Revalida (Brazil Medical Diploma Revalidation Exam) · Clinical Medicine and Surgery

Internal Medicine and Emergencies

20 practice questions, each with the answer and an explanation.

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Random questions from this topic, one at a time. You see the answer and the explanation straight after each one.

All 20 questions

  1. A patient has an ST-elevation myocardial infarction and a hospital with a catheterisation laboratory is reachable within the recommended time. Which reperfusion strategy is preferred?
  2. In diabetic ketoacidosis with severe dehydration, what is the first treatment step?
  3. Which drug is the first-line treatment of anaphylaxis, and by which route?
  4. A healthy adult with non-severe community-acquired pneumonia is treated as an outpatient. Which drug is a standard first choice?
  5. A diabetic patient with hypertension and albuminuria needs an antihypertensive. Which class is preferred?
  6. A patient with atrial fibrillation is hypotensive, confused and has chest pain. What is the indicated treatment?
  7. A patient with renal failure has peaked T waves and serum potassium of 7.2 mmol/L. What is the first drug to give?
  8. A patient with acute pulmonary embolism has sustained hypotension (systolic below 90 mmHg) and right ventricular dysfunction on echocardiography. What is the best management?
  9. Which treatment is standard for an acute asthma exacerbation in the emergency department?
  10. A cirrhotic patient with ascites has fever and abdominal pain. Ascitic fluid shows 600 neutrophils/mm3. What is the best management?
  11. In the first hour of septic shock, which set of actions is recommended?
  12. Which drug is used to treat primary hypothyroidism?
  13. Which empirical regimen is appropriate for suspected community-acquired bacterial meningitis in an adult?
  14. A patient with cirrhosis presents with haematemesis and is haemodynamically unstable. Which combination is most appropriate?
  15. Which drug is commonly used for an acute gout flare in a patient without contraindications?
  16. Which drug class has been shown to reduce mortality in heart failure with reduced ejection fraction?
  17. A patient arrives 2 hours after the onset of right hemiparesis and aphasia. A non-contrast CT shows no haemorrhage. What is the treatment?
  18. A patient with diarrhoea has pH 7.25, HCO3 of 12 mmol/L and PaCO2 of 28 mmHg. By Winter's formula (1.5 x HCO3 + 8, plus or minus 2), what is the interpretation?
  19. Na 140, Cl 100 and HCO3 14 mmol/L in a patient with polyuria and vomiting. What is the anion gap and what does it suggest?
  20. What is the standard first-line regimen in Brazil for drug-susceptible pulmonary tuberculosis in adults?

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