question
stringlengths 7
1.06k
| op2
stringlengths 2
358
| op1
stringlengths 2
370
| op4
stringlengths 2
399
| category
stringclasses 6
values | op3
stringlengths 2
355
| exam_id
int64 1
210
| cop
int64 0
4
| unique_id
stringlengths 36
36
| year
stringclasses 5
values |
|---|---|---|---|---|---|---|---|---|---|
An 88-year-old woman seeks consultation for frequent falls, general health deterioration, hyporexia, and insomnia. Her medical history shows moderate cognitive impairment, type 2 diabetes mellitus with a latest glycosylated hemoglobin of 8%, hypertension, hypercholesterolemia with LDL at 121 mg/dl, and chronic kidney disease with a glomerular filtration of 42 mL/m. She is being treated with sulfonylureas, simvastatin, benzodiazepines, and valsartan/amlodipine. Indicate the most correct course of action: | The hypercholesterolemia is poorly controlled, so I would add ezetimibe. | The diabetes treatment needs to be intensified to reduce glycated hemoglobin. | I would increase the dosage of benzodiazepines for insomnia control. | Medicine | I would review the pharmacological treatment to perform a de-prescription prioritizing essential drugs. | 166 | 3 | 152bcf6d-fc66-4ce5-89bd-010c93d81770 | 2022 |
One of the following components is not considered key to achieving the effectiveness of comprehensive geriatric assessment programs: | Use of standardized scales and instruments. | Clinical leadership. | Intense intervention temporarily. | Medicine | Plan by objectives with interdisciplinary team work. | 167 | 4 | 886d12fa-3873-4ab8-bfa8-4ef15b740522 | 2022 |
A 58-year-old obese male, asymptomatic, moderate drinker, presents with an initial fasting blood sugar level of 153 mg/dl with negative glycosuria. In the following weeks, he has had two more fasting blood sugar levels of 118 and 136 mg/dl. What is the most appropriate approach to confirm the diagnosis of diabetes mellitus? | Already meets diagnostic criteria for diabetes mellitus. | Perform a glucose curve test with 75 g of glucose. | Request a determination of glycated hemoglobin. | Medicine | Request a determination of basal insulinemia or C-peptide. | 168 | 2 | 451b6d80-f519-4eb8-a606-282312fd2110 | 2022 |
Which of the following neoplasms is not usually associated with a multiple endocrine neoplasia syndrome type MEN-1?: | Pheochromocytoma. | Pituitary adenoma. | Glucagonoma. | Medicine | Insulinoma. | 169 | 2 | b9b2b0a3-af40-4b28-b934-3705455a1e2d | 2022 |
A 75-year-old woman who is taking sertraline comes to the emergency room due to a confused state. No edema is evident, and the blood pressure is 130/70 mmHg. Lab results show a Na level of 126 mEq/l and K level of 4 mEq/l, her sodium in urine is 45 mEq/l and the possibility of diuretic intake has been ruled out. Among the following, what would be the most appropriate response? | Administer hypertonic saline solution in order to restore natremia as soon as possible. | This is a case of Addison's disease and corticosteroids must be administered immediately. | Request a brain magnetic resonance imaging, as it is likely a case of diabetes insipidus. | Medicine | Indicate water restriction and if the natremia does not increase, proceed to slow infusion of saline solution. | 170 | 3 | 2ec759c3-fd49-4860-a74f-23e1ef4b47be | 2022 |
A 38-year-old woman consults for asthenia and hypotension evolving over six months. After a thorough evaluation, in the analysis only cortisol 8 microg/dl (5-25 microg/dl) and ACTH of 240 pg/ml (10-60 pg/ml) stand out. Which of the following statements is true?: | This is a syndrome of resistance to ACTH and genetic counseling should be sought. | An ACTH stimulation test should be requested with suspicion of primary adrenal insufficiency. | This refers to an ectopic secretion of ACTH and a neoplasm should be sought. | Medicine | An ACTH-secreting pituitary tumor must be ruled out. | 171 | 1 | 72701fa2-1cfd-4e2f-bf25-adfc02024f84 | 2022 |
In Klinefelter's syndrome, which of the following statements is correct?: | The levels of gonadotropins are decreased in most of the patients. | Testosterone treatment enhances fertility. | The incidence of erythematous lupus is higher than in the male population in general. | Medicine | The X0 karyotype underlies most of the cases. | 172 | 4 | ac0a1922-00df-4a47-8e4e-a9640e3cbfed | 2022 |
37-year-old woman, diagnosed three months ago with Graves' disease, being treated with methimazole and propranolol, who consults for fever and painful swallowing. In the physical examination she has a temperature of 38.7ºC and the oropharynx is erythematous, without exudates. Which of the following is the most appropriate management?: | Obtain a rapid antigen detection test for Group A Streptococcus. | Start an empirical treatment with oral penicillin V. | Discontinue the methimazole and obtain a complete blood count with differential. | Medicine | Discontinue the propranolol and obtain an oropharyngeal culture. | 173 | 4 | eb22f0c3-644c-491e-ada0-8df6e02d0a2c | 2022 |
Which of the following semiological findings in a patient with herpes zoster does not indicate a particular severity?: | Multimetameric involvement. | Presence of vesicles in the external auditory canal. | Skin lesions in different evolutionary stages. | Medicine | Involvement of the nasal wing. | 174 | 4 | 87215ea5-fe9b-4271-8503-dfec30dfce5d | 2022 |
A 62-year-old patient presents after having close contact in recent weeks with a person with active tuberculosis. The Mantoux test is positive (12 mm). Noteworthy in their medical history is being on treatment with oral anticoagulants (acenocoumarol) for a deep vein thrombosis a few months ago. The patient reports no fever or cough and is asymptomatic. The chest X-ray is normal. Which of the following treatments is most recommended?: | Rifampicin, for four months. | Isoniazid, for nine months. | Isoniazid and Rifapentin, for three months. | Medicine | Isoniazid and rifampicin, for three months. | 175 | 1 | 5ca2193b-b780-4eb3-88af-032cee8bddd0 | 2022 |
A 73-year-old patient with a history of hypertension and diabetes is suffering from bilateral pneumonia due to SARS-CoV2. After receiving oxygen through nasal prongs, prophylactic dose of enoxaparin (60 mg/day SC), remdesivir, and dexamethasone (6 mg/day IV), the clinical evolution is not favorable, and on the fourth day of hospitalization, they are found to be tachypneic at 30 breaths per minute, temperature of 38°C and oxygen saturation of 92%; beginning to receive high flow nasal oxygen. Analysis: 12,000 leukocytes (75% neutrophils), PCR 80 (N<3 mg/L), ferritin 823 (N<350 ng/mL), D-dimer 1800 (N <500 ng/mL), procalcitonin 0.45 (N< 0.3 ng/mL). The chest X-ray shows progression of the bilateral pneumonia. What is the most recommended therapeutic approach from the following options?: | Increase the dose of steroids (methylprednisolone, 80 mg/8 h IV). | Increase the dose of enoxaparin to anticoagulant doses (60 mg/12 h SC). | Add meropenem. | Medicine | Add tocilizumab. | 176 | 3 | 2b5224f4-4155-44f1-b6da-968646e9a997 | 2022 |
