Oman Medical Specialty Board Examination (OMSB) · Clinical Medicine And Surgery

Internal Medicine and Therapeutics

31 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 31 questions

  1. A 58-year-old male presents to the emergency department with severe retrosternal chest pressure lasting 45 minutes. His ECG shows 2.5 mm ST-segment elevation in leads V1 through V4. What is the immedi…
  2. A 64-year-old female with chronic heart failure with reduced ejection fraction (HFrEF 30%) is currently taking ramipril 10 mg daily and bisoprolol 10 mg daily. She remains in NYHA Class II. What medic…
  3. A 72-year-old male with hypertension and a prior ischemic stroke is diagnosed with non-valvular atrial fibrillation. His CHA2DS2-VASc score is 4. What is the recommended stroke prevention strategy?
  4. A 42-year-old previously healthy male presents with fever, productive cough with rust-colored sputum, and right lower lobe consolidation on chest radiograph. His CURB-65 score is 0. What is the first…
  5. A 68-year-old male with severe chronic obstructive pulmonary disease (COPD) presents with worsened dyspnea, increased sputum volume, and sputum purulence (Anthonisen Type 1 exacerbation). Blood gas sh…
  6. A 52-year-old male with known cirrhosis presents with hematemesis and melena. His blood pressure is 88/54 mmHg and heart rate is 118 bpm. Along with restrictive blood transfusion (target Hb 7-8 g/dL)…
  7. A 60-year-old patient with end-stage renal disease misses two hemodialysis sessions and presents with generalized weakness. Serum potassium is 7.4 mmol/L. The ECG shows peaked T waves, prolonged PR in…
  8. A 24-year-old female with type 1 diabetes presents with nausea, vomiting, abdominal pain, and Kussmaul respirations. Blood glucose is 420 mg/dL, arterial blood pH is 7.15, serum bicarbonate is 10 mEq/…
  9. A 35-year-old woman with Graves' disease develops high fever (39.8 degrees Celsius), severe tachycardia (160 bpm), agitation, and delirium following an acute dental infection. What is the priority mul…
  10. A 45-year-old traveler returning from East Africa presents with cyclic fevers, chills, diaphoresis, and splenomegaly. A peripheral blood smear demonstrates ring-form trophozoites within erythrocytes.…
  11. A 66-year-old male presents with sudden onset of right facial droop and right-sided arm and leg weakness. Symptoms started 75 minutes ago. Non-contrast brain CT excludes intracranial hemorrhage. Blood…
  12. A 32-year-old female presents with malar rash, photosensitivity, arthralgias, and pleuritic chest pain. Urinalysis reveals 3+ proteinuria and cellular casts. Serum antinuclear antibody (ANA) is positi…
  13. A 50-year-old farmer from the interior of Oman presents with undulant fever, profuse drenching night sweats, fatigue, and lower back pain. Blood cultures confirm Brucella melitensis. What is the stand…
  14. A 70-year-old male with chronic kidney disease (eGFR 22 mL/min/1.73m^2) has secondary hyperparathyroidism. His serum calcium is 8.4 mg/dL and serum phosphate is 6.8 mg/dL (elevated). What is the prefe…
  15. A 62-year-old male smoker presents with progressive exertional dyspnea and persistent dry cough. Physical exam reveals end-inspiratory 'velcro-like' crackles at both lung bases and digital clubbing. H…
  16. A 28-year-old medical resident suffers an accidental deep needle-stick injury from a patient known to be positive for hepatitis B surface antigen (HBsAg). The resident completed the full hepatitis B v…
  17. A 38-year-old female presents with recurrent severe headaches, sweating episodes, and palpitations. On exam, her blood pressure is 210/115 mmHg and pulse is 112 bpm. Suspicion for pheochromocytoma is…
  18. A 54-year-old male with chronic hepatitis C cirrhosis presents with fever and abdominal distension. Diagnostic paracentesis yields fluid with an absolute neutrophil count of 340 cells/mm^3 (0.34 * 10^…
  19. A 65-year-old woman presents with severe unilateral headache over the right temple, pain while chewing solid food (jaw claudication), and transient visual blurring in the right eye. Her erythrocyte se…
  20. A 48-year-old male presents with acute severe pain, swelling, and redness in his right first metatarsophalangeal joint (podagra). Arthrocentesis reveals needle-shaped, negatively birefringent crystals…
  21. A 29-year-old male with inflammatory bowel disease presents with severe bloody diarrhea (10 stools/day), tachycardia (110 bpm), fever, and marked abdominal distension. Plain abdominal radiograph shows…
  22. A 30-year-old female presents with severe generalized muscle weakness that worsens toward the end of the day and improves with rest. On exam, she has bilateral ptosis and diplopia. Edrophonium test te…
  23. A 63-year-old male with chronic alcoholism is admitted for severe pneumonia. Forty-eight hours after admission, he becomes agitated, tremors markedly, sweats profusely, and experiences visual hallucin…
  24. A 55-year-old male presents with painless gross hematuria. He has a 30-pack-year smoking history. Physical examination is unremarkable. Renal ultrasound reveals a 4.5 cm solid, vascular mass in the up…
  25. A 22-year-old male is admitted with fever, headache, photophobia, and neck stiffness. Cerebrospinal fluid (CSF) analysis reveals opening pressure 280 mm H2O, WBC count 2,400 cells/mm^3 with 92% neutro…
  26. A 44-year-old female with systemic hypertension is found to have hypokalemia (serum potassium 2.9 mmol/L) on routine laboratory testing. Plasma aldosterone concentration is elevated and plasma renin a…
  27. A 62-year-old male with long-standing poorly controlled hypertension presents with tearing retrosternal chest pain radiating into the interscapular region. Blood pressure is 194/110 mmHg in the right…
  28. A 52-year-old female presents with recurrent episodes of diaphoresis, severe palpitations, tremors, and confusion relieved promptly by ingestion of fruit juice. Laboratory evaluation during a 72-hour…
  29. A 48-year-old male presents with severe acute right flank pain radiating to the groin. Non-contrast helical CT reveals a 7 mm stone lodged in the distal third of the right ureter. The patient is comfo…
  30. A 36-year-old male is admitted with severe acute pancreatitis. On day 2, his vital signs are: BP 86/54 mmHg, HR 126 bpm, RR 28/min, temperature 38.6°C. Arterial blood gas on room air shows PaO2 55 mmH…
  31. A 70-year-old male with chronic obstructive pulmonary disease presents with progressive resting dyspnea and bilateral ankle edema. Examination reveals elevated jugular venous pulse, right ventricular…

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