name
large_stringclasses 12
values | year
large_stringclasses 2
values | category
large_stringclasses 6
values | qid
int64 1
235
| qtext
large_stringlengths 5
1.24k
| ra
int64 1
5
| answers
large list |
|---|---|---|---|---|---|---|
Cuaderno_2014_1_M | 2014 | medicine | 129 | The analysis of the data obtained from cases of Ebola virus disease in Guinea and Sierra Leone, allows us to affirm that: | 2 | [
{
"aid": 1,
"atext": "The mortality of the infection exceeds 85%."
},
{
"aid": 2,
"atext": "The treatment is based on support measures (hydroelectrolitic replenishment i.v. and antibiotics)."
},
{
"aid": 3,
"atext": "More than half of the cases correspond to health personnel."
},
{
"aid": 4,
"atext": "Gastrointestinal hemorrhage is a common cause of mortality."
},
{
"aid": 5,
"atext": "Mortality is higher in adolescents."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 130 | A 40-year-old patient, classified as ASA I according to the scale of the American Society of Anesthesiologists, is undergoing laparoscopic cholecystectomy for cholelithiasis. The intervention takes place initially without complications, but fifty minutes into the procedure there is a significant increase in the levels of teleespiratory carbon dioxide (CO2), without altering the oxygen saturation by pulse oximetry or raising the ventilation pressures . What would be your diagnosis of presumption and your attitude to this finding? | 1 | [
{
"aid": 1,
"atext": "With these findings we must suspect the existence of subcutaneous emphysema, so we must explore the patient and request that the insufflation pressure of the pneumoperitoneum be reduced or even interrupted."
},
{
"aid": 2,
"atext": "The most likely diagnosis is a pneumothorax secondary to carbon dioxide or capnothorax, so an urgent chest radiograph must be ordered and the insertion of a thoracic drain must be prepared."
},
{
"aid": 3,
"atext": "The elevation of carbon dioxide levels is normal in the context of a laparoscopic intervention. The only attitude to take is to increase the minute volume in the anesthetic machine."
},
{
"aid": 4,
"atext": "The placement of the orotracheal tube should be checked for the possibility that it has progressed and that we are facing an endobronchial intubation, which is relatively frequent in this surgery due to the elevation of the diaphragm secondary to the pneumoperitoneum."
},
{
"aid": 5,
"atext": "Elevation of the teleespiratory carbon dioxide, without affecting ventilation pressures, is typical of massive pulmonary embolism. The intervention must be interrupted, ventilated with pure oxygen and prepare vasoactive drugs for the possible hemodynamic instability."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 131 | A patient comes to the clinic for general malaise and yellowing of the skin and his doctor suspects that it is a hepatitis A picture. Which of the following answers constitutes the most accurate and safest factor to determine the pre-test probability ( before carrying out any study) of what is said table? | 2 | [
{
"aid": 1,
"atext": "Intensity of jaundice."
},
{
"aid": 2,
"atext": "Frequency of hepatitis A in the environment."
},
{
"aid": 3,
"atext": "Days of duration of the painting."
},
{
"aid": 4,
"atext": "Professional experience on jaundice pictures."
},
{
"aid": 5,
"atext": "Previous illnesses of the patient."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 132 | JMC, a 14-year-old patient admitted to the Emergency Department. The attending physician considers a blood transfusion necessary. The parents of the patient express their refusal to be given blood, signing the corresponding document of refusal to transfusion. The doctor warns that if the transfusion is not carried out, his life is in danger. They insist on their refusal, the alleged reason for the rejection is basically religious. Which of the following options would be the most correct? | 5 | [
{
"aid": 1,
"atext": "Transfuse the patient."
},
{
"aid": 2,
"atext": "Transfuse the patient, but only when he has lost consciousness."
},
{
"aid": 3,
"atext": "Transfer the case to the healthcare ethics committee so that it adopts the decision."
},
{
"aid": 4,
"atext": "Respect expressed preference and attend without transfusion"
},
{
"aid": 5,
"atext": "I would inform the judge and not administer any treatment until the latter indicated it."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 133 | In the clinical interview: | 3 | [
{
"aid": 1,
"atext": "The doctor has to show friend before professional."
},
{
"aid": 2,
"atext": "The doctor should avoid warning the patient of the time available to assist him."
},
{
"aid": 3,
"atext": "The professional must verify that the patient has understood the information."
},
{
"aid": 4,
"atext": "It is advisable to take long breaks to avoid fatiguing the patient."
},
{
"aid": 5,
"atext": "The doctor, during the interview, must remain standing or placed behind the head of the bed."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 134 | A 24-year-old girl suffers a bicycle fall with trauma to the abdominal area with the handlebar. A few hours after the trauma begins with intense pain in the left hypochondrium, so he goes to consult an emergency service. Upon arrival the patient is pale and sweaty, the blood pressure figures are 82/54 mmHg and the heart rate is 120 beats per minute. What kind of shock is the most likely to suffer from this patient? | 1 | [
{
"aid": 1,
"atext": "Hypovolemic"
},
{
"aid": 2,
"atext": "Septic."
},
{
"aid": 3,
"atext": "Cardiogenic"
},
{
"aid": 4,
"atext": "Anaphylactic."
},
{
"aid": 5,
"atext": "Neurogenic"
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 135 | Young person who goes to the emergency room for second degree flame burn of 10% of the body surface, affecting the right arm in an extensive and circular way. There is no arterial pulse in the hand measured by Doppler. What is the treatment of choice? | 3 | [
{
"aid": 1,
"atext": "Cures with occlusive silver sulfadiacin and evaluation of depth per week."
},
{
"aid": 2,
"atext": "Lymphatic drainage and assess a vascular by-pass."
},
{
"aid": 3,
"atext": "Escarotomy or emergency decompression incisions."
},
{
"aid": 4,
"atext": "Expectant behavior"
},
{
"aid": 5,
"atext": "Amputation of the extremity."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 136 | Enter in our plant from the Emergency Room to study an 80-year-old patient reporting weight loss and nonspecific central-abdominal discomfort, together with loss of appetite. The diagnostic process that we must develop during your admission will be guided by the following principles EXCEPT: | 1 | [
{
"aid": 1,
"atext": "All those tests that can bring light to the process suspected by the doctor covering the widest differential diagnosis from the beginning will be carried out."
},
{
"aid": 2,
"atext": "The healthcare process will be adapted to the individual clinical context of the patient and it will be sought that the latter be a participant in the decisions regarding diagnosis and treatment."
},
{
"aid": 3,
"atext": "It is important to think first of all in the most ordinary way, only later, once the most frequent entities are discarded with certainty, to consider the odd."
},
{
"aid": 4,
"atext": "Some complementary tests may be redundant and may not add value to the diagnostic process, but at the cost of health. Thus, before two complementary tests of similar performance, it will always be decided by the most economical and least risky."
},
{
"aid": 5,
"atext": "It is essential that the doctor does not add new discomforts with the practice of complementary explorations that are not strictly necessary."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 137 | A patient consulted for recent and progressive development of acropachies and general deterioration. The search for possible underlying neoplasia begins. Which of the following tumors is more likely to be diagnosed? | 5 | [
{
"aid": 1,
"atext": "Gastric adenocarcinoma."
},
{
"aid": 2,
"atext": "Esophageal epidermoid."
},
{
"aid": 3,
"atext": "Mediastinal thymoma."
},
{
"aid": 4,
"atext": "Follicular thyroid."
},
{
"aid": 5,
"atext": "Pleural mesothelioma."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 139 | We attended an 87-year-old hypertensive, diabetic woman with heart failure class D and a baseline functional grade 3-4 of the NYHA in the Emergency Department. In the last six months he entered from the Emergency Department in our service 6 times. The last time was an admission of torpid evolution in which her possible intensive ICU care was assessed, but it was discarded given her baseline situation and the patient's desire to avoid supportive measures of doubtful and invasive effectiveness. He came back 48 hours after the discharge of his last admission for clinical increase of dyspnea to grade 4 in the context of cough and purulent expectoration. It is poorly perfused and its saturation with oxygen therapy using an O2 reservoir mask is 85%. In relation to the diagnostic and therapeutic attitude to adopt, it is necessary to bear in mind that: | 3 | [
{
"aid": 1,
"atext": "The precise and immediate diagnosis by CT of the thorax and the obtaining of microbiological samples, even of an invasive nature, is crucial to adjust the treatment."
