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Answer the following medical question with one of the provided options:
Q:A 30-year-old man presents to his family physician admitting to using heroin. He says he started using about 6-months ago when his back pain medication ran out. At first, he says he would borrow his wife’s Percocet but, eventually, that ran out and he had to find a different source. Since then, he has been having mor...
A: Improved interpersonal relationships
Answer the following medical question with one of the provided options:
Q:A 53-year-old man presents to an urgent care center with severe fever that began during the day along with muscle and joint pains. He states that he felt fine the day before but then developed a fever to 103°F (39.4°C) and had to leave work after which he developed a headache and body pains. The patient states that h...
B: Dengue virus
Answer the following medical question with one of the provided options:
Q:A 64-hour-old baby girl is being evaluated for discharge. She was born by forceps-assisted vaginal delivery at 39 weeks gestation. The mother has no chronic medical conditions and attended all her prenatal visits. The mother’s blood type is A+. On day 1, the patient was noted to have a scalp laceration. Breastfeeding...
D: Observation
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Q:An autopsy of a 75-year-old man reveals obliterating endarteritis of the vasa vasorum of the aorta. Which of the following investigations will most likely be positive in this patient?? {'A': 'Perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA)', 'B': 'Increased double-stranded (ds) DNA titer', 'C': 'Increased k...
E: Rapid plasma reagin (RPR)
Answer the following medical question with one of the provided options:
Q:A 43-year-old woman comes to the physician for a routine examination prior to starting a new job as a nurse. Over the past year, the patient has had mild shortness of breath and a cough productive of white sputum, particularly in the morning. She immigrated to the United States from South Africa with her parents 40 y...
E: Interferon-gamma release assay
Answer the following medical question with one of the provided options:
Q:A 24-year-old G1P0000 presents for her first obstetric visit and is found to be at approximately 8 weeks gestation. She has no complaints aside from increased fatigue and occasional nausea. The patient is a recent immigrant from Africa and is currently working as a babysitter for several neighborhood children. One of...
E: Intramuscular flu vaccine
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Q:A 54-year-old man is brought to the emergency department by his wife because of progressive nausea, vomiting, and right-sided flank pain for 2 days. The pain is colicky and radiates to the groin. He has a history of gout and type 2 diabetes mellitus. Current medications are metformin and allopurinol. He recently bega...
D: Vitamin C
Answer the following medical question with one of the provided options:
Q:A 33-year-old man comes to the physician because of decreased hearing in his right ear for the past 4 months. During this period, he has also had multiple episodes of dizziness and a constant ringing noise in his right ear. Over the past 5 weeks, he has also noticed scant amounts of right-sided ear discharge. He has ...
E: Surgical excision
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Q:A 73-year-old woman presents to the emergency department with diffuse abdominal pain, nausea, and vomiting. Her daughter who accompanies her says she was in her usual state of health until two days ago when she started to complain of abdominal pain and was unable to tolerate oral intake. She has hypertension, congest...
C: Administer fresh frozen plasma and Vitamin K
Answer the following medical question with one of the provided options:
Q:You are asked to examine a 1-year-old child brought to the emergency department by his sister. The sister reports that the child has been acting strangely since that morning after "getting in trouble" for crying. The child appears lethargic and confused and is noted to have a cigarette burn on his forearm. Emergency ...
B: Bilateral retinal hemorrhages
Answer the following medical question with one of the provided options:
Q:Paramedics respond to a call regarding an 18-year-old male with severe sudden-onset heart palpitations. The patient reports symptoms of chest pain, fatigue, and dizziness. Upon examination, his heart rate is 175/min and regular. His blood pressure is 110/75 mm Hg. Gentle massage below the level of the left mandible e...
D: Slowing conduction in the AV node
Answer the following medical question with one of the provided options:
Q:A 57-year-old female visits her primary care physician with 2+ pitting edema in her legs. She takes no medications and does not use alcohol, tobacco, or illicit drugs. 4.5 grams of protein are collected during 24-hour urine excretion. A kidney biopsy is obtained. Examination with light microscopy shows diffuse thicke...
E: Membranous nephropathy
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Q:A 28-year-old woman, gravida 1, para 0, at 10 weeks' gestation comes to the physician for her initial prenatal visit. She has no history of serious illness, but reports that she is allergic to penicillin. Vital signs are within normal limits. The lungs are clear to auscultation, and cardiac examination shows no abnor...
C: Administer penicillin desensitization dose
Answer the following medical question with one of the provided options:
Q:A 46-year-old man is brought to the emergency room by police after being found passed out on the sidewalk. He is intermittently alert and smells strongly of alcohol. He is unable to provide a history, but an electronic medical record search reveals that the patient has a history of alcohol abuse and was seen in the e...
