Sample Of Exam Questions-2

exam of Diagnosis

Part one: multiple choice (60’) Directions: Each of the numbered items is followed by answers. Select the one lettered answer that is best in each case. Then mark the corresponding letter on the Answer Sheet with a single line through the centre. 1. A loud S1 (increased intensity) is heard in which of the following conditions? A. Mitral stenosis(MS) B. Mitral regurgitation (MR) C. Left bundle branch block(LBBB) D. Aortic insufficiency(AI) E. Tricuspid regurgitation(TR) A 2 ． Which of the following diseases manefest pyrexia accompanying chills in common Except: A. lobar pneumonia; B. septicemia; C. acute cholecystitis; D. acute pyelonephritis; E. viral hepatitis. E 3 ． Which is necessary for sinus rhythm in ECG: A. heart rate 60-100beats per minute B. erectile P wave in lead V1-V6 C. inverse P wave in lead avR D. duration of P wave <0.12s E. P-R interval 0.12-0.20s C 4. According to the cardinal positions of gaze, which of the following pairings of ocular muscles and actions is correct? A. Inferior oblique muscle-abduction and elevation B. Lateral rectus muscle-adduction C. Medial rectus-abduction and depression D. Superior oblique muscle-adduction and

depression Superior rectus muscle-depression

E. D 5.A 48-year-old man presents with the inability to move the right side of his mouth. On physical examination, the patient has difficulty raising his right eyebrow, puffing out his right cheek, and smiling using the right side of his mouth. His nasolabial fold on the right is absent. Blinking is sparse on the right compared to the left, but extraocular muscles are intact and pupils are equal and reactive. The patient’s tongue is midline. Which of the following is the most likely diagnosis? A. Paralysis of cranial nerve V B. Paralysis of cranial nerve VII C. Paralysis of cranial nerve XII D. Horner syndrome E. Pancoast tumor B 6. The most likely cause of large amount proteinuria, casts and decreased SG(specific gravity) is: A. acute glomerulonephritis B. rapidly progressive glomerulonephritis C. chronic glomerulonephritis D. chronic pyelonephritis E. diabetic nephropathy C 7. If a patient has significant right-side lung disease, his of her preferred recumbent position would be which of the following? A. Right lateral decubitus position B. Left lateral decubitus position C. Prone position D. Supine position E. No preferred position B 8. Which of the following is the most common site of spider angioma Except? A. face B. neck C. dorsum of hands D. anterior chest

E. abdomen. E 9. A man is stabbed and arrives to the emergency room within 30min. You notice that the trachea is deviated away from the side of the chest with the puncture. The most likely lung finding on physical examination of the traumatized side is which of the following? A. Increased fremitus B. Incrersed breath sounds C. Dullness to percussion D. Hyperresonant percussion E. Wheezing D 10. Which of the following statements is true regarding normal tracheal anatomy and structure? A. The trachea is posterior to the esophagus B. The trachea is 4cm long C. The trachea is 4cm in diameter D. The trachea divides into right and left main stem bronchi below the sternal angle E. The trachea is to the right of the midline D 11. A 55-year-old man with emphysema will have which kind of repiratory pattern of breathing? A. Biot respiration B. Apneustic breathing C. Cheyne-Stokes respiration D. Rapid and shallow breathing E. Kussmaul breathing D 12. Clubbing of the fingers is associated with which of the following? A. Asthma B. Emphysema C. Bronchitis D. Tuberculosis E. Cystic fibrosis E 13. Which of the following is the common cause of decreasement of abdominal rigidity

Except? A. chronic consumptive disease; B. gestated women; C. older-aged weak person; D. patient with ascites after being drained off excess fluid E. postcholecystectomy. E 14. Which of the following is true regarding auscultation of breath sounds? A. Vesicular breath sounds are high-pitched sounds B. Bronchial breath sounds are normally heard over the trachea C. Bronchovesicular breath sounds are normally heard over the lung periphery D. Bronchial breath sounds are low-pitched sounds E. Maximal intensity of the breath sounds is heard normally at the lung bases B 15. A Which of the following is the most important first step in the diagnostic and treatment process? A. A thorough history and physical examination B. Blood work C. Urinalysis D. Electrocardiogram E. Radiographic A 16. Which of the following statements is true regarding grading of heart murmurs? A. Grade 1 murmurs are never audible B. Grade 2 murmurs are never audible C. Grade 3 murmurs are loud D. Grade 4 murmurs are loud obvious murmurs with a palpable thrill E. Grade 5 murmurs may be heard with the stethoscope completely off the chest D 17. Which of the following statements best describes a precordial thrill? A. It is a normal finding

B. C. D. E.

It accompanies most heart murmurs It only exists during systole It is a palpable murmur It is always a sign of congestive heart failure

D 18. Which of the following is NOT the characteristics of renal edema? A. orthostatic edema B. pitting edema C. edema most pronounced in the morning D. proteinuria may be found E. renal function may be normal A 19. Which of the following statement refers to inspiratory dyspnea? A. Difficulty in the expiratory phase of breathing with prolonged expiratory time B. Three depression sign C. Often associated with rhonchi D. Due to reduced alveolar elasticity and/or bronchiole obstruction E. Cannot caused by airway obstruction in the larynx or large bronchi B 20. Which of the following is true regarding the second heart sound(S2)? A. It is best heard at the apex B. It is louder than S1 at the apex C. It is normally made up of P2 followed by A2 D. When split, it is always abnormal E. When it is split, the split may be increased by inspiration E 21.Which of the following is the proper sequence for examination of the abdomen? A. Auscultation, percussion, inspection, palpation B. Auscultation, inspection, palpation, percussion C. Inspection,percussion, auscultation, palpation D. Inspection, auscultation, percussion,

