June Weekly Quiz 7 Quiz 1 / 100 A cirrhotic patient presents with elevated ferritin. You suspect: Primary biliary cholangitis Wilsonâs disease Hemochromatosis Acute hepatitis Iron overload from hemochromatosis causes liver damage and high ferritin levels. Iron overload from hemochromatosis causes liver damage and high ferritin levels. 2 / 100 What is the most common cause of cirrhosis worldwide? Viral hepatitis B Alcohol Hepatitis C Non-alcoholic fatty liver disease (NAFLD) Hepatitis C is the most common cause globally, though alcohol and NAFLD are leading in many regions. Hepatitis C is the most common cause globally, though alcohol and NAFLD are leading in many regions. 3 / 100 Which of the following is a protective factor against GERD? Smoking Delayed gastric emptying LES incompetence Normal esophageal peristalsis Effective esophageal clearance reduces acid exposure time. Effective esophageal clearance reduces acid exposure time. 4 / 100 Which of the following conditions is not associated with increased TIA risk? Smoking Diabetes mellitus Hypothyroidism Hyperlipidemia Hypothyroidism is not a significant stroke or TIA risk factor. Hypothyroidism is not a significant stroke or TIA risk factor. 5 / 100 The most common cause of TIA is: Hemorrhage Infection Embolism from atherosclerotic plaque Epilepsy Most TIAs are caused by emboli from atherosclerotic plaques in large arteries. Most TIAs are caused by emboli from atherosclerotic plaques in large arteries. 6 / 100 Phlegmasia cerulea dolens is: Arterial embolism Massive DVT with venous gangrene Mild DVT Hemorrhagic DVT It is a severe, limb-threatening form of DVT with cyanosis and ischemia. It is a severe, limb-threatening form of DVT with cyanosis and ischemia. 7 / 100 Which of the following is a major risk factor for PE? Chronic bronchitis Oral contraceptive use Hypothyroidism Asthma Estrogen-containing medications increase coagulability, predisposing to PE. Estrogen-containing medications increase coagulability, predisposing to PE. 8 / 100 Which cancer is most associated with thrombosis and PE? Lung Pancreatic Colon Prostate Pancreatic and gastric cancers are highly thrombogenic. Pancreatic and gastric cancers are highly thrombogenic. 9 / 100 Which marker appears first after HBV infection? HBeAg HBsAg Anti-HBc IgM Anti-HBs HBsAg is the earliest marker of acute infection. HBsAg is the earliest marker of acute infection. 10 / 100 Which of the following is not a component of Virchows triad? Endothelial injury Venous stasis Hypercoagulability Hypoxia Virchowâs triad includes stasis, endothelial injury, and hypercoagulability. Virchowâs triad includes stasis, endothelial injury, and hypercoagulability. 11 / 100 What is the most common cause of community-acquired pneumonia (CAP)? Klebsiella pneumoniae Streptococcus pneumoniae Haemophilus influenzae Mycoplasma pneumoniae Streptococcus pneumoniae is the most common cause of CAP globally. Streptococcus pneumoniae is the most common cause of CAP globally. 12 / 100 Presence of HBsAg for more than 6 months indicates: Resolved infection Immunity Vaccination Chronic hepatitis B Persistence of HBsAg beyond 6 months defines chronic hepatitis B. Persistence of HBsAg beyond 6 months defines chronic hepatitis B. 13 / 100 Which of the following is associated with micronodular cirrhosis? Hemochromatosis Autoimmune hepatitis Alcoholic liver disease Viral hepatitis Alcoholic liver disease typically shows small uniform nodules. Alcoholic liver disease typically shows small uniform nodules. 14 / 100 Which of the following is a modifiable risk factor for stroke? Gender Family history Smoking Age Smoking is a major modifiable risk factor for stroke. Smoking is a major modifiable risk factor for stroke. 