Which of the following are extrinsic causes of sinus bradycardia?
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a) hypothyroidism, b) intracranial hypertension, e) digoxin.
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Which of the following are extrinsic causes of sinus bradycardia?
a) hypothyroidism, b) intracranial hypertension, e) digoxin.
Which statement about type 2 diabetes is TRUE?
d) Type 2 diabetes can be diagnosed directly in the stage of chronic complications (e.g., diabetic retinopathy).
What fasting plasma glucose value indicates diabetes?
A single fasting plasma glucose value is ≥ 126 mg/dl, in the absence of symptoms of hyperglycemia.
What imaging technique is included in the diagnostic algorithm for a stable patient with pulmonary embolism?
Lung radiography.
What is one medication used in the treatment of hypertrophic cardiomyopathy?
Verapamil.
Which of the following drugs are oral direct factor Xa inhibitors?
d) rivaroxaban, e) apixaban.
Which of the following is a chronic diabetic macrovascular complication?
Atherosclerotic cardiovascular disease (myocardial infarction, stroke, peripheral arterial disease).
What are the severe features of preeclampsia?
a) SBP >160 mmHg or DBP >110 mmHg, b) platelets < 200,000 /mmc, c) increased creatinine.
When do most pregnant women experience nausea and vomiting?
In the first trimester of pregnancy.
What diseases of the exocrine pancreas can lead to secondary diabetes?
Pancreatitis, pancreatectomy, neoplasm, cystic fibrosis, hemochromatosis.
Is insulin secreted continuously in subjects without diabetes?
Yes, insulin is secreted 24 hours a day (basal and prandial insulin secretion).
What is a key characteristic of congenital rubella syndrome?
Includes cardiovascular abnormalities, CNS abnormalities, and deafness.
What is a true statement about fondaparinux?
It is excreted by the kidneys and cannot be used in patients with severe renal failure.
Which local factor influences systemic vascular resistance (SVR) and blood pressure?
Endothelin.
Which statement about vitamin K antagonists is wrong?
Prothrombin time is a more sensitive parameter than INR.
What characterizes third-degree atrioventricular block?
b) the QRS complexes of the ventricular escape rhythm are always wide.
What gastrointestinal side effects may patients experience while on metformin?
Nausea and diarrhea.
What is a common effect of lithium administration during pregnancy?
Ebstein anomaly.
What role do antibiotics play in liver disease?
They block bacterial translocation.
What is the therapy of choice for anticoagulation in pregnancy?
Low molecular weight heparin.
Which substances are frequently involved in increasing blood pressure?
Alcohol, NSAIDs, calcineurin inhibitors, and oral contraceptive pills.
What is a true statement regarding renal artery stenosis?
Patients may have a history of acute pulmonary edema with normal cardiac function.
What is the effect of Terlipressin on mortality in gastrointestinal rupture of esophageal varices?
It reduces mortality.
What impact does reducing salt intake to <6 g/day have on BP values?
It can reduce BP by approximately 5 mm Hg.
What is the dosing adjustment for Terlipressin after 48 hours of administration?
Reduced to 1 mg every 4 hours.
Which of the following is the wrong answer regarding cardiopulmonary resuscitation?
e) adrenaline (epinephrine) 10 mg should be administered if the patient presents asystole.
Does metformin stimulate insulin secretion?
No, metformin does not stimulate insulin secretion.
What causes Lymphogranuloma Venereum?
Chlamydia trachomatis.
Which of the following are part of 'the four Hs' (reversible causes of cardiac arrest)?
a) hyperkalemia, b) hypovolemia, d) hypothermia, e) hypoxia.
What is a significant risk factor for breast cancer related to family history?
Having a first-degree relative with breast cancer.
What is a common treatment for Precocious Puberty?
Antagonists of GnRH (gonadotropin-releasing hormone).
Which condition is a secondary endocrine cause of hypertension?
Acromegaly.
What is the correct diagnosis for a 53-year-old male with HbA1c = 5.3% and 2-hour plasma glucose = 148 mg/dl?
b) Impaired glucose tolerance.
What is a true statement regarding therapy in pulmonary embolism?
Administration of edoxaban and dabigatran is preceded by anticoagulation with low molecular weight heparin for 5 days.
Which statement about warfarin is wrong?
