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What is the key benefit to MRI?
  1. High detail of bone
  2. High detail of soft tissue
  3. Low costs
  4. Quick

High detail of soft tissue

What is the key drawback of CT scanning?
  1. Radiation exposure
  2. Expensive
  3. Time consuming
  4. They are sometimes invasive if contrast is used

Radiation exposure

Which of the following would appear most white on a x-ray?
  1. Hip prostheses
  2. Rib
  3. Vertebrae
  4. Femur

Hip prostheses
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Chronic hyperglycaemia directly contributes to all of the following problems EXCEPT:
  1. retinopathy
  2. nephropathy
  3. neuropathy
  4. hyperinsulinemia

Hyperinsulinemia

Which of the following is NOT a risk factor for type 2 diabetes?
  1. High blood pressure
  2. Ethnicity
  3. Low serum triglycerides
  4. Family history

Low serum triglycerides

Deep venous thrombosis may lead to which life-threatening condition?
  1. Superficial thrombophlebitis
  2. Varicose veins
  3. Pulmonary metastasis
  4. Pulmonary embolism

Pulmonary embolism

Which of the following statements is TRUE about the symptoms of dyslipidemia?
  1. Symptoms of the early stages of dyslipidemia often include pain in the chest
  2. Difficulty breathing is a common symptom of dyslipidemia
  3. Women have much more severe symptoms of dyslipidemia compared to men
  4. Dyslipidemia usually does not cause any direct symptoms

Dyslipidemia usually does not cause any direct symptoms

Which best describes the recovery after a stroke?
  1. A full recovery is always made with no impairments
  2. A person can have functional improvement after a stroke
  3. No recovery can be made after a stroke
  4. Hemorrhagic strokes have better recovery than ischemic strokes

A person can have functional improvement after a stroke

Stereotypically breast cancer will more likely have which combination of the following signs and symptoms?


  • Soft, painful, movable masses
  • Hard, painless, fixed and immobile masses
  • Dimpling of skin, mobile lumps, smooth and regular margins of the mass
  • Hard, painless masses, without bloody discharge from the nipple

Hard, painless, fixed and immobile masses



What is the most common form of noninvasive breast cancer?

  • Ductal carcinoma in situ
  • Inflammatory breast cancer
  • Lobular carcinoma in situ
  • Ductal carcinoma in vivo

Ductal carcinoma in situ

How are mutations in the BRCA1 and BRCA2 genes linked to breast cancer?

  • Their presence makes breast cancer more likely.
  • They're present in most cases of breast cancer.
  • Their presence makes breast cancer definite.
  • They're present in all cases of breast cancer.

Their presence makes breast cancer more likely

What is the main difference between invasive and non-invasive breast cancer?


  • Invasive breast cancer is malignant, while non-invasive breast cancer is not.
  • Invasive breast cancer has spread beyond the basement membrane, while non-invasive breast cancer has not.
  • Invasive breast cancer causes pain, while non-invasive breast cancer does not.
  • Invasive breast cancer has entered the milk ducts, while non-invasive breast cancer has not.

Invasive breast cancer has spread beyond the basement membrane, while non-invasive breast cancer has not

What is the most common form of Colorectal cancer?

  • An Adenoma
  • A Sarcoma
  • An Adenocarcinoma
  • A Polypoma

An Adenocarcinoma

Deep-red blood in the feces and tenesmus are signs of

  • cancer in the ascending colon
  • cancer in the transverse colon
  • cancer in the rectal part of the colon

Cancer in the rectal part of the colon

Which person has the highest risk of colorectal cancer?


  • A 60-y old woman with a low-fiber diet
  • A 60-y old male obese smoker
  • A 40-y old man with familial adenomatous polyposis (FAP)
  • A 40-y old woman with inflammatory bowel disease

A 40-y old man with familial adenomatous polyposis (FAP)

If a patient is undergoing chemotherapy for colorectal cancer, than what drug is used?

5-FU

After looking at the results of patient's blood test, their doctor suspected Colorectal cancer. How could the doctor confirm their suspicion?

By administering a Colonoscopy

Which of the following statements about polyps is TRUE?

  • They're malignant tumors.
  • They're early warning signs for colorectal cancer.
  • They don't arise from glandular tissue very often.
  • They're nothing to be worried about.

They've early warning signs for colorectal cancer

What are the top-3 reasons for visiting a general practitioner in the Netherlands?

