GMRC 4 Quiz


GMRC 4 QuizOnline version Core medicine topics for GMRC 4 by JENNA FIGUEROA 1 Which is the first-line treatment for stable hypertension in most adults? a Thiazide diuretics (e.g., hydrochlorothiazide) b Beta-blockers (e.g., metoprolol) c ACE inhibitors (e.g., lisinopril) d Calcium channel blockers (e.g., amlodipine) 2 In acute coronary syndrome, which biomarker is most specific for myocardial injury? a CK-MB b Myoglobin c BNP d Troponin I 3 Which antibiotic is preferred for community-acquired pneumonia in a previously healthy adult without comorbidities? a Amoxicillin b Ceftriaxone c Azithromycin d Levofloxacin 4 Which spirometry pattern is typical of obstructive airway disease? a Increased FVC with normal FEV1 b Normal FEV1 to FVC ratio c Increased FEV1/FVC ratio d Decreased FEV1 with reduced FEV1/FVC ratio 5 What is the initial management step in anaphylaxis? a Oral antihistamines b Intravenous fluids only c Intramuscular epinephrine 1:1000 d Bronchodilators inhalation therapy alone 6 Which lifestyle modification has the strongest evidence for reducing type 2 diabetes risk? a Vitamin supplements b Regular physical activity c Strict fasting d Low-protein diet 7 Which electrolyte disturbance is most dangerous post-seizure and requires urgent correction? a Hypercalcemia b Hyperkalemia c Hyponatremia d Hypophosphatemia 8 Which vaccine schedule is recommended for adults with no contraindications? a MMR booster monthly b Tdap once, then Td every 10 years c Tdap every year d HPV only after 50 years old 9 Which feature distinguishes bacterial meningitis from viral in adults? a Lymphocytic CSF with normal protein b Positive CSF glucose in bacterial meningitis c Low opening pressure in LP d Neutrophilic predominance in CSF with high protein 10 Which compensation mechanism occurs in metabolic acidosis? a Hyperventilation with decreased PaCO2 b Renal ammoniagenesis only c Hypoventilation with increased PaCO2 d Increased bicarbonate retention Feedback 1 ACE inhibitors are often first-line unless contraindicated; other options may be added based on comorbidity. 2 Troponin I is highly specific for myocardial injury and remains elevated longer. 3 Macrolides like azithromycin are commonly used in otherwise healthy adults; regional guidelines vary. 4 Obstructive diseases show reduced FEV1 and a reduced FEV1/FVC ratio. 5 Immediate IM epinephrine is life-saving; secure airway and call for help. 6 Exercise reduces insulin resistance and improves glucose tolerance. 7 Post-ictal hyponatremia can worsen cerebral edema; correct with caution. 8 Adults should start Tdap once, then Td every 10 years. 9 Bacterial meningitis typically shows neutrophils, high protein, low glucose. 10 To compensate metabolic acidosis, ventilation increases to lower CO2 (Henderson–Hasselbalch).

1

Which is the first-line treatment for stable hypertension in most adults?

a

Thiazide diuretics (e.g., hydrochlorothiazide)

b

Beta-blockers (e.g., metoprolol)

c

ACE inhibitors (e.g., lisinopril)

d

Calcium channel blockers (e.g., amlodipine)

2

In acute coronary syndrome, which biomarker is most specific for myocardial injury?

a

CK-MB

b

Myoglobin

c

BNP

d

Troponin I

3

Which antibiotic is preferred for community-acquired pneumonia in a previously healthy adult without comorbidities?

a

Amoxicillin

b

Ceftriaxone

c

Azithromycin

d

Levofloxacin

4

Which spirometry pattern is typical of obstructive airway disease?

a

Increased FVC with normal FEV1

b

Normal FEV1 to FVC ratio

c

Increased FEV1/FVC ratio

d

Decreased FEV1 with reduced FEV1/FVC ratio

5

What is the initial management step in anaphylaxis?

a

Oral antihistamines

b

Intravenous fluids only

c

Intramuscular epinephrine 1:1000

d

Bronchodilators inhalation therapy alone

6

Which lifestyle modification has the strongest evidence for reducing type 2 diabetes risk?

a

Vitamin supplements

b

Regular physical activity

c

Strict fasting

d

Low-protein diet

7

Which electrolyte disturbance is most dangerous post-seizure and requires urgent correction?

a

Hypercalcemia

b

Hyperkalemia

c

Hyponatremia

d

Hypophosphatemia

8

Which vaccine schedule is recommended for adults with no contraindications?

a

MMR booster monthly

b

Tdap once, then Td every 10 years

c

Tdap every year

d

HPV only after 50 years old

9

Which feature distinguishes bacterial meningitis from viral in adults?

a

Lymphocytic CSF with normal protein

b

Positive CSF glucose in bacterial meningitis

c

Low opening pressure in LP

d

Neutrophilic predominance in CSF with high protein

10

Which compensation mechanism occurs in metabolic acidosis?

a

Hyperventilation with decreased PaCO2

b

Renal ammoniagenesis only

c

Hypoventilation with increased PaCO2

d

Increased bicarbonate retention

Feedback

1

ACE inhibitors are often first-line unless contraindicated; other options may be added based on comorbidity.

2

Troponin I is highly specific for myocardial injury and remains elevated longer.

3

Macrolides like azithromycin are commonly used in otherwise healthy adults; regional guidelines vary.

4

Obstructive diseases show reduced FEV1 and a reduced FEV1/FVC ratio.

5

Immediate IM epinephrine is life-saving; secure airway and call for help.

6

Exercise reduces insulin resistance and improves glucose tolerance.

7

Post-ictal hyponatremia can worsen cerebral edema; correct with caution.

8

Adults should start Tdap once, then Td every 10 years.

9

Bacterial meningitis typically shows neutrophils, high protein, low glucose.

10

To compensate metabolic acidosis, ventilation increases to lower CO2 (Henderson–Hasselbalch).

GMRC 4 QuizOnline version

by JENNA FIGUEROA