A 33-year-old patient, living in Valencia, is seeking consultation due to a plaque, erythematous-orange in color, on the right cheek after an insect bite which has slowly grown to reach 1.5 cm and has ulcerated and become covered with a crust in recent weeks. The lesión only causes him slight discomfort if scratched. His medical history notably includes plaque psoriasis being treated with subcutaneous adalimumab. He is in good general health and does not take other drugs nor has he reported allergies to medications. Indicate the treatment you would use: | Intralesional meglumine antimoniate. | Oral Isotretinoin. | Oral Amoxicillin. | Medicine | Systemic corticosteroids. | 177 | 2 | d8360b3c-11c0-4183-a32f-ed82a9e660c7 | 2022 |
A 48-year-old male who visits your clinic due to chronic constipation resistant to usual measures. In addition, he reports palpitations and in recent weeks, shortness of breath from moderate effort. Indicate, from the possibilities offered, which would guide you more to suspect a specific etiological diagnosis: | Perform a barium enema. | Perform an ECG. | Ask about the country of origin. | Medicine | Perform an echocardiogram. | 178 | 4 | 94b1f9b3-dddf-44b1-bc19-bb8a115a910b | 2022 |
A 54-year-old patient with a history of chronic alcoholism and poor living and hygiene conditions. He presents a clinical picture of two weeks of asthenia, low-grade fever, and night sweats. In the chest X-ray and CT scan, a single, cavitated lesion is observed in the upper segment of the right lower lobe, 4 cm in diameter, with a hydric-aerial level. The microbiological study of the sputum is negative. He decides to start with an empirical antibiotic treatment. Indicate which of the following would be the LEAST effective treatment: | Clindamycin IV. | Metronidazole IV. | Oral Moxifloxacin. | Medicine | The association of a beta-lactam and beta-lactamase IV. | 179 | 1 | 287ac4c7-28ef-4849-b540-b0dc8aa1e7f1 | 2022 |
A 26-year-old woman diagnosed with systemic lupus erythematosus, undergoing treatment with hydroxychloroquine, consults due to a feeling of generalized weakness that has progressively established over the last 15 days. The physical examination reveals skin paleness and the blood test shows Hb 7.4 gr/dL, Hct 31%, MCV 108. Which of the following determinations will be most useful to decide the action to take?: | Coombs Test. | Haptoglobin. | Antinuclear antibodies. | Medicine | Vitamin B12. | 180 | 2 | d6d5f04d-6456-4134-91f3-e5823cbb88b7 | 2022 |
A 67-year-old male presenting with a 3-month history of weakness and low-grade fever, with nasal obstruction and mucus emission with some clots added in the last month. In recent days he notices pain in his right eye and asymmetry compared to the opposite side. Physical examination shows proptosis of the right eyeball and inspection of the nasal cavities confirms an erythematous mucosa with serohematic scabs. The rest of the examination is normal. Blood tests (complete blood count, kidney and liver function) are normal, except for an ESR of 65 mm/h; in the urine analysis, microhematuria and proteinuria of 520 mg/24h are detected. What is the most likely initial diagnosis? | Microscopic polyangiitis. | Eosinophilic granulomatosis with polyangiitis. | Polyarteritis nodosa. | Medicine | Granulomatosis with polyangiitis. | 181 | 3 | 96f75abc-2616-4a9a-b76d-c89181c6374e | 2022 |
In Sjögren's syndrome, one of the prognostic factors associated with a worse outcome is: | Raynaud's Phenomenon. | Polyarthritis of large and small joints. | Cryoglobulinemia. | Medicine | Hepatosplenomegaly. | 182 | 4 | 95f7122d-7acb-4255-b240-be59ba45bc8f | 2022 |
A 45-year-old woman with no relevant medical history presents with a dyspneic sensation that has evolved over the last 4 days. Examination shows rhythmic tachycardia, without murmurs, and normal lung auscultation. Arterial blood gas shows a pO2 of 70 mmHg and a pCO2 of 32 mmHg. The blood count, renal and liver functions are normal. Prothrombin time 90%, activated partial thromboplastin time (APTT) with a ratio of 2 to control (N <1.2). Which of the following diagnoses is most likely?: | Leiden Factor V. | Antiphospholipid Syndrome. | Acute pericarditis. | Medicine | Hemophilia. | 183 | 1 | d21f1a30-0c66-4fb1-a8bb-e2a31c955c82 | 2022 |
A 70-year-old woman reports experiencing pain and stiffness in the shoulder and pelvic girdle for the past month, predominantly upon getting out of bed and improving with movement, with no fever, headache, or general health impairment. Physical examination reveals stiffness and pain when mobilizing the shoulders and hips. Laboratory tests show an elevation in ESR and C-reactive protein. What is the most likely diagnosis and what treatment would you prescribe? | Fibromyalgia, would start treatment with duloxetine. | Rheumatoid arthritis, would start treatment with methotrexate. | Ankylosing spondylitis, would start treatment with non-steroidal anti-inflammatory drugs. | Medicine | Polymyalgia rheumatica, would start treatment with corticosteroids. | 184 | 3 | cac03742-0719-4eff-9fde-920038789082 | 2022 |
Medical consultation in hospitalized patients is a common activity among internal medicine/geriatrics specialists, especially in surgical services. Indicate which of the following characteristics does not correspond to the care model of consultation known as shared care: | On-demand care. | Shared responsibility. | Fluid communication between doctors. | Medicine | Comprehensive and holistic care. | 185 | 2 | d3718989-c390-4c51-98fd-09ac94b68854 | 2022 |
The moral obligation to act for the benefit of others is a basic principle of bioethics which is called: | Charity. | Autonomy. | Justice. | Medicine | Non-maleficence. | 186 | 2 | 80749cb3-4d70-4f22-8ac8-0cc833a2f164 | 2022 |
Regarding the use of gabapentin as an adjunct analgesic to opioids in patients with neuropathic pain in palliative care, indicate the incorrect answer: | The combination of gabapentin and nortriptyline is no more effective than gabapentin alone. | It starts with doses of 100 to 300 mg two or three times a day. | A dosage of 900 to 3,600 mg/day is usually effective. | Medicine | Confusion and drowsiness are side effects, particularly in older patients. | 187 | 2 | 80ebffad-66db-4370-acb4-0ca9974629c3 | 2022 |