},
{
"aid": 2,
"atext": "Given the advanced age and clinical situation, therapeutic abstention is recommended, \"primun non nocere\", given the evolution of the picture."
},
{
"aid": 3,
"atext": "It is essential to explicitly define the therapeutic objectives, simplifying them and avoiding unnecessary treatments, as well as respecting the values and preferences of the patient and his family."
},
{
"aid": 4,
"atext": "It is a high-risk community-acquired pneumonia (CAP) that requires intensive treatment with ventilatory support, including mechanical, and high-spectrum antibiotic therapy for the risk of bacterial multiresistance."
},
{
"aid": 5,
"atext": "It is an end-of-life process in an agonizing situation to whom priority should be given to sedation to alleviate their suffering."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 140 | The most frequent malignant tumor of the submaxillary gland is: | 4 | [
{
"aid": 1,
"atext": "Mucoepidermoid carcinoma."
},
{
"aid": 2,
"atext": "Carcinoma ex-pleomorphic adenoma."
},
{
"aid": 3,
"atext": "Lymphoma"
},
{
"aid": 4,
"atext": "Cylindroma or cystic adenoid carcinoma."
},
{
"aid": 5,
"atext": "Papillomatous cystadedenolymphoma."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 141 | Faced with a patient with diffuse otitis externa, what is the initial treatment? | 4 | [
{
"aid": 1,
"atext": "Surgery."
},
{
"aid": 2,
"atext": "Antibiotics plus analgesics, both intravenously."
},
{
"aid": 3,
"atext": "Antibiotics and analgesics, both orally."
},
{
"aid": 4,
"atext": "Cleaning of the external auditory canal, topical antibiotic therapy plus oral analgesics."
},
{
"aid": 5,
"atext": "Topical antibiotics"
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 142 | Within head and neck carcinomas, what type of tumor is most obviously related to the human papillomavirus? | 2 | [
{
"aid": 1,
"atext": "Squamous cell carcinoma of the larynx."
},
{
"aid": 2,
"atext": "Squamous cell carcinoma of the oropharynx."
},
{
"aid": 3,
"atext": "Squamous cell carcinoma of the hypopharynx."
},
{
"aid": 4,
"atext": "Adenocarcinoma sinonasal."
},
{
"aid": 5,
"atext": "Undifferentiated carcinoma of cavum."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 143 | A 1-year-old boy, who did not pass the tests of auditory screening at birth and who has auditory brainstem evoked potentials that determine bilateral mild-moderate hearing loss in the right ear and moderate-severe hearing loss in the left ear. What is the most correct attitude to follow at the present time? | 4 | [
{
"aid": 1,
"atext": "Perform an audiometry within 6 months to confirm the diagnosis."
},
{
"aid": 2,
"atext": "Surgery to adapt a cochlear implant in the right ear."
},
{
"aid": 3,
"atext": "Wait until 3 years to check if you develop the language."
},
{
"aid": 4,
"atext": "Adaptation of bilateral hearing prosthesis and logopedic rehabilitation."
},
{
"aid": 5,
"atext": "Surgery to adapt a cochlear implant in the left ear."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 144 | A baby with 39º C of axillary temperature, edema of the left eyelid and rhinorrhea on the same side goes to the emergency room. What is the most likely diagnosis? | 3 | [
{
"aid": 1,
"atext": "Pansinusitis"
},
{
"aid": 2,
"atext": "Left maxillary sinusitis."
},
{
"aid": 3,
"atext": "Left ethmoid sinusitis."
},
{
"aid": 4,
"atext": "Sphenoid sinusitis left."
},
{
"aid": 5,
"atext": "Left frontal sinusitis."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 145 | Which of the following skin diseases is associated with celiac disease? | 2 | [
{
"aid": 1,
"atext": "Atopic dermatitis."
},
{
"aid": 2,
"atext": "Dermatitis herpetiformis"
},
{
"aid": 3,
"atext": "Molluscum contagiosum."
},
{
"aid": 4,
"atext": "Annular granuloma."
},
{
"aid": 5,
"atext": "Rosacea"
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 146 | Which of the following clinical contexts should make us suspect a paraneoplastic process and, therefore, obliges us to perform a screening for malignancy? | 5 | [
{
"aid": 1,
"atext": "13-year-old boy with palpable purpura on lower limbs and buttocks, arthralgias and abdominal pain."
},
{
"aid": 2,
"atext": "36-year-old man with maculo-papules with a central bulla \"on target\" on his back, hands, palms and forearms with erosions and ulcerations on the oral mucosa."
},
{
"aid": 3,
"atext": "A 44-year-old woman with erythema in both malar and nasal dorsal regions, photosensitivity and palmar erythema in fingertips."
},
{
"aid": 4,
"atext": "A 27-year-old man with depigmented macules well delimited symmetrically in the peribucal, periorbital region and in the distal part of the fingers and toes together with alopecia in plaque in the occipital region with short and broken hair stems without scaling or erythema."
},
{
"aid": 5,
"atext": "A 68-year-old woman with progressive muscle weakness in limb root, erythema and violaceous periorbital rash and keratotic papules on the dorsal aspect of the interphalangeal joints."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 147 | The following entities may be accompanied by ocular inflammation (uveitis) except one. Indicate which: | 4 | [
{
"aid": 1,
"atext": "Sarcoidosis"
},
{
"aid": 2,
"atext": "Juvenile idiopathic arthritis."
},
{
"aid": 3,
"atext": "Behçet's disease."
},
{
"aid": 4,
"atext": "Marfan's disease"
},
{
"aid": 5,
"atext": "Multiple sclerosis."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 148 | A 30-year-old woman who came to the emergency room due to loss of vision, pain, red eye and photophobia of OI of 5 days of evolution. In the differential diagnosis you must include all these pathologies EXCEPT one: | 5 | [
{
"aid": 1,
"atext": "Anterior uveitis."
},
{
"aid": 2,
"atext": "Corneal ulcer."
},
{
"aid": 3,
"atext": "Traumatic iritis"
},
{
"aid": 4,
"atext": "Sclerouveitis."
},
{
"aid": 5,
"atext": "Serous central chorioretinopathy."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 149 | A 75-year-old man who reported decreased visual acuity in his right eye of two weeks of evolution. In the fundus examination, soft drusen and serous detachment at the level of the macula are seen. What treatment is currently the most indicated for this disease? | 3 | [
{
"aid": 1,
"atext": "Focal photocoagulation with laser."
},
{
"aid": 2,
"atext": "Photodynamic therapy."
},
{
"aid": 3,
"atext": "Intravitreal injections of anti-angiogenic drugs."
},
{
"aid": 4,
"atext": "Posterior vitrectomy."
},
{
"aid": 5,
"atext": "Observation."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 150 | What analysis should be controlled in maintenance treatments with lithium salts? | 4 | [
{
"aid": 1,
"atext": "Hepatic enzymes."
},
{
"aid": 2,
"atext": "Antinuclear antibodies."
},
{
"aid": 3,
"atext": "Ferritin and sideremia."
},
{
"aid": 4,
"atext": "Thyroid and renal function."
},
{
"aid": 5,
"atext": "Tirocalcitonina."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 151 | Which of the following characteristics is NOT typical of the contents of obsessive ideas? | 2 | [
{
"aid": 1,
"atext": "Sexual thoughts"
},
{
"aid": 2,
"atext": "Phonemes"
},
{
"aid": 3,
"atext": "Need for symmetry."
},
{
"aid": 4,
"atext": "Pathological doubt."
},
{
"aid": 5,
"atext": "Pollution."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 152 | Man of 42 years, married, with three children under age. No psychiatric history. After an ERE in the bank where he worked, he is finally fired and has been unemployed for 5 months. He does not find another work activity. He comes to consultation with the following clinical picture: general discouragement, lack of appetite, nervousness, insomnia, recurrent worries about his future and avoidance of socio-family activities. Which diagnostic option of the following is the most appropriate? | 2 | [
{
"aid": 1,
"atext": "Obsessive disorder"
},
{
"aid": 2,
"atext": "Adaptive disorder with anxious-depressive symptoms."
},
{
"aid": 3,
"atext": "Social phobia."
},
{
"aid": 4,
"atext": "Dysthymia"
},
{
"aid": 5,
"atext": "Anxiety with agoraphobia."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 153 | Stereotyping is called: | 2 | [
{
"aid": 1,
"atext": "Strange buccolingual gestures."
},
{
"aid": 2,
"atext": "Repeated and unnecessary repetition of an act."