It does not pass into breast milk.
Which statement is correct regarding atrial fibrillation?
a) it is a common arrhythmia.
What is a key pathophysiological mechanism in the progression of liver disease?
The intestinal-liver axis.
What can cause hypoglycemia in patients on insulin therapy?
Physical exercise without additional carbohydrate intake or decreasing insulin dose.
What does a cervical length > 15 mm indicate?
It is associated with a very low risk of preterm birth.
What is the risk of viral transmission in utero for HIV infection?
95%.
What happens to cardiac output during pregnancy?
It increases by 20%.
What is the correct chronological order of events of normal female puberty?
c) adrenarche (adrenal androgen production), gonadarche (activation of gonads by FSH and LH), thelarche (appearance of breast tissue), pubarche (appearance of pubic hair), growth spurt, menarche (onset of menses).
What side effect may Terlipressin cause due to generalized vasoconstriction?
Abdominal pain.
What surgical procedure can be performed for hypertrophic cardiomyopathy?
Surgical septal myectomy.
What is a common misconception about metformin?
Metformin has a high risk of hypoglycemia and weight gain.
What characterizes type 1 diabetes?
The insulin secretion deficit is absolute, determined by the destruction of pancreatic beta cells by autoimmune mechanisms.
What is the maternal mortality rate in HELLP syndrome?
Approximately 1%.
What is a true statement about orthostatic hypotension?
It refers to a sustained decrease in BP of more than 20 mmHg for systolic BP, 3 minutes after switching to orthostatism.
What is a key characteristic of direct oral anticoagulants (DOACS) regarding their use?
They require a 5-day overlap with fractionated heparin.
What is one limitation of one-dimensional transient elastography (FibroScan) in liver cirrhosis?
It is achievable in only a small proportion of patients.
What hormone induces ovulation in the menstrual cycle?
Luteinizing hormone (LH).
What is an absolute contraindication for liver transplantation?
Identification of extrahepatic malignancies.
What is the initial dosing regimen for Terlipressin?
1 mg every 12 hours.
What should patients be informed about prior to any procedure or therapy?
Indications for treatment, alternative treatments and their risks, potential risks and benefits of the proposed treatment, and benefits of refusing treatment.
What is Naegele’s rule used for?
To estimate delivery date by taking the last menstrual period (LMP), adding 7 days, subtracting 3 months, and adding 1 year.
What is a characteristic of HELLP syndrome?
It is a form of preeclampsia.
Type 4b myocardial infarction is associated with which condition?
c) stent thrombosis.
What is the anticoagulation treatment recommended in the first 5-10 days for pulmonary embolism?
Fractionated heparin.
What are the two types of Precocious Puberty?
Isosexual and heterosexual.
What is an indication for liver transplantation related to acute liver failure?
Acute liver failure of any cause.
Which condition is NOT an indication for liver transplantation?
Primitive biliary cholangitis when serum bilirubin is constantly increased <20 μmol / L.
What is a characteristic finding in primary hyperaldosteronism?
Increased K+ levels and low aldosterone: renin ratio.
What is the initial treatment for acute variceal bleeding?
Restoring blood volume with plasma expanders or blood transfusions.
What is considered abnormal regarding menstrual intervals?
Menses within < 24-day interval are considered abnormal.
Do DOACs increase the risk of bleeding compared to low molecular weight heparin?
No, they do not increase the risk of bleeding.
What is the recommended duration of anticoagulation for cancer patients?
At least 6 months or until the cancer is in remission.
What is true about masked hypertension?
BP measured at the office is increased, while BP measured outside the office is normal.
What information are patients NOT entitled to be informed about?
The doctor's health condition.
What defines sustained ventricular tachycardia?
a) lasts more than 30 seconds, b) AV dissociation, c) wide QRS complexes.
Which of the following are antiplatelets used for the treatment of acute coronary syndromes?
a) ticagrelor, b) clopidogrel, d) heparin, e) fondaparinux.
What causes maternal nausea and vomiting during pregnancy?
Most likely increases in human chorionic gonadotropin (hCG) and may be related to an imbalance of progesterone and estrogen.
How does insulin affect hepatic glucose production?
Insulin inhibits hepatic glucose production (glycogenolysis, gluconeogenesis).