Which of the following characteristics is not typical of the symptoms presented by patients with advanced chronic disease with limited life expectancy?: | Intense. | Multiple. | Multifactorial. | Medicine | Stable. | 188 | 3 | d1d1dfb2-e8e7-40ab-b60b-b422815eaaa4 | 2022 |
Parallel and varying depth wounds, which sometimes appear on the wrist of a person's non-dominant limb as a result of the action of a bladed weapon, suggest one of the following options: | Defensive wounds. | Battle wounds, produced by the handling of a weapon. | Self-inflicted wounds for the purpose of simulation. | Medicine | Exploratory wounds (suicidal intent). | 190 | 3 | 5ce0925b-e901-4fa6-a116-010e6be0531f | 2022 |
A 54-year-old male attends his health center following hospital discharge after an acute myocardial infarction. Noteworthy in his history is that he has been a smoker of 25 cigarettes/day since age 20, a regular drinker of 6 standard drinks/day, and in several analyses from previous years, cholesterol levels of 247-298 mg/dl, triglycerides of 150-216 mg/dl, HDL cholesterol between 45-52 mg/dl. In his family history, it is noted that his parents (ages 86 and 83) are diabetic and hypertensive, and his two siblings (ages 58 and 60) are healthy, all without cardiovascular diseases. What type of dyslipidemia is most likely? | Heterozygous familial hypercholesterolemia. | Dysbetalipoproteinemia. | Polygenic hypercholesterolemia. | Medicine | Combined familial hyperlipidemia. | 191 | 4 | ea7260cd-61da-437c-a865-a00d5d522c40 | 2022 |
Once a diagnosis of type 2 diabetes mellitus has been established and good or acceptable control has been achieved, within the periodic follow-up activities, when should a hemoglobin A1c be requested? | Every 6 months. | Every 3 months. | Every 12 months. | Medicine | Every 9 months. | 192 | 2 | d905e2f4-e513-413f-b879-7f48289023e6 | 2022 |
According to the cardiovascular preventive recommendations of the Program for Preventive Activities and Health Promotion (PAPPS), indicate the correct option about the frequency of screening for high blood pressure in people over 40 years old: | It is recommended to take blood pressure every two years. | It is recommended to take your blood pressure annually. | It is recommended to take the blood pressure every four years. | Medicine | It is recommended to measure blood pressure every three years. | 193 | 1 | 928badc6-10e4-4439-b3c2-16b4c3a3704d | 2022 |
Regarding the cardiorenal syndrome, indicate the false statement: | An S1-S2 gallop rhythm and peripheral and pulmonary edema are observed. | It is of multifactorial cause. | The anemia associated with kidney failure can worsen the symptoms of heart failure. | Medicine | Its presence significantly worsens the prognosis and symptoms of heart failure and complicates its treatment. | 194 | 2 | a079d7bd-1a5d-41d3-ad0c-607dca85b53d | 2022 |
A 66-year-old woman with type 2 diabetes mellitus. Evaluating her kidney function, she presents a stage G3a/A1. What values does this stage correspond to, the most common in patients with diabetic nephropathy? | Glomerular filtration rate 30-44 ml/min/1.73 m2 and albuminuria < 30 mg/ml. | Glomerular filtration 45-59 ml/min/1.73 m2 and albuminuria < 30 mg/ml. | Glomerular filtration 15-29 ml/min/1.73 m2 and albuminuria < 30 mg/ml. | Medicine | Glomerular filtration 45-59 ml/min/1.73 m2 and albuminuria 30-300 mg/ml. | 195 | 1 | 09218b51-221c-4c02-b1b8-8e0cc28de7f7 | 2022 |
A 25-year-old woman is being studied for a liver disease of autoimmune origin, with significant cholestasis. She reports intense itching and the appearance of skin lesions suggestive of xanthomas. Total cholesterol levels of 800 mg/dL with LDL cholesterol 395 mg/dL. Indicate the correct answer regarding her disease: | It is essential to perform a genetic test to rule out familial hypercholesterolemia. | This is hypercholesterolemia secondary to cholestasis. | The elimination of cholesterol is primarily renal, so a primary cause of hypercholesterolemia must be ruled out. | Medicine | Given the total cholesterol and LDL cholesterol levels, it is a case of homozygous familial hypercholesterolemia. | 196 | 1 | de8ea278-4cd5-4dbf-8138-0eb8fc2e883c | 2022 |
A 30-year-old male presents with severe acute respiratory failure that requires orotracheal intubation upon his arrival in the emergency department and transfer to the ICU for invasive mechanical ventilation. A chest x-ray is performed which is consistent with respiratory distress. Which of the following statements best fits the clinical case?: | During the first seven days of progression, the proliferative phase usually occurs. | The most common cause is infectious. | The relationship between the partial pressure of oxygen and the inspired fraction of oxygen is greater than 300. | Medicine | It is characterized by an increase in lung distensibility. | 197 | 1 | 82b52d7c-929c-48c8-b467-9679135293aa | 2022 |
35-year-old woman, referred to the emergency department for head trauma due to a scooter fall, without loss of consciousness or amnesia. On examination, it is a closed head injury with concussion and mild headache without the presence of nausea and vomiting. The neurological examination is normal and she has a Glasgow score of 15. Given this situation, which imaging test is indicated first?: | Cranial CT scan with contrast. | Non-contrast cranial CT scan. | Simple skull X-ray. | Medicine | No imaging test. | 198 | 3 | 8796704d-1692-4c9a-b816-898d8609b76d | 2022 |
In relation to hemodynamic support in patients with septic shock, indicate the incorrect answer: | Fluids (crystalloids) should be administered at a rate of 30 ml/kg in the first hour of care. | Immediate hemodynamic control is essential for prognosis. | A noradrenaline infusion should be initiated if hemodynamic control (mean arterial pressure higher than 65 mmHg) is not achieved after the administration of fluids. | Medicine | Hydrocortisone should be administered if hemodynamic control has not been achieved after the first liter of crystalloids. | 199 | 3 | 1857ad8f-df60-413d-8971-7b160cd8e4a5 | 2022 |
An 83-year-old male with a history of hypertension, diabetes mellitus, and heart failure presents to the health center's emergency department with resting dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and malleolar edema for 24 hours' duration. Upon arrival, his EKG shows atrial fibrillation at 126 bpm and his clinical parameters are BP 79/47 mmHg, SatO2 89%, temperature 36.7ºC, and respiratory rate 26 rpm. Auscultation reveals bibasal crackles on both sides. He is given oxygen via a 50% Venturi mask, 20mg IV furosemide, and 2mg IV morphine. He will be transferred to the hospital on advanced life support where non-invasive positive pressure ventilation (CPAP) will be administered. What is the reason for applying the CPAP in this case?: | It is especially effective in patients with low blood pressure and cardiac rhythm disorders. | Increases the functional residual capacity of the respiratory system. | It causes an increase in the transmural pressure of the left ventricle. | Medicine | It produces an increase in intrathoracic pressure that increases cardiac preload. | 200 | 1 | 5252f6f7-a8e3-40d2-b876-c53eb1cceac0 | 2022 |