},
{
"aid": 3,
"atext": "Very bulky movements that increase the expressiveness of the gestures."
},
{
"aid": 4,
"atext": "Very intense psychotic agitations."
},
{
"aid": 5,
"atext": "Apparent gestures accompanied by profanity."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 154 | A 28-year-old man brought to the emergency room, on a Saturday morning, in a state of psychomotor agitation and delirious ideas. His companion reports previous abuse, by the patient, of cocaine. What sign / symptom would you NOT expect to find? | 1 | [
{
"aid": 1,
"atext": "Hypothermia."
},
{
"aid": 2,
"atext": "Tachycardia."
},
{
"aid": 3,
"atext": "Mydriasis."
},
{
"aid": 4,
"atext": "Diaphoresis"
},
{
"aid": 5,
"atext": "Thoracic pain."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 155 | A 67-year-old man comes to the surgery accompanied by two of his children who say that his father has been showing increasing memory losses in the last two months. Prior to this he went through a season in which he had low mood. Over the last few months, he has also begun to give a "no se" or "I do not care" answer to most of the questions that are asked while increasing their complaints of complaint and discomfort due to their forgetfulness , especially in the mornings. In spite of all this, it seems to work with relative comfort on a day-to-day basis. One of the following would be the most indicated drug for the treatment of this patient, point it out. | 5 | [
{
"aid": 1,
"atext": "Quetiapine"
},
{
"aid": 2,
"atext": "Lamotrigine"
},
{
"aid": 3,
"atext": "Tacrina."
},
{
"aid": 4,
"atext": "Donepezil"
},
{
"aid": 5,
"atext": "Sertraline"
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 156 | In the course of a patient's interview, you realize that you are not understanding what the patient is saying. He decides to focus his attention on the discourse and realizes that he does not have a guiding idea even though specific fragments of it are understandable. This alteration of the thinking language, typical of schizophrenia on the other hand, is what in psychopathology is known as: | 4 | [
{
"aid": 1,
"atext": "Dissociation of thought."
},
{
"aid": 2,
"atext": "Fugue of ideas."
},
{
"aid": 3,
"atext": "Persistent language."
},
{
"aid": 4,
"atext": "Disorganization of thought."
},
{
"aid": 5,
"atext": "Blocking of thought."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 157 | A 28-year-old violinist who is consulting for having presented panic attacks during his public performances in the last 3 months. The crises are accompanied by intense fear of being blocked and not being able to continue with the performance, something that would be humiliating for him. This fear has made him cancel his next performances. In the rest of his daily activities he does not experience this fear, nor does he experience it when he rehearses with his orchestra colleagues. What diagnosis would you consider most likely for this case? | 3 | [
{
"aid": 1,
"atext": "Simple phobia"
},
{
"aid": 2,
"atext": "Panic disorder"
},
{
"aid": 3,
"atext": "Social phobia of execution."
},
{
"aid": 4,
"atext": "Generalized anxiety disorder."
},
{
"aid": 5,
"atext": "Agoraphobia."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 158 | A 28-year-old Caucasian woman, Nulípara, attends an annual gynecological examination and requests the possibility of reducing the risk of ovarian cancer given that her mother died of this neoplasm at 64 years of age. In the detailed questioning, no other family history of ovarian or breast cancer is identified. Which of the following strategies is the most appropriate to reduce the risk of ovarian cancer in this patient? | 5 | [
{
"aid": 1,
"atext": "Bilateral tubal occlusion."
},
{
"aid": 2,
"atext": "Bilateral laparoscopic salpingo-oophorectomy."
},
{
"aid": 3,
"atext": "Continuous daily administration of aspirin at low dose."
},
{
"aid": 4,
"atext": "Advise her to use artificial lactation if she is pregnant."
},
{
"aid": 5,
"atext": "Treatment with combined oral contraceptives."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 159 | Human papilloma virus has been linked to cervical intraepithelial neoplasia and cervical cancer. Which genotype is the most oncogenic? | 1 | [
{
"aid": 1,
"atext": "Genotype 16."
},
{
"aid": 2,
"atext": "Genotype 11"
},
{
"aid": 3,
"atext": "Genotype 6."
},
{
"aid": 4,
"atext": "Genotype 23."
},
{
"aid": 5,
"atext": "Genotype 55."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 160 | Which of the following data does NOT correspond to a fungal vulvovaginitis ?: | 5 | [
{
"aid": 1,
"atext": "Pregnancy increases the risk of this infection."
},
{
"aid": 2,
"atext": "It can occur in women who never had sex."
},
{
"aid": 3,
"atext": "Vaginal discharge with white patches or lumps adhered to the walls of the vagina is typical."
},
{
"aid": 4,
"atext": "It can be diagnosed in a fresh smear of vaginal discharge without the need for staining."
},
{
"aid": 5,
"atext": "Adding a drop of potash to the vaginal discharge gives off a strong fishy odor."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 161 | Primigesta of 41 years, in the 38th week, with gestational diabetes treated with a diet of 2200 Kilocalories and essential hypertension. He went to the emergency room for sudden-onset hypogastric pain, with involvement of his general condition, accompanied by a scarce metrorrhage of dark blood. In Non-Stress Monitoring (MNS) we detect a non-reactive fetal heart rate pattern. The main diagnostic suspicion will be: | 2 | [
{
"aid": 1,
"atext": "Decompensation of your gestational diabetes."
},
{
"aid": 2,
"atext": "Premature detachment of the placenta."
},
{
"aid": 3,
"atext": "Severe pre-eclampsia"
},
{
"aid": 4,
"atext": "Break of \"vasa previa\"."
},
{
"aid": 5,
"atext": "Previous placenta."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 162 | A pregnant woman of 31 weeks goes to the emergency department referring loss of fluid through the vagina. Objective speculum exploration of clear fluid through the external cervical os. It is apyletic. The cardiotocographic record does not reveal contractions and the fetal heart rate is normal. The ultrasound scan reveals no malformations and the cervix is not shortened. What therapeutic combination would it indicate? | 5 | [
{
"aid": 1,
"atext": "Tocolytics, corticosteroids and antibiotics."
},
{
"aid": 2,
"atext": "Tocolytics and antibiotics."
},
{
"aid": 3,
"atext": "Tocolytics and corticosteroids."
},
{
"aid": 4,
"atext": "Oxytocin, corticosteroids and antibiotics."
},
{
"aid": 5,
"atext": "Corticosteroids and antibiotics"
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 163 | A 26-year-old woman comes to the emergency room due to abdominal pain and scarce vaginal blood loss. It refers to an amenorrhea of 7 weeks. You perform a pregnancy test, with a positive result. What is the next step? | 1 | [
{
"aid": 1,
"atext": "Perform a vaginal ultrasound examination."
},
{
"aid": 2,
"atext": "Recommend home rest and repeat the pregnancy test in a week."
},
{
"aid": 3,
"atext": "Evacuate the uterus by curettage by aspiration."
},
{
"aid": 4,
"atext": "Standard progesterone micronized vaginally until week 14 of gestation."
},
{
"aid": 5,
"atext": "Evacuate the uterus by intravaginal administration of prostaglandins."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 164 | With respect to the behavior of obstetric patients exposed to Varicella, it is FALSE: | 5 | [
{
"aid": 1,
"atext": "Infected women should be separated from other obstetric patients."
},
{
"aid": 2,
"atext": "All obstetric patients exposed, without certainty of prior immunity, must make a serological determination of their immunization status."
},
{
"aid": 3,
"atext": "Specific immunoglobulin should be administered to exposed non-immune obstetric patients."
},
{
"aid": 4,
"atext": "The maximum period for administering the specific immunoglobulin after contact is 96 hours."
},
{
"aid": 5,
"atext": "Pregnant women without immunity to Varicella-Zoster virus can be vaccinated during pregnancy to prevent primary infection."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 165 | With vaginal ultrasound, from how long after conception is it possible to see an embryo with a heartbeat? | 2 | [
{
"aid": 1,
"atext": "Between 14 and 21 days."
},
{
"aid": 2,
"atext": "Between 21 and 28 days."
},
{
"aid": 3,
"atext": "Between 28 and 35 days."
},
{
"aid": 4,
"atext": "Between 35 and 42 days."
},
{
"aid": 5,
"atext": "Between 42 to 49 days."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 166 | One of the following answers is FALSE regarding breast cancer. | 3 | [
{
"aid": 1,
"atext": "The majority of tumors (70%) have receptors for hormones."
