Internal Medicine Question Bank

Read the Internal Medicine Question Bank sample questions

1. 1.case of depressed man after death of his son, he can`t sleep at all for 2 days, which drug will for short term :

   • A.LorazepamCorrect
   • B.Imipramin

   Why: Acute insomnia after an acute stressor (his son's death) is best managed with a short-term hypnotic. Lorazepam, a short/intermediate-acting benzodiazepine, provides rapid relief of severe insomnia for brief use. Imipramine is a tricyclic antidepressant that takes weeks to act and is not for acute, short-term sleep relief.

2. 2.What do we use in TB prophelaxis

   • A.IsoniasideCorrect
   • B.Ethambutole
   • C.Refambecin

   Why: Isoniazid is the standard agent for tuberculosis prophylaxis (treatment of latent TB infection), typically given for 6-9 months. Ethambutol and rifampicin are components of active TB treatment regimens, not first-line single-agent prophylaxis.

3. 3.A boy who was bitten by his brother .. and received tetanus shot 6 month ago and his laceration was 1 cm and you cleaned his wound next you will:

   • A.give augmentin
   • B.suture the wound
   • C.give tetanus shotCorrect
   • D.send home with close observation and return in 48 hr

   Why: Human bites are heavily contaminated and high-risk for infection, but the key tetanus issue here is timing: for a tetanus-prone wound, a booster is given if the last dose was more than 5 years ago. Although 6 months seems recent, the keyed answer reflects giving tetanus prophylaxis as the next step. [REVIEW: keyed answer may be incorrect — with a booster only 6 months ago the patient is adequately protected against tetanus; for a contaminated human bite the more appropriate next step is prophylactic antibiotics such as amoxicillin-clavulanate (option a), and bite wounds are generally not sutured.]

4. 4.Patient with retrosternal chest pain, barium swallow show corkscrew appearance:

   • A.Achalasia
   • B.Esophagitis
   • C.GERD
   • D.Diffuse esophageal spasmCorrect

   Why: A corkscrew or rosary-bead appearance on barium swallow with intermittent retrosternal chest pain is classic for diffuse esophageal spasm, caused by uncoordinated, simultaneous high-amplitude contractions. Achalasia instead shows a bird-beak tapering with a dilated esophagus.

5. 5.in aspirin overdose :

   • A.liver enzyme will peak within 3-4 hr
   • B.first signs include peripheral neuropathy and loss of reflexes
   • C.150 mg/kg of aspirin will not result in aspirin toxicityCorrect

   Why: In salicylate (aspirin) overdose, toxicity is dose-related; ingestions below roughly 150 mg/kg generally do not cause significant toxicity. Aspirin does not cause an early hepatic enzyme peak (that pattern fits paracetamol), and peripheral neuropathy is not an early feature, making option c the correct exception/threshold statement.

6. 6.40 y/o with mild epigastric pain and nausea for 6 months..endoscopy>loss of rugeal folds, biopsy> infiltration of B lymphocytes..treated with abx..cause:

   • A.salmonella
   • B.H.pyloriCorrect

   Why: Chronic epigastric symptoms with loss of rugal folds and B-lymphocyte infiltration on biopsy that responds to antibiotics describes gastric MALT lymphoma, which is driven by Helicobacter pylori. Eradication of H. pylori often induces remission of low-grade MALT lymphoma.

7. 7.mitral stenosis :

   • A.diastolic high pitchCorrect
   • B.systolic low pitch
   • C.diastolic low pitch

   Why: Mitral stenosis classically produces a low-pitched, rumbling mid-diastolic murmur best heard at the apex with the bell. Among the given choices the diastolic timing is the key feature; the murmur is low-pitched, not high-pitched. [REVIEW: keyed answer may be incorrect — the murmur of mitral stenosis is a low-pitched diastolic rumble, so option c (diastolic, low pitch) is the more accurate descriptor than option a (diastolic, high pitch).]

8. 8.All are 1ry prevention of anemia except:

   • A.health education about food rish in iron
   • B.iron fortified food in childhood
   • C.limitation of cow milk before 12 month of age
   • D.genetic screening for hereditary anemiaCorrect

   Why: Primary prevention aims to stop disease before it occurs (e.g., dietary iron education, iron-fortified foods, limiting cow's milk in infancy). Genetic screening for hereditary anemia detects existing/predisposing disease and is secondary prevention, so it is the exception.

9. 9.pt on anti Tb medication with hear loss what is the cause:

   • A.pyrenzmaid
   • B.StreptomycinCorrect

   Why: Among anti-TB drugs, streptomycin (an aminoglycoside) is the classic cause of ototoxicity and sensorineural hearing loss. Pyrazinamide causes hepatotoxicity and hyperuricemia, not hearing loss.

10. 10.human bite to the hand .. greatest risk of infection in which position :

    • A.dependentCorrect
    • B.clenched
    • C.finger extended

    Why: Human bites over the clenched fist (clenched position, e.g., a fight bite over the metacarpophalangeal joints) carry the greatest infection risk because flexor tendon sheaths and joint spaces are penetrated and seal off bacteria when the hand is later extended. [REVIEW: keyed answer may be incorrect — the highest-risk presentation of a hand human bite is the clenched-fist injury (option b), not the dependent position.]