15 / 100 Which is the most common presenting feature of DVT? Redness Fever Leg pain Swelling Swelling is the most consistent symptom in DVT. Swelling is the most consistent symptom in DVT. 16 / 100 Atypical pneumonia typically presents with: Sudden high fever and lobar consolidation Cyanosis and pleuritic chest pain Dry cough and extrapulmonary symptoms Productive cough with purulent sputum Atypical pneumonia presents with a dry cough, headache, and myalgia. Atypical pneumonia presents with a dry cough, headache, and myalgia. 17 / 100 A patient with atrial fibrillation is at risk of TIA due to: Atrial thrombus formation Low BP Bradycardia Increased blood viscosity Atrial fibrillation can cause thrombi in the atria, which may embolize to the brain. Atrial fibrillation can cause thrombi in the atria, which may embolize to the brain. 18 / 100 A patient with bradycardia, hypotension, and altered mental status needs immediate treatment. What is the first-line drug? Isoproterenol Epinephrine Atropine Dopamine Atropine is the first-line drug in symptomatic bradycardia to increase heart rate. Atropine is the first-line drug in symptomatic bradycardia to increase heart rate. 19 / 100 Which lifestyle habit worsens GERD symptoms? Fiber intake Morning walks Alcohol intake Frequent water drinking Alcohol decreases LES pressure and promotes acid reflux. Alcohol decreases LES pressure and promotes acid reflux. 20 / 100 What is the typical age range for TIA patients? <20 years 45â85 years >90 years 20â40 years TIAs are more common in middle-aged and elderly adults. TIAs are more common in middle-aged and elderly adults. 21 / 100 Smoking contributes to GERD primarily by: Enhancing gastric acid secretion Relaxing the LES Increasing mucus production Narrowing the esophagus Smoking reduces LES tone and saliva production, increasing acid exposure. Smoking reduces LES tone and saliva production, increasing acid exposure. 22 / 100 Which condition increases the risk of aspiration pneumonia? Stroke with dysphagia GERD Diabetes mellitus Asthma Neurological deficits impair swallowing, leading to aspiration. Neurological deficits impair swallowing, leading to aspiration. 23 / 100 Which of the following is a typical pneumonia pathogen? Mycoplasma pneumoniae Chlamydophila pneumoniae Streptococcus pneumoniae Legionella pneumophila Typical pathogens include S. pneumoniae, H. influenzae, and M. catarrhalis. Typical pathogens include S. pneumoniae, H. influenzae, and M. catarrhalis. 24 / 100 Which stroke type is associated with atrial fibrillation? Embolic stroke Subdural hematoma Hemorrhagic stroke Lacunar stroke Atrial fibrillation increases risk of thromboembolism to the brain. Atrial fibrillation increases risk of thromboembolism to the brain. 25 / 100 Caput medusae is: Ascitic fluid accumulation Petechiae on the chest Collateral veins on the abdomen Hyperpigmented skin Due to portal hypertension, abdominal wall veins become engorged. Due to portal hypertension, abdominal wall veins become engorged. 26 / 100 Asterixis is a sign of: Alcoholism Hepatic encephalopathy Renal failure Hypoglycemia Asterixis is a flapping tremor indicating metabolic encephalopathy. Asterixis is a flapping tremor indicating metabolic encephalopathy. 27 / 100 Immobilization contributes to PE by: Increasing cardiac output Decreasing fibrin production Promoting venous stasis Increasing oxygen saturation Venous stasis is a major factor in Virchowâs triad for thrombosis. Venous stasis is a major factor in Virchowâs triad for thrombosis. 28 / 100 The cell type primarily involved in hepatic fibrosis is: Kupffer cells Cholangiocytes Hepatic stellate cells (Ito cells) Hepatocytes Stellate cells produce collagen when activated in chronic liver injury. Stellate cells produce collagen when activated in chronic liver injury. 29 / 100 Which of the following is the most common cause of sinus bradycardia? Hypothyroidism Increased vagal tone Hyperthyroidism Myocardial infarction Increased vagal tone is the most common benign cause of sinus bradycardia, especially in athletes. Increased vagal tone is the most common benign cause of sinus bradycardia, especially in athletes. 