SAMPLE QUESTIONS

Completion Items (Format 1): - 1 point each

Directions:  Each of the following questions or incomplete statements is followed by five suggested answers or completions. Select the ONE best answer in each case

1.   A 70-year-old woman is brought to the emergency department because she is experiencing chest pain. Based on the electrocardiogram tracing shown      above, which of the following is the most likely diagnosis?

            (A) Acute anterior infarction in the left ventricle of the heart

            (B) Acute anterior infarction in the right ventricle of the heart 

            (C) Acute posterior infarction in the left ventricle of the heart

            (D) Acute posterior infarction in the right ventricle of the heart

            (E) Right ventricular hypertrophy

            (Answer = A)

2.   A female patient has unexplained severe hypernatremia (plasma Na⁺ =   167mmol/L) and complains of frequent urination and large urine volumes. A urine specimen reveals that the Na⁺ concentration is 15 mmol/L (very low) and the osmolarity is 155 mOsm/L (very low). Laboratory tests reveal the           following:

           Plasma renin activity = 3 ng angiotensin I/ml/hr             (normal = 1.0)

           Plasma antidiuretic hormone (ADH) = 30 pg/ml              (normal = 3 pg/mL)

           Plasma aldosterone = 20 ng/dl                                        (normal = 6 ng/dl)

Which of the following is the most likely reason for her hypernatremia?

(A) Simple dehydration due to decreased water intake 

(B) Nephrogenic diabetes insipidus

(C) Central diabetes insipidus

(D) Syndrome of inappropriate ADH

(E) Primary aldosteronism

(F) Renin-secreting tumor                                                  

(Answer = B)

3.  A 30-year-old woman performs a Valsalva maneuver about 30 minutes after eating lunch.  Which of the following best describes the changes in pulmonary and systemic blood volumes that occur in this woman?

      (Answer = B)

Matching Items (Format 3):                         1 point each

Directions:  In each of the following questions, there are two parts.  First, a list of lettered headings followed by a list of numbered words or phrases. For each numbered word or phrase, select the one lettered heading which is most closely related to it. In every instance there is an answer, but all the letters in the first list may be used more than once or not at all.

A.     Regional enteritis

B.      Chronic peptic ulcer

C.     Carcinoma of the colon

D.     Chronic atrophic gastritis

E.      Intussusception

1. Most often associated with macrocytic anemia.      (Answer = D)

2. Most often located in lower ileum.                            (Answer = A)

3. Most common during first year of life.                        (Answer = E)

4.Secondary lesions in liver.                                            (Answer = C)

5.Most often located in duodenum.                              (Answer = B)

6. Achlorhydria common.                                               (Answer = D)

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