How is intestinal barrier function affected in advanced liver disease?
It is compromised.
What can lead to hypoglycemia related to insulin dosing?
Administration of higher doses of insulin than needed.
Which cancer is considered a risk factor for breast cancer?
Ovarian cancer.
What is a risk factor for breast cancer related to hormone exposure?
Increased estrogen exposure.
What is one reason for performing FibroScan in liver cirrhosis?
To avoid liver biopsy.
How does the risk of bleeding from thrombolysis compare to unfractionated heparin?
The risk of bleeding is similar.
What maternal complication can iron deficiency cause during pregnancy?
Maternal anemia.
What can indicate early stages of kidney disease in hypertension?
Increased microalbuminuria or urine albumin: creatinine ratio.
What is the effect of GLP-1 receptor agonists on insulin and glucagon secretion?
They increase insulin secretion and decrease glucagon secretion.
What are risk factors for osteoporosis?
b) advanced age.
What is a characteristic symptom of primary syphilis?
c) solitary chancre forms near area of contact.
Which statement regarding recommended glycemic targets in adult patients with diabetes is FALSE?
b) The HbA1c target is <6.5% in all patients with diabetes, regardless of the clinical and biological characteristics.
What is the first step in the diagnostic algorithm for a stable patient with suspected pulmonary embolism?
Wells score evaluation.
What is the recommended diagnostic approach for a patient with pulmonary embolism presenting with shock or hypotension?
Pulmonary angiography by CT.
Which endocrine diseases can induce secondary diabetes?
Acromegaly, Cushing's syndrome, glucagonoma, pheochromocytoma.
Can type 1 diabetes be diagnosed during chronic complications?
Yes, it can be diagnosed directly in the stage of chronic complications (e.g., diabetic retinopathy).
Is ultrasound measurement of cervical length useful to estimate the risk of preterm birth?
Yes, it is useful.
What diagnostic tool may be helpful for diagnosing Toxoplasma gondii infection?
Amniotic fluid PCR.
Can diabetic retinopathy be detected at the time of diagnosis in type 2 diabetes patients?
Yes, it may be detected.
What characterizes inflammatory carcinoma?
It is a subtype of ductal carcinoma characterized by rapid progression and angioinvasive behavior.
What is a key effect of Sodium-Glucose Cotransporter-2 (SGLT 2) inhibitors?
They increase urinary excretion of glucose and sodium.
What tests may be required to rule out cancer in cases of Abnormal Uterine Bleeding?
Endometrial biopsy.
What percentage of the population will develop venous thromboembolism during their lifetime?
5%.
What are strong risk factors for venous thromboembolism related to childbirth?
Birth and the postpartum period.
Which class of medication is commonly prescribed for hypertrophic cardiomyopathy?
Beta-blockers.
Which type of study can determine relative risk?
Cohort study.
What is the study power?
The ability of a study to detect an actual difference between two groups.
What is the most accurate method of determining gestational age in the second trimester?
Ultrasound (US) measurement of crown–rump length.
What is the clinical challenge of diagnosing Deep Venous Thrombosis (DVT) in pregnant patients?
Diagnosis may be more difficult due to edema.
What is the age threshold for the onset of pubertal changes in girls for Precocious Puberty?
Less than 13 years.
What is the primary treatment for diabetic ketoacidosis?
Correction of fluids and electrolytes deficit with 0.9% sodium chloride solution.
What happens if insulin flow is interrupted in patients using an insulin pump?
It can cause hypoglycemia due to lack of basal insulin storage.
How can high alcohol intake affect blood sugar levels?
High alcohol intake can lead to hypoglycemia.
What is ductal carcinoma in situ (DCIS)?
A condition where there are malignant cells in the ducts.
How can pregnancy affect diabetic retinopathy?
It may induce a short-term progression of retinopathy lesions.
What are some causes of secondary amenorrhea?
Gonadal dysgenesis, pregnancy, Asherman syndrome, anatomical abnormalities, Anorexia nervosa.
Do direct oral anticoagulants (DOACs) have similar efficiency to low molecular weight heparin?
Yes, they have similar efficiency.
What medications should be avoided in liver cirrhosis?
Aspirin and nonsteroidal anti-inflammatory drugs.