},
{
"aid": 2,
"atext": "The stage measured according to the TNM system is one of the prognostic factors of the disease."
},
{
"aid": 3,
"atext": "The presence of axillary adenopathies contraindicates breast surgery."
},
{
"aid": 4,
"atext": "Anthracyclines and taxanes are the chemotherapeutic agents most used in the complementary treatment."
},
{
"aid": 5,
"atext": "The breast-conserving surgery associated with radiotherapy has comparable results to mastectomy."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 167 | Which gene is most frequently associated with acquired mutations in breast cancer? | 1 | [
{
"aid": 1,
"atext": "p53."
},
{
"aid": 2,
"atext": "PTEN."
},
{
"aid": 3,
"atext": "BRCA-2."
},
{
"aid": 4,
"atext": "BRCA-1."
},
{
"aid": 5,
"atext": "Her2 / neu."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 168 | Regarding substance abuse by the adolescent, point out the correct answer: | 5 | [
{
"aid": 1,
"atext": "It is usually an individual consumption which indicates a better prognosis."
},
{
"aid": 2,
"atext": "The onset of abuse in adolescence has not shown an increased risk of becoming addicted."
},
{
"aid": 3,
"atext": "It is independent of the risk of HIV infection."
},
{
"aid": 4,
"atext": "The most popular drug among teenagers is cannabis."
},
{
"aid": 5,
"atext": "It should be considered in adolescents who come to the emergency with a crisis."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 169 | Which of the following congenital heart diseases is NOT considered as heart disease that produces volume overload ?: | 4 | [
{
"aid": 1,
"atext": "Interauricular communication."
},
{
"aid": 2,
"atext": "Ventricular communication."
},
{
"aid": 3,
"atext": "Defects of the atrio-ventricular septum."
},
{
"aid": 4,
"atext": "Coarctation of the aorta."
},
{
"aid": 5,
"atext": "Persistent ductus arteriosus."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 170 | In the most frequent type of esophageal atresia: | 5 | [
{
"aid": 1,
"atext": "Prenatal ultrasound performed in the third trimester allows diagnosis in 6080% of cases."
},
{
"aid": 2,
"atext": "It is associated in 50% of cases with microgastria and neural tube defects."
},
{
"aid": 3,
"atext": "The distance between the proximal and distal atresic pockets is greater than in the other types of atresia."
},
{
"aid": 4,
"atext": "Gastrostomy should be performed in the first 48 hours of life to allow enteral feeding."
},
{
"aid": 5,
"atext": "The presence of air in the stomach and small intestine on abdominal radiography confirms the existence of a distal fistula."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 171 | To decide to postpone discharge to a child in maternity 48 hours after childbirth, the following criteria will be taken into account EXCEPT one, indicate it. | 3 | [
{
"aid": 1,
"atext": "Jaundice evident on the first day of life."
},
{
"aid": 2,
"atext": "VDRL positive."
},
{
"aid": 3,
"atext": "Weight loss of 7%."
},
{
"aid": 4,
"atext": "Breastfeeding not established."
},
{
"aid": 5,
"atext": "Lack of evacuation of meconium."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 172 | Which of the following data is NOT specific to hypertrophic pyloric stenosis? | 2 | [
{
"aid": 1,
"atext": "Metabolic alkalosis"
},
{
"aid": 2,
"atext": "Projective vomiting of bilious content."
},
{
"aid": 3,
"atext": "Family incidence"
},
{
"aid": 4,
"atext": "Predominance of the masculine sex."
},
{
"aid": 5,
"atext": "Palpable mesoepigastric mass."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 173 | Diabetes mellitus type MODY (maturityonset diabetes of the young) is characterized by all the following EXCEPT: | 3 | [
{
"aid": 1,
"atext": "It is an autosomal dominant disorder."
},
{
"aid": 2,
"atext": "It is characterized by a genetic defect in the function of beta cells of the pancreas."
},
{
"aid": 3,
"atext": "Share the same HLA risk as Diabetes Mellitus type 1."
},
{
"aid": 4,
"atext": "The patients have a slight fasting hyperglycemia."
},
{
"aid": 5,
"atext": "They may need treatment with insulin for their control."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 174 | What is the most common developmental complication in bacterial meningitis in the pediatric age? | 1 | [
{
"aid": 1,
"atext": "Hearing loss"
},
{
"aid": 2,
"atext": "Residual epilepsy"
},
{
"aid": 3,
"atext": "Mental retardation."
},
{
"aid": 4,
"atext": "Hydrocephalus"
},
{
"aid": 5,
"atext": "Visual defects."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 175 | A premature newborn presents at 2 days of life a picture of poor general condition, subcutaneous petechiae and ecchymoses and persistent bleeding from the puncture sites. The chest radiograph is compatible with pulmonary hemorrhage. In the coagulation study, prothrombin and partial thromboplastin times are elongated. The platelet count is 105,000 / uL. What is the most likely diagnosis? | 1 | [
{
"aid": 1,
"atext": "Disseminated intravascular coagulation secondary to neonatal sepsis."
},
{
"aid": 2,
"atext": "Neonatal autoimmune thrombocytopenia."
},
{
"aid": 3,
"atext": "Neonatal alloimmune thrombocytopenia."
},
{
"aid": 4,
"atext": "Hemorrhagic disease of the newborn due to vitamin K deficiency."
},
{
"aid": 5,
"atext": "Neonatal hemorrhage due to platelet dysfunction."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 176 | Which of the following correlates with retinopathy of the premature newborn? | 4 | [
{
"aid": 1,
"atext": "The bilirubin."
},
{
"aid": 2,
"atext": "Gentamicin"
},
{
"aid": 3,
"atext": "The corticoids"
},
{
"aid": 4,
"atext": "The Oxigen."
},
{
"aid": 5,
"atext": "Fentanyl"
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 177 | The parents of a 2-year-old girl consult because they are concerned about their daughter's development. They have observed that approximately from 18 months, their behavior is different from that of other children of their age. Until then, they had attributed their limited interaction to the fact that they were becoming more independent, and the lack of language development, to which they were not yet enrolled. In the consultation you observe that the girl does not respond when she calls her by her name, shows little eye contact, performs vocalizations without communicative intention, and does not look at where the parents point her. Given these findings, all of the following statements are true, EXCEPT one: | 1 | [
{
"aid": 1,
"atext": "Parents should be reassured, recommended schooling as soon as possible, and arrange a follow-up in 3 months."
},
{
"aid": 2,
"atext": "The most likely diagnosis is autistic spectrum disorder."
},
{
"aid": 3,
"atext": "A diagnostic evaluation must be carried out by a team with experience in autism."
},
{
"aid": 4,
"atext": "Appropriate early intervention is recommended."
},
{
"aid": 5,
"atext": "The origin of the disorder is multifactorial."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 178 | If you want to study the efficacy and safety of a new cytostatic for a specific oncological process and, at the same time, contrast the efficacy that adds a new monoclonal antibody to this treatment, what would be the most appropriate study design? | 3 | [
{
"aid": 1,
"atext": "Parallel test."
},
{
"aid": 2,
"atext": "Cross test"
},
{
"aid": 3,
"atext": "Factorial test."
},
{
"aid": 4,
"atext": "Sequential test."
},
{
"aid": 5,
"atext": "Test of n = 1."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 179 | Which of these statements is NOT a characteristic of phase I clinical trials? | 4 | [
{
"aid": 1,
"atext": "They usually have non-therapeutic goals."
},
{
"aid": 2,
"atext": "They can be done in healthy volunteers."
},
{
"aid": 3,
"atext": "They can be done in patients."
},
{
"aid": 4,
"atext": "They are usually randomized."
},
{
"aid": 5,
"atext": "They are usually open."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 180 | When comparing the characteristics of pragmatic or confirmatory clinical studies with explanatory or exploratory clinical studies, which of the following is an advantage of the former? | 1 | [
{
"aid": 1,
"atext": "Information about subgroups of patients representative of the usual clinical practice."
},
{
"aid": 2,
"atext": "Very homogeneous sample, with little variability."
},
{
"aid": 3,
"atext": "Greater capacity to detect differences in the effectiveness of interventions."
},
{
"aid": 4,
"atext": "Greater internal validity"
},
{
"aid": 5,
"atext": "Smaller sample size"
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 181 | He is presented with a cohort study involving 1000 female smokers and 2000 non-smoking women of the same age. If, after 5 years, 30 smokers and 20 nonsmoking women have experienced a stroke, what would be the relative risk and the attributable risk? | 2 | [
{
"aid": 1,
"atext": "Relative risk = 3, attributable risk = 10 out of every 1000."
