tomshe/Internal_Medicine_questions_binary · Datasets at Hugging Face

question stringlengths 36 630	optionA stringlengths 3 173	optionB stringlengths 8 160	answer stringlengths 3 160	answer idx stringclasses 2 values
A woman presents to the E.R after a two-week upper respiratory system infection with chest pain and shortness of breath and with an ECG showing pulsus alternans. Blood pressure is 80/50. What is typical to find in the physical examination?	Systolic click	Neck vein congestion	Neck vein congestion	B
A patient with kidney failure comes to the ER with urgency and burning sensation on urination. On examination, fever 38 and flank sensitivity. How should the case be managed?	Urine cultures and treatment with gentamicin	Urine cultures and ceftriaxone treatment	Urine cultures and ceftriaxone treatment	B
A 25-year-old is usually healthy, presents with hypertension and potassium of 3.1-3.5 (normal values 3.5-5.2) in various tests. What is the most likely diagnosis?	Primary hyperaldosteronism	Cushing's syndrome	Primary hyperaldosteronism	A
A patient complains of palpitations and intolerance to heat, the TSH is 0.01(low), the suspicion of subacute thyroiditis is raised. What will confirm the diagnosis?	TPO Antibodies	Radioactive iodine uptake (RAIU)	Radioactive iodine uptake (RAIU)	B
A 27-year-old girl went through a dramatic and traumatic event during the Jerusalem Half Marathon. She collapsed due to cardiac arrest and had a full CPR. There is no record of the rhythm at the time of CPR, but the team that used the automatic defibrillator believes it showed ventricular fibrillation. Now she comes to the ER without complaints, a regular pace. No relevant family history, does not consume alcohol. On the echocardiogram, very poor right ventricular function. She underwent catheterization which demonstrated normal coronary arteries. she began receiving Metoprolol. What should be done further upon discharge?	ICD	Genetic testing	ICD	A
37 year old patient with active Crohn's disease for 7 years. Recently complains of weakness and fatigue and in addition a decrease in sensation in his legs and balance disorder. On recent blood tests RDW 22, MCV 90, Hb 10. Blood smears show hypersegmented neutrophils. What is most likely and how it should be treated?	Combination of iron deficiency and B12 deficiency - give intravenous iron and B12 by IM injection.	A combination of iron deficiency anemia and anemia of chronic disease - oral iron administration.	Combination of iron deficiency and B12 deficiency - give intravenous iron and B12 by IM injection.	A
68 year old patient, for the past two weeks he has been short of breath on exertion and had worsening of edema in his limbs. Describes chills, didn't measure fever. Has a history of ischemic heart disease. On TEE a week ago EF was 25% and there was a new finding of a mitral valve leak. Upon his arrival to ER he has fever of 38.2 and on physical examination there are Janeway lesions. Which of the following would diagnose endocarditis according to the Duke's criteria?	2 positive cultures of Proteus mirabilis	2 positive cultures of Strep bovis	2 positive cultures of Strep bovis	B
A 74-year-old man with a history of diabetes and hypertension comes to the emergency room at 3 in the morning with chest pains that appears while resting for the past two days. In the laboratory now troponin is 80 times above normal. On the ECG, ST depressions were observed in leads V4-V6, without ST elevations, even after connecting the rear/right leads. Assuming there is an indication for catheterization, how soon should it be performed?	Within two hours	Within 12-24 hours	Within 12-24 hours	B
A nodule was observed in the thyroid gland on an Ultrasound, what indicates that the finding is benign?	Cystic without a solid component	Microcalcifications	Cystic without a solid component	A
A 60-year-old patient with metastatic melanoma, receiving Pembrolizumab (anti-PD-1), is referred for medical examination due to severe weakness and low blood pressure. In the laboratory, low morning cortisol (87), low ACTH, TSH 1 (normal), low 4T, hyponatremia (120) High osmolality in urine. What is the likely diagnosis?	Addison secondary to metastases in the adrenals	Hypophysitis due to treatment with anti-PD-1	Hypophysitis due to treatment with anti-PD-1	B
A 70-year-old female patient is healthy with no previous fractures. On 5-years treatment with ALENDRONATE. Referred to you for further advice Recent bone density test - T Score in the spine -2, in the femoral neck -1.8, in the hip -1.5, in the distal third of the forearm -2.2. What would you recommend?	She is at increased risk of fracture, continue the treatment	She is at low risk of fracture, a therapeutic break can be recommended	She is at low risk of fracture, a therapeutic vacation can be recommended	B