30 / 100 A patient presents with sudden dyspnea after a long flight. The most likely diagnosis is: Asthma Pulmonary embolism Heart failure Pneumothorax Long flights can lead to stasis and DVT, increasing PE risk. Long flights can lead to stasis and DVT, increasing PE risk. 31 / 100 Gynecomastia in cirrhosis results from: Alcohol use Elevated cortisol Poor hygiene Hormonal imbalance Liver failure reduces estrogen breakdown, causing feminization. Liver failure reduces estrogen breakdown, causing feminization. 32 / 100 Visual field loss in the same side of both eyes (homonymous hemianopia) is due to a lesion in: Frontal lobe Optic nerve Optic chiasm Occipital lobe Damage to the occipital cortex or optic tract causes homonymous hemianopia. Damage to the occipital cortex or optic tract causes homonymous hemianopia. 33 / 100 Pneumonia occurring â¥48 hours after hospital admission is classified as: Ventilator-associated pneumonia Hospital-acquired pneumonia Aspiration pneumonia Community-acquired pneumonia HAP develops â¥48 hours after admission, unrelated to initial infection. HAP develops â¥48 hours after admission, unrelated to initial infection. 34 / 100 First-line drug for AVNRT if vagal maneuvers fail: Adenosine Amiodarone Digoxin Verapamil Adenosine transiently blocks AV node and terminates AVNRT. Adenosine transiently blocks AV node and terminates AVNRT. 35 / 100 What is the most common cause of hospital-acquired pneumonia (HAP)? Pseudomonas aeruginosa Influenza virus Escherichia coli Streptococcus pneumoniae Pseudomonas and other gram-negative organisms are common in HAP. Pseudomonas and other gram-negative organisms are common in HAP. 36 / 100 Multifocal atrial tachycardia is commonly seen in: Diabetes Hypertension COPD Stroke MAT is a chaotic atrial rhythm commonly triggered by hypoxia in COPD. MAT is a chaotic atrial rhythm commonly triggered by hypoxia in COPD. 37 / 100 In DVT, leg swelling is usually: Painless Localized to the knee Unilateral Bilateral DVT classically presents with unilateral leg swelling. DVT classically presents with unilateral leg swelling. 38 / 100 Delta waves on ECG suggest: Atrial fibrillation Ventricular tachycardia AVNRT WPW syndrome Delta waves signify pre-excitation through an accessory pathway. Delta waves signify pre-excitation through an accessory pathway. 39 / 100 What is the most common source of pulmonary embolism? Deep veins of the legs Right atrium Arm veins Pulmonary artery Most emboli originate from deep veins in the lower limbs (DVT). Most emboli originate from deep veins in the lower limbs (DVT). 40 / 100 Which of the following indicates past infection with HBV? HBeAg HBsAg Anti-HBs and Anti-HBc IgG Anti-HBs alone Both anti-HBc and anti-HBs show natural immunity after resolved infection. Both anti-HBc and anti-HBs show natural immunity after resolved infection. 41 / 100 Which inherited thrombophilia increases the risk of PE? Hemophilia A Factor V Leiden mutation Hypokalemia Iron deficiency Factor V Leiden is a common genetic cause of hypercoagulability. Factor V Leiden is a common genetic cause of hypercoagulability. 42 / 100 Which surgery carries the highest PE risk? Appendectomy Cataract surgery Cesarean section Hip replacement Major orthopedic surgeries like hip and knee replacement are high risk for DVT/PE. Major orthopedic surgeries like hip and knee replacement are high risk for DVT/PE. 43 / 100 A key precipitating factor in GERD is: Hypercalcemia Obesity Decreased gastric acid production High-fiber diet Obesity increases intra-abdominal pressure, promoting reflux. Obesity increases intra-abdominal pressure, promoting reflux. 44 / 100 A young patient with recurrent TIAs should be evaluated for: Hypothyroidism Patent foramen ovale (PFO) Diabetes insipidus COPD PFO allows paradoxical emboli to bypass the lungs and reach the brain. PFO allows paradoxical emboli to bypass the lungs and reach the brain. 