ENAM Practice (Peru National Medical Examination) · Internal Medicine

Gastroenterology, endocrinology and nephrology

14 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 14 questions

  1. A 50-year-old man has burning epigastric pain relieved by food and a positive urea breath test. What is the appropriate treatment?
  2. A 45-year-old alcoholic man has abdominal distension, a tender abdomen and fever. Paracentesis shows 400 neutrophils per mm3. What is the diagnosis?
  3. A 35-year-old woman has fatigue, jaundice and elevated AST and ALT in the thousands after taking paracetamol in a suicide attempt. What is the antidote?
  4. A 28-year-old woman has bloody diarrhoea, tenesmus and continuous mucosal inflammation starting at the rectum. What is the most likely diagnosis?
  5. A 40-year-old man has epigastric pain radiating to the back, serum lipase of five times normal and gallstones on ultrasound. What is the diagnosis?
  6. A 24-year-old woman has polyuria, polydipsia, vomiting and a fruity breath. Glucose is 480 mg/dL with metabolic acidosis. What is the first step in management?
  7. A 55-year-old woman has fatigue, weight gain, cold intolerance and constipation. TSH is high and free T4 is low. What is the treatment?
  8. A 30-year-old woman has weight loss, tremor, exophthalmos and a diffuse goitre. Which antibody is typical?
  9. A 45-year-old woman has hypotension, hyperpigmentation, hyponatraemia and hyperkalaemia. What is the most likely diagnosis?
  10. A 60-year-old man with type 2 diabetes and normal renal function needs first-line oral therapy. Which drug is recommended?
  11. A 20-year-old man has facial oedema, hypertension and cola-coloured urine two weeks after a sore throat. Which finding is expected?
  12. A 5-year-old boy has periorbital oedema, albumin of 1.8 g/dL and proteinuria of 4 g per day, without haematuria. What is the most likely histology?
  13. A 60-year-old man has potassium of 7.2 mEq/L with peaked T waves. What is the first drug to give?
  14. A 70-year-old man has a rising creatinine after contrast and a urine sediment with muddy brown casts. What is the likely diagnosis?

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