Which of the following characterizes a patient with a suspected PTHrP-secreting adenocarcinoma of the lung?	High calcium, low phosphorus, low PTH, normal vitamin D	High calcium, high phosphorus, high PTH, normal vitamin D	High calcium, low phosphorus, low PTH, normal vitamin D	A
18 years old, started taking contraceptive pills based on a combination of Estrogen and Progesterone. Swelling of the lips appears once every few weeks Now presents with severe stomach pain. 0n the CT scan that was performed, extensive edema of the intestine was demonstrated. What is the most appropriate medical treatment?	Antihistamines	Icatibant - bradykinin antagonist	Icatibant - bradykinin antagonist	B
What is a clinical feature of chronic pancreatitis?	Chronic pain in the upper abdomen worsening with eating and weight loss	First pain in his life for 6 hours in the upper abdomen with an increase in amylase	Chronic pain in the upper abdomen with worsening eating and weight loss	A
For which of the following patients are the following lung function test results suitable (The results are given in percentages in relation to the expected age, height and sex). DLCO 95%, RV 75%, TLC 60%, FEV1/FVC 0.83, FEV1 73%, FVC 60%	A 45-year-old woman with a background of rheumatoid arthritis, when listening to the lungs dry whistling at the end of the expiration, changes in CT include severe fibrosis.	63 years old, in the background of amyotrophic lateral sclerosis on auscultation of the lungs, a diffuse decrease in air intake, on CT without notable findings.	63 years old, in the background of amyotrophic lateral sclerosis on auscultation of the lungs, a diffuse decrease in air intake, on CT without notable findings.	B
In which of the following situations will we take a sputum culture in a patient with community acquired pneumonia?	When the sputum is green	When there is a clinical suspicion of a resistant bacteria	When there is a clinical suspicion of a resistant bacteria	B
A 40-year-old man is admitted to the emergency department with fever and confusion. Creatinine 1.6, hemoglobin 10, platelets 95,000 were found in the laboratory. The blood smear shows Schistocytes. What is the mechanism of the disease he suffers from?	destruction of red blood cells in the spleen	Multiple multimers of von Willebrand	Multiple multimers of von Willebrand	B
A patient suffering from essential thrombocytosis with baseline values of 750,000 platelets.The patient is admitted to the emergency room with pneumonia. During hospitalization he receives prophylactic clexane subcutaneously. A week later he develops swelling and pain in his right leg. A proximal femoral DVT was found by duplex. 250,000 platelets were found in the laboratory, DDIMER 15 (normal range up to 0.5). What is the recommended treatment?	Dose increase to 1 Mg/Kg CLEXANE SC twice a day	FONDAPARINUX SC	FONDAPARINUX SC	B
How can metabolic acidosis caused by diarrhea be differentiated from RTA?	AG in urine	AG in the blood	AG in urine	A
What characterizes renal injury from contrast?	Recovery usually within a week	Fena > 2%	Recovery usually within a week	A
A patient with ankylosing spondylitis improves on NSAIDS, what would his physical examination show?	A decrease in spine flexibility in a Schober test	Tenderness in the Trochanteric bursae	A decrease in spine flexibility in a schober test	A
38 years old, 5 months after giving birth. For the past 3 months she has been complaining of wrist pain in CMCs, MCPs, and PIPs with morning stiffness for about an hour. On physical examination, symmetrical swelling in the joints. What is the diagnosis?	ankylosing spondylitis	Rheumatoid arthritis	Rheumatoid arthritis	B
What is the absolute indication for starting dialysis in a CKD level 5 patient?	Pericardial rub	Calciphylaxis	Pericardial rub	A
A patient is hospitalized with pneumonia, without any improvement after 3 days of macrolide + beta lactam antibiotic treatment, what should be done next?	Expanding the antibiotic treatment to fluroquinlones in order to cover HAP	Repeat assessment by chest x-ray	Repeat assessment by chest x-ray	B
What is the treatment for HEPATORENAL SYNDROME?	Furosemide and liquids IV	Vasopressin and albumin analog	Vasopressin and albumin analog	B
27 years old woman of Kurdish origin, first pregnancy, week 22. The laboratory found hemoglobin, 9.5, RDW 22, MCV 67. Tests results from one year ago - Hemoglobin 11 with 78 MCV. Which of the following is most likely and how would it be diagnosed?	The patient probably has iron deficiency. I can prove it with a ferritin test.	The patient probably has thalassemia, I can prove it by hemoglobin electrophoresis.	The patient probably has iron deficiency. I can prove it with a ferritin test.	A
