protein (0.45 from the serum) and LDH (0.65 from the blood and 0.6 from the accepted upper value of LDH). What is true about this patient? 
+A. If the protein gradient is greater than 31 L/g, it is a transudate. 
+B. There is a greater than 95% chance that it is an exudate. 
+C. This is a transudate, possibly secondary to the patient's arthritis. 
+D. A glucose level in the pleural fluid above 60 dL/mg indicates a transudate. 
+
+",A
+"What should be added to the drug treatment of an 82-year-old woman with HFrEF (25% ejection fraction), who suffers from anasarca that is resistant to high doses of furosemide in the presence of normal renal function and the following lab results?
+PH: 7.48, Glucose 120 mg/dL, pCO2 67 mmHg, Na 141 mEq/L, HCO3 46, mEq/L, K 5.3 mEq/L, Lactate ג€“ normal levels, Cl 89 mEq/L, Albumin 3.8 gr/dL.
+A. Amiloride.
+B. Disothiazide.
+C. Aldospirone.
+D. Acetazolamide.
+",D
+"In what situation can a fourth heart sound be heard?
+A. Mitral stenosis.
+B. Tricuspid stenosis.
+C. Aortic stenosis.
+D. Pulmonic stenosis.
+",C
+"What is recommended for a 35-year-old whose sister was diagnosed with colon cancer at the age of 50?
+A. Fecal occult blood test.
+B. DNA test in feces.
+C. Colonoscopy now.
+D. Colonoscopy at age 40.
+",D
+"Which drug is not suitable for the treatment of a patient suffering from inflammatory bowel disease with sacroiliitis And uveitis?
+A. Infliximab.
+B. Cetrolizumab.
+C. Etanercept.
+D. Adalimumab.
+",C
+"An 18-year-old came to the hospital because of weakness. In the laboratory, she found a metabolic alkalosis, and it is suspected that she is suffering from eating disorders and vomiting proactively after every meal. What to expect to find in the urinalysis.
+That will help in this diagnosis.
+A. Ph acidosis, potassium high.
+B. Ph acidosis, potassium low.
+C. Ph alkalosis, potassium low.
+D. Ph alkalosis, potassium high.
+",D
+"A 50-year-old woman is being treated with peritoneal dialysis. He was admitted due to abdominal pain without fever. What constitutes a diagnosis of Peritonitis in this patient?
+A. The presence of a large amount of free fluid in the stomach.
+B. Neutrophil count / 60 ml in the ascites fluid.
+C. Glucose concentration 300 mg in the ascites fluid.
+D. Evidence of purulent discharge from the catheter entry area.
+",B
+"84 years old is known to suffer from chronic lymphocytic leukemia (CLL) In stage II of the disease according to Rai Staging. She is Hospitalized due to syncope and in the blood count hemoglobin is 8 g/dL, lymphocytes 100,000  in cubic meters, platelets 300,000 in cubic meters, and reticulocytes 150,000 in cubic meters. What can be said about her condition?
+A. This is about the progression of her disease to stage III.
+B. It is probably IgM and complements antibody-mediated hemolysis.
+C. Pure red cell aplasia in.
+D. It is probably IgG antibody-mediated hemolysis.
+",D
+"A 63-year-old woman with metastatic breast cancer is admitted after falling into a state of consciousness. On inspection, it makes an impression Of poor emotional condition, very elevated JVP, and low blood pressure. What is expected to be found in this patient?
+A. Left ventricular hypertrophy.
+B. Slow atrial fibrillation.
+C. Diastolic IV sound.
+D. Pulsus alternans.
+",D
+"A 25-year-old with recently diagnosed celiac disease, asks about co-morbidities that can appear.
+What disease may accompany as diseases associated Celiac?
+A. Atopic Dermatitis.
+B. Diabetes mellitus type 1.
+C. Acute Leukemia.
+D. Acute pancreatitis.
+",B
+"A 60-year-old man has been suffering from lower back pain for several years and edema in his legs. Come due to Advanced kidney failure (creatinine 3 mg/dL).