},
{
"aid": 2,
"atext": "Relative risk = 3, attributable risk = 20 out of every 1000."
},
{
"aid": 3,
"atext": "Relative risk = 1.5, attributable risk = 10 out of every 1000."
},
{
"aid": 4,
"atext": "Relative risk = 1.5, attributable risk = 30 out of 1000."
},
{
"aid": 5,
"atext": "Relative risk = 10 out of 1000, attributable risk = 3."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 182 | A study is being conducted in a health center to determine the effect of exposure to tobacco smoke in children of smoking parents. For this purpose, a group of healthy children between 3 and 7 years old whose parents are smokers is selected and at the same time an equal number of children whose parents are non-smokers are selected in the same center. A year later, the appearance of respiratory diseases during that year will be investigated in both groups. Indicate the correct answer: | 1 | [
{
"aid": 1,
"atext": "The study design is a prospective cohort."
},
{
"aid": 2,
"atext": "The study design is cases and controls."
},
{
"aid": 3,
"atext": "The study design follows a qualitative methodology."
},
{
"aid": 4,
"atext": "The study is experimental."
},
{
"aid": 5,
"atext": "The type of design used is efficient to study rare diseases."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 183 | A study has been carried out to determine the risk of upper gastrointestinal bleeding (UGIB) associated with the use of different non-steroidal anti-inflammatory drugs (NSAIDs). For this purpose, 2,777 patients with UGIB and 5,532 patients matched with the previous ones were included by age and month of admission or consultation, in the same hospitals, but for reasons that had nothing to do with the use of NSAIDs. The comparative risk of suffering a UGIB associated with previous exposure to different NSAIDs was calculated. What kind of study is it? | 2 | [
{
"aid": 1,
"atext": "Cohort study."
},
{
"aid": 2,
"atext": "Cases and controls study."
},
{
"aid": 3,
"atext": "Transversal study."
},
{
"aid": 4,
"atext": "Experimental study"
},
{
"aid": 5,
"atext": "Ecological study"
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 184 | The presence (x = 1) or absence (x = 0) of bacteriuria has been determined in a group of subjects. What kind of variable is it? | 3 | [
{
"aid": 1,
"atext": "Ordinal."
},
{
"aid": 2,
"atext": "Numeric"
},
{
"aid": 3,
"atext": "Categorical"
},
{
"aid": 4,
"atext": "Continuous quantitative"
},
{
"aid": 5,
"atext": "Discrete quantitative."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 185 | A population estimate of blood creatinine levels is made in a group of pregnant women, obtaining the following results: mean (×) 0.8 mg / dL; typical deviation (s) 0.62 mg / dL; sample size (n) 85 women. According to the previous data, the confidence interval for the population mean (μ) with a confidence level of 95% (Z = 1.96) is: | 2 | [
{
"aid": 1,
"atext": "0.8 ± 0.04."
},
{
"aid": 2,
"atext": "0.8 ± 0.13."
},
{
"aid": 3,
"atext": "0.8 ± 0.62."
},
{
"aid": 4,
"atext": "0.8 ± 1.96."
},
{
"aid": 5,
"atext": "0.8 ± 0.07."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 186 | Some studies show signs that there is a relationship between the quality of people's sleep and the tendency to depression. To obtain the above results, the researchers used two different questionnaires, one on the quality of sleep and another on the symptoms of depression that assigned a score to each patient in each of them. What statistical test do you think they used to test your hypothesis? | 5 | [
{
"aid": 1,
"atext": "Test \"Student's t\"."
},
{
"aid": 2,
"atext": "Logistic regression analysis."
},
{
"aid": 3,
"atext": "Analysis of variance."
},
{
"aid": 4,
"atext": "\"Chi square\" test."
},
{
"aid": 5,
"atext": "Correlation coefficient."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 187 | In economic evaluations, which of the following costs correspond to indirect non-health costs? | 3 | [
{
"aid": 1,
"atext": "Hospitalization of the patient."
},
{
"aid": 2,
"atext": "Care at the patient's home."
},
{
"aid": 3,
"atext": "Loss of patient productivity."
},
{
"aid": 4,
"atext": "Travel expenses of the patient."
},
{
"aid": 5,
"atext": "Rehabilitation of the patient."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 188 | In a pharmacoeconomic study, drug A produces a life expectancy of 5 years with a total cost of 5,000 euros, while drug B produces a life expectancy of 6 years with a total cost of 15,000 euros (average values per patient) . The decision criterion is based on choosing the most effective intervention with a cost-effectiveness threshold of 30,000 euros per year of additional life earned per patient, what drug is cost-effective compared to the other and why? | 1 | [
{
"aid": 1,
"atext": "Drug B, because the incremental cost-effectiveness with respect to A is below the cost-effectiveness threshold."
},
{
"aid": 2,
"atext": "Drug A, because it costs much less than B and there is only one year of difference in life expectancy."
},
{
"aid": 3,
"atext": "Drug A, because the incremental cost-effectiveness of B with respect to A is above the cost-effectiveness threshold."
},
{
"aid": 4,
"atext": "Drug B, because each year of life has a cost of 29,500 euros below the cost-effectiveness threshold."
},
{
"aid": 5,
"atext": "Drug A, because the incremental cost-effectiveness with respect to B is above the cost-effectiveness threshold."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 189 | A study is carried out to investigate the association between factor X and disease Z. To do this, 120 subjects with the disease and 420 controls (without the disease) are matched by age and sex. In both groups it is found that 20 subjects were exposed to factor X. What is the odds ratio (OR) between factor X and disease Z? | 3 | [
{
"aid": 1,
"atext": "OR = 1 (no association)."
},
{
"aid": 2,
"atext": "OR = 2."
},
{
"aid": 3,
"atext": "OR = 4"
},
{
"aid": 4,
"atext": "OR = 6"
},
{
"aid": 5,
"atext": "OR = 8"
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 190 | In a clinical trial, the non-inferiority of the HDP-MDI inhaler (experimental) was evaluated against the FDC-ELIPTUS inhaler (control). The lower clinically relevant limit was set at -50 ml in the forced expiratory volume in the first second (FEV1). The results showed an absolute difference in FEV1 between treatments of +8 mL in favor of the HDP-MDI inhaler (95% confidence interval: -59 ml to +67 ml). Point out the CORRECT answer: | 3 | [
{
"aid": 1,
"atext": "The new HDP-MDI inhaler is superior to the control inhaler."
},
{
"aid": 2,
"atext": "The FDC-ELIPTUS inhaler is non-inferior to the experimental inhaler."
},
{
"aid": 3,
"atext": "The study is not conclusive."
},
{
"aid": 4,
"atext": "Both inhalers are equivalent."
},
{
"aid": 5,
"atext": "The HDP-MDI inhaler is non-inferior to the control inhaler."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 191 | Does vaccination with inactivated poliomyelitis vaccine generate group immunity? (point to the correct answer). | 1 | [
{
"aid": 1,
"atext": "Yes"
},
{
"aid": 2,
"atext": "Do not."
},
{
"aid": 3,
"atext": "Only when vaccines are used with adjuvants."
},
{
"aid": 4,
"atext": "Only against polio virus type 3."
},
{
"aid": 5,
"atext": "Only if it is administered with DTP vaccine."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 192 | Regarding vaccination with rubella vaccine in pregnant women, point out the correct answer: | 3 | [
{
"aid": 1,
"atext": "It should be encouraged as it is very convenient for Public Health."
},
{
"aid": 2,
"atext": "It is the procedure of choice for the control of congenital rubella syndrome."
},
{
"aid": 3,
"atext": "It is no longer considered as an indication of abortion."
},
{
"aid": 4,
"atext": "It is allowed in the case of vaccines of strain RA 27/3, but not in the case of vaccines of the strain Cendehill."
},
{
"aid": 5,
"atext": "It must be administered in conjunction with specific immunoglobulin"
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 193 | In a clinical trial that evaluates the efficacy of a hypolipidemic agent in the primary prevention of coronary heart disease, if the researchers have planned analysis of intermediate results and in view of them suspending the study before its completion they must know that: | 4 | [
{
"aid": 1,
"atext": "The study can only be interrupted when in some intermediate analysis there is a difference between the results of the interventions, p <0.05."
},
{
"aid": 2,
"atext": "Only interruption is justified in those studies that have mortality as the outcome variable."