A: Bacteroides melaninogenicus
Answer the following medical question with one of the provided options:
Q:A 27-year-old woman who resides in an area endemic for chloroquine-resistant P. falciparum malaria presents to the physician with fatigue, malaise, and episodes of fever with chills over the last 5 days. She mentions that she has episodes of shivering and chills on alternate days that last for approximately 2 hours, ...
C: Quinine sulfate plus clindamycin
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Q:An 8-year-old boy presents to your office for a routine well-child visit. Upon physical examination, he is found to have a harsh-sounding, holosystolic murmur that is best appreciated at the left sternal border. The murmur becomes louder when you ask him to make fists with his hands. Which of the following is the mos...
D: Ventricular septal defect
Answer the following medical question with one of the provided options:
Q:A 50-year-old woman, gravida 5, para 5, comes to the physician for the evaluation of decreased sexual desire for approximately 6 months. She has been sexually active with her husband but reports that she has no desire in having sexual intercourse anymore. She states that she feels guilty and is worried about losing h...
C: Decreased testosterone
Answer the following medical question with one of the provided options:
Q:A 37-year-old previously healthy woman presents to the emergency room with right leg pain and difficulty breathing. She recently returned from a trip to Alaska and noticed her leg started to swell when she got home. Her medications include a multivitamin and oral contraceptives. She is diagnosed with a deep venous th...
C: VII
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Q:A 25-year-old man presents to the emergency department after fainting at his investment banking office. He states that he has experienced intermittent headaches since high school, but has never fainted. He reports eating multiple small meals regularly throughout the day. He further notes that multiple family members ...
D: smooth endoplasmic reticulum
Answer the following medical question with one of the provided options:
Q:A 43-year-old man presents to the emergency department with nausea and vomiting. He says symptoms onset 4 hours ago and is progressively worsening. He denies any hematemesis. Past medical history is significant for a recent negative screening colonoscopy that was performed due to a family history of colon cancer. His...
C: Fibrinogen
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Q:A group of investigators is evaluating the diagnostic properties of a new blood test that uses two serum biomarkers, dityrosine and Nε-carboxymethyl-lysine, for the clinical diagnosis of autism spectrum disorder (ASD) in children. The test is considered positive only if both markers are found in the serum. 50 childre...
D: 70%
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Q:A 51-year-old man is brought to the local emergency room in severe respiratory distress. The patient is an industrial chemist and was working in his lab with a new partner when a massive chemical spill occurred releasing fumes into their workspace. The patient and his lab partner attempted to clean up the spill befor...
C: Continue to administer albuterol
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Q:Blood cultures are sent to the laboratory. Antibiotic treatment is started. Blood cultures confirm an infection with methicillin-susceptible Staphylococcus epidermidis. Which of the following is the most appropriate next step in management?? {'A': 'Oral penicillin V + gentamicin for 4 weeks', 'B': 'Intravenous ampici...
E: Intravenous nafcillin + rifampin for 6 weeks + gentamicin for 2 weeks
Answer the following medical question with one of the provided options:
Q:A 6-week-old child is brought to his pediatrician for a physical exam and hepatitis B booster. The boy was born at 39 weeks gestation via spontaneous vaginal delivery to a 19-year-old G-1-P-1. He was previously up to date on all vaccines and is mildly delayed in some developmental milestones. His mother is especially...
B: Contact child protective services
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Q:A 16-year-old girl presents to the emergency room with her 8-month-old daughter for evaluation of “turning blue when she cries.” The baby is found to have an atrial septal defect that is causing a left to right shunt, resulting in cyanosis and pulmonary hypertension. Surgical intervention is indicated; however, the m...
D: Allow the mother to take the patient for a second opinion.
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Q:A 27-year-old man presents to the outpatient clinic with a swollen and painful toe. The pain intensity increased further after he went to a party last night. Which of the following is the drug of choice for the treatment of this patient's condition?? {'A': 'Aspirin', 'B': 'Probenecid', 'C': 'Rasburicase', 'D': 'Indom...
D: Indomethacin
Answer the following medical question with one of the provided options:
Q:A 30-year-old woman, gravida 2, para 1, at 40 weeks' gestation is admitted to the hospital in active labor. Pregnancy has been complicated by iron deficiency anemia, which was treated with iron supplements. Her first pregnancy and vaginal delivery were uncomplicated. There is no personal or family history of serious ...
D: Cesarean section
Answer the following medical question with one of the provided options:
Q:A scientist is studying the process by which innate immune cells are able to respond to damage and pathogen infiltration. Specifically, she examines patients with an immunodeficiency where they are unable to respond to local infections. She notices that these patients do not produce pustulant fluid and do not have re...