E.

palpation Inspection, auscultation

percussion,

palpation,

D 22. Which of the following statements is true regarding the term “scaphoid” abdomen? A. An unremarkable abdomen should be called scaphoid B. It is a convex abdomen C. It is seen in patients who have ascites. D. It is absent in obese patients E. It implies guarding D 23. Which of the following best describes the location of McBurney’s point? A. In the midclavicular line just under the right costal margin B. At the midpoint of a line connecting the symphysis pubis and the anterior superior iliac spine C. Midway along the right inguinal ligament D. One-third of the way along a line drawn from the right anterior superior iliac spine to the umbilicus E. One centimeter to the right of the umbilicus D 24. Patients with tracheal tumour have: A. Inspiratory dyspnea B. Expiratory dyspnea C. Mixed dyspnea D. Toxic dyspnea E. Dyspneoneurosis A 25. In which situation we can’t find the weaken of the tactile fremitus and vocal resonance? A emphysema B pulmonary consolidation C pulmonary atelectasis D pleural effusion E spontaneous pneumothorax B 26. Which of the following statements is true

regarding palpation of the thyroid gland? A. The left lobe of the thyroid is 25% larger than the right lobe B. The consistency of the thyroid gland should be gritty and coarse C. The patient should never be examined from the front D. The thyroid gland should remain immobile with swallowing E. The patient should be positioned with the neck flexed slightly forward and laterally toward the side being examined E 27. Patients with a left hypoglossal nerve palsy will have which of the following? A. Deviation of the tongue to the left B. Deviation of the tongue to the right C. Loss of taste on the left D. Deviation of the jaw to the left E. Deviation of the jaw to the right A 28. Which of the following stantements regarding lymphadenopathy is true? A. The harder the node, the more likely it is to be benign B. The more discrete the node , the more likely it is to be benign C. The more tender the node, the more likely it is to be inflammation D. Lymph nodes may occasionally be pulsatile E. A palpable left supraclavicular node is often benign C 29. Which of the following characteristics NOT refers to blood from the lower respiratory tract? A. Bright red B. Foamy, runny C. Mixed with mucus D. Acidic pH E. Persistent cough D 30. Asthma is characterized by which of the

following? A. Inspiratory dyspnea B. Expiratory dyspnea C. Mixed dyspnea D. Three depression sign E. None of above B 31. Massive hemoptysis means A. Less than 100ml of blood lost in a 24 hour period B. More than 100ml to 500ml of blood lost in a 24 hour period C. More than 100ml of blood lost in a 24 hour period D. More than 300-500ml of blood lost for the whole episode E. None of above D 32. The color of hematochezia is major determined by: A. bleeding volume B. stagnation time of blood in gastrointestinal tract C. volume of stool in colon D. with or without hematemesis E. location of hemorrhage of gastrointestinal tract E 33. Which of following is the most typical image of cholelithiasis? A. The gallbladder with increased size and dilated biliary ducts.. B. There is a echogenic movable mass in the gallbladder with posterior acoustic shadowing. C. There are multiple ,fixed polyps found in the gallbladder wall.

D.

The gallbladder with an irregular outline

of a thickened wall. E. None of above. B 34. In which situations we can’t find the shift of trachea?

A. massive pleural effusion B. pneumothorax C. pulmonary atelectasis D. pulmonary consolidation E. thicken of pleural D 35 Which one of the followings can indicate the renal failure? A. Increase of GFR and BUN B. Increase of Ccr and Scr C. Increase of Scr and BUN D. Increase of GFR and Scr E. Increase of Ccr and BUN C 36 Which one of the followings is abnormal in urinalysis? A. RBC 0-2/HP B. WBC 0-4/HP C. Cast (-) D. Protein (+) E. Glucose (-) D 37. What’s the dagnosis of ECG1? A. atrial flutter B. sinus tachycardia C. paroxysmal supraventricular tachycardia D. atrial fibrillation E. paroxysmal ventricular tachycardia A. D 38.What’s the dagnosis of ECG2? A. Premature ventricular contraction B. Premature atrial contraction C. Left anterior fascicular block D. Preexcitation syndrome E. Premature junctional contraction B 39.What’s the dagnosis of ECG3? A. Normal sinus rhythem B. Sinus Tachycardia C. Paroxysmal supraventricular tachycardia D. Atrial fibrillation E.

Paroxysmal ventricular tachycardia

E 40. Ultrosonography can Not be used to detect: A. Heart B. Abdomen C. Lung D. Aortic artery E. Thyroid gland C Part two: essay question (40’) Directions: In this part there are four questions. You should answer them in a concise statement. 1. Please bring out the three signs of meningeal irritation by nervous examination? 2. What will be revealed in patients with the right side pleural effusion by lung examination? 3. Please describe the signs of Mitral Stenosis. 4. How should you describe the abdominal mass?

ECG 1：

ECG 2：

ECG 3：