A 30-year-old comes to the clinic with a high direct bilirubin, normal GGT/ALP/ALT/AST. What statement is correct?	If there is over 15% direct bilirubin, it is Dubin Johnson or Rotor	Suitable for a genetic disorder called Gilbert in which high direct bilirubin is seen as well as dark urine in acute situations	If there is over 15% direct bilirubin, it is Dubin Johnson or Rotor	A
A patient with known cirrhosis presents with bloody vomiting. What is the initial treatment?	Vasoactive medicine + antibiotics even before the gastroscopy	We will perform an urgent gastroscopy and then treat according to the etiology	Vasoactive medicine + antibiotics even before the gastroscopy	A
A chest X-ray shows pleural effusion on the right side.What is expected on physical examination?	Decrease in air flow and increase in fremitus	Decrease in air flow and dull percussion	Decrease in air flow and dull percussion	B
What is true about COPD exacerbation	Prolonged treatment with systemic steroids improves prognosis in severe exacerbations	Nasal intermittent positive pressure ventilation improves prognosis for patients with CO2 accumulation	Nasal intermittent positive pressure ventilation improves prognosis for patients with CO2 accumulation	B
A 52-year-old female patient with cirrhosis due to HBV, pleural effusion on chest X-ray. LDH in fluid 391 protein in fluid 1.7, LDH in the blood 430 (normal LDH is up to 100). Protein in the blood 2.3 What could be the etiology of his problem?	Worsening of heart failure	Non Hodgkin lymphoma	Non Hodgkin lymphoma	B
A patient with recurrent lung infections (3 in the last year that required antibiotic treatment).On CT - diffuse bronchiectasis is shown in both lungs. Which test can lead to a diagnosis of the problem:	Checking the level of immunoglobulins	Genetic testing for a mutation in the PKD-1 gene	Checking the level of immunoglobulins	A
A 40-year-old man went on a trip to Israel a month ago. During the trip he visited many caves and rivers. reported he was stung many times but had no rash. Since then, he has had recurrent febrile episodes, headaches, fatigue and reduced appetite. Physical examination: enlarged spleen, no futher findings. On laboratory tests AST & ALT are 2 times higher than normal. The patient was hospitalized for investigation and treatment. Blood smears reveals a spirochete. What did the most likly pathogen?	Borrelia persica	Brucella	borrelia persica	A
19 years old of Turkish-Iraqi origin.Since the age of 5 recurrent episodes of fever and abdominal pain lasting 48-72 hours. His brother and cousin have similar symptoms. What is the most significant complication of his disease?	Amyloidosis	Heart disease	Amyloidosis	A
A 50-year-old patient with heart failure, hypertension and diabetes, EF of 45%, HbA1c of 7%, resting heart rate of 64, blood pressure 120/80. On examination, there is no neck vein congestion, no edema. Treated with metformin, atorvastatin, metoprolol and Entrasto. What drug treatment should be added?	Nothing needs to be added	Empagliflozin	Empagliflozin	B
60 years old, with asthma that has been treated with LABA+ICS for the last 8 years, sometimes with a need for systemic steroids. Also suffering from chronic sinusitis. In the last two weeks he has been suffering from progressive weakness in his left hand and numbness in his right leg and a purpuric rash. On testing for eosinophils- 3000. what is true about his illness?	All patients have pANCA antibodies	The most common cause of death is cardiac	The most common cause of death is cardiac	B
A 65-year-old man with no known underlying diseases presents himself with a red and swollen big toe for the first time in his life. Rate his pain as 10/10. how will you manage this case?	NSAIDs	Alloporinol	NSAIDs	A
A 60-year-old female patient comes to the emergency department with claudication of the jaw, headaches for three weeks. Describes difficulty in raising her hands and combing her hair. On examination, swelling in the temporal region is seen. What treatment will we start in the emergency room?	Prednisone 5 mg	Prednisone 60 mg	Prednisone 60 mg	B
A lack of which of the following vitamins can cause anemia, abnormal gait, memory problems and loss of sensation while standing?	B12	Vitamin B3	B12	A
A 30 year old patient, normally healthy, without a family history of inflammatory bowel diseases, suffers from diarrhea, about five times a day for six months. What is the next recommended diagnostic test?	Antibodies to celiac disease	Colonoscopy	Antibodies to celiac disease	A
32 year old female, lives in Ma'ale Adumim, during the last week complains about weakness, fever up to 38, joint and muscle pain. Physical examinationis normal. She is generally healthy, apart from iron deficiency anemia attributed to severe menstrual bleeding. Leukocytes 1500 of which 200 lymphocytes, hemoglobin 10, platelets 135,000. What will your initial investigation include?	HIV test	Serology for leishmaniasis	HIV test	A