What characterizes acute hepatic failure on chronic liver disease?
High short-term mortality.
What mechanism compromises intestinal barrier function in advanced liver disease?
Activation of stellate cells.
Why are vasodilators contraindicated in acute coronary syndromes?
They can worsen the condition.
What is associated with Toxic Shock Syndrome?
Prolonged tampon use.
Is vancomycin contraindicated in Toxic Shock Syndrome?
Yes, vancomycin is contraindicated.
What is true about urinary copper in Wilson's disease?
Urinary copper is elevated.
What should be done for large or suspicious palpable breast masses?
Excisional biopsy.
What percentage of women experience severe symptoms of premenstrual syndrome (PMS) that interfere with daily life?
b) 5-10%.
What is a non-medication treatment option for hypertrophic cardiomyopathy?
Alcohol septal ablation.
Are vasodilators part of the treatment for hypertrophic cardiomyopathy?
No, they are not typically used.
What are the primary actions of metformin?
It decreases hepatic glucose production and increases insulin sensitivity.
What are the genetic defects that can induce specific types of diabetes?
MODY syndromes (Maturity Onset Diabetes of the Young).
What is the typical onset of type 1 diabetes?
The onset is sudden with severe signs and symptoms of hyperglycemia.
What are the possible effects of Cytomegalovirus infection in pregnancy?
Intrauterine fetal growth restriction (IUGR), deafness, hepatosplenomegaly, hydrocephalus.
What symptoms may occur due to orthostatic hypotension?
Dizziness and falling.
What is a biological criterion for severe diabetic ketoacidosis?
Arterial/venous pH < 7.00.
What role does follicle-stimulating hormone (FSH) play in the menstrual cycle?
Stimulates development of ovarian follicles and regulates ovarian granulosa cell activity.
What does FibroScan correlate with in liver cirrhosis?
The degree of portal hypertension.
Which statement about classes of eye damage in hypertension is incorrect?
Severe: signs of moderate retinopathy plus papillary edema.
What lifestyle change is recommended for patients with liver cirrhosis?
Avoiding alcohol.
What common screening labs are performed during the initial visit?
Blood antibody and Rh typing, quadruple screen, Pap smear, urinalysis, and hepatitis B surface antigen.
What maternal complications are associated with Pregestational Diabetes Mellitus?
Preeclampsia, fetal cardiac defects, maternal renal insufficiency, and diabetic ketoacidosis.
Which clinical manifestations are found in pulmonary embolism?
Pleuritic pain, hemoptysis, syncope.
What characterizes PCOS as a disease?
It is a hypothalamic–pituitary disease characterized by anovulation or oligoovulation.
What is useful in the treatment of Toxic Shock Syndrome?
Removing intravaginal objects.
What can cause isolated systolic hypertension?
Aortic insufficiency.
What can be used for prophylaxis in surgical interventions?
Direct Oral Anticoagulants (DOACs).
What is the treatment of choice for pheochromocytoma?
Surgical resection after adequate beta-blockade.
What are some risk factors for spontaneous abortion?
Increased maternal age, multiple prior births, uterine abnormalities.
Which factor do low molecular weight heparins inhibit more strongly?
Factor II.
What do direct oral anticoagulants (DOACs) inhibit?
Factors X or II.
What creatinine value is a marker of unfavorable prognosis in liver cirrhosis?
Creatinine value > 1.5 mg/dl.
What aspect of the portal vein system can ultrasonography evaluate?
The portal vein system.
Which of the following is NOT included in the etiological classification of diabetes mellitus?
c) Diabetes insipidus.
In which patients should Terlipressin not be used?
Patients with ischemic heart disease.
Which of the following drugs can be used to treat heart failure?
b) ivabradine, c) ramipril, d) bisoprolol, e) valsartan.
Which of the following are minor Duke criteria?
a) fever (over 38°C), b) Osler nodes, c) predisposing cardiac condition, d) Roth spots.
What is Valsartan classified as?
e) an angiotensin II receptor blocker.
What clinical feature is included in the Wells score for pulmonary embolism?
Heart rate >100/min.
What is the age threshold for the onset of pubertal changes in boys for Precocious Puberty?
Less than 9 years.
What is a potential consequence of diabetic retinopathy?
It can cause blindness.
