Dip Int Med(SA) Practice Questions - Diploma in Internal Medicine of the College of Physicians of South Africa Dip Int Med(SA) Exam - Dip Int Med(SA) Practice Questions - Diploma in Internal Medicine of the College of Physicians of South Africa Dip Int Med(SA) Exam

Question 1

A 34-year-old HIV-positive man with a CD4 count of 45 cells/µL presents to a South African district hospital with a 2-week history of worsening severe headache, low-grade fever, and photophobia. On examination, he is confused with neck stiffness. Lumbar puncture shows an opening pressure of 32 cm H2O, and India ink staining of the CSF is positive for encapsulated yeast cells. According to current South African NDoH adult guidelines, what is the initial preferred induction therapy for this patient?

High-dose oral Fluconazole 1200 mg daily for 2 weeks IV Amphotericin B deoxycholate 1 mg/kg daily plus oral Flucytosine 25 mg/kg four times daily for 1 week IV Amphotericin B deoxycholate 1 mg/kg daily for 4 weeks as monotherapy Oral Voriconazole 400 mg twice daily plus IV Ceftriaxone 2 g daily for 2 weeks

Correct Answer:

IV Amphotericin B deoxycholate 1 mg/kg daily plus oral Flucytosine 25 mg/kg four times daily for 1 week

Question 2

A 42-year-old woman presents to the outpatient clinic for initiation of antiretroviral therapy (ART) in South Africa. Baseline laboratory investigations show HIV-1 positive status, CD4 count 210 cells/µL, serum creatinine 68 µmol/L (eGFR 98 mL/min/1.73m2), and negative HBsAg. According to the South African National Department of Health guidelines, what is the standard first-line ART regimen for this adult patient?

Tenofovir Disoproxil Fumarate (TDF) + Lamivudine (3TC) + Dolutegravir (DTG) Abacavir (ABC) + Lamivudine (3TC) + Efavirenz (EFV) Zidovudine (AZT) + Lamivudine (3TC) + Nevirapine (NVP) Tenofovir Disoproxil Fumarate (TDF) + Emtricitabine (FTC) + Atazanavir/ritonavir (ATV/r)

Correct Answer:

Tenofovir Disoproxil Fumarate (TDF) + Lamivudine (3TC) + Dolutegravir (DTG)

Question 3

A 58-year-old man with a history of long-standing hypertension presents to a district emergency unit with acute severe shortness of breath, orthopnoea, and pink frothy sputum. Blood pressure is 210/120 mmHg, heart rate 118 bpm, SpO2 82% on room air, and chest examination reveals bilateral extensive crackles to the mid-zones. What is the immediate first-line pharmacological treatment of choice?

IV Furosemide 40-80 mg bolus and sublingual/IV Nitroglycerin IV Digoxin 0.5 mg slow bolus and IV Amiodarone 300 mg Oral Amlodipine 10 mg and oral Enalapril 20 mg IV Adrenaline 1 mg bolus and IV Hydrocortisone 200 mg

Correct Answer:

IV Furosemide 40-80 mg bolus and sublingual/IV Nitroglycerin

Question 4

A 28-year-old pregnant woman (26 weeks gestation) is admitted to a district hospital with a severe asthma exacerbation. SpO2 is 90% on room air, peak expiratory flow rate (PEFR) is 40% of predicted, and she has marked intercostal retractions. In addition to high-flow oxygen and frequent nebulised Salbutamol, which systemic corticosteroid regimen is indicated?

Systemic corticosteroids must be strictly avoided during pregnancy due to teratogenicity Oral Prednisone 40-50 mg daily (or IV Hydrocortisone 100 mg 6-hourly) for 5-7 days Inhaled Fluticasone high-dose monotherapy without any systemic steroids Single dose of IM Dexamethasone 6 mg only for fetal lung maturation

Correct Answer:

Oral Prednisone 40-50 mg daily (or IV Hydrocortisone 100 mg 6-hourly) for 5-7 days

Question 5

A 62-year-old man with chronic kidney disease (baseline creatinine 180 µmol/L) presents with generalized muscle weakness. His ECG reveals tall, peaked T waves, broadened QRS complexes, and prolonged PR intervals. Serum potassium is reported as 7.2 mmol/L. What is the mandatory immediate first step in medical management?

Administer IV 10% Calcium Gluconate 10-20 mL over 5-10 minutes under ECG monitoring Administer oral Sodium Polystyrene Sulfonate (Resonium) 30 g Initiate IV Insulin 10 units in 50 mL 50% Dextrose over 15 minutes Perform urgent emergent hemodialysis without any medical temporizing measures

Correct Answer:

Administer IV 10% Calcium Gluconate 10-20 mL over 5-10 minutes under ECG monitoring

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Prepare with the Dip Int Med(SA) Practice Questions - Diploma in Internal Medicine of the College of Physicians of South Africa Dip Int Med(SA) Exam practice quiz. This question bank includes 100 questions covering year-old, presents, blood, mmol, and male. Use it to review important concepts, identify knowledge gaps, and build confidence for the related exam, course, or assessment.

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Dip Int Med(SA) Practice Questions - Diploma in Internal Medicine of the College of Physicians of South Africa Dip Int Med(SA) Exam

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Dip Int Med(SA) Practice Questions - Diploma in Internal Medicine of the College of Physicians of South Africa Dip Int Med(SA) Exam

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