45 / 100 Which of the following is a modifiable risk factor for TIA? Male sex Hypertension Age Family history Hypertension is the most important modifiable risk factor. Hypertension is the most important modifiable risk factor. 46 / 100 Which genetic disorder causes copper accumulation and cirrhosis? Wilsonâs disease Alpha-1 antitrypsin deficiency Gilbertâs syndrome Hemochromatosis Wilsonâs disease is an autosomal recessive condition causing copper buildup. Wilsonâs disease is an autosomal recessive condition causing copper buildup. 47 / 100 A 24-year-old college student has dry cough, low-grade fever, and diffuse infiltrates. Likely pathogen? Mycoplasma pneumoniae Klebsiella pneumoniae Pseudomonas aeruginosa Streptococcus pneumoniae Mycoplasma causes âwalking pneumoniaâ in young adults. Mycoplasma causes âwalking pneumoniaâ in young adults. 48 / 100 Anti-HBs positivity and anti-HBc negativity suggest: &. What is the treatment of choice for pregnant women with high HBV DNA? Tenofovir Lamivudine No treatment Interferon-alpha Tenofovir is safe in pregnancy and reduces vertical transmission. Tenofovir is safe in pregnancy and reduces vertical transmission. 49 / 100 Homans sign in DVT is: Always present Neither sensitive nor specific Specific Diagnostic Homanâs sign (pain on dorsiflexion) is unreliable for diagnosis. Homanâs sign (pain on dorsiflexion) is unreliable for diagnosis. 50 / 100 HBV is most commonly transmitted in developing countries via: Blood transfusion Vertical transmission Sexual contact Organ transplant Perinatal transmission is common in high-prevalence areas. Perinatal transmission is common in high-prevalence areas. 51 / 100 Calf tenderness in DVT is due to: Muscle spasm Inflammatory response Nerve compression Joint effusion Thrombus triggers local inflammation causing pain and tenderness. Thrombus triggers local inflammation causing pain and tenderness. 52 / 100 What is the treatment for symptomatic complete heart block? Beta-blockers Atropine Digoxin Permanent pacemaker Complete heart block requires pacing due to risk of sudden cardiac death. Complete heart block requires pacing due to risk of sudden cardiac death. 53 / 100 The most likely pathogen in post-influenza pneumonia is: Staphylococcus aureus Pseudomonas aeruginosa Haemophilus influenzae Streptococcus pneumoniae Secondary bacterial pneumonia after influenza is often due to S. aureus. Secondary bacterial pneumonia after influenza is often due to S. aureus. 54 / 100 Sinus arrest is best diagnosed by which ECG feature? Short PR interval Regular QRS complexes Absent P waves for >2 seconds Inverted P waves Sinus arrest is a prolonged pause with no P waves or associated QRS. Sinus arrest is a prolonged pause with no P waves or associated QRS. 55 / 100 Atrial flutter usually has an atrial rate of: >400 bpm 250â350 bpm 100â150 bpm 60â100 bpm Classic atrial flutter has a sawtooth pattern with ~300 bpm atrial rate. Classic atrial flutter has a sawtooth pattern with ~300 bpm atrial rate. 56 / 100 In cirrhosis, fibrotic tissue replaces: Kupffer cells Sinusoids Hepatocytes Bile Cirrhosis involves irreversible replacement of hepatocytes with fibrous tissue. Cirrhosis involves irreversible replacement of hepatocytes with fibrous tissue. 57 / 100 By definition, how long do symptoms of a TIA typically last? Indefinitely 1â2 days 48â72 hours Less than 24 hours Symptoms resolve within 24 hours, usually within minutes to hours. Symptoms resolve within 24 hours, usually within minutes to hours. 58 / 100 Window period of HBV is detected by: HBeAg HBsAg Anti-HBc IgM Anti-HBs Anti-HBc IgM is the only marker during the window phase. Anti-HBc IgM is the only marker during the window phase. 