San Lazaro Hospital Shifting Exam

Dengue hemorrhagic fever (if included in the choices, serum IgM)

Topics

Herpes (Tzanck smear)

A.

Definition of nosocomial infection and the most common mode of

transmission of nosocomial infection

Schistosomiasis (COPT, Kato-Kat)

Malaria (Thin and thick blood smear)
Diphtheria (culture of pharyngeal swab)

B.

What will you do if you will see a hyperlucency of the Right lung
field in chest x-ray of an 18 year-old male patient who while
playing basketball, suddenly developed pleuritic chest pain?
a.
Insert CTT

Cryptococcosis India ink stain of CSF ; CALAS

B. Drug of choice
-

know the steps in proper handwashing in correct sequence

know the IMCI guidelines in dehydration (including calculation of

fluid resuscitation)
-

Rabies category and post-exposure prophylaxis

Rabies Immune Globulin (in pedia, 20 IU/Kg BW)

Vaccine

A.
B.
C.
D.
E.
F.
G.

Pregnant with complicated typhoid fever - ceftriaxone

Pregnant with malaria - quinine
Clinical leptospirosis Pen G
Leptospirosis Pen G
Severe pneumonia Imipenem, cabapenem
Dengue Fever none
Tetanus Metronidazole

C. Give the etiologic organism and the drug of choice

Thai Red Cross (1-1-1-1-1) given ID

Day 0

Day 3

1. risus sardonicus Clostridium tetany Metronidazole

2. pertussis Bordetella pertussis Eryhtromycin
3. Acute parotitis Mumps virus (paramyxoviridae) supportive therapy

Day 7
4. diphtheria Corynebacterium diphtheriae Pen G

Day 28/30
5. Leptospirosis Leptospira interrogans Pen G

Day 90

Zagreb Protocol (2- 1 -1) given IM

Day 0

6. Schistosomiasis Schistosoma japonicum praziquantel

7. Measles Measles virus supportive treatment

Day 7

Day 21

The criteria of correct attachment of a breastfeeding babys mouth with

the mothers breast

8. Washerwomans hands Vibrio cholerae Fluoroquinolone

(Ciprofloxacin)
9. complictated Typhoid fever Salmonella typhi Ciprofloxacin
10. Dystentery Shigella flexneri/sonnei/ boydii Ciprofloxacin
11. Amoebiasis Entamoeba histolytica - Metronidazole

Chin of the baby attached to the chin of the mothers breast

Mouth of the baby is opened wide

The lower lip of the baby is sucked inward

There is more exposed areola above the babys upper lip.

Oral Medications:
Paracetamol 10-15 mkdose q4
Salbutamol 0.1 mkdose q6-q8
Matching type
Amoxicillin 20-40 mkd (0 mkd for otitis media)
A. Diagnostic test of choice
Leptospirosis (blood culture)
Typhoid fever (blood culture)
Cryptosporidiosis (stool)
Tetanus (clinical)
Rabies (FAT)
Pneumonia (chest x-ray)
Pulmonary tuberculosis (Sputum culture)

Ampicillin/Chloramp enicol/Cloxacill in 50-100 mkd (Ampicillin 100 mkd for

Haemophilus influenza, 200-400 for meningitis)
Cefalexin 25-50 mkd
Diphenhydramine: 3-5 mkd q6
Chlorphenamine maleate: 0.35 mkd
Metronidazole 10 mkd for amoebiasis, 5 mkd for giardiasis
Anti-TB meds:
INH 5-10 mkd

Rifampicin 10-15

a.
Breastfed babies
only

c. Vitamin K deficiency

b.

d. all of the above

e. A and C

Pyrazinamide 15-25
Ethambutol

Babies born in a hospital

15-25
_______ 3. When the head circumference is greater than the chest
circumference at 1 year old, it is an indication of:

Streptomycin 20-30

a.
b.

IV
Penicillin G 200,000 Ukd q4-q6

Cerebral palsy

c. Seizure disorder

Malnutrition

_______ 4. The most common clinical manifestation of Kwashiorkor is:

Ampicillin 100-200 mkd q6
a.

old mans facies

b.

edema

c. brittle hair

Gentamicin 4mkd
d. weight loss

Diphenhydramine: 1 mkd
_______ 5. Anthropometry involves:
a.

computing for daily caloric requirements

b.

measuring physical dimensions of the human body at different ages

c.

monitoring growth and development

Computation of Fluids

1.

Holiday Method
_______ 6. The EPI targets children:

a.
b.

Maintenance: makes up for urine output and insensible water loss

b.

