Internal Medicine Quiz
Questions: 16 · 10 minutes
1. A patient has seasonal nasal itching and sneezing suggestive of allergic rhinitis, but extensive eczema and required antihistamine use make skin-prick testing impractical. Which test can assess sensitization to a suspected allergen?
Serum total complement level
Erythrocyte sedimentation rate
Serum allergen-specific IgE testing
Antinuclear antibody testing
2. Which thyroid test pattern is most consistent with primary hyperthyroidism?
High TSH and low free T4
High TSH and high free T4
Low TSH and low free T4
Low TSH and high free T4
3. A hemodynamically stable patient has persistent fever, a new heart murmur, and peripheral findings suggestive of infective endocarditis. What should be obtained before starting antibiotics when this can be done without delaying urgent care?
A single throat culture
A stool culture after antibiotics begin
A sputum sample from one collection
Multiple blood-culture sets from separate venipuncture sites
4. Which laboratory finding most specifically supports iron-deficiency anemia?
Low ferritin
Elevated haptoglobin
Elevated ferritin
Elevated mean corpuscular volume
5. A patient with diabetic ketoacidosis has a serum potassium level within the reference range before treatment. Which interpretation is most accurate?
Total body potassium is elevated because insulin is deficient
Potassium balance is normal, so monitoring during treatment is unnecessary
Potassium cannot change when insulin treatment begins
Total body potassium is usually depleted despite the serum result
6. A patient has generalized edema, frothy urine, low serum albumin, and marked hyperlipidemia. Which additional finding best fits the same syndrome?
Red blood cell casts with only mild proteinuria
Urinary protein excretion greater than 3.5 grams per day
Urine glucose with normal serum glucose as the defining feature
Isolated bacteriuria without urinary symptoms
7. A patient taking lisinopril develops a persistent dry cough with no other apparent cause. Which medication is the most appropriate alternative for similar renin-angiotensin system blockade?
Amlodipine
Hydrochlorothiazide
Propranolol
Losartan
8. Which combination is most consistent with syndrome of inappropriate antidiuretic hormone secretion, or SIADH?
High serum osmolality with maximally dilute urine
Low serum osmolality with inappropriately concentrated urine in a clinically euvolemic patient
Low serum osmolality with marked volume depletion from diarrhea
Normal serum sodium with glucosuria and ketonuria
9. A patient with macrocytic anemia also reports numb feet and difficulty with balance. Which deficiency best explains this combination?
Iron deficiency
Vitamin B12 deficiency
Vitamin K deficiency
Copper excess
10. Which spirometry pattern most strongly supports a diagnosis of asthma?
Reduced lung volumes with a preserved FEV1/FVC ratio
Airflow obstruction that improves significantly after a bronchodilator
Fixed airflow obstruction without bronchodilator response
Normal airflow accompanied by a reduced hemoglobin level
11. Which electrocardiogram change is classically associated with hyperkalemia?
Prominent U waves
A shortened PR interval with a delta wave
Tall, peaked T waves
Diffuse ST elevation with PR depression
12. Which crystal finding in synovial fluid supports a diagnosis of gout?
Needle-shaped, negatively birefringent crystals
Rhomboid-shaped, positively birefringent crystals
Cholesterol crystals within red blood cells
Cystine crystals forming hexagonal plates
13. A patient develops widespread hives, wheezing, and dizziness within minutes of eating a food. What is the first-line treatment for this suspected anaphylaxis?
Intramuscular epinephrine in the outer thigh
Intravenous diphenhydramine alone
Nebulized albuterol alone
Oral prednisone before further assessment
14. An adult has acute hives but no breathing difficulty, throat swelling, dizziness, or other signs of anaphylaxis. Which medication class is generally preferred for initial symptom control?
A leukotriene modifier used alone
A long-term oral corticosteroid
A second-generation H1 antihistamine
A proton-pump inhibitor
15. A patient develops one-sided calf swelling and tenderness several days after surgery. Deep vein thrombosis is suspected. Which test is typically used first to evaluate the affected leg?
Exercise electrocardiography
Plain radiography
Compression ultrasonography
Abdominal magnetic resonance imaging
16. An adult has recurrent bacterial sinus and lung infections, low IgG with low IgA, and poor antibody responses to vaccines. Which immunodeficiency best fits this pattern?
Common variable immunodeficiency
Chronic granulomatous disease
Selective IgA deficiency
Hereditary angioedema