},
{
"aid": 3,
"atext": "If the intervention is safe, the study can not be interrupted before it has finished."
},
{
"aid": 4,
"atext": "When a clinical trial is interrupted early, the effect of the evaluated intervention is often overestimated."
},
{
"aid": 5,
"atext": "The performance of intermediate analyzes decreases the Type I error."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 194 | When screening for a disease, aimed at high-risk groups, looking for disease in its initial stage, is called: | 2 | [
{
"aid": 1,
"atext": "Simple screening, non-selective, precocious."
},
{
"aid": 2,
"atext": "Simple, selective, precocious screening."
},
{
"aid": 3,
"atext": "Multiple, non-selective, late screening."
},
{
"aid": 4,
"atext": "Multiple screening, selective, precocious."
},
{
"aid": 5,
"atext": "Simple, selective, delayed screening."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 195 | A 52-year-old woman is detected on a mammogram by a nodule and is advised to perform a biopsy by puncture with ultrasound control. The patient asks you about the probability of having cancer if the test comes out positive. Since you have no experience in this area, you are looking for and find a study that includes 112 patients, 18 with cancer and 94 without cancer. Of the 18 patients with cancer, the puncture gave a positive result in 16 and of the 94 patients without cancer the puncture gave a negative result in 88. With these data the correct answer is: | 1 | [
{
"aid": 1,
"atext": "0,727."
},
{
"aid": 2,
"atext": "0.93."
},
{
"aid": 3,
"atext": "0.645."
},
{
"aid": 4,
"atext": "0.56."
},
{
"aid": 5,
"atext": "It can not be calculated because the prevalence of the disease is not known."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 196 | A group of researchers conducted a prospective study to evaluate the efficacy of three alternatives in the treatment of acute otorrhea in children with tympanostomy tubes. Randomized, 76 children received oral amoxicillin-clavulanic acid, 77 received ear drops with hydrocortisone-bacitracinacolistin and other 77 children did not receive any pharmacological treatment, only observation. The main variable was the presence of otorrhea. What kind of study is it? | 4 | [
{
"aid": 1,
"atext": "Cohort study."
},
{
"aid": 2,
"atext": "Post-authorization study of prospective follow-up."
},
{
"aid": 3,
"atext": "Post-authorization study linked to the authorization."
},
{
"aid": 4,
"atext": "Clinical trial"
},
{
"aid": 5,
"atext": "Transversal study."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 197 | We have the registry of subjects who are vaccinated against the flu in a specific region and campaign, which includes information at the time of vaccination on pathological history, age, sex and type of vaccine. For the same subjects we also have the registry with hospital discharge diagnoses, which occurred after the date of vaccination, and there is a personal identifier common to both registers. Indicate which of these studies would be possible to carry out using only the aforementioned sources of information: | 2 | [
{
"aid": 1,
"atext": "An analytical cohort study to determine if vaccination increases the risk of developing Guillain-Barré syndrome in the first 16 weeks after influenza vaccination."
},
{
"aid": 2,
"atext": "A descriptive analysis to estimate the incidence of acute myocardial infarction in the first 16 weeks after anti-flu vaccination."
},
{
"aid": 3,
"atext": "A descriptive analysis to estimate the incidence of fever in the first week after the influenza vaccination."
},
{
"aid": 4,
"atext": "A clinical trial that compares the risk of serious post-vaccine reactions (involving hospital admission) with two of the types of influenza vaccines used in that campaign."
},
{
"aid": 5,
"atext": "A case-control study to determine if vaccination increases the risk of developing an acute myocardial infarction."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 198 | In a cohort study, the population treated with an anticoagulant drug had an incidence of severe hemorrhage of 3%, while in the untreated population the incidence of severe bleeding was 1%, with the NNH ("Number Needed to Harm") of 50. What is the correct interpretation of this data? | 4 | [
{
"aid": 1,
"atext": "In the group treated with the anticoagulant 50 people presented a severe hemorrhage."
},
{
"aid": 2,
"atext": "In the group treated with anticoagulant there were 50 cases of severe hemorrhage more than in the untreated group."
},
{
"aid": 3,
"atext": "The risk of severe hemorrhage in those treated with the anticoagulant was 50 times higher than in those not treated."
},
{
"aid": 4,
"atext": "It was necessary to treat 50 people with the anticoagulant to produce 1 case of severe hemorrhage attributable to the drug."
},
{
"aid": 5,
"atext": "Of every 100 patients treated with the anticoagulant, 50 had a severe hemorrhage."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 199 | In a meta-analysis of 15 studies, the incidence of myocardial infarction with the new drug Tromboclean is 10.8% compared to 8% with heparin. The relative risk is 1.35, with a 95% confidence interval of 1.15 to 1.50 and absence of significant heterogeneity between studies (p-value of heterogeneity = 0.95). Point out the CORRECT answer: | 5 | [
{
"aid": 1,
"atext": "The heterogeneity is not significant, which suggests that the results are inconclusive."
},
{
"aid": 2,
"atext": "Trombo Clean presents a risk of myocardial infarction similar to that of heparin."
},
{
"aid": 3,
"atext": "It can not be ruled out with a 95% confidence that Tromboclean reduces the risk of myocardial infarction by 50%."
},
{
"aid": 4,
"atext": "Thromboclean increases the absolute risk of myocardial infarction between 15% and 50%."
},
{
"aid": 5,
"atext": "Heparin presents a significantly lower risk of myocardial infarction than Tromboclean."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 201 | After a strong blow to the knee and especially if the affected lower limb is resting on the floor, the so-called "unfortunate triad" may occur that affects three elements of the anatomical components of the knee joint. What are these? | 2 | [
{
"aid": 1,
"atext": "Peroneal collateral ligament, posterior cruciate ligament and lateral meniscus."
},
{
"aid": 2,
"atext": "Tibial collateral ligament, anterior cruciate ligament and medial meniscus."
},
{
"aid": 3,
"atext": "Tibial collateral ligament, posterior cruciate ligament and anterior cruciate ligament."
},
{
"aid": 4,
"atext": "Anterior cruciate ligament, posterior cruciate ligament and medial meniscus."
},
{
"aid": 5,
"atext": "Peroneal collateral ligament, tibial and anterior cruciate collateral ligament."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 202 | Which of the following cranial nerves has the longest path through a bone canal? | 4 | [
{
"aid": 1,
"atext": "The trigeminal."
},
{
"aid": 2,
"atext": "The pathetic or troclear."
},
{
"aid": 3,
"atext": "The optician"
},
{
"aid": 4,
"atext": "The facial."
},
{
"aid": 5,
"atext": "The olfactory."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 203 | Reviewing the CT angiography of a 70-year-old man under study for abdominal aortic aneurysm, the radiologist reports the presence of complete occlusion of the inferior mesenteric artery. The patient is completely asymptomatic. Occlusion of the inferior mesenteric artery occurs asymptomatically on many occasions since the irrigating territory can receive flow from: | 1 | [
{
"aid": 1,
"atext": "The middle colic artery."
},
{
"aid": 2,
"atext": "The gastroduodenal artery."
},
{
"aid": 3,
"atext": "The left inferior epigastric artery."
},
{
"aid": 4,
"atext": "The splenic artery."
},
{
"aid": 5,
"atext": "The gastroepiploic artery."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 204 | What is the most common malignant tumor of the thyroid? | 2 | [
{
"aid": 1,
"atext": "Oxyphilic carcinoma"
},
{
"aid": 2,
"atext": "Papillary carcinoma"
},
{
"aid": 3,
"atext": "Follicular carcinoma."
},
{
"aid": 4,
"atext": "Anaplastic carcinoma"
},
{
"aid": 5,
"atext": "Spinal carcinoma"
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 205 | In which of the following entities is NOT the Epstein-Barr Virus involved? | 5 | [
{
"aid": 1,
"atext": "Infectious mononucleosis"
},
{
"aid": 2,
"atext": "Burkitt lymphoma."
},
{
"aid": 3,
"atext": "Large B cell lymphoma in immunosuppressed patients."
},
{
"aid": 4,
"atext": "Nasopharyngeal carcinoma"
},
{
"aid": 5,
"atext": "Cervical carcinoma"
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 206 | Among the exogenous factors that favor the appearance of gout are the drugs. Of the following indicated, which one do you consider that it does NOT favor hyperuricemia? | 5 | [
{
"aid": 1,
"atext": "Acetylsalicylic acid at doses lower than 1g daily."