1-6 years old

c. 0-12 months old

16 gtts/min
_______ 7. To ensure the potency of a vaccine from time of manufacture to
the time it is given, one should implement the:

insensible water loss = 400 x BSA

BSA = [ht (cm) x wt (Kg)]

a.

preservation chain

b.

refrigeration chain

c. cold chain

_______ 8. A completely immunized child in a health center setting means:

3600
Lindaus Method
Mild
3-5%
<2 years, <15 kg 50 mL/kg
> 2 years, > 15kg 30

3.

0-12 years old

TFR = 1600 mL/day + 24 h = 0.66mL/h x 4- any factor

66 ugtts/hr

2.

a.

Moderate

Severe

6-9%
100
60

>10%
150
90

a.

vaccines under the EPI were given

c. MMR was given at 15 months

b.

BCG, DPT and Polio only were given

d. all of the above

_______ 9. Measles vaccine:

a.

is given at 0.5 ml

e. A and C only

b.

is injected IM (subcu)

d. all of the above

c.

may cause fever and rashes after

f. none of the above

few days

Nelsons

Maintenance Holidays, deficit Lindaus

_______ 10. Live vaccines can be given to:

a.

patients on chemotherapy

c. hemophilia patients?

b.

AIDS patients

d. patients on steroids

Revalida ata to...

NUTRITION/IMMUNIZAT ION:

Write check () for the true statement or zero (0) for the false statement.

______ 1. A type of anemia that shows macrocytic RBCs is seen in

deficiency of:
_____t__ 11. A 2year old infants height should be measured standing up.
a. Vitamin A

c. Vitamin B6

b.

d. Vitamin B12

Iron

_______ 2. Hemorrhagic disease of the newborn is seen in:

_____t__ 12. The head and chest circumference should also be included in the
anthropometric
data.
______t_ 13. Minimal clothing is required in weighing the child.

_____t__ 14. Multivitamins should be routinely given.

a.

March 15, 2006

c. Feb. 29, 2006

_____t__ 15. Breastfeeding is best up to 6 months of age.

b.

March 1, 2006

d. April 1, 2006

______ 28. The most common site of breast malignancy is at which quadrant?
PRIMARY OBSTETRICS/GYNECOLO GY

28 years old patient consulted because of vaginal spotting accompanied by

hypo gastric pain since 2 days PTC. LMP: _________ OB Hx: 1998TERM,
NSD; 1993, 94, 95abortions incomplete, completed by curretage; 1998
TERM, NSD, live girl; PH: March 2002 myomectomy; January 2000 Dx
Hyperthyroid; PPPE: BP 130/90; PR: 102/min RR: 30/min; HHENT: pink
palpable conjunctivae with anterior neck mass; Speculum exam ex. bluish
with minimal blood coming from the OS; whitish curd like discharge on the
lateral vaginal walls. IE Cx soft, long closed; uterus slightly enlarged;
adnexae (-) for mass/tenderness.

a.

right upper inner

b.

left lower inner

c. left upper outer

d. right lower outer

______ 29. During the rainy season the most common infection consulting at
the outpatient is:
a.

Bacterial

c. Parasitic

b.

Viral

d. Protozoal

______ 30. At the rural community, the most important preventive measure
against Pulmonary Kochs infection is:
a.

Prophylactic anti-B

c. environmental sanitation

b.

immunization

d. health education

______ 16. The bleeding in this case may be:

a. normal findings

c. incomplete abortion

b. ectopic pregnancy

d) threatened abortion

______ 31. Poisoning among farmers using fertilizer may best be prevented
by:

______ 17. The bleeding in this case may be managed by:

a.

proper hygiene

c. use of goggles and gloves

a. traditional birth attendant at home c. doctor at the district hospital

b.

using cap and mask

d. organic farming instead

b. midwife in the rural health unit

______ 32. To monitor if patients with serious illnesses are compliant with
medical advise, it is the responsibility of the doctor to:

d. referral to tertiary hospital

______ 18. The complete age of gestation is:

a. advise weekly visit to Center
a) 910 weeks b) 1112 weeks

c) 1011 weeks

c. send to UST hospital

d) 1213

weeks

b. track patients to see their status

d. refer to district hospital

19,20,21. Patient is high risk because: a. ____________ _________

_________ _____

______ 33. Since patients rarely consult at SMPCSMC for natural family
planning (NFP), we must:

b.__________ _________ _________ __ c. ____________ _________ __

a.

do house to house campaign

b.

give brochures to all our patients

______ 22. Whitish curd like discharge is most probably:

c.

create the opportunity to facilitate the NFP

a) bacterial vaginitis

d.

lecture to all the women in the Barangay

b) gonorrhea c) candidiasis

d) trichomoniasis

______ 34. The most common co-morbid condition why some children at the
nutrition program are slow to thrive is:

______ 23. Yellowish frothy vaginal discharge accompanied by vulvar

prunitis is:
a) gardnerella
vaginitis

b) moniliasis

c) trichomoniasis

d) bacterial

b) bacteria

c) fungus

d) protozoa

______ 25. Treatment for threatened abortion is:

a) curettage

b) syntocinon c) multivitamins

d) tocolytic agents

______ 26. To estimate the date of ovulation in a patient with regular 28-32
days cycle, it is important to observe the fertile cervical mucus that is usually
felt:
a.