+In US shows bilateral hydronephrosis and CT also shows peri-aortitis. What is the initial treatment for the patient?
+A. Methotrexate.
+B. Corticosteroids.
+C. Cyclophosphamide.
+D. Anti-IL-6 antibody.
+",B
+"74 years old, known to suffer from COPD level GOLD III. About a year ago, he was in the emergency room due to a flare-up of his illness. For the past two days, he has reported worsening shortness of breath, increased coughing, and white sputum. In the impression of a flare-up is hospitalized. What is the treatment for this patient? 
+A. Prednisone (40 mg daily for 5-14 days) and antibiotics. 
+B. Prednisone (40 mg daily and decrease over 3-6 weeks) and antibiotics. 
+C. Prednisone, (40 mg daily for a week) without antibiotics. 
+D. Oxygen in a concentration that will maintain a saturation of at least 95%. 
+",A
+"A 30-year-old man was admitted with weakness, headache, abdominal pain, and frequent urination last week, no fever,
+and his blood pressure is 110/80. In blood - potassium is 6.1, sodium 158, and in urine: 800 Osmolality. What explains the findings?
+A. Nephrogenic diabetes insipidus.
+B. Central diabetes insipidus.
+C. Addison's crisis.
+D. Type I diabetes mellitus.
+",D
+"A 40-year-old, usually healthy, was referred to the hospital due to platelet values of 600,000/mm3 and a headache. On physical examination without neurological deficit. CT with and without contrast material cerebral infarction. During The hospitalization was diagnosed as having primary thrombocytosis (ET). What is the treatment?
+A. Platelet pheresis.
+B. Apixaban.
+C. Aspirin.
+D. Hydroxyurea + Aspirin.
+","C,D"
+"A 40-year-old woman suffers from repeated episodes of pain attributed to a peptic ulcer and diarrhea. Gastrin level 300 picogram/ml (normal up to 150 picogram/ml). An adenoma was recently found in the parathyroid. Her sister has pituitary adenoma. What is the treatment of choice for her condition?
+A. Surgical resection of an adenoma.
+B. Somatostatin analog treatment.
+C. High-dose PPI therapy.
+D. Gastrectomy.
+",C
+"A 35-year-old woman suffers from FMF, which manifests itself in repeated attacks of arthritis, abdominal pain, and an Erysipelas rash. She is treated with Colchicine 2 mg per day. Despite the treatment, she is symptomatic and the attacks
+coming back. What is the recommended treatment for this patient?
+A. Low-dose daily prednisone.
+B. Rituximab every 6 months.
+C. Canakinumab once a month.
+D. Tocilizumab once a month.
+",C
+"35 years old, with no history of lung disease, has been suffering from fever and shortness of breath for about a week. In a chest x-ray Scattered filtrates and significant distortion. He was treated with an antibiotic without improvement 3 days later. In BAL
+51% macrophages, 22% neutrophils, and 27% eosinophils were found. What is the most likely diagnosis?
+A. Acute Eosinophilic Pneumonia.
+B. Cryptogenic Organizing Pneumonia.
+C. Acute Hypersensitivity Pneumonitis.
+D. Eosinophilic Granulomatosis with Polyangiitis (EGPA).
+",A
+"What is the treatment for a patient with polyuria and hypernatremia secondary to chronic lithium treatment?
+IV DDAVP .a.
+B. Furosemide.
+C. Thiazide.
+D. Acetazolamide.
+",C
+". A 70-year-old man is admitted to investigating dyspnea on exertion. On inspection: in good general condition, a mid-systolic murmur was heard. What is the most likely to be found in this patient?
+A. A second voice is weakened.
+B. First sound split.
+C. The increase in the murmur after an early beat.
+D. The murmur increases when changing from lying down to standing.
+",
+"A 68-year-old man is admitted to the hospital for an investigation of progressively worsening shortness of breath. In ECO there is a pressure drop according to.