},
{
"aid": 2,
"atext": "Hydrochlorothiazide"
},
{
"aid": 3,
"atext": "Cyclosporin A."
},
{
"aid": 4,
"atext": "Ethambutol"
},
{
"aid": 5,
"atext": "Estrogens"
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 208 | The development of generic drugs is based on the evaluation of the bioequivalence of the generic compared to a reference product already marketed. This concept refers to: | 4 | [
{
"aid": 1,
"atext": "The evaluation of equivalence in clinical efficacy trials."
},
{
"aid": 2,
"atext": "The assessment of similarity in clinical trials of tolerance."
},
{
"aid": 3,
"atext": "The equivalence in the distribution process of a drug and, therefore, to the verification that it has the same concentrations in the place of action."
},
{
"aid": 4,
"atext": "The evaluation of pharmacokinetic equivalence."
},
{
"aid": 5,
"atext": "The verification of a similar effect of the factors that influence the bioavailability of a drug."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 209 | In a 60-year-old man with moderate renal insufficiency, treatment is started, without administration of loading dose, with a digitalis medication. Under these conditions, the half-life or plasma half-life of digitalis is estimated at 72 hours. Indicate how much treatment time in days should elapse from the start of treatment to reach the steady state concentration or equilibrium concentration. | 3 | [
{
"aid": 1,
"atext": "In 3 days."
},
{
"aid": 2,
"atext": "Between 3 and 9 days."
},
{
"aid": 3,
"atext": "Between 12 and 15 days."
},
{
"aid": 4,
"atext": "More than 30 days"
},
{
"aid": 5,
"atext": "More than 60 days"
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 210 | Of the following anticoagulants which is a direct inhibitor of thrombin: | 1 | [
{
"aid": 1,
"atext": "Dabigatran"
},
{
"aid": 2,
"atext": "Apixaban."
},
{
"aid": 3,
"atext": "Rivaroxaban."
},
{
"aid": 4,
"atext": "Acenocoumarol."
},
{
"aid": 5,
"atext": "Clopidogrel"
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 211 | Which of the following conditions causes a decrease in the O2 saturation of the hemoglobin that is not due to a decrease in the partial pressure of oxygen? | 3 | [
{
"aid": 1,
"atext": "Ventilation-perfusion ratio lower than normal."
},
{
"aid": 2,
"atext": "Anemia."
},
{
"aid": 3,
"atext": "Carbon monoxide poisoning."
},
{
"aid": 4,
"atext": "Hypoventilation."
},
{
"aid": 5,
"atext": "Shunt venoarterial."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 213 | Which of the mentioned vasoactive substances preferentially contracts the glomerular efferent arterioles in most physiological states? | 4 | [
{
"aid": 1,
"atext": "Adrenalin."
},
{
"aid": 2,
"atext": "Noradrenaline"
},
{
"aid": 3,
"atext": "Endothelin"
},
{
"aid": 4,
"atext": "Angiotensin II."
},
{
"aid": 5,
"atext": "Bradykinin"
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 214 | What studies should be performed in an adenocarcinoma with prominent mucinous differentiation of ascending colon diagnosed in a 32-year-old man? | 2 | [
{
"aid": 1,
"atext": "Reorganization of the MYC gene."
},
{
"aid": 2,
"atext": "Analysis of microsatellite instability."
},
{
"aid": 3,
"atext": "Study of mutations of the RET gene."
},
{
"aid": 4,
"atext": "Study of BRCA1-2 mutations."
},
{
"aid": 5,
"atext": "Studies of TP53 mutations."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 215 | A healthy couple has an 8-year-old daughter with hepatosplenomegaly. The laboratory of biochemical genetics has detected in it a deficiency of the acid beta-glucosidase enzyme (glucocerebrosidase) and molecularly presents the mutation N370S in homozygosis. Which diagnosis is correct? | 5 | [
{
"aid": 1,
"atext": "Fabry disease (Xq22.1)."
},
{
"aid": 2,
"atext": "Huntington's disease (4p16.3)."
},
{
"aid": 3,
"atext": "Autosomal dominant cerebellar ataxia SCA1 (6p22.3)."
},
{
"aid": 4,
"atext": "Adrenoleukodystrophy (Xq28)."
},
{
"aid": 5,
"atext": "Gaucher disease (1q22)."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 216 | Which of the following in an oncogene whose transcription product is a membrane receptor with tyrosine kinase activity of a growth factor? | 1 | [
{
"aid": 1,
"atext": "HER2 / neu."
},
{
"aid": 2,
"atext": "p53."
},
{
"aid": 3,
"atext": "myc"
},
{
"aid": 4,
"atext": "APC."
},
{
"aid": 5,
"atext": "Ras."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 217 | Point out the correct answer regarding B lymphocytes. | 3 | [
{
"aid": 1,
"atext": "Its two main subpopulations are called B-helper and B-cytotoxic."
},
{
"aid": 2,
"atext": "They are the cells responsible for the production of antibodies in the rejection of an autologous transplant of hematopoietic progenitors."
},
{
"aid": 3,
"atext": "They are the target cells of the anti-CD20 monoclonal antibody (rituximab)."
},
{
"aid": 4,
"atext": "They require co-stimulation CD20-CD19 for the expression of the CD3 molecule on its surface."
},
{
"aid": 5,
"atext": "It is the type of majority lymphocyte in the peripheral blood of patients with Bruton's disease."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 218 | In IgE-mediated hypersensitivity reactions: | 1 | [
{
"aid": 1,
"atext": "Eosinophils and mast cells play an important role."
},
{
"aid": 2,
"atext": "There are no cellular elements involved."
},
{
"aid": 3,
"atext": "Antibody-mediated cytotoxicity reactions play a key role."
},
{
"aid": 4,
"atext": "There are no elements of the immune system involved in atopy."
},
{
"aid": 5,
"atext": "The IgE immunoglobulin receptor does not intervene."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 219 | An 8-month-old girl meets diagnostic criteria for hemophagocytic syndrome / hemophagocytic lymphohistiocytosis-fever, hepatosplenomegaly, anemia, thrombocytopenia, hipetransaminasemia, increased sCD25-and has a defect in the capacity of degranulation of her lymphocytes (expression of CD107a). Point out the correct therapeutic attitude in this case: | 1 | [
{
"aid": 1,
"atext": "Quickly initiate HLA typing and immunosuppressive therapy for the donor search (haematopoietic stem cell transplant)."
},
{
"aid": 2,
"atext": "Biological treatment with Daclizumab (antiCD25) as the only therapy until the molecular diagnosis of the disease is obtained."
},
{
"aid": 3,
"atext": "Symptomatic and supportive treatment (transfusion of red blood cells and platelets) and avoid any immunosuppressant drug."
},
{
"aid": 4,
"atext": "Broad-spectrum antibiotic therapy via iv for the treatment of an eventual microorganism that triggers hemophagocytosis."
},
{
"aid": 5,
"atext": "Treatment with intravenous gamma globulins, to maintain for life."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 220 | A 43-year-old man consulted for diarrheal syndrome, and reported among his background 3 pneumonias in adulthood. Which of the following immunological studies should we request ?: | 1 | [
{
"aid": 1,
"atext": "Serum immunoglobulin count and antibody production capacity test."
},
{
"aid": 2,
"atext": "Phagocytosis test and oxidative metabolism of neutrophils."
},
{
"aid": 3,
"atext": "Apoptosis test (programmed cell death) in the circulating lymphocytes of the patient."
},
{
"aid": 4,
"atext": "Study of the repertoire and clonality of the T lymphocytes (alpha / beta)."
},
{
"aid": 5,
"atext": "In this patient, it would not be appropriate to request any immunological study."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 221 | In what clinical situation would you use a combined antimicrobial treatment? | 3 | [
{
"aid": 1,
"atext": "In an acute pharyngotonsillitis in a child."
},
{
"aid": 2,
"atext": "In a community pneumonia due to Mycoplasma pneumoniae in a teenager."
},
{
"aid": 3,
"atext": "In an acute meningitis in an elderly patient."
},
{
"aid": 4,
"atext": "In a postmenopausal patient with a recurrent urinary infection."
},
{
"aid": 5,
"atext": "In a skin abscess in a young patient."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 222 | 8-year-old boy who goes to the Emergency Room because he has been bitten by a child while playing, about 6 hours ago. It presents a slight incisocontuse wound on the right forearm. In addition to considering other measures, what antimicrobial would you recommend? | 3 | [
{
"aid": 1,
"atext": "Ciprofloxacin, thinking that the oral flora is composed of mixed flora with predominance of anaerobic flora."