Indicate from among the following which etiological factor is not related or implicated in the pathogenesis of stress cardiomyopathy or tako-tsubo syndrome: | Increased susceptibility of the catecholaminergic receptors in the myocardium. | Microvascular dysfunction. | Significant obstructive coronary disease. | Medicine | Coronary spasm. | 201 | 4 | 85db9e7f-46c5-45fa-a121-783ad1aa059f | 2022 |
Which of these symptoms does not support the diagnosis of central vertigo due to a lesion in the brainstem? | The appearance of diplopia accompanying vertigo. | The presence of hearing loss and tinnitus accompanying vertigo. | That during the examination a vertical nystagmus is observed. | Medicine | The description of vertigo as a sensation of instability, it being less common for it to be a rotational vertigo. | 202 | 1 | c6ac82f5-b209-49ea-899c-ba6606ceac6e | 2022 |
The facioscapulohumeral dystrophy: | It more frequently affects women. | It is transmitted with an autosomal recessive trait. | It significantly shortens life expectancy. | Medicine | It affects the major pectoral muscle in early stages. | 203 | 3 | c1495ce8-7d1e-4f4e-9be2-47a2873741b2 | 2022 |
Regarding abdominal aortic aneurysms, indicate the false statement: | They are usually asymptomatic and incidentally diagnosed during imaging tests done for other reasons. | Surgical repair is indicated when the aneurysm's diameter exceeds 5-5.5 cm in diameter. | In case of rupture, urgent surgical treatment is indicated through open surgery or endovascular surgery. | Medicine | The most frequent complication is aneurysmal thrombosis. | 204 | 3 | 570e8e0c-b886-47c9-a866-e7239aff7b00 | 2022 |
61-year-old male, smoker and hypertensive, who goes to the emergency room due to sudden loss of strength and tingling sensation in his right hand lasting about 15 minutes, with almost complete subsequent recovery. ECG: sinus rhythm at 93 bpm. In relation to the most probable diagnosis, indicate the false answer: | The doppler ultrasound of supra-aortic trunks is of little use for diagnosis. | A probable cause is an arterioarterial embolism due to detachment of a carotid plaque. | Surgical treatment is indicated if imaging tests reveal a carotid stenosis >70%. | Medicine | It is necessary to perform a cranial CT scan to evaluate the impact on the cerebral parenchyma. | 205 | 2 | 469a941d-88f9-41e2-b276-d624ac070ac2 | 2022 |
In the case of a right pleural effusion with the following parameters: pH 7.49; proteins in pleural fluid 3.8 g/dl; LDH in pleural fluid 360 UI/L; serum proteins 5.9 g/dl; serum LDH 210 UI/L. We can affirm that we are facing a: | Pleural effusion of the exudate type, probably secondary to heart failure. | Pleural effusion of the transudate type, therefore it is necessary to treat the underlying cause. | The measured values are not credible and a new sample is required. | Medicine | Exudative type pleural effusion for which the cause must be investigated. | 206 | 3 | d2fccf06-2175-4b7a-8ca9-b123e1707d65 | 2022 |
In a bronchial asthma crisis, in the initial phase, arterial blood gas analysis usually shows: | Normal PaO2 with a decrease in PaCO2 and an increase in pH. | Normal pH and PaCO2 with a decrease in PaO2. | Increase in PaCO2 with a decrease in PaO2 and pH. | Medicine | Decrease in PaCO2 and PaO2 with an increase in pH. | 207 | 2 | aec4aee0-9b4b-4490-bb21-7f2cbe293ffe | 2022 |
A 53-year-old male with no significant medical history experiences lumbar pain after a wrong move at the gym. The pain radiates down to his right leg along the backside, reaching the lateral edge of the foot. Upon examination, a positive Lasègue's sign at 40° was noted, the Achilles reflex was absent, and he couldn't stand on tiptoe. The most likely etiological diagnosis is: | Right L3-L4 disc herniation. | Right L2-L3 disc herniation. | Right L5-S1 disc herniation. | Medicine | Right L4-L5 disc herniation. | 208 | 4 | 4bf2ee6d-7cb0-4ec5-9b9c-2b043342c8f3 | 2022 |
In an oral endoscopy of a patient with long-term heartburn, an ascending pink-flamed mucosa is observed without erosions or ulcers. Esophageal biopsies are taken which show the presence of metaplastic epithelium, with 3-4 eosinophils per field and without dysplasia. The most likely diagnosis is: | Eosinophilic esophagitis. | Barrett's Esophagus. | Los Angeles Grade B Esophagitis. | Medicine | Non-erosive gastroesophageal reflux disease. | 209 | 1 | b87cbe93-4f72-4fdc-b2fa-60c0d710c4cc | 2022 |
Indicate which of the following is not a usual manifestation of leptomeningeal metastases from carcinomas: | Hemiparesis. | Cervical radiculopathy. | Encephalopathy due to hydrocephalus. | Medicine | Cranial neuropathy. | 210 | 2 | 4e752de8-9957-4317-83cf-699942bb7256 | 2022 |
The metabolic adaptation at the start of intermediate fasting (beyond 24 hours) is accompanied by an increase in proteolysis and the release of amino acids from the muscle. In this situation, which of the following statements is true?: | The released alanine is absorbed by the liver for use as a gluconeogenic substrate. | Branched-chain amino acids are broken down in the liver. | Amino acids are largely used in the liver for the synthesis of plasma proteins. | Medicine | Glutamine is transformed into alanine in the enterocytes, generating ammonia and arginine. | 26 | 2 | f2a667d6-4c11-49f8-8dd3-1354bbe4ee77 | 2021 |
The 2,3-BPG (2,3-bisphosphoglycerate) is an organic compound that modulates the binding of oxygen to hemoglobin. This metabolite is synthesized in the red blood cells through a derivation of the glycolytic pathway. Indicate the false answer: | The presence of 2,3-BPG barely influences the oxygenation of hemoglobin at the level of the pulmonary capillaries under physiological conditions. | The concentration of 2,3-BPG in the red blood cells (usually close to 5 mM) increases in situations of hypoxia, severe anemia, and adaptation to high altitudes. | Fetal hemoglobin has a higher affinity for 2,3-BPG than hemoglobin A1. | Medicine | The addition of 2,3-BPG to stored blood for transfusions is ineffective. | 27 | 4 | 837e4d79-6095-48fd-8a4e-e46238e94ffc | 2021 |