  1. Depression, eczema, abdominal pain
  2. Common flu, headaches, cataract
  3. Low back pain, fatigue, cuts
  4. Hypertension, cystitis, diabetes mellitus

  1. Hypertension, cystitis, diabetes mellitus

What is the anamnesis of a patient?

  1. data on antropometry such as height and weight
  2. the preliminary diagnosis based on physical examination
  3. their cognitive performance
  4. their medical history

  1. their medical history

A physical examination of a patient may consist of:

  1. Inspection, auscultation, and palpation
  2. Family history, blood chemistry, urine testing
  3. Family history, medication, and percussion of the chest
  4. Urine testing, antropometry, and medication history


  1. Inspection, auscultation, and palpation

The diagnosis cataract is typically made in this age group:

  1. newborn babies during screening
  2. children attending primary school
  3. men between their 40s and 60s
  4. men and women aged 65 years and older

  1. men and women aged 65 years and older

Sudden onset of fever, shivering, generalized muscle and limb pain, headache, and cough are symptoms of:

  1. Influenza
  2. Rhinitis
  3. Pneumothorax
  4. Asthma

  1. Influenza


Which of the following is not a cause of osteoporosis?


  1. Hypothyroidism
  2. Estrogen deficiency
  3. Obesity
  4. Vitamin D deficiency

  1. Obesity

Which of the following is the most prominent sign of Parkinson’s disease?

  1. Impaired memory, forgetfulness
  2. Loss of the ability to speak and be understood by others
  3. Tremors during speech and walking
  4. Loss of the ability to plan tasks


  1. Tremors during speech and walking

Diabetes mellitus type 1 is charaterised by:

  1. hypoglycemia due to antibodies against pancreatic islet cells
  2. an increased insulin need while production is normal
  3. a normal insulin need while insulin production is absent
  4. ketoacidosis due to hyperglycemia


  1. a normal insulin need while insulin production is absent

Type 1 diabetes mellitus has an incidence in Europe of roughly

  1. < 1 per 1.000 population
  2. < 1 per 100.000 population
  3. 10-20 per 1.000 population
  4. 10-20 per 100.000 population

  1. 10-20 per 100.000 population

What is the reason that insulin cannot be administered orally?

  1. release from insulin from a tablet is too slow
  2. insulin is converted in the liver into an inactive form
  3. many people are intolerant to insulin when given by mouth
  4. insulin is degraded by protein enzymes in the gut

  1. many people are intolerant to insulin when given by mouth

A high HbA1C concentration in blood is a sign of

  1. an increased lifespan of the red blood cells which is seen when serum glucose concentrations are low
  2. a decreased lifespan of the red blood cells as glucose molecules have not yet been released from the cell surface
  3. good glycemic control: the right amount of insulin is used to prevent hyperglycemia
  4. insufficient glycemic control; the higher the blood glucose the higher the percentage of glycated hemoglobin in red blood cells

  1. insufficient glycemic control; the higher the blood glucose the higher the percentage of glycated hemoglobin in red blood cells

The main cause of type 2 diabetes is:

  1. overeating and a sedentary lifestyle
  2. consumption of sucrose and fructose
  3. pancreatitis
  4. smoking

  1. overeating and a sedentary lifestyle

When a patient is able to understand what is being said, but cannot respond in words, this is called:

  1. Paresthesia
  2. Dyspnoea
  3. Aphasia
  4. Dysphagia

  1. Aphasia

Which disease causes heartburn?

  1. Pancreatitis
  2. Gastritis
  3. Angina pectoris
  4. Gastro-Oesophagal-Reflux-Disease (GORD)

  1. Gastro-Oesophagal-Reflux-Disease (GORD)

Ulcerative colitis is characterised by:

  1. Flare-ups with diarrhea, high fever, and blood loss
  2. Jaundice, itchiness, and erythema nodosum
  3. Burning epigastric pain, breathlessness, and fatigue
  4. Heartburn, melaena, and vomiting of blood.


  1. Flare-ups with diarrhea, high fever, and blood loss

Crohn's disease is a chronic inflammation of:

  1. the gallbladder
  2. the bladder
  3. the gastrointestinal tract
  4. the oral cavity


  1. the gastrointestinal tract

Which of the following is the most likely factor to cause liver cirrhosis?