What adverse effect is associated with warfarin during pregnancy?
Causes embryopathy between the 6th and 12th weeks.
What is the recommended method of insulin administration?
Subcutaneously using syringe, insulin pen, or insulin pump.
In Endometriosis, where is endometrial tissue found?
Outside the uterus.
What is a key treatment approach for liver cirrhosis?
Treatment of the root cause.
Which HPV types are significant risk factors for cervical cancer?
Persistent infection with HPV type 16 and 18.
What should be reduced in the diet of patients with liver cirrhosis?
Salt intake.
What parameters are predictors of mortality in liver transplant waiting list patients?
Serum creatinine, serum bilirubin, platelet count, alkaline phosphatase, and glycemia.
What is a common feature of acute hepatic failure in chronic liver disease?
The presence of organ failure.
What does an increase in D-dimers indicate?
It is not specific for venous thromboembolism.
What symptoms accompany a significant increase in BP in hypertensive emergencies?
Signs or symptoms of acute damage of the target organs.
Can pre-eclampsia occur at BP values above 140/90 mmHg?
Yes, it can.
How can infection from Pelvic Inflammatory Disease extend?
It can extend into the abdomen and cause inflammation of the renal capsule.
What device may be used for venous thromboembolism prophylaxis?
Intermittent pneumatic compression devices.
Is serum β-hCG useful in diagnosing ectopic pregnancy?
No, it is not useful.
What is true about serum alpha1 antitrypsin in alpha1 antitrypsin deficiency?
Serum alpha1 antitrypsin is low.
What is recommended for induction of labor at > 34 weeks’ gestation?
Terbutaline.
What risk do DOACs increase?
The risk of intracranial hemorrhage.
What are the threshold values for the diagnosis of grade 2 hypertension?
Systolic BP at the office = 140-159 mm Hg and Diastolic BP at the office = 90-99 mm Hg.
In which situation do D-dimers not rise?
Hepatic diseases.
What does sensitivity measure in a screening test?
The probability that a screening test will be positive in patients with a disease.
How is metabolic control evaluated in diabetes patients?
By dosage of HbA1c.
What is a correct statement about insulin?
Insulin is a hypoglycemic hormone.
Is metformin a first-line pharmacological agent for diabetes?
Yes, it is a first-line agent and can be initiated independently of eGFR.
Which is NOT a common cause of vaginal bleeding in early pregnancy?
Physiologic bleeding related to implantation.
Is the intestinal-liver axis involved in the development of cirrhosis complications?
No, it is not involved.
What is a correct indication for thrombolysis in venous thromboembolism?
It can be administered to patients with high-risk pulmonary embolism.
How can thrombolysis be administered?
By catheter infusion directly into the thrombus.
How does the risk of subsequent invasive cancer in DCIS compare to lobular carcinoma in situ (LCIS)?
The risk is higher in DCIS than in LCIS.
Which patient can be diagnosed with type 2 diabetes based on the provided information?
The 59-year-old female with obesity, fasting plasma glucose=156 mg/dL, and HbA1c=7.4%.
What fetal condition can result from iron deficiency in pregnancy?
Low birth weight.
How can glomerular filtration rate be estimated?
Based on urinary creatinine and demographic criteria.
What may indicate kidney disease in hypertension?
A difference in pulse or BP between the upper and lower limbs.
What is considered the best fourth-line drug for antihypertensive therapy?
Spironolactone.
What alteration affects intestinal motility in advanced liver disease?
Alteration of intestinal motility.
What imaging technique has replaced venography for deep vein thrombosis (DVT)?
Ultrasonographic evaluation.
What is the sensitivity of ultrasonography for diagnosing proximal DVT?
Very sensitive (>95%).
What is seen in Pelvic Inflammatory Disease regarding white blood cell count?
Low WBC (white blood cells) count is seen.
What are the most common causes of secondary hypertension?
Hyperthyroidism, obstructive sleep apnea syndrome, primary hyperaldosteronism, hypercortisolism, and obesity.
What ultrasound feature suggests a diagnosis of ectopic pregnancy?
Absence of the gestational sac in utero.
What might the clinical examination of pheochromocytoma reveal?
A vasculitic rash.
What percentage of pregnancies may result in spontaneous abortions?
Up to 50%.