14 days after the last period

b.

14 days before the next period

Primary complex

b.

Parasitism

c. Scabies
d. Upper Respiratory Tract Infection

______ 35. The Schistosomiasis discovered in a patient who consulted at the

SMPCSMC had a chief complaint of:

______ 24. Trichomoniasis is caused by:

a) virus

a.

c. anytime before the next period

a.

loss of weight

b.

pruritus

c. fever
d. edema

______ 36. The most widely used screening for MTB is:
a.

Chest X-ray, PA & Lateral

b.

Sputum microscopy

c. PPD
d. history and physical exam

______ 37. The final diagnosis of Julius Macawile, 37 years old, male, single,
was Pulmonary

d. near the midcycle

______ 27. The LMP of Mrs. Anita Garcia, 40, G6P4 (4014) is May 25-29,
2005. Her estimated date of confinement is:

Tuberculosis, Relapse, Return after Default, Treatment Category II. The

treatment regimen of which consist of:
a.

2 HRZE / 4 HR

c. 2 HRZ / 4 HR

b.

2 HRZES / 1 HRZE / 5 HRE

d. 2 HRZ / 1 HRZE / 5 HRE

A. The appropriate research design for the above scenario to determine the
magnitude of malnutrition and low IQ is:

______ 38. The most cost effective intervention for TB control is

_______51. case series
a. INH

c. BCG vaccine
_______52. experimental study

b.

DOTS

d. lifestyle improvement/ proper nutrition

_______53. cohort study

______ 39. Most common route of pneumonia infection is through:

_______54. cross-sectional study
a.

direct inoculation of the organism from an open wound in the chest

b.

blood contamination/ transfusion

c.

inhalation

_______55. case-control study

d.

B. The research question is the most important part of your research proposal
and

aspiration of organisms from the oropharynx

should contain the following:

______ 40. Atypical pneumonia:

_______56. biologic rationale

a. is a viral infection
b.

presents with sudden onset of fever, cold, cough

c.

has prominent pleuritic pains

d.

has malaise and other extra pulmonary symptoms

_______57. population
_______58. exposure/cause/ independent variable
_______59. outcome/effect/ dependent variable
_______60. study design

FAMILY MEDICINE
MULTIPLE CHOICE:

______ 41. Separation anxiety

a. nuclear family

______ 42. Consists of one generation

b. family tree

______ 43. Determines family resources available

a.

c. APGAR

______ 44. Shows dynamic interaction between family

relationship members
______ 45. Brought about by remarriage
family

______ 61. It is calculated in a case-control study:

d. functional

e. blended

incidence rate

b. relative risk c. prevalence

d. odds ratio

______ 62. This term determines which started first, the cause or the effect:
a. matching
randomization

b. temporal sequence

c. blinding

d.

______ 63. This timing or approach is preferred for making causal inferences:
______ 46. Comprehensive medical management for patient
health care plan and his family

f. family
a. retrospective
d. none of the

______ 47. Denotes hereditary illness in the family

history

g. medical

______ 48. Determines family function/dysfunctio n

lifeline

h. family

b. ambispective

c. prospective

above
______ 64. This is done in a case-control study wherein subjects are in two
groups to minimize variability:

______ 49. Index patient is indicated with an arrow

young children

i. family with

a. matching
randomization

______ 50. Parents and children living in one household

j. SCREEM

______ 65. The purpose of BLINDING is to achieve:

k. 1st order change

a. validity

b. temporal sequence

b. objectivity

c. blinding

d.

c. precision

d.

accuracy
l. none of the above
______ 66. A variable that distorts the apparent relationship between exposure
and outcome:

RESEARCH METHODOLOGY

a. independent var

b. dependent var

c. confounder var

d.

control var
______ 67. Characteristics of a cross-sectional study:

Scenario: As a medical student you were tasked to do a research on the

relationship between nutritional status and IQ levels among grade 2 students.
I.

Write check () for true statement or zero (0) for false statement.

a. subjects have rare diseases

c. incidence rate can be

measured
b. applicable for short duration diseases
magnitude of a disease

d. determines

______ 68. A measure of the precision of an instrument/tool:

a. accuracy

b. repeatability

______ 77. In a very sensitive test, it is more useful if the test result is
negative because:

c. both

d.

neither

a.

the patient can be excluded as having the disease

______ 69. One criteria for choosing a research topic is the serenity/gravity of
the problem and persons affected. It means:

b.

the patient can be included as having the disease

c.

it has high true positive rate

d.

it has high false negative rate

a. novelty
ethical issues

b. relevance

c. feasibility

d.