A woman presents to the E.R after a two-week upper respiratory system infection with chest pain and shortness of breath and with an ECG showing pulsus alternans. Blood pressure is 80/50. What is typical to find in the physical examination?

Systolic click

Neck vein congestion

B

A patient with kidney failure comes to the ER with urgency and burning sensation on urination. On examination, fever 38 and flank sensitivity. How should the case be managed?

Urine cultures and treatment with gentamicin

Urine cultures and ceftriaxone treatment

B

A 25-year-old is usually healthy, presents with hypertension and potassium of 3.1-3.5 (normal values 3.5-5.2) in various tests. What is the most likely diagnosis?

Primary hyperaldosteronism

Cushing's syndrome

Primary hyperaldosteronism

A

A patient complains of palpitations and intolerance to heat, the TSH is 0.01(low), the suspicion of subacute thyroiditis is raised. What will confirm the diagnosis?

TPO Antibodies

Radioactive iodine uptake (RAIU)

B

A 27-year-old girl went through a dramatic and traumatic event during the Jerusalem Half Marathon. She collapsed due to cardiac arrest and had a full CPR. There is no record of the rhythm at the time of CPR, but the team that used the automatic defibrillator believes it showed ventricular fibrillation. Now she comes to the ER without complaints, a regular pace. No relevant family history, does not consume alcohol. On the echocardiogram, very poor right ventricular function. She underwent catheterization which demonstrated normal coronary arteries. she began receiving Metoprolol. What should be done further upon discharge?

ICD

Genetic testing

ICD

A

37 year old patient with active Crohn's disease for 7 years. Recently complains of weakness and fatigue and in addition a decrease in sensation in his legs and balance disorder. On recent blood tests RDW 22, MCV 90, Hb 10. Blood smears show hypersegmented neutrophils. What is most likely and how it should be treated?

Combination of iron deficiency and B12 deficiency - give intravenous iron and B12 by IM injection.

A combination of iron deficiency anemia and anemia of chronic disease - oral iron administration.

Combination of iron deficiency and B12 deficiency - give intravenous iron and B12 by IM injection.

A

68 year old patient, for the past two weeks he has been short of breath on exertion and had worsening of edema in his limbs. Describes chills, didn't measure fever. Has a history of ischemic heart disease. On TEE a week ago EF was 25% and there was a new finding of a mitral valve leak. Upon his arrival to ER he has fever of 38.2 and on physical examination there are Janeway lesions. Which of the following would diagnose endocarditis according to the Duke's criteria?

2 positive cultures of Proteus mirabilis

2 positive cultures of Strep bovis

B

A 74-year-old man with a history of diabetes and hypertension comes to the emergency room at 3 in the morning with chest pains that appears while resting for the past two days. In the laboratory now troponin is 80 times above normal. On the ECG, ST depressions were observed in leads V4-V6, without ST elevations, even after connecting the rear/right leads. Assuming there is an indication for catheterization, how soon should it be performed?

Within two hours

Within 12-24 hours

B

A nodule was observed in the thyroid gland on an Ultrasound, what indicates that the finding is benign?

Cystic without a solid component

Microcalcifications

Cystic without a solid component

A

A 60-year-old patient with metastatic melanoma, receiving Pembrolizumab (anti-PD-1), is referred for medical examination due to severe weakness and low blood pressure. In the laboratory, low morning cortisol (87), low ACTH, TSH 1 (normal), low 4T, hyponatremia (120) High osmolality in urine. What is the likely diagnosis?

Addison secondary to metastases in the adrenals

Hypophysitis due to treatment with anti-PD-1

B

A 70-year-old female patient is healthy with no previous fractures. On 5-years treatment with ALENDRONATE. Referred to you for further advice Recent bone density test - T Score in the spine -2, in the femoral neck -1.8, in the hip -1.5, in the distal third of the forearm -2.2. What would you recommend?