When should diuretics be temporarily discontinued in liver cirrhosis with ascites?
In cases of increased serum creatinine.
What does ultrasonography assess regarding liver fat?
Fatty load of the liver.
Which EKG change is commonly associated with pulmonary embolism?
S1Q3T3.
What is the recommended treatment for DVT in pregnancy?
IV heparin dosed to maintain PTT at two times normal.
Which condition is more common in patients with orthostatic hypotension?
Conditions associated with autonomic neuropathies.
Is the administration of 10% glucose solutions recommended in diabetic ketoacidosis?
No, it is contraindicated.
What dietary factor can contribute to hypoglycemia after short-acting insulin administration?
Low or no carbohydrate intake.
What condition occurs in nondiabetic women during pregnancy?
Hyperinsulinemia with mild glucose intolerance.
What is the most common histological form of cervical cancer?
Squamous cell cancer.
What is a common place for porto-systemic collaterals to occur?
Gastroesophageal junction.
What is a benefit of GLP-1 receptor agonists?
They determine weight loss.
What vasodilator medications are initially given to patients with acute aortic dissection?
Nitroglycerin or nicardipine.
What can be concluded if D-dimers are below the reference value in a patient with an unlikely pulmonary embolism?
Pulmonary embolism may be excluded.
What is indicated for treating hypertensive emergencies?
Intravenous drug therapy.
What are the signs of acute aortic dissection?
Chest pain and difference in BP between the upper limbs.
Where does ectopic pregnancy most commonly implant?
In the cervical cavity.
What is unfractionated heparin (UFH) derived from?
A mixture of polysaccharides from porcine intestinal mucosa.
What does histological examination reveal in alpha1 antitrypsin deficiency?
Blood cells negative for PAS staining in periportal hepatocytes.
What are the most important risk factors for placenta praevia?
Nulliparity, prior cesarean section, prior placenta praevia, unicornuate uterus, history of uterine surgery.
Is diabetic retinopathy classified as a chronic macrovascular complication?
No, it is a microvascular complication.
What are the grading severities of diabetic retinopathy?
Non-proliferative, preproliferative, proliferative retinopathy, advanced retinopathy, and maculopathy.
What are classical symptoms of hyperglycemia?
Polyuria, thirst and polydipsia, weight loss.
What is the change in glomerular filtration rate during pregnancy?
It increases by 40%.
How is kidney disease related to hypertension?
It is both a cause and a consequence.
What are some adverse effects of SGLT 2 inhibitors?
Acute pancreatitis, pulmonary edema, genital candidosis, ketoacidosis.
Do GLP-1 receptor agonists have a high risk of hypoglycemia?
No, they generally have a low risk of hypoglycemia.
What medications are administered for pre-eclampsia in hypertensive emergencies?
Labetalol and intravenous magnesium.
What is required for patients with proximally-located acute aortic syndromes?
Early surgery.
What is the relationship between increased pulse pressure and vascular injury?
Increased pulse pressure is associated with increased vascular injury.
In which patients is prophylaxis indicated for venous thromboembolism?
High risk patients hospitalized for medical conditions.
What is useful for the diagnosis of pheochromocytoma?
Determination of plasma metanephrines.
What is the molecular weight range of unfractionated heparin?
3000-300000 daltons.
What usually causes first-trimester spontaneous abortions?
Fetal chromosomal abnormalities.
What appears on histological examination in alpha1 antitrypsin deficiency?
Diastase-resistant globules in periportal hepatocytes.
What condition indicates hypovolemia in liver cirrhosis?
It requires discontinuation of diuretics.
In which patients is FibroScan not used?
In patients with ascites.
How much does total body O2 consumption increase during pregnancy?
By 20%.
What are some target organ injuries induced by high blood pressure?
Retinopathy, hypertrophy of the right ventricle, kidney disease, and left ventricular hypertrophy.
What dietary restriction may be necessary for patients with liver cirrhosis and serum sodium > 128 mmol/L?
Water restriction.
What are some risk factors for venous thromboembolism?
Advanced age, major surgical intervention, heparin-induced thrombocytopenia, inflammatory bowel diseases, smoking.
What are useful paraclinical investigations for kidney disease in hypertension?
Renal ultrasound or immunological tests.