  1. Vitamin B12 deficiency
  2. Alcohol abuse
  3. Hepatitis A
  4. Genetic susceptibility

  1. Alcohol abuse

Formation or presence of gallstones in the gallbladder is called

  1. hepatitis
  2. cirrhosis
  3. cholelithiasis
  4. cholecystitis

  1. cholelithiasis

What is the cause of irritable bowel syndrome (IBS)?

  1. Gluten intolerance
  2. An overactive immune response
  3. Infection with Helicobacter pylori bacteria
  4. Unknown

  1. Unknown

Typical symptoms of peripheral artery disease are:

  1. Dry cold skin, without hairs, weak pulse at the ankles, and skin ulcers
  2. Muscle cramps in the legs during the night
  3. Swollen feet and ankles
  4. Varicose veins

  1. Dry cold skin, without hairs, weak pulse at the ankles, and skin ulcers

Stiffening of the arteries due to lipid accumulation followed by calcification of the vessel wall is called:

  1. Fibrosis
  2. Atherosclerosis
  3. Intima media thickness
  4. Vasculitis

  1. Atherosclerosis

Blood testing after a myocardial infarction will show an increased concentration of:

  1. Ketones
  2. Alkaline phosphatase
  3. Potassium
  4. Troponine

  1. Troponine

Who are most at risk for developing varicose veins?:

  1. A male marathon runner
  2. A male office worker
  3. A female hairdresser
  4. A female ice skater


  1. A female hairdresser

Which statement about intermittent claudication is wrong?

  1. It is pain affecting the calf and less commonly the thigh and buttock
  2. it is induced by exercise
  3. it Is relieved by rest
  4. it is typical for people with varicose veins

  1. it is typical for people with varicose veins

Main risk factors for peripheral arterial disease are:

  1. smoking, hypertension, and diabetes
  2. obesity, inactivity, and venous thrombosis
  3. low blood pressure and malnutrition
  4. overweight and use of betablockers


  1. smoking, hypertension, and diabetes


Tachycardia is the medical term for:


  1. Premature ventricular contractions.
  2. Hyperventilation .
  3. Palpitations
  4. Abnormally fast heart rhythm

  1. Abnormally fast heart rhythm

Which of the following types of cancer are in the world’s top 5

  1. Prostate cancer and leukaemia
  2. Skin cancer and lung cancer
  3. Lung cancer and breast cancer
  4. Colorectal cancer and stomach cancer


  1. Lung cancer and breast cancer

Which of the following are alarm symptoms for cancer?

  1. Low back pain and stiffness
  2. Hairloss and pale skin
  3. Unintended weight loss and changes in stool pattern
  4. Bleeding gums and slower wound healing


  1. Unintended weight loss and changes in stool pattern

The TNM-classification is used to describe tumours according to:

  1. their size and invasiveness
  2. their cell type and location
  3. the presence of blood vessels
  4. their tissue of origin



  1. their size and invasiveness

What are the most important causes of cancer?

  1. smoking and obesity
  2. alcohol and genetic predisposition
  3. air pollution and food additives
  4. smoking and alcohol


  1. smoking and obesity

If women want to decrease their risk of breast cancer, the best advice is to:

  1. use oral contraceptives
  2. quit or limit their alcohol intake
  3. increase their physical activity
  4. avoid sugar-sweetened beverages


  1. quit or limit their alcohol intake

Which respiratory disease has the largest mortality worldwide?

  1. Tuberculosis
  2. Chronic obstructive pulmonary disease (COPD)
  3. Asthma
  4. Lung cancer


  1. Chronic obstructive pulmonary disease (COPD)

This disease can be caused by bacteria, viruses, fungi, tumors, and aspiration:

  1. Pleuritis
  2. Tuberculosis
  3. Pneumonia
  4. Asthma

  1. Pneumonia

What is a typical characteristic of Chronic obstructive pulmonary disease (COPD)?

  1. Enlarged lung volume
  2. Fluid in the lungs
  3. Episodic high fever
  4. Tachycardia


  1. Enlarged lung volume

Smoking is an important risk factor for COPD. However, about 80% of smokers will not develop COPD. This can be explained by differences in:

  1. Type of tobacco use (cigarette, cigars, etc)
  2. Genetic susceptibility
  3. Age at which smoking was started
  4. Geographical region


  1. Genetic susceptibility

Fever is one of the main symptoms of:

  1. Pneumonia
  2. Pneumothorax
  3. Asthma
  4. COPD

  1. Pneumonia

In which patients does the use of a bronchodilator medicine improve lung function?