She is at increased risk of fracture, continue the treatment

She is at low risk of fracture, a therapeutic break can be recommended

She is at low risk of fracture, a therapeutic vacation can be recommended

B

Which of the following characterizes a patient with a suspected PTHrP-secreting adenocarcinoma of the lung?

High calcium, low phosphorus, low PTH, normal vitamin D

High calcium, high phosphorus, high PTH, normal vitamin D

High calcium, low phosphorus, low PTH, normal vitamin D

A

18 years old, started taking contraceptive pills based on a combination of Estrogen and Progesterone. Swelling of the lips appears once every few weeks Now presents with severe stomach pain. 0n the CT scan that was performed, extensive edema of the intestine was demonstrated. What is the most appropriate medical treatment?

Antihistamines

Icatibant - bradykinin antagonist

B

What is a clinical feature of chronic pancreatitis?

Chronic pain in the upper abdomen worsening with eating and weight loss

First pain in his life for 6 hours in the upper abdomen with an increase in amylase

Chronic pain in the upper abdomen with worsening eating and weight loss

A

For which of the following patients are the following lung function test results suitable (The results are given in percentages in relation to the expected age, height and sex). DLCO 95%, RV 75%, TLC 60%, FEV1/FVC 0.83, FEV1 73%, FVC 60%

A 45-year-old woman with a background of rheumatoid arthritis, when listening to the lungs dry whistling at the end of the expiration, changes in CT include severe fibrosis.

63 years old, in the background of amyotrophic lateral sclerosis on auscultation of the lungs, a diffuse decrease in air intake, on CT without notable findings.

B

In which of the following situations will we take a sputum culture in a patient with community acquired pneumonia?

When the sputum is green

When there is a clinical suspicion of a resistant bacteria

B

A 40-year-old man is admitted to the emergency department with fever and confusion. Creatinine 1.6, hemoglobin 10, platelets 95,000 were found in the laboratory. The blood smear shows Schistocytes. What is the mechanism of the disease he suffers from?

destruction of red blood cells in the spleen

Multiple multimers of von Willebrand

B

A patient suffering from essential thrombocytosis with baseline values of 750,000 platelets.The patient is admitted to the emergency room with pneumonia. During hospitalization he receives prophylactic clexane subcutaneously. A week later he develops swelling and pain in his right leg. A proximal femoral DVT was found by duplex. 250,000 platelets were found in the laboratory, DDIMER 15 (normal range up to 0.5). What is the recommended treatment?

Dose increase to 1 Mg/Kg CLEXANE SC twice a day

FONDAPARINUX SC

B

How can metabolic acidosis caused by diarrhea be differentiated from RTA?

AG in urine

AG in the blood

AG in urine

A

What characterizes renal injury from contrast?

Recovery usually within a week

Fena > 2%

Recovery usually within a week

A

A patient with ankylosing spondylitis improves on NSAIDS, what would his physical examination show?

A decrease in spine flexibility in a Schober test

Tenderness in the Trochanteric bursae

A decrease in spine flexibility in a schober test

A

38 years old, 5 months after giving birth. For the past 3 months she has been complaining of wrist pain in CMCs, MCPs, and PIPs with morning stiffness for about an hour. On physical examination, symmetrical swelling in the joints. What is the diagnosis?

ankylosing spondylitis

Rheumatoid arthritis

B

What is the absolute indication for starting dialysis in a CKD level 5 patient?

Pericardial rub

Calciphylaxis

Pericardial rub

A

A patient is hospitalized with pneumonia, without any improvement after 3 days of macrolide + beta lactam antibiotic treatment, what should be done next?

Expanding the antibiotic treatment to fluroquinlones in order to cover HAP

Repeat assessment by chest x-ray

B

What is the treatment for HEPATORENAL SYNDROME?

Furosemide and liquids IV

Vasopressin and albumin analog

B

27 years old woman of Kurdish origin, first pregnancy, week 22. The laboratory found hemoglobin, 9.5, RDW 22, MCV 67. Tests results from one year ago - Hemoglobin 11 with 78 MCV. Which of the following is most likely and how would it be diagnosed?

The patient probably has iron deficiency. I can prove it with a ferritin test.

The patient probably has thalassemia, I can prove it by hemoglobin electrophoresis.

The patient probably has iron deficiency. I can prove it with a ferritin test.

A

A 30-year-old comes to the clinic with a high direct bilirubin, normal GGT/ALP/ALT/AST. What statement is correct?