What is a characteristic of Polycystic Ovary Syndrome (PCOS) related to insulin?
Some patients may have hyperinsulinemia and an increased risk of insulin resistance.
Which antihypertensive therapy is recommended for elderly or black patients?
Calcium channel blockers.
What does ultrasonographic evaluation check for in veins?
Whether the vein is compressible and the presence of the thrombus.
What condition can malignant hypertension be associated with?
Acute renal injury.
What is indicated after major surgical interventions for venous thromboembolism?
Prophylaxis.
What are the clinical presentations of pheochromocytoma?
Palpitations, sweating, hypertensive attacks.
How is an unruptured ectopic pregnancy of < 6 weeks’ gestation treated?
With methotrexate.
What side effect can heparin cause?
Thrombocytopenia.
What is an option for expectant management in preterm labor at < 34 weeks’ gestation?
Expectant management itself.
Do DOACs require monitoring of the anticoagulant effect?
No, they do not require monitoring.
Is thrombolysis appropriate for intermediate-risk pulmonary embolism with right ventricular dysfunction?
Yes, it can be administered in this case.
What is a potential treatment for severe cases of Endometriosis?
Hysterectomy.
Which anticoagulant is more effective for patients with venous thromboembolism and cancer?
Fractionated heparin is more effective than oral vitamin K antagonists.
Which ultrasound measurements are used for gestational age assessment in the second trimester?
Fetal abdominal circumference, crown–rump length, biparietal diameter, fetal head circumference, and humerus length.
What prenatal assessment is performed for congenital diseases in high-risk pregnancies?
Amniocentesis and chorionic villi sampling.
Are all GLP-1 receptor agonists administered orally?
No, not all are administered orally.
What may increase in pulmonary embolism?
N T proBNP and troponin.
What can transvaginal ultrasonography detect in Pelvic Inflammatory Disease?
Tubo-ovarian abscess.
What symptoms can Lichen planus cause?
Pruritus, bleeding, dyspareunia, painful defecation, and dysuria.
Does a liver biopsy provide diagnostic input in Wilson's disease?
No, it does not provide diagnostic input.
Can renal biopsy provide additional information in pheochromocytoma?
No, it is not typically useful.
Is heparin-induced thrombocytopenia symptomatic?
No, it is asymptomatic and does not require discontinuation of treatment.
What is the half-life of low molecular weight heparins?
18 hours.
What is the bleeding risk of DOACs compared to heparin and warfarin?
Similar.
How does prothrombin time relate to the severity of liver cirrhosis?
It increases proportionally to the severity of the disease.
Which immunosuppressive therapy is commonly used after liver transplantation?
Tacrolimus.
Is thrombolysis administered for deep vein thrombosis without pulmonary embolism?
No, it is not administered in this case.
Do SGLT 2 inhibitors cause weight loss?
Yes, they determine weight loss.
What is the third leading cause of cardiovascular mortality?
Venous thromboembolism.
In what percentage of venous thromboembolism cases is the etiology unknown?
50%.
What type of cysts are associated with PCOS?
Large ovarian cysts.
What are contraindications for ACE inhibitors?
Bilateral renal artery stenosis.
What are the clinical signs of acute pulmonary edema?
Bilateral basal crackling rales and jugular vein turgor.
What are the symptoms of hypertensive encephalopathy?
Visual disturbances, headache, confusion.
Which statement about Wilson's disease is true regarding neurological symptoms?
Young adults have more frequent neurological symptoms.
In which conditions may CA-125 be increased?
Benign and malignant ovarian tumors, endometrial cancer, cervical cancer, endometriosis, and leiomyomatosis.
What is the effective treatment for chelating copper in Wilson's disease?
Penicillamine at a dose of 1-1.5 g daily.
What is the half-life of unfractionated heparin?
5 hours.
Do alpha1 antitrypsin levels vary by phenotype?
Yes, they vary by phenotype.
Is treatment with antibiotics recommended at > 34 weeks’ gestation?
No, it is not recommended.
What does a low sodium level indicate in liver disease?
It indicates mild liver disease.
What can ultrasonography detect in liver cirrhosis?
Hepatocellular carcinoma.
Should insulin therapy be recommended for all patients with type 1 diabetes?
Yes, it is recommended.
What should be evaluated in a patient with acute variceal bleeding?
