PBCR Multiple Choice Questions & Answers Vol. 1

Sample Chapter 1
Here are some of the multiple choice question which you will find in this book

Q1. A patient's serum SMA 6 result reveals Na 136, Cl 104, K 4.0, BUN 21, creatinine 0.9, and glucose 90. What is the serum osmolality?

1. 270
2. 280
3. 284
4. 300
5. 310

Q2. The term DKA (diabetic keto acidosis) means all of the following except:

1. Serum glucose is more than 300 mg/dL
2. Ketonemia
3. pH less than 7.30
4. Bicarbonate less than 15 mEq/L
5. Absence of ketone in the urine

Q3. Human beta cells can be infected by all of the following organisms expect:

1. Coxsackievirus
2. Group B streptococcus (GBS)
3. CMV
4. Mumps
5. Rubella

Q4. The first abnormality noted in iron deficiency anemia is:

1. Reduced iron stores in tissue (hemosiderin in bone marrow disappear)
2. Reduced serum ferritin
3. Reduced serum iron and incresed TIBC (total iron-binding capacity)
4. Increased FEP (free erythrocyte protoporphyrin)
5. Decreased MCH & MCV

Q5. A 3.9 kg newborn appears with cyanosis at 2 hours of age, cyanosis progressively gets worse, also dyspnea. An examination reveals lower extremities are less cyanotic than upper extremities, hyperactive precordium, either no murmur or PDA murmur of grade 3/6, 2nd heart sound single and loud, or occasionally it may be split. Chest X-ray reveals mild cardiomegaly, normal or increased pulmonary flow, narrow mediastinum. ABG reveals Pao2 15 to 30, pH 7.30, Pco2 35, O2 saturation 30 to 70%, base deficit - 15.0. Pao2 increases slightly after hyperoxia test (i.e., 100% oxygen). EKG reveals biventricular hypertrophy. Newborn was intubated and placed on mechanical ventilator. PGE1 and NaHCO3 are given. Baby's oxygen saturation improved up to 85 to 90%. Next appropriate step in management:

1. Fontan procedure
2. Blalock-Taussig shunt
3. Rashkind balloon atrial septostomy
4. Norwood operation
5. Starnes procedure

Q6. The following congenital infection is associated with diabetes ( type 1 ) in later life:

1. Coxsackie B3
2. Coxsackie B4
3. CMV
4. Rubella
5. Mumps

Q7. A 10-year-old boy appears with history of purulent discharge from the left ear for the last 5 days. Past medical history reveals that a tympanostomy tube was placed in his left ear 12 months ago due to recurrent purulent left otitis media. The child is afebrile. He denies any history of headache, dizziness, and vomiting. He likes to swim. He is doing well in school. Physical examination reveals purulent yellowish discharge from the left ear through tympanostomy tube. The most common organism responsible for discharge through tympanostomy tube is:

1. Staphylococcus aurius
2. Streptococcus pneumoniae
3. Staphylococcus epidermidis
4. Pseudomonas aeruginosa
5. Candida albicans

Q8. A 3.5 kg baby who is full term, AGA (appropriate of gestational age) was born by NSVD with a Apgar score 7 at 1 minute and 8 at 5 minutes. The child developed mild respiratory distress and placed under oxyhood with 40% oxygen. Chest X-ray reveals TTNB (transient tachypnea of newborn). Lung fluid is absorbed after birth mostly by:

1. Lymphatics
2. Aortic circulation
3. Superior vena cava
4. Pulmonary circulation
5. Inferior vena cava

Q9. A boy is affected with a genetically transmitted disease. He has one brother who is not affected. He has two sisters, one is affected and other is not affected. His father is normal but the mother has the disease. His mother's sisters (aunt) are all affected but the mother's brothers are not affected. His father's siblings are not affected. His maternal grandfather was affected but maternal grandmother was normal. The disease is most likely transmitted:

1. X-linked recessive
2. X-linked dominant
3. Autosomal dominant
4. Autosomal recessive
5. Multifactorial

Q10. A postmature newborn was admitted to NICU with tachypnea. The newborn was delivered by NSVD with Apgar scores of 9 and 9 at 1 minute and 5 minutes respectively. A chest X-ray revealed normal findings. Complete blood count (CBC) revealed central hematocrit 72 with mild thromocytopenia but the rest of the result was within normal limit. Partial exchange transfusion was performed with normal saline through umbilical vein. This procedure may reduce the following problems except:

1. Speech deficits
2. Decreased IQ and school problems
3. Abnormal fine motor abnormalities
4. NEC (necrotizing enterocolitis) and feeding problem
5. Other neurologic abnormalities

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