Regarding the interrelationships between pressure, flow, and resistance in blood vessels, identify the incorrect statement: | In laminar flow, the flow speed in the center of the vessel is greater than at the outer edges. | Resistance is directly proportional to the pressure difference and inversely proportional to the flow. | If blood vessels are added in parallel in a circuit, the total vascular resistance increases. | Medicine | Small changes in the diameter of a vessel cause significant changes in its conductance. | 28 | 4 | e74d5e13-b3ac-4291-bd38-de53f559a24d | 2021 |
Regarding the self-regulation of glomerular filtration (GF) and renal blood flow (RBF) under physiological conditions, indicate the incorrect statement: | They self-regulate in parallel, but under certain conditions, the self-regulation of the FSR is more efficient. | The values of GFR and RPF remain relatively constant despite sharp changes in systemic blood pressure. | Angiotensin II exerts a preferential vasoconstrictor action on the efferent renal arterioles. | Medicine | The reduction of sodium chloride in the dense macula dilates the afferent arterioles and increases the release of renin. | 29 | 2 | 9c9ecfe0-f1ff-475d-b0b0-71f43d6a2deb | 2021 |
In a healthy person, standing upright, in relation to the ventilation-perfusion ratio, indicate the incorrect answer: | Capillary flow is lower in upper pulmonary areas. | Alveolar ventilation is higher in the upper areas of the lungs. | Alveolar ventilation is greater than capillary flow in upper pulmonary areas. | Medicine | Alveolar ventilation is slightly lower than capillary flow in lower pulmonary areas. | 30 | 1 | f6c578b0-90bc-4ef9-a1c1-bbf90e2e30ba | 2021 |
The result of a patient's arterial blood gas is: pH: 7.40, PaCO2 60 mmHg; bicarbonate 36 mM/L. What is the abnormality it shows?: | Respiratory acidosis. | None, the pH is normal. | Metabolic alkalosis. | Medicine | Respiratory acidosis and metabolic alkalosis. | 31 | 3 | 04d77a9f-4dd8-45e0-86ce-65a629e44193 | 2021 |
Which of the following consequences can a mutation of the G nucleotide to the A nucleotide in the first nucleotide of an intron have?: | Being a transition (the two nucleotides have the same structure) it does not have any repercussions. | As it is an intronic mutation, it has no repercussions. | The mutation in this nucleotide can affect the maturation of RNA (splicing) and change the structure of the RNA and, consequently, the protein. | Medicine | Although it is an intronic mutation, it causes the exclusion of all exons that are located behind the mutation. | 32 | 4 | e7aa0d86-672d-415b-b3cc-1081473b9e41 | 2021 |
When the same clinical picture (or with minor modifications) is caused by different mutations of the same gene, we refer to it as: | Allelic heterogeneity. | Locus heterogeneity. | Parental imprinting. | Medicine | Genetic heterogeneity. | 33 | 2 | 0aa17acd-1557-4e90-a43d-d46582312c33 | 2021 |
The SARS-CoV-2 is a single-stranded RNA virus. Among the mechanisms involved in the innate immune response against RNA viruses, such as SARS-CoV-2, are: | The production of gamma interferon by Th1 CD4+ lymphocytes after recognizing viral peptides in antigen-presenting cells. | The production of type I interferons after the recognition of viral RNA by pattern recognition receptors such as the Toll-like receptors (TLR) or the RIG-like receptors (RLR). | The cytotoxic activity mediated by CD8+ T lymphocytes after recognizing viral peptides in infected cells. | Medicine | The production of IgG type neutralizing antibodies produced in response to viral proteins. | 34 | 1 | 8a8f6b15-cb83-41af-b208-af90e03f982e | 2021 |
The receptors for the Fc fragments of the different classes of immunoglobulins (Ig) can be expressed in different types of cells that carry out effector functions. Indicate which of the following statements is false: | IgA binds to the poly-Ig receptor (pIgR) of the intestinal epithelium to reach the intestinal lumen. | IgG binds to the Fc-gamma receptor III (Fcgamma-RIII) on NK cells activating antibody-dependent cell cytotoxicity (ADCC). | The IgE binds to the Fc-epsilon (Fcepsilon-R) receptor on mast cells and induces their degranulation. | Medicine | The IgM binds to the neonatal Fc receptor (FcRn) in the syncytiotrophoblast to cross the placenta. | 35 | 3 | 1659f05c-9761-4f56-a741-8df85858312c | 2021 |
The PPSV23 pneumococcal polysaccharide vaccine generates a thymus-independent immune response against 23 subtypes of pneumococcus. Immunization with repeated doses of PPSV23: | It induces a secondary response with high levels of specific IgG. | It is indicated for children under two years old who are at risk. | It does not generate immunological memory. | Medicine | They induce maturation of the affinity of the generated antibodies. | 36 | 4 | 4fe8d451-0940-44ef-a3c7-ade8b15c1655 | 2021 |
In relation to immunotherapy based on T lymphocytes with chimeric antigen receptors (CAR) that recognize CD19 (CART19): | A serious side effect of this therapy is the cytokine release syndrome. | It is approved for the treatment of refractory or recurrent acute myeloblastic leukemia. | It is associated with permanent hypergammaglobulinemia due to chronic activation of CD19+ B lymphocytes. | Medicine | The CAR receptor recognizes CD19 in a manner restricted by the HLA. | 37 | 2 | bff6efa5-9782-4b24-8e2c-4116c88260ef | 2021 |
A 72-year-old patient arrives at the emergency room presenting with pronounced and significant lingual angioedema. The patient does not exhibit any associated hives and has no reported history of allergies to medications or food. Among his personal history, type 2 diabetes mellitus, dyslipidemia, high blood pressure, hypothyroidism, and Parkinson's disease stand out. He is regularly treated with metformin, simvastatin, enalapril, thyroxine, and levodopa. Which of the following drugs is most likely the cause of the clinical condition described? | Simvastatin. | Enalapril. | Levodopa. | Medicine | Metformin or levodopa equally. | 38 | 1 | 8d5f18bc-a4a7-4384-b2a2-7923c28c6a26 | 2021 |
Which of the following diagnostic criteria is considered a major criterion for making a diagnosis of systemic mastocytosis?: | Multifocal dense infiltrates of mast cells (>15 mast cells per aggregate) in bone marrow or other extracutaneous tissues. | Total serum tryptase higher than 20 ng/ml. | Altered morphology of mast cells (spindle-shaped, eccentric bilobed or multilobed nucleus, hypogranulated cytoplasm). | Medicine | Surface phenotype of abnormal mast cells with expression of CD25 or CD2 or both. | 39 | 2 | 71f69dae-40aa-4ae2-a25f-ab58bf9708e9 | 2021 |
