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1. Which organ is most commonly injured in blunt abdominal trauma?
A. Liver
B. Kidney
C. Spleen
D. Small intestine
The spleen is the most commonly injured organ in blunt abdominal trauma due to its highly
vascular, fragile parenchyma and relatively exposed location in the left upper quadrant. Splenic
lacerations can cause life-threatening hemorrhage and may be managed conservatively or with
splenectomy depending on severity.
2. A patient reports sudden floaters followed by painless vision loss. What is the most likely
diagnosis?
A. Acute angle-closure glaucoma
B. Central retinal artery occlusion
C. Retinal detachment
D. Vitreous hemorrhage
Retinal detachment classically presents with photopsia (flashes of light), floaters (from blood or
debris), and then a 'curtain' or painless loss of visual field — progressing to complete vision loss.
,It is an ophthalmic emergency requiring prompt ophthalmology referral for surgical
reattachment (photocoagulation, cryotherapy, or vitrectomy).
3. What is the clinical term for implantation of an embryo outside the uterine cavity?
A. Placenta previa
B. Abruptio placentae
C. Ectopic pregnancy
D. Hydatidiform mole
An ectopic pregnancy occurs when a fertilized embryo implants outside the uterine cavity —
most commonly in the fallopian tube (95%). It is a life-threatening emergency because tubal
rupture causes massive internal hemorrhage. Classic presentation: amenorrhea, unilateral
pelvic pain, vaginal bleeding, and positive β-hCG. Tx: methotrexate (unruptured) or surgery
(ruptured).
4. A patient presents with high fever, cough, runny nose, red eyes, a blotchy rash, and tiny
white papules on the buccal mucosa. What is the diagnosis?
A. Rubella
B. Roseola
C. Scarlet fever
D. Measles (Rubeola)
Measles (Rubeola) follows the '3 Cs' prodrome: Cough, Coryza (runny nose), Conjunctivitis (red
eyes) — plus high fever. Koplik spots (tiny white papules on the buccal mucosa opposite the
molars) are pathognomonic and appear before the maculopapular rash spreads head-to-toe. It
is a notifiable, vaccine-preventable paramyxovirus infection.
5. Koplik spots are pathognomonic for which infection?
A. Rubella
B. Chickenpox (Varicella)
C. Measles (Rubeola)
,D. Roseola (HHV-6)
Koplik spots are tiny bluish-white papules on an erythematous base found on the buccal
mucosa (cheek lining), appearing 1–2 days before the measles rash. They are pathognomonic
for measles (Rubeola) and their presence enables early clinical diagnosis before the rash
appears.
6. Which bacterium is the most common cause of community-acquired pneumonia (CAP)?
A. Haemophilus influenzae
B. Klebsiella pneumoniae
C. Streptococcus pneumoniae
D. Mycoplasma pneumoniae
Streptococcus pneumoniae (pneumococcus) is the most common bacterial cause of CAP in all
age groups. It presents with sudden onset fever, productive cough (rusty sputum), pleuritic
chest pain, and lobar consolidation on CXR. First-line treatment for outpatient CAP includes
amoxicillin or a macrolide.
7. What is the first-line antibiotic treatment for Legionella pneumonia?
A. Amoxicillin-clavulanate
B. Ceftriaxone
C. Azithromycin (macrolide)
D. Vancomycin
Azithromycin (or a fluoroquinolone) is first-line for Legionella pneumonia. Legionella is an
atypical intracellular organism that does not respond to beta-lactams (no cell wall
susceptibility). Fluoroquinolones (levofloxacin, moxifloxacin) are equally effective. Legionella
pneumonia is associated with contaminated water systems and presents with GI symptoms,
confusion, and hyponatremia.
8. Which organism is most commonly associated with pneumonia in alcoholic patients?
, A. Streptococcus pneumoniae
B. Pseudomonas aeruginosa
C. Staphylococcus aureus
D. Klebsiella pneumoniae
Klebsiella pneumoniae is classically associated with pneumonia in alcoholics (and also in
diabetics and nursing home patients). Classic features: 'currant jelly' sputum (bloody, mucoid),
upper lobe consolidation with bulging fissure on CXR, and rapid cavitation. Alcoholism impairs
mucociliary clearance and cough reflexes, increasing aspiration and gram-negative infection risk.
9. What is the typical CSF profile seen in bacterial meningitis?
A. Low protein, high glucose, lymphocyte predominance
B. Normal protein, low glucose, mixed cells
C. High protein, low glucose, >250 PMN (neutrophil predominance)
D. High protein, high glucose, eosinophil predominance
Bacterial meningitis CSF: HIGH protein (>45 mg/dL — blood-brain barrier breakdown), LOW
glucose (<40 mg/dL or CSF:serum ratio <0.6 — bacteria consume glucose), and >250 WBCs with
PMN (neutrophil) predominance. Contrast with viral meningitis (normal glucose, moderate
lymphocytes, mildly elevated protein).
10. A child presents with a 'slapped cheek' rash. Which organism is responsible?
A. HHV-6 (Roseola)
B Varicella-Zoster Virus
C. Parvovirus B19 (Fifth Disease)
D. Group A Streptococcus
Parvovirus B19 causes Erythema Infectiosum (Fifth Disease) — classically presenting with bright
red 'slapped cheek' facial erythema followed by a lacy, reticular rash on the trunk and
extremities. It is generally mild in healthy children but dangerous in immunocompromised
patients (aplastic crisis) and pregnant women (hydrops fetalis).