Pulse, blood pressure, and state of consciousness.
What is a treatment option for carcinoma with microscopic invasion in cervical cancer?
Conization or total abdominal hysterectomy.
How long is anticoagulation prescribed after the first episode of pulmonary embolism?
At least 3 months.
What are the initial therapy options for hypertension?
One or two of ACE inhibitors/sartans, aldosterone antagonists, calcium channel blockers, loop diuretics, or thiazide-like diuretics.
What defines a hypertensive emergency?
Any increase in blood pressure over 180/120 mmHg.
What is the significance of the Keyser-Fleischer ring in Wilson's disease?
It is a specific sign of the disease.
What is used for prophylaxis in patients with medical conditions?
Vitamin K antagonists.
Is zinc acetate effective in treating Wilson's disease?
No, it is ineffective.
Can fibrosis and cirrhosis occur in alpha1 antitrypsin deficiency?
Yes, they can occur.
Can DOACs be given in severe kidney dysfunction?
No, they should be used with caution.
When should thrombophilia testing be considered?
In persons with unprovoked VTE, especially with a family history.
What is a condition associated with antiphospholipid syndrome?
Three or more miscarriages before the 10th week of pregnancy.
What immune function is suppressed in the intestine due to advanced liver disease?
The immune functions of the intestine.
What causes Pelvic Inflammatory Disease?
A progressive infection with N. gonorrhoeae or Chlamydia.
Does Pelvic Inflammatory Disease produce complications?
No, it produces no complications.
What is mandatory in managing a palpable breast mass in women younger than 30?
Reassessment following every menses.
What are the main causes of spontaneous abortions?
Abnormal placenta/abnormal umbilical cord.
Do low molecular weight heparins cause thrombocytopenia more or less frequently than unfractionated heparin?
Less frequently.
What condition related to the portal vein requires discontinuation of diuretics?
Portal vein thrombosis.
What is a sign that antiphospholipid syndrome should be sought?
Venous thromboembolism at a young age.
What treatments are administered intravenously in acute pulmonary edema?
Nitroglycerin and morphine.
What is a false statement regarding Toxic Shock Syndrome?
It is a severe systemic reaction to group B streptococcus (GBS).
What supportive care is needed in Toxic Shock Syndrome?
Supportive care for hypertension.
How does the treatment of isolated systolic hypertension differ from mixed hypertension?
It has a different treatment approach.
What happens to serum copper and ceruloplasmin levels in Wilson's disease?
They are elevated.
What imaging is recommended for palpable breast masses in younger women?
Bilateral breast ultrasound.
How is the dose of penicillamine adjusted in Wilson's disease treatment?
According to the level of urinary copper.
How do low molecular weight heparins interact with antithrombin?
They interact with antithrombin.
Does protamine sulfate completely inhibit the effect of low molecular weight heparins?
No, it does not completely inhibit their effect.
What are the best indicators of liver function in liver cirrhosis?
Serum albumin and bilirubin.
What can ultrasonography evaluate in liver cirrhosis?
Changes in the size and shape of the liver.
What is the risk of developing endometrial cancer in patients with PCOS?
Patients have a lower risk to develop endometrial cancer.
What does an ultrasound exam show in patients with PCOS?
Enlarged ovaries with multiple cysts.
What symptoms are associated with pre-eclampsia?
Visual disturbances, edema, newly installed proteinuria.
What causes isolated systolic hypertension?
Age-related arterial stiffness.
Is isolated systolic hypertension more common in young people?
No, it is more common in older adults.
What is a major risk factor for ectopic tubal implantation?
Pelvic inflammatory disease.
When is the treatment for Wilson's disease administered until?
Until the disappearance of neurological symptoms.
What tocolytic therapy is an option at < 34 weeks’ gestation?
MgSO4.
What is a reason to stop diuretics in liver cirrhosis?
The appearance of leg edema.
What is the use of Trientine in Wilson's disease?
It is used for asymptomatic cases.
What is a common cause of first-trimester spontaneous abortions?
Cervical insufficiency.
What is another situation to discontinue diuretics in liver cirrhosis?
Worsening of encephalopathy.
What albumin level indicates an unfavorable prognosis in liver cirrhosis?
Albumin level < 28 g/l.