+The tricuspid gradient of 55 and MR severe-moderate. In the background, it is known about COPD with 1FEV of 60% of the expected and sleep apnea, moderate, which is not treated. Mean was found in the right heart catheter PAP 44 mmHg and Wedge Capillary Pulmonary pressure 19 mmHg. What can be concluded about The main cause of pulmonary hypertension?
+A. This is pulmonary precapillary blood pressure that is consistent with his lung disease.
+B. This pulmonary blood pressure corresponds to group I - idiopathic primary hypertension.
+C. This is postcapillary pulmonary hypertension that corresponds to his lung disease.
+D. This is postcapillary pulmonary hypertension consistent with his heart disease.
+",D
+"What is the most likely cause of the following laboratory results in a 55-year-old man?
+Serum: Osmolality - 265 mOsm/KgH, Na - 115 mEq/L.
+Urine: Osmolality  80 mOsm/KgH, Na  15 mEq/L.
+A. Nephrogenic DI.
+B. SIADH.
+C. Beer potomania.
+D. Diuretics.
+",C
+"What is true about follicular lymphoma?
+A. Follicular lymphoma is the most common lymphoma.
+B. Remission can be achieved in most patients and most of them have a complete cure of the disease.
+C. Most patients will have a translocation (14:18) and increased expression of bcl2.
+D. The rate of transformation to DLBCL lymphoma is about 10% per year.
+",C
+"78 years old with atrial fibrillation, pacemaker implanted following a pause in the transition from atrial fibrillation to sinus. She was admitted to the hospital due to new heart failure. What would indicate that this is a problem with the pacemaker? 
+A. Regular heart rate. 
+B. Maximum systolic murmur in the intercostal space on the right. 
+C. Pulsations are prominent when looking at the jugular vein. 
+D. Irregular heart rate. 
+
+",C
+"To which condition/disease can the lung functions (all in values greater than expected) show:
+FVC 85% DLCO, 99% FRC, 75% TLC, 59% FEV1, 63%.
+A. Myasthenia Gravis.
+B. Morbid Obesity.
+C. Pulmonary Fibrosis.
+D. COPD + Emphysema.
+",A
+"26 years old, with type 1 diabetes for 4 years. Hospitalized for DKA. Treated with fluids and insulin.
+Intravenously at a rate of 2 units per hour. In the last few hours, she began complaining of weakness and paraesthesia at the fingers' ends. In the laboratory L/U 700 CPK (norm up to L/U 170). What is the possible explanation for her condition?
+A. Hyperkalemia.
+B. Hypophosphatemia.
+C. Hypercalcemia.
+D. Hypermagnesemia.
+",B
+"How are drug doses adjusted according to creatinine clearance (CrCl) in patients with Chronic kidney failure? A. Doses of drugs whose 40% clearance is hepatic, should not be adjusted.
+ B. Loading doses of most drugs for intravenous administration should not be adjusted. 
+C. The dose of any antibiotic currently in use must be adjusted. 
+D. Maintenance doses of most orally administered drugs should not be adjusted. 
+",B
+"Which condition is associated with venous and arterial thrombotic events?
+A. Factor V Leiden .
+B. Polycythemia Vera.
+C. Elevated Factor VIII.
+D. Prothrombin G20210A .
+",B
+"In a routine physical examination of a 74-year-old woman, a significant but non-tender enlargement of a gland was found the shutter The gland is freckled with an uneven texture with bilateral knots, and the largest one on the right side is approx.
+2 cm. The patient denies difficulty breathing or swallowing and states that the findings in the examination have been present for many  years.In the laboratory: mL/miU 0.3 TSH (the normal range mL/miU 0.34-4.25). What is the next step?
+A. US neck to characterize the contextuality.
+B. Neck-chest CT with contrast material.
+C. Technetium mapping of the thyroid gland.
+D. FNA for the large nodule under US guidance.
+",C
+"Which of the following immunological effects of the following drugs is true? 
+A. Daratumumab is an antibody against CD30. 
+B. Nivolumab works against -PD1. 
+C. Brentuximab is an antibody against CD20. 
+D. Ipilimumab works against -PD1. 
+
+",B