  1. patients with acute bronchitis
  2. patients with chronic bronchitis
  3. patients with asthma
  4. patients with pneumonia


  1. patients with asthma

Inhalation allergens and viruses can both be causes of

  1. Conjunctivitis
  2. Asthma
  3. Rhinitis
  4. Pneumonia

  1. Rhinitis

One-sided chest pain and difficulty to breathe in healthy young men is usually a sign of:

  1. Upper respiratory tract infection
  2. Acute bronchitis
  3. Pleuritis
  4. Pneumothorax

  1. Pneumothorax

Which disease is more common in international students than in Dutch students?

  1. Tuberculosis
  2. Asthma
  3. Acute bronchitis
  4. Pneumonia

  1. Tuberculosis

A loss of sensation in the arms and legs, tingling and numbness of the fingers and a burning sensation in the feet or hands are signs of :

  1. stroke
  2. polyneuropathy
  3. encephalitis
  4. duchenne muscular dystrophy

  1. polyneuropathy

Which neurological problem is not visible on a CT-scan?

  1. Brain infarction
  2. Brain tumour
  3. Cerebral bleeding
  4. Epilepsy

  1. Epilepsy

Which of the following is not a symptom of a brain haemorrhage?

  1. Dyspnoea
  2. Vomiting
  3. Severe headache
  4. Paralysis

  1. Dyspnoea

What is the most important risk factor for stroke?

  1. Hypertension
  2. Diabetes mellitus type 2
  3. Calcification of blood vessel walls
  4. Use of antithrombotic drugs

  1. Hypertension

Which terms are used to distinguish between different types of strokes?

  1. Haemorrhagic and ischaemic stroke
  2. Vascular and neurological stroke
  3. Central and peripheral stroke
  4. Type I and type II stroke


  1. Haemorrhagic and ischaemic stroke

Paralysis of the right arm and leg indicates problems in the

  1. left brain hemisphere
  2. right brain hemisphere
  3. spinal cord
  4. brain stem


  1. left brain hemisphere

Headache, stiff neck, vomiting and fever could be signs of...

  1. Subarachnoid bleeding
  2. Autonomic neuropathy
  3. Meningitis
  4. Tinnitus

  1. Meningitis

The most common cause for obesity is

  1. Overeating and a sedentary lifestyle
  2. Genetics
  3. Medication
  4. Metabolic disease


  1. Overeating and a sedentary lifestyle

What can be a comorbidity of obesity?

  1. Reflux disease
  2. Osteoporosis
  3. Lumbago
  4. Hyperventilation


  1. Reflux disease

Which of the following conditions is not a typical consequence of obesity?

  1. Hypertension
  2. Type 1 diabetes mellitus
  3. Heart failure
  4. Obstructive sleep apnoea


  1. Type 1 diabetes mellitus

Which of the following statements about bariatric surgery is false?

  1. It is the most effective long-term therapy for treating obesity
  2. It is sometimes called metabolic surgery as it improves insulin metabolism
  3. Is more effective in men than in women
  4. Is recommended for obese people with a BMI of at least 40 kg/m2


  1. Is more effective in men than in women

John is a 30-year old man with a BMI of 38 kg/m2. He has been overweight since he was a child and has tried several weight-loss diets which were not effective. Would he be eligible for bariatric surgery?

  1. Yes, if the weight-loss diets were under the supervision of a dietitian
  2. Yes, if he has comorbidities such as type 2 diabetes
  3. No, he is too young for bariatric surgery
  4. No, because it is unlikely he will be able to stick to a diet after his surgery


  1. Yes, if he has comorbidities such as type 2 diabetes



Which nutrient deficiency is most likely after a gastric bypass procedure?

  1. Vitamin B12 deficiency
  2. Folate deficiency
  3. Vitamin C deficiency
  4. Magnesium deficiency


  1. Vitamin B12 deficiency

After bariatric surgery, patients may experience dumping syndrome. What is this?

  1. Weakness, dizziness, and diarrhea after a meal
  2. Vomiting within 10-30 minutes after a meal
  3. Fatty stools (steatorrhoea) due to impaired fat absorption
  4. Delayed emptying of the gastric pouch after a meal


  1. Weakness, dizziness, and diarrhea after a meal

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