59 / 100 The most likely cause of early satiety in cirrhosis is: Esophageal varices Gastric ulcers Massive ascites Splenic infarct Ascitic fluid compresses the stomach, limiting meal size. Ascitic fluid compresses the stomach, limiting meal size. 60 / 100 Which symptom suggests advanced liver failure? Palmar erythema Confusion and disorientation Mild fatigue Right upper quadrant pain Altered mental status reflects hepatic encephalopathy. Altered mental status reflects hepatic encephalopathy. 61 / 100 Which of the following is a hemorrhagic stroke? Lacunar infarct Middle cerebral artery infarct Subarachnoid hemorrhage Pontine infarct Subarachnoid hemorrhage results from bleeding into the subarachnoid space. Subarachnoid hemorrhage results from bleeding into the subarachnoid space. 62 / 100 GERD is most commonly seen in which age group? Neonates Children Elderly only Adults aged 30â60 GERD is common in middle-aged adults due to lifestyle and anatomical changes. GERD is common in middle-aged adults due to lifestyle and anatomical changes. 63 / 100 Which of the following is least likely to cause a TIA? Cardioembolism Subdural hematoma Carotid artery stenosis Small vessel disease Subdural hematoma is not an ischemic process and doesnât cause TIA. Subdural hematoma is not an ischemic process and doesnât cause TIA. 64 / 100 Which lab result suggests synthetic liver failure? Elevated ALT Prolonged INR Positive ANA Increased ALP The liver produces clotting factors; a prolonged INR reflects reduced synthesis. The liver produces clotting factors; a prolonged INR reflects reduced synthesis. 65 / 100 In pregnancy, PE is most likely to occur in: Third trimester First trimester Postpartum period Second trimester The risk of PE is highest immediately postpartum due to hormonal and hemodynamic changes. The risk of PE is highest immediately postpartum due to hormonal and hemodynamic changes. 66 / 100 Which stroke location leads to contralateral hemiparesis affecting the leg more than the arm? Anterior cerebral artery Middle cerebral artery Vertebral artery Posterior cerebral artery ACA supplies the medial portion of the frontal lobe (leg area of motor cortex). ACA supplies the medial portion of the frontal lobe (leg area of motor cortex). 67 / 100 Smoking increases PE risk mainly by: Increasing heart rate Decreasing fibrinogen Raising LDL Enhancing platelet activation Smoking contributes to hypercoagulability and endothelial dysfunction. Smoking contributes to hypercoagulability and endothelial dysfunction. 68 / 100 A lacunar stroke most commonly involves which type of vessel? Large cerebral arteries Small penetrating arteries Cerebellar arteries Jugular veins Lacunar strokes affect small, deep penetrating vessels and often occur in the basal ganglia, pons, or internal capsule. Lacunar strokes affect small, deep penetrating vessels and often occur in the basal ganglia, pons, or internal capsule. 69 / 100 Skin changes in chronic DVT include: Alopecia Petechiae Hyperpigmentation Bullae Chronic venous stasis may cause darkening due to hemosiderin deposition. Chronic venous stasis may cause darkening due to hemosiderin deposition. 70 / 100 Which is not a complication of DVT? Chronic venous insufficiency Hemoptysis Post-thrombotic syndrome PE Hemoptysis is a symptom of PE, not DVT directly. Hemoptysis is a symptom of PE, not DVT directly. 71 / 100 Irregularly irregular rhythm with no visible P waves is classic for: Sinus arrhythmia Atrial flutter Junctional rhythm Atrial fibrillation AF shows chaotic atrial activity and variable ventricular response. AF shows chaotic atrial activity and variable ventricular response. 72 / 100 The most common symptom of GERD is: Dysphagia Hematemesis Heartburn Vomiting GERD occurs due to decreased tone or inappropriate relaxation of the LES. GERD occurs due to decreased tone or inappropriate relaxation of the LES. 73 / 100 Classic symptoms of DVT include all except: Tenderness Warmth Unilateral leg swelling Bruising Bruising is not a typical DVT sign; it suggests bleeding. Bruising is not a typical DVT sign; it suggests bleeding. 