______ 70. The statement of the research Problem means:

______ 78. Positive predictive value of diagnostic test is affected by the

following:

a. first step in the development of a research project

b.

it is an integral part of selecting of a research project

c.

focusing the investigators chosen topic

d.

all of the above

a.

sensitivity

c. specificity

b.

prevalence of a disease

d. likelihood ratio

______ 79. The ideal diagnostic cut off value in a ROC curve with high
specificity and sensitivity is found near the:

______ 71. Elements of a research question is/are:

a. biological rationale

c. exposure and outcome

a.

upper left corner

c. under the curve

b.

upper right corner

d. left lower corner

are defined
______ 80. This is used to convert pre-test probability to post-test probability:
b. study population

d. all of the above

a.

positive predictive value

b.

prevalence of a disease

c. sensitivity

______ 72. Purpose of a comprehensive literature search is/are:

d. likelihood ratio

a. to elaborate on the significance of the study

______ 81. Odds ratio of 4 is equivalent to a probability of:
b. to cite similar studies done on the subject of interest
a. 80%
c.

to find

d.

all of the above

b. 20%

c. 75%

d. 25%

______ 82. Probability of 50% is equivalent to odds of:

a. 4

b. 3

c. 2

d. 1

______ 73. The term means unawareness of the true nature of treatment:
______ 83. Type II error is:
a. manipulation

b. randomization

c. masking

d. matching
a.

rejecting a false Ho

c. accepting a true Ho

b.

accepting a false Ho

d. rejecting a true Ho

______ 74. True of case-control studies:

a. there should be a disease no disease groups at the start of the
study

______ 84. P-value is compared with alpha, which of the following is true?
b. only the disease group should be included
c. very expensive
d. needs a large of sample population

______ 75. This characteristics is true of cohort studies:

a. subjects should have the outcome in generation
b. exposed and unexposed groups should be similar with regards
possible
confounding factors
c. there should be equal numbers of persons in both study groups
d. subjects to be chosen should have the outcome in question at the start of

a.

alpha should be greater than P-value to be significant

b.

alpha should be lower than P-value to be significant

c.

alpha is not related to P-value

d.

alpha value is the size of type I error

______ 85. Relative risk value of more than one means:

a.

treatment option A is the same as option B

b.

treatment option A is better than option B

c.

treatment option A is worst than option B

d.

treatment option A and B are not related

______ 86. Source of indoor air pollution:

the study
______ 76. An ideal diagnostic test/procedure should be able to transform
significantly the pre-test probability to the post-test probability. This is
achieved:
a. with high positive likelihood ratio
b. with low negative likelihood ratio

d. neither

c. both

a. environmental tobacco smoke (ETS)

b. criteria pollutants

c. hazardous pollutants
d. ozone

______ 87. Biological sources of indoor air pollution:

a. households pets

c. disinfectants

e. glues

b. smoking (ETS)

d. textile

c. cross-sectional study

______ 88. Primarily combustion-related products:

a. asbestos

d. cohort study

c. criteria pollutants

b. carcinogens

e. waste products

d. industries products

f. none of the above

______ 89. Binds to hemoglobin to reduce capacity of the blood to deliver

oxygen in the tissues:
a. nitrogen oxide

c. carbon monoxide

b. sulfur oxide

d. hydrogen peroxide

______ 90. Populations susceptible to air pollution:

a. asthmatics

c. elderly

e. all of the above

b. cigarette smokers

d. only A and C

______ 91. Food preservatives:

a.

nitrates and nitrites

c. metals

b.

ethylene dibromide

d. glass

e. all of the above

______ 92. Addition of poisonous or other deleterious ingredient, which may

render such article injurious to health:
a. bacterial food poisoning

c. adulteration of food

b. chemical food poisoning

d. food decomposition

______ 93. Diseases spread in milk:

a. salmonella

c. staphylococcus aureus

b. E coli

e. only A

d. all of the above

______ 94. Carcinogen found in tea:

a. caffeine

c. tannins

e. hydrazines

b. alcohol

d. aflatoxins

______ 95. Particle size that can be carried by diffusion to the alveolar level:
a. 10 um

c. 1-2 um
b. <10 um

e. 0.05 um
d. 0.5 um

MATCHING TYPE
______ 96. Matching is done in this study design
______ 97. The appropriate research design if all factors are
not known
______ 98. Describes
simultaneously

association

between

exposure

______ 99. The patients are survivors at a point or period

time
______ 100. The timing can be either prospective or
retrospective
a. case report
b. case-control study

e. experimental study

and disease