I receive a call from a fellow graduate who works in another hospital. He requests information about a patient admitted to my hospital for whom he has been asked for a consultation in his specialty. As I know and can identify the physician asking me, the most appropriate action is: | Tell them that I have nothing to do with the patient and end the conversation. | Consult the patient's medical history and provide the information that they are asking for. | Send a written report of the patient to avoid giving information over the phone. | Medicine | Convey to the patient's responsible doctor the question from my colleague and put them in contact. | 40 | 3 | cc51a1a5-da65-4dd7-82c0-34a0bb2b4bfe | 2021 |
In a terminal patient, the omission or interruption of vital medical treatments, to allow the person to die (interruption of treatments that allow preserving life) is called: | Involuntary active euthanasia. | Voluntary active euthanasia. | Physician-assisted suicide. | Medicine | Passive euthanasia. | 41 | 3 | e4515e98-2099-48a6-a56b-680d6c9bdac2 | 2021 |
Which of the following answers is not true in relation to pain management in a cancer patient?: | Clinical trials show differences in efficacy and tolerability among different major opioids. | Transmucosal fentanyl (oral or nasal) is the drug of choice in the treatment of breakthrough cancer pain. | The efficacy of the World Health Organization (WHO) analgesic ladder is 80-90%. | Medicine | Opioid rotation or spinal analgesia are treatment measures for refractory pain. | 42 | 2 | f1c50cce-e45d-4363-ad3e-77db60c89046 | 2021 |
In a poisoning by organophosphorus insecticides, indicate the correct answer: | Death commonly occurs after a few minutes. | There is no absorption through the skin. | Its selective action is anticholinesterase. | Medicine | It begins with nicotine symptoms. | 43 | 4 | 1dafb36e-9acd-467c-8df1-ae50e96b28c9 | 2021 |
In which of the following plant poisonings should we consider an accidental etiology due to intentional use for recreational purposes?: | Thevetia peruviana (yellow oleander). | Taxus baccata (yew). | Aconitum napellus (aconite). | Medicine | Atropa belladona (scopolamine). | 44 | 3 | df7018ba-c0bd-473e-81d1-9239a4b0036e | 2021 |
In order to determine if the regular consumption of a Mediterranean-type diet is associated with a lower risk of non-fatal myocardial infarction, a group of subjects is selected, the degree of adherence to said diet is ascertained, and they are followed for 5 years to identify new cases of myocardial infarction. Indicate the correct answer about the design of this study: | It is a cohort study, because subjects are followed according to their exposure to identify the risk of a disease. | It is a clinical trial because it can guide prevention in the clinic. | It is a cross-sectional study because adherence to the Mediterranean diet is assessed at a specific point in time (at the start of the follow-up). | Medicine | It is an ecological study because a group of subjects is being followed. | 45 | 2 | 41f3e365-24c6-4838-9d87-c84b15b7f03f | 2021 |
A forest plot or forest diagram is: | A type of histogram that is used in systematic reviews of the literature. | A type of graphical representation of the results (for example, effect estimators) from a meta-analysis of clinical trials. | The flowchart of articles in a literature review. | Medicine | A way to present the modes of a non-normal distribution. | 46 | 1 | 8bc113ed-06e6-46ec-8347-7a83e669da14 | 2021 |
Clinical practice guidelines: | All of its content must be based on scientific evidence. | They are mandatory for all doctors. | These are recommendations that the doctor must adapt to the clinical situation of each patient. | Medicine | They should only take into account the health benefits of the patients (therefore, the cost of clinical interventions should not be considered). | 47 | 4 | a53f1e6a-ce97-4340-ab5b-85fddc5031cd | 2021 |
The objective of phase II clinical trials is: | Demonstrate the therapeutic effect. | Initial estimation of safety and tolerance. | Evaluate the occurrence of side effects. | Medicine | Obtain information on efficacy. | 48 | 3 | 3de471f9-ba86-4372-8735-da91282e2f1c | 2021 |
Which of the following diseases has the highest lethality? | COVID-19. | Stroke. | Bovine spongiform encephalopathy. | Medicine | Acute myocardial infarction. | 49 | 4 | 3be0a584-9b9d-410f-b180-8176eb4d5793 | 2021 |
Regarding the characteristics of a diagnostic test, indicate the correct answer: | The specificity is the ability of the test to correctly classify, with a negative result, the sick patients. | Predictive values depend on the prior probability of having the disease. | The positive predictive value indicates the probability that a patient with a positive result does not have the disease. | Medicine | Specificity is the ability of the test to correctly classify, with a positive result, those who are sick. | 50 | 1 | 388c7eba-e537-4cee-9291-b2f6d5a72e59 | 2021 |
Regarding chlorhexidine, indicate the correct answer: | It lacks activity against fungi. | It is a substance of the same chemical type as biguanides. | On mucous membranes and wounds, a 5% concentrated solution in water is used. | Medicine | It should not be used as an antiseptic. | 51 | 1 | ff9eb5ab-140d-45b2-abb8-fe7e13e7a2b8 | 2021 |
Regarding the probability quotients or likelihood ratios of a diagnostic test, indicate the incorrect response: | Diagnostic tests with probability ratios close to the value of 1 are not useful, as their results will not change the prior probability. | The odds ratio is established as the index that encompasses sensitivity and specificity and their complements. | The likelihood ratios indicate to what extent a certain result from a diagnostic test will increase or decrease the pre-test probability of a target disorder. | Medicine | The odds ratio of a positive test result indicates how many times more likely it is that the test will be positive in a person who does not have the disease than in a person who does have it. | 52 | 3 | 43db371b-dab8-4683-9c63-6a209b8594a4 | 2021 |
A 42-year-old woman goes to her family doctor's office for knee pain. The consultation is opportunistically used to assess lifestyle, especially smoking habits. If one wants to follow the health education strategy based on the model of the five "A's", which of the following is not included in this strategy? | Increase: enhance the perception of risk to facilitate change (explain the consequences of smoking). | Find out: ask about risk factors and behaviors (ask the patient if she smokes). | Agree: collaboratively negotiate the objectives for change (assess the availability to make an attempt to quit smoking). | Medicine | Advise: to give clear, specific, and personalized advice (advise quitting smoking). | 53 | 2 | 718f9eaf-5e5b-498f-99fb-f77311aedf0f | 2021 |