74 / 100 Which of the following is not a cause of cirrhosis? Primary biliary cholangitis Acute pancreatitis Hemochromatosis Wilsonâs disease Acute pancreatitis affects the pancreas, not the liver. Acute pancreatitis affects the pancreas, not the liver. 75 / 100 Which of the following symptoms would raise suspicion for DVT? Swelling in one leg after a long flight General fatigue Cough with sputum Bilateral leg pain Unilateral swelling after immobilization is suspicious for DVT. Unilateral swelling after immobilization is suspicious for DVT. 76 / 100 The development of portal hypertension in cirrhosis is due to: Hepatic vein thrombosis Fibrosis obstructing blood flow Increased bile secretion Splenic infarction Fibrosis increases resistance to portal blood flow, leading to portal hypertension. Fibrosis increases resistance to portal blood flow, leading to portal hypertension. 77 / 100 Chronic HBV infection is defined by HBsAg presence for: 3 months 12 months 6 months 1 month Chronicity is confirmed if HBsAg persists for more than 6 months. Chronicity is confirmed if HBsAg persists for more than 6 months. 78 / 100 What is a transient ischemic attack (TIA)? Bleeding into the brain Stroke that lasts more than 24 hours A reversible episode of neurological dysfunction A type of epilepsy TIA is a transient episode of neurological dysfunction caused by ischemia, without infarction. TIA is a transient episode of neurological dysfunction caused by ischemia, without infarction. 79 / 100 Sinus arrest is best diagnosed by which ECG feature? &. Which antiarrhythmic is contraindicated in WPW with atrial fibrillation? Verapamil Procainamide Flecainide Amiodarone Verapamil slows AV conduction, worsening pre-excited AF and risking VF. Verapamil slows AV conduction, worsening pre-excited AF and risking VF. 80 / 100 What is a transient ischemic attack (TIA)? A stroke with permanent damage A type of hemorrhagic stroke Stroke due to trauma A brief, reversible episode of neurologic dysfunction TIA resolves without infarction, typically within minutes to hours. TIA resolves without infarction, typically within minutes to hours. 81 / 100 Which organism is associated with pneumonia in alcoholics? Mycoplasma pneumoniae Klebsiella pneumoniae Legionella Pseudomonas aeruginosa Klebsiella is associated with aspiration and produces âcurrant jellyâ sputum. Klebsiella is associated with aspiration and produces âcurrant jellyâ sputum. 82 / 100 Ascites in cirrhosis is primarily due to: Renal failure Portal hypertension and hypoalbuminemia Cardiac failure Dehydration Increased hydrostatic pressure and low oncotic pressure promote fluid accumulation. Increased hydrostatic pressure and low oncotic pressure promote fluid accumulation. 83 / 100 Pregnancy increases the risk of GERD due to: Progesterone-induced LES relaxation Increased gastric acid Increased esophageal motility Hypotension Elevated progesterone during pregnancy relaxes the LES and delays gastric emptying. Elevated progesterone during pregnancy relaxes the LES and delays gastric emptying. 84 / 100 Which rhythm is characterized by progressive prolongation of the PR interval followed by a dropped QRS complex? Mobitz type I Complete heart block Sinus pause Mobitz type II Mobitz I (Wenckebach) shows grouped beating with progressively longer PR intervals. Mobitz I (Wenckebach) shows grouped beating with progressively longer PR intervals. 85 / 100 Which finding suggests poor prognosis in cirrhosis? Fatigue Splenomegaly Hepatic encephalopathy Spider nevi Encephalopathy reflects advanced liver dysfunction. Encephalopathy reflects advanced liver dysfunction. 86 / 100 Which of the following medications can worsen GERD? NSAIDs Levothyroxine Metoprolol Furosemide NSAIDs can irritate the esophageal lining and contribute to reflux symptoms. NSAIDs can irritate the esophageal lining and contribute to reflux symptoms. 