},
{
"aid": 2,
"atext": "Aztreonam, thinking that the oral flora is composed of mixed flora with a predominance of Enterobacteriaceae."
},
{
"aid": 3,
"atext": "Amoxicillin-clavulanate, thinking that the oral flora is composed of mixed flora with a predominance of gram-positive and anaerobic flora."
},
{
"aid": 4,
"atext": "Fluconazole, thinking that the oral flora is composed of mixed flora with predominance of yeasts such as Candida albicans."
},
{
"aid": 5,
"atext": "Metronidazole, thinking that the oral flora is composed of mixed flora with predominance of anaerobic flora."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 223 | Which of the following bacterial species is not an Enterobacteriaceae? | 4 | [
{
"aid": 1,
"atext": "Escherichia coli"
},
{
"aid": 2,
"atext": "Proteus vulgaris."
},
{
"aid": 3,
"atext": "Klebsiella pneumoniae."
},
{
"aid": 4,
"atext": "Pseudomonas aeruginosa."
},
{
"aid": 5,
"atext": "Salmonella enteritidis."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 224 | A 69-year-old woman consulted for dysuria and frequency, symptoms that she has suffered numerous times in the last two years. He says that he has been taking cotrimoxazole in a daily dose for three months, prescribed by his family doctor. In the hospital's emergency department, a sediment and a urine culture were taken. The urinary sediment was pathological (significant pyuria, positive nitrites). He was prescribed ciprofloxacin, and was re-cited with his primary care physician. The urine culture was positive (Escherichia coli,> 10 (5) CFU / ml) and the results of the antibiogram showed resistance to ampicillin, cotrimoxazole and quinolones, but sensitivity to fosfomycin, the antimicrobial agent that you prescribe. Which of the following answers is FALSE? | 1 | [
{
"aid": 1,
"atext": "The change from ciprofloxacin to norfloxacin would have been correct, according to the results of the antibiogram."
},
{
"aid": 2,
"atext": "Cotrimoxazole was being used as a prophylaxis."
},
{
"aid": 3,
"atext": "The choice of fosfomycin constitutes a targeted treatment."
},
{
"aid": 4,
"atext": "The choice of ciprofloxacin constitutes an empirical treatment."
},
{
"aid": 5,
"atext": "The change from ciprofloxacin to fosfomycin was correct, according to the results of the antibiogram."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 225 | Before a 7-month-old girl who comes to the emergency room with a picture suggestive of bronchiolitis, what would be the most probable etiologic agent? | 5 | [
{
"aid": 1,
"atext": "Adenovirus."
},
{
"aid": 2,
"atext": "Parainfluenza virus 1"
},
{
"aid": 3,
"atext": "Influenza B virus"
},
{
"aid": 4,
"atext": "Bocavirus"
},
{
"aid": 5,
"atext": "Respiratory syncytial virus."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 226 | Which of the following drugs is NOT used in the treatment of autoimmune hepatitis? | 4 | [
{
"aid": 1,
"atext": "Prednisone."
},
{
"aid": 2,
"atext": "Azathioprine"
},
{
"aid": 3,
"atext": "Budesonide"
},
{
"aid": 4,
"atext": "Lamivudine"
},
{
"aid": 5,
"atext": "Mycophenolate mofetil."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 227 | Acute aortic syndrome includes entities such as aortic dissection, intramural aortic hematoma, and penetrating atherosclerotic ulcer. Regarding the diagnostic and therapeutic considerations of this entity, point out the CORRECT statement: | 4 | [
{
"aid": 1,
"atext": "Currently, in our environment, the diagnosis of this pathology is established routinely by percutaneous arteriography."
},
{
"aid": 2,
"atext": "Computed tomography is not a good imaging technique for its diagnosis."
},
{
"aid": 3,
"atext": "The echocardiographic techniques do not usually provide data of interest in the diagnosis and study of these nosological entities."
},
{
"aid": 4,
"atext": "It is considered a Stanford type A aortic intramural dissection or hematoma when the ascending aorta is affected, regardless of the place of origin of the lesion or its extension."
},
{
"aid": 5,
"atext": "The surgical indication of an aortic dissection is independent of the involvement of the ascending aorta."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 228 | A 58-year-old woman enters the Short Stay Medical Unit due to a clinical picture that began with an episode of syncope and then presented feeling of dizziness and dyspnea. On physical examination, she is sweaty, afebrile at 126 beats per minute and at 30 breaths per minute, with a blood pressure of 88/46 and an oxygen saturation of 85% while breathing room air. Cardiac auscultation shows tachycardia without murmurs or gallop and pulmonary auscultation is clean. Which, among the following, seems the most likely diagnosis? | 1 | [
{
"aid": 1,
"atext": "Pulmonary embolism."
},
{
"aid": 2,
"atext": "Acute cerebrovascular accident of posterior territory."
},
{
"aid": 3,
"atext": "Acute coronary syndrome"
},
{
"aid": 4,
"atext": "Hypovolemic shock."
},
{
"aid": 5,
"atext": "Acute pulmonary edema secondary to atrial flutter."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 229 | A 69-year-old woman consulted for hemoptotic expectoration. In the two previous months she had low-grade fever, asthenia, anorexia and unquantified weight loss. In the cytological analysis of sputum, hemosiderophages were observed and in the chest radiograph bilateral alveolar infiltrates were observed. Analytically it stood out: Hb 8.2gr / dL, PO2: 58mmHg, creatinine: 5mg / dL, urine: proteinuria +++ microhematuria, cylinders, hematics. ANCAp (antibodies against the cytoplasm of perinuclear neutrophils): positive: anti-glomerular basement membrane antibodies: negative. Antinuclear antibodies: negative. The most likely diagnosis would be: | 5 | [
{
"aid": 1,
"atext": "Idiopathic pulmonary hemosiderosis."
},
{
"aid": 2,
"atext": "Goodpasture syndrome."
},
{
"aid": 3,
"atext": "Systemic lupus erythematosus with severe renal involvement."
},
{
"aid": 4,
"atext": "Classical polyarteritis nodosa."
},
{
"aid": 5,
"atext": "Microscopic polyarteritis."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 230 | What is true of essential tremor? | 1 | [
{
"aid": 1,
"atext": "It usually improves with propranolol."
},
{
"aid": 2,
"atext": "Initially it is at rest."
},
{
"aid": 3,
"atext": "It can be improved with levodopa at low doses."
},
{
"aid": 4,
"atext": "It is more serious in cases of family presentation."
},
{
"aid": 5,
"atext": "It usually gets worse with alcohol intake."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 231 | A 24-year-old woman, asymptomatic, with a history of father and sister with medullary thyroid carcinoma. Incidentally, an adrenal mass measuring 5 cm in diameter was discovered on computed tomography (CT). Which of the following options should be the next clinical decision? | 5 | [
{
"aid": 1,
"atext": "Given that it is asymptomatic, semestral control is recommended with serial CT scans of said lesion."
},
{
"aid": 2,
"atext": "The search for a possible medullary carcinoma of the thyroid is a priority."
},
{
"aid": 3,
"atext": "A pre-clinical Cushing syndrome should be suspected in the context of multiple endocrine neoplasia."
},
{
"aid": 4,
"atext": "Puncture-aspiration of said lesion should be performed to elucidate the nature of said lesion."
},
{
"aid": 5,
"atext": "Catecholamines should be determined in urine to rule out a pheochromocytoma."
}
] |
Cuaderno_2014_1_M | 2014 | medicine | 232 | A 45-year-old patient on the 15th day post-transplant of hematopeytic progenitors, with absolute neutropenia, platelets of 15,000 / uL and a hemoglobin of 7 g / dL, which presents a clinical picture of eye pain with periorbital edema with discrete serosanguinous nasal discharge . What is the diagnosis of presumption? | 5 | [
{
"aid": 1,
"atext": "Periorbital hematoma."
},
{
"aid": 2,
"atext": "Allergic reaction, possibly to medication."
},
{
"aid": 3,
"atext": "Acute bacterial sinusitis, probably staphylococcal."
},
{
"aid": 4,
"atext": "Sinusitis due to Aspergillus spp."
},
{
"aid": 5,
"atext": "Mucormycosis"
}
] |
Subsets and Splits
No saved queries yet
Save your SQL queries to embed, download, and access them later. Queries will appear here once saved.