86-year-old woman in whom non-valvular atrial fibrillation has been detected. She has a CHADS2 score of 3 points. In the literature, similar patients treated with warfarin have a stroke risk of 2.2% compared to 5.2% in patients without warfarin. What would be the number needed to treat (NNT) to prevent an embolic stroke with anticoagulant treatment? | 19.2. | 3. | 49.5. | Medicine | 33.3. | 54 | 3 | 6a18dc9c-8e5e-47b5-ab63-3230b96c2c0f | 2021 |
When assessing the different pharmacotherapeutic alternatives for a patient with pain, what pharmacological parameter do you think will determine the maximum efficacy of the analgesic? | Its intrinsic activity. | Its potency. | Its affinity for the target site of action. | Medicine | Your therapeutic index. | 55 | 2 | d9dd99c8-8440-4e6b-ba91-078fe93e9978 | 2021 |
The ability of a medication to produce the desired effect under ideal use conditions is what we call: | Efficacy. | Effectiveness. | Intrinsic affinity. | Medicine | Pharmacological potency. | 56 | 2 | fb89beae-9ab5-45b7-88ac-dc36ed993fc8 | 2021 |
Which of the following situations is not an indication for direct oral anticoagulants?: | Treatment of pulmonary embolism. | Carrier of mechanical aortic valve prosthesis. | Prevention of stroke in non-valvular atrial fibrillation. | Medicine | Prophylaxis of venous thrombosis in the postoperative period of knee prosthesis. | 57 | 1 | 031db24d-e5f2-4f02-ae51-5fa65a37d449 | 2021 |
In a patient who presents with an ulcerative-vegetative lesion on the mandibular gum at the level of the molar region with a 5-month evolution, the appearance of hypoesthesia in the chin region requires ruling out: | The diagnosis of sarcoidosis with facial paralysis "on a seesaw". | A paraneoplastic neuropathy. | The diagnosis of carcinoma with infiltration of the mandibular canal. | Medicine | Herpes virus infection in immunocompromised patient. | 58 | 4 | b7ab0913-9ce1-430e-9129-ee5ecbcb32cc | 2021 |
In the case of a 9-year-old patient who has recently suffered direct trauma to the chin, and who is experiencing difficulty opening their mouth and dental malocclusion, we should rule out as the most probable diagnosis: | Comminuted fracture of both mandibular horizontal branches. | Lefort-1 type fracture. | Greenstick fracture in the symphyseal region of the mandible. | Medicine | Mandibular condyle fracture. | 59 | 3 | ba22d079-7341-4768-86a7-bb910f4292cf | 2021 |
In regards to the anatomy of the abdominal wall in relation to reconstructive surgery, it is false that: | After the dissection and rotation of a TRAM (transversus rectus abdominis musculus) flap, there is a weakening of the abdominal wall, especially above the arcuate line. | The innervation of the abdominal rectus muscles comes from nerves that run between the transverse abdominal muscle and the internal oblique muscle. | The rectus abdominis muscle can be used for the reconstruction of mediastinal defects. | Medicine | The irrigation of the rectus abdominis muscle mainly comes from the deep inferior and superior epigastric vessels. | 60 | 2 | 20173310-f397-4e3f-9356-8a46cfcaaf13 | 2021 |
Which of the following is not a risk factor for primary open-angle glaucoma?: | Having hypermetropia. | Take oral contraceptives. | That the siblings are diagnosed with glaucoma. | Medicine | Being of black race. | 61 | 2 | 81d53540-4431-4357-b366-06af6b2c1748 | 2021 |
A 3-year-old boy arrives at the emergency room with his parents because the boy has suddenly and abruptly exhibited high fever, chills, stridor, dyspnea, muffled voice, and drooling. What is the most likely suspected diagnosis? | Angioneurotic edema of the larynx. | Acute laryngotracheitis. | Epiglottitis. | Medicine | Acute Tonsillitis. | 62 | 4 | caf1564c-5281-4267-be5c-43cfdd611674 | 2021 |
A 56-year-old woman consulted because she has been experiencing, for the past 6 months, stammering speech, with ups and downs, as if strangled, and trembling in her voice. After laryngeal endoscopic examination, acoustic voice and speech analysis, the diagnostic suspicion is a laryngeal dystonia or spasmodic adductor dysphonia. Which of the following treatment proposals is indicated?: | Removal of the thyroarytenoid muscle. | Section of the inferior or recurrent laryngeal nerve. | Injection of botulinum toxin into the vocal cord muscle. | Medicine | Speech therapy treatment and administration of muscle relaxants. | 63 | 4 | c2ca4f53-bb12-4059-b2ad-6c8d5024c29d | 2021 |
Of the following elements, which would act as a protective factor against endometrial cancer? | Etonogestrel implant. | Late menopause. | Ovarian Endometriosis. | Medicine | Polycystic ovary syndrome. | 64 | 2 | 21fec954-38bd-4b80-851f-9f7e97ce720a | 2021 |
A 15-year-old woman comes to the clinic with intense pain at the start of her periods. The pain is located in the hypogastrium and radiates to the lumbar area. She often associates nausea and diarrhea; sometimes she can't go to school. The symptoms disappear by the end of her period. The result of the gynecological examination is normal as are the analytical values. Indicate the correct answer: | They prescribe hormonal contraceptives, but not NSAIDs due to the digestive clinic. | This is a case of dysmenorrhea secondary to a digestive problem. | He prescribes NSAIDs and, if there's no improvement, he could prescribe hormonal contraceptives. | Medicine | They prescribe NSAIDs and explain to her that hormonal contraceptives are not recommended in her case due to her age. | 65 | 4 | 34e9c6d0-b198-4451-a1a5-1d317fea38a1 | 2021 |
What would be the most advisable contraceptive method for a 37-year-old woman with no relevant medical history, who gave birth 4 months ago, has resumed her menstrual cycles, and is breastfeeding? | Intrauterine device with levonorgestrel. | None; breastfeeding, through the release of oxytocin, prevents pregnancy. | Combined hormonal preparations with third-generation progestogens. | Medicine | Hormonal preparations combined with 20 micrograms of ethinylestradiol. | 66 | 2 | ca2c2fc4-8c95-4bda-8b12-7f93682e13b3 | 2021 |
A 26-year-old woman, with a history of a pregnancy at 24 years old that ended in a spontaneous miscarriage at the 12th week which did not require curettage, comes to the clinic presenting with daily vaginal bleeding for a month, without fever or pain. Ultrasound shows an increase in the endometrial line, with an intracavitary image of a polypoid appearance. The endometrial biopsy shows proliferation of the intermediate trophoblast. What is the correct diagnosis? | Atypical endometrial hyperplasia. | Tumor of the placental bed. | Choriocarcinoma. | Medicine | Endometrial polyp. | 67 | 1 | c2c0aa24-2de1-48b4-86eb-0332fd1e6489 | 2021 |