If there is over 15% direct bilirubin, it is Dubin Johnson or Rotor

Suitable for a genetic disorder called Gilbert in which high direct bilirubin is seen as well as dark urine in acute situations

If there is over 15% direct bilirubin, it is Dubin Johnson or Rotor

A

A patient with known cirrhosis presents with bloody vomiting. What is the initial treatment?

Vasoactive medicine + antibiotics even before the gastroscopy

We will perform an urgent gastroscopy and then treat according to the etiology

Vasoactive medicine + antibiotics even before the gastroscopy

A

A chest X-ray shows pleural effusion on the right side.What is expected on physical examination?

Decrease in air flow and increase in fremitus

Decrease in air flow and dull percussion

B

What is true about COPD exacerbation

Prolonged treatment with systemic steroids improves prognosis in severe exacerbations

Nasal intermittent positive pressure ventilation improves prognosis for patients with CO2 accumulation

B

A 52-year-old female patient with cirrhosis due to HBV, pleural effusion on chest X-ray. LDH in fluid 391 protein in fluid 1.7, LDH in the blood 430 (normal LDH is up to 100). Protein in the blood 2.3 What could be the etiology of his problem?

Worsening of heart failure

Non Hodgkin lymphoma

B

A patient with recurrent lung infections (3 in the last year that required antibiotic treatment).On CT - diffuse bronchiectasis is shown in both lungs. Which test can lead to a diagnosis of the problem:

Checking the level of immunoglobulins

Genetic testing for a mutation in the PKD-1 gene

Checking the level of immunoglobulins

A

A 40-year-old man went on a trip to Israel a month ago. During the trip he visited many caves and rivers. reported he was stung many times but had no rash. Since then, he has had recurrent febrile episodes, headaches, fatigue and reduced appetite. Physical examination: enlarged spleen, no futher findings. On laboratory tests AST & ALT are 2 times higher than normal. The patient was hospitalized for investigation and treatment. Blood smears reveals a spirochete. What did the most likly pathogen?

Borrelia persica

Brucella

borrelia persica

A

19 years old of Turkish-Iraqi origin.Since the age of 5 recurrent episodes of fever and abdominal pain lasting 48-72 hours. His brother and cousin have similar symptoms. What is the most significant complication of his disease?

Amyloidosis

Heart disease

Amyloidosis

A

A 50-year-old patient with heart failure, hypertension and diabetes, EF of 45%, HbA1c of 7%, resting heart rate of 64, blood pressure 120/80. On examination, there is no neck vein congestion, no edema. Treated with metformin, atorvastatin, metoprolol and Entrasto. What drug treatment should be added?

Nothing needs to be added

Empagliflozin

B

60 years old, with asthma that has been treated with LABA+ICS for the last 8 years, sometimes with a need for systemic steroids. Also suffering from chronic sinusitis. In the last two weeks he has been suffering from progressive weakness in his left hand and numbness in his right leg and a purpuric rash. On testing for eosinophils- 3000. what is true about his illness?

All patients have pANCA antibodies

The most common cause of death is cardiac

B

A 65-year-old man with no known underlying diseases presents himself with a red and swollen big toe for the first time in his life. Rate his pain as 10/10. how will you manage this case?

NSAIDs

Alloporinol

NSAIDs

A

A 60-year-old female patient comes to the emergency department with claudication of the jaw, headaches for three weeks. Describes difficulty in raising her hands and combing her hair. On examination, swelling in the temporal region is seen. What treatment will we start in the emergency room?

Prednisone 5 mg

Prednisone 60 mg

B

A lack of which of the following vitamins can cause anemia, abnormal gait, memory problems and loss of sensation while standing?

B12

Vitamin B3

B12

A

A 30 year old patient, normally healthy, without a family history of inflammatory bowel diseases, suffers from diarrhea, about five times a day for six months. What is the next recommended diagnostic test?

Antibodies to celiac disease

Colonoscopy

Antibodies to celiac disease

A

32 year old female, lives in Ma'ale Adumim, during the last week complains about weakness, fever up to 38, joint and muscle pain. Physical examinationis normal. She is generally healthy, apart from iron deficiency anemia attributed to severe menstrual bleeding. Leukocytes 1500 of which 200 lymphocytes, hemoglobin 10, platelets 135,000. What will your initial investigation include?

HIV test

Serology for leishmaniasis

HIV test

A