87 / 100 Which brain area, if affected, most commonly causes expressive aphasia? Basal ganglia Wernickeâs area Brocaâs area Occipital lobe Brocaâs area (left inferior frontal gyrus) controls speech production. Brocaâs area (left inferior frontal gyrus) controls speech production. 88 / 100 A DVT in the left leg is more common because: Left valves are incompetent Right vein is narrower Left iliac vein is compressed by right iliac artery Left leg is more used May-Thurner syndrome causes left iliac vein compression, increasing DVT risk. May-Thurner syndrome causes left iliac vein compression, increasing DVT risk. 89 / 100 Which statement about TIA is true? It is a warning sign of possible stroke It causes permanent disability It always progresses to stroke It affects only motor function TIA increases risk of future stroke, especially within 48 hours. TIA increases risk of future stroke, especially within 48 hours. 90 / 100 Spider angiomas are caused by: Hyperestrogenemia Hypertension Vitamin C deficiency B12 deficiency Estrogen buildup due to liver dysfunction causes vascular changes. Estrogen buildup due to liver dysfunction causes vascular changes. 91 / 100 What is the most common type of stroke? Hemorrhagic stroke Subarachnoid hemorrhage Embolic stroke Ischemic stroke About 85% of strokes are ischemic, resulting from obstruction of blood flow. About 85% of strokes are ischemic, resulting from obstruction of blood flow. 92 / 100 What is the most common cause of cirrhosis in children? Wilsonâs disease Hepatitis C Biliary atresia NAFLD Biliary atresia is the leading cause of pediatric liver transplantation. Biliary atresia is the leading cause of pediatric liver transplantation. 93 / 100 Which of these patients is most at risk of Pseudomonas pneumonia? Healthy 30-year-old man Elderly nursing home resident with tracheostomy Teenager with influenza Pregnant woman in third trimester Tracheostomy and prolonged hospital stay predispose to Pseudomonas. Tracheostomy and prolonged hospital stay predispose to Pseudomonas. 94 / 100 Which marker indicates active viral replication in hepatitis B? HBeAg HBsAg Anti-HBc IgG Anti-HBs HBeAg is associated with high infectivity and active replication. HBeAg is associated with high infectivity and active replication. 95 / 100 Which type of stroke commonly presents with vertigo, vomiting, and ataxia? Posterior circulation stroke Lacunar infarct Middle cerebral artery infarct Anterior cerebral artery infarct Strokes in the vertebrobasilar system affect the brainstem and cerebellum. Strokes in the vertebrobasilar system affect the brainstem and cerebellum. 96 / 100 GERD results from dysfunction of which structure? Duodenum Lower esophageal sphincter (LES) Upper esophageal sphincter Pyloric sphincter GERD occurs due to decreased tone or inappropriate relaxation of the LES. GERD occurs due to decreased tone or inappropriate relaxation of the LES. 97 / 100 Hiatal hernia contributes to GERD by: Displacing LES above diaphragm Enhancing LES tone Reducing esophageal motility Increasing gastric emptying A hiatal hernia compromises the LESs function, allowing acid to reflux into the esophagus. A hiatal hernia compromises the LESs function, allowing acid to reflux into the esophagus. 98 / 100 Which of the following is a classic sign of cirrhosis? Jaundice Cyanosis Flushed skin Diaphoresis Jaundice reflects impaired bilirubin metabolism in liver failure. Jaundice reflects impaired bilirubin metabolism in liver failure. 99 / 100 Which of the following is not a common trigger of GERD? Caffeine Milk Citrus fruits Chocolate Milk may initially soothe symptoms, though fat content in some milk products can still worsen reflux. Milk may initially soothe symptoms, though fat content in some milk products can still worsen reflux. 100 / 100 The best indicator of HBV immunity is: HBeAg Anti-HBs HBsAg Anti-HBc Anti-HBs presence indicates immunity due to past infection or vaccination. Anti-HBs presence indicates immunity due to past infection or vaccination. Your score is Send feedback