Regarding hormonal therapy in menopause, indicate the correct answer: | The doses of estrogens administered in hormonal therapy should reach plasma levels similar to or higher than those achieved in a normal menstrual cycle. | Vaginal estrogens are an effective pharmacological treatment for urogenital symptoms. | In women with a uterus, systemic hormonal therapy with estrogen only is indicated. | Medicine | Tibolone is a drug indicated for women with a history of breast cancer and intense vasomotor symptoms. | 68 | 1 | 9a32085c-c109-4473-b497-80889429921b | 2021 |
Which of the following data is not useful for determining ovarian reserve?: | Basal serum anti-Mullerian hormone. | Basal serum progesterone. | Basal serum follicle-stimulating hormone. | Medicine | Ultrasound count of antral follicles. | 69 | 1 | 90d46144-b21f-4a76-a631-a692c4801455 | 2021 |
Which of the following factors does not increase the risk of breast cancer?: | Obesity. | Moderate alcohol consumption. | Late menopause. | Medicine | Fibrocystic breast disease. | 70 | 3 | e0616fa4-d126-4f7f-ae54-33122cf021e8 | 2021 |
A 31-year-old woman goes to her family doctor to inform him that she is pregnant. She has no relevant medical history. She is advised to get screened for gestational diabetes. When should this test be done?: | Between weeks 16 and 20 of gestation. | Between weeks 12 and 16 of gestation. | Between weeks 32 and 38 of gestation. | Medicine | Between weeks 24 and 28 of gestation. | 71 | 3 | 3f450770-636f-4a0d-ba8b-347f462fddae | 2021 |
Regarding pregnancy in systemic lupus erythematosus, it is true that: | During pregnancy, outbreaks tend to be more frequent and severe. | Fertility is not affected. | A patient with anti-Ro antibodies and fetal AV block has a lower risk of presenting the fetal AV block in the next pregnancy. | Medicine | In the postpartum period, the disease usually does not reactivate. | 72 | 1 | c4582533-ff54-437a-b20a-3ce4d84bc465 | 2021 |
In congenital aganglionic megacolon (Hirschsprung's disease), all of the following characteristics are present, except for one. Indicate it: | The recto-anal inhibitory reflex is absent. | In the affected area, there is an increased concentration of acetylcholinesterase. | The presence of encopresis or fecal incontinence is common. | Medicine | The reference diagnostic tests are suction rectal biopsies. | 73 | 4 | acc54e23-118f-420b-9d07-26b8c936624d | 2021 |
A 9-year-old male presents with macroscopic hematuria, headache, and asthenia, with no abdominal pain or edema. There is a history of pharyngo-tonsillar infection 1-2 weeks prior. Serum C3 levels are decreased. Out of the following diagnostic options, indicate the most likely one based on its frequency and clinical presentation: | IgA nephropathy (Berger's nephropathy). | Membranous glomerulopathy. | Post-infectious acute glomerulonephritis. | Medicine | Membranoproliferative glomerulonephritis or mesangiocapillary. | 74 | 4 | 42b2eea7-d5e0-47c5-b491-78d2e8e23330 | 2021 |
Which of the following criteria is not characteristic of a simple febrile seizure in a child?: | Duration less than 15 minutes. | Generalized primary crisis. | There is no neurological focus. | Medicine | Recurrence in the first 24 hours. | 75 | 3 | 83ca5b05-6b43-4f7e-9400-7ea41ea6a5f8 | 2021 |
A 7-year-old girl comes to the clinic because her parents noticed her face turned red since the day before and in the last few hours they have noticed red spots on her body. Upon examination, she is not feverish, with no alterations in her tonsils and ears, and normal cardiopulmonary auscultation. She presents a confluent maculopapular rash on both cheeks, sparing the upper lip, resembling "slapped" face. On her chest, she presents a reticular, lace-like rash that is not itchy. What is the most likely clinical diagnosis? | Measles. | Chickenpox. | Sudden rash or 6th disease. | Medicine | Infectious erythema or 5th disease. | 76 | 3 | 9a6ad4a5-3bc6-4642-bf41-0b30b3aa47aa | 2021 |
A 4-month-old infant presents to the emergency room with vomiting and lethargy. On examination, significant decrease in consciousness level stands out, with an inability to wake up despite stimuli. Auxiliary examinations highlight the presence of anemia, retinal hemorrhages at the fundus of the eye, subdural hematoma in the cranial CT, and a fracture at the back part of the third rib. Which of the following diagnoses do you consider most likely responsible for these injuries?: | Multiple injuries due to falling from the crib. | Physical abuse. | Acute promyelocytic leukemia after performing bone marrow aspiration. | Medicine | Chest trauma in infant with coagulation disorder. | 77 | 1 | ea42ebae-40c4-49ab-8f7c-53968e117ee4 | 2021 |
Referring to epidemic parotitis in childhood, indicate the false response: | The mumps vaccine is included in the MMR (measles, mumps, and rubella) vaccine and the tetravalent vaccine and requires two doses. | The mumps virus only presents one immunotype and the human being is the only natural host. | Pancreatitis can occur in parotitis with or without clinical involvement of the parotid glands. | Medicine | Orchitis as a complication is more common in early childhood. | 78 | 3 | 1cfa5ffc-2ccf-4fbc-8da6-4602c92f00ee | 2021 |
Indicate the false answer regarding the clinic, diagnosis and treatment of cystic fibrosis: | Liver disease is independent of genotype, although it is more associated with pancreatic insufficiency and meconium ileus. | Fibrosing colonopathy is a consequence of chronic diarrhea due to insufficient doses of pancreatic enzymes. | In infants, it can manifest as hypochloremic metabolic alkalosis. | Medicine | The determination of fecal elastase 1 is the most useful test for the diagnosis of pancreatic insufficiency. | 79 | 1 | b1e78572-c2ec-4f24-a251-0a9c37dccd49 | 2021 |
In congenital adrenal hyperplasia due to the classic form of 21-hydroxylase deficiency, indicate the correct answer: | It usually manifests itself in the neonatal period with salt-wasting syndrome and virilization in girls. | There is a defect in the synthesis of androstenedione. | The levels of 17-OH-progesterone are decreased. | Medicine | Maintenance treatment with hydrocortisone monotherapy is sufficient to control salt loss. | 80 | 2 | 4df5cbc7-c6a6-4cda-a550-f73841ffef47 | 2021 |
Regarding Fanconi anemia, indicate the incorrect answer: | Skeletal malformations are typical. | Aplastic anemia is usually already present in the first few months of life. | Androgens usually produce a favorable but transient response. | Medicine | The transplant of hematopoietic progenitors is the curative treatment, but it does not eliminate the risk of cancer. | 81 | 1 | 2dea7ced-39b4-45f9-b431-468d010d0f12 | 2021 |
Subsets and Splits
No saved queries yet
Save your SQL queries to embed, download, and access them later. Queries will appear here once saved.