A: C5a
Answer the following medical question with one of the provided options:
Q:A 1-month-old boy is brought to the physician because of a 5-day history of generalized fatigue and multiple episodes of vomiting which is most pronounced after formula feeding. His vomiting progressed from 2–3 episodes on the first day to 6–8 episodes at present. The vomitus is whitish in color. The mother reports t...
A: Administer IV 0.9% NaCl and replace electrolytes
Answer the following medical question with one of the provided options:
Q:In order to study the association between coffee drinking and the subsequent development of lung cancer, a group of researchers decides to carry out a multicentric case-control study with a large number of participants–800 with a diagnosis of lung cancer, and 800 as age-adjusted controls. According to the results out...
C: Confounding bias
Answer the following medical question with one of the provided options:
Q:A 48-hour-old newborn presents in respiratory distress. He is gasping for breath in the neonatal intensive care unit (NICU) and has had a fever for the past 2 days with a temperature ranging between 37.2°C (99.0°F) and 38.6°C (101.5°F). He also has not been feeding well and seems to be lethargic. The patient was deli...
A: Ampicillin and gentamicin
Answer the following medical question with one of the provided options:
Q:A 8-year-old boy is brought to the clinic by his father for an annual well-check. His dad reports that he has been “difficult to handle” as he would not listen and follow instructions at home. “Telling him to sit still and do something is just so hard,” the father says. His teacher also reports difficulties in the cl...
C: Methylphenidate
Answer the following medical question with one of the provided options:
Q:A previously healthy 30-year-old woman comes to the physician because of a 3-month history of progressive shortness of breath and nonproductive cough. She also complains of constipation and fatigue during the same time period. She has not traveled recently or been exposed to any sick contacts. Physical examination sh...
D: Low serum CD4+ T-cell count
Answer the following medical question with one of the provided options:
Q:A 29-year-old female reports having a positive home pregnancy test result 9 weeks ago. She presents today with vaginal bleeding and complains of recent onset abdominal pain. Ultrasound of the patient’s uterus is included as Image A. Subsequent histologic analysis (Image B) reveals regions of both normal as well as en...
C: 69 XXY
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Q:A mother brings her infant for a regular well-child check-up with the pediatrician. During the routine developmental examination, the physician notes that the child is looking at him with his head lifted upwards when he is about to pick up the child from the table. At what age is it common to begin to observe this fi...
B: 2 months
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Q:A 55-year-old man comes to the physician because of a 2-month history of headaches, facial numbness, recurrent epistaxis, and a 5-kg (11-lb) weight loss. He recently immigrated from Hong Kong. Examination shows right-sided cervical lymphadenopathy. Endoscopy shows an exophytic nasopharyngeal mass. Histologic examinat...
C: Transfer of saliva
Answer the following medical question with one of the provided options:
Q:An 8-year-old boy is brought to the physician by his parents for blurry vision for the past 2 months. He is at the 97th percentile for height and 25th percentile for weight. Physical examination shows joint hypermobility, a high-arched palate, and abnormally long, slender fingers and toes. Slit lamp examination shows...
C: Fibrillin
Answer the following medical question with one of the provided options:
Q:A 70-year-old man presents to a medical office with painful micturition for 2 weeks. He denies any other symptoms. The past medical history is unremarkable. He has been a smoker most of his life, smoking approx. 1 pack of cigarettes every day. The physical examination is benign. A urinalysis shows an abundance of red...
D: Urothelial carcinoma-in-situ
Answer the following medical question with one of the provided options:
Q:A 13-year-old girl is brought to the physician by her father because of a 1-month history of pain in her right knee. She is a competitive volleyball player and has missed several games recently due to pain. Examination shows swelling distal to the right knee joint on the anterior surface of the proximal tibia; there ...
B: Patellar ligament
Answer the following medical question with one of the provided options:
Q:A 51-year-old woman presents the following significant and unintentional weight loss. She denies any personal history of blood clots in her past, but she says that her mother has also had to be treated for pulmonary embolism in the recent past. She also mentions that she had been struggling with her weight, so she wa...
D: Chronic myelogenous leukemia
Answer the following medical question with one of the provided options:
Q:A 75-year-old man presents to the physician with a complaint of persistent back pain. The patient states that the pain has been constant and occurs throughout the day. He says that he has also been experiencing greater fatigue when carrying out his daily activities. On review of systems, the patient notes that he los...
C: Rouleaux formation
Answer the following medical question with one of the provided options:
Q:An 8-year-old girl is brought into your clinic with a 5 day history of decreased oral intake, body aches and lymphadenopathy. She has no significant medical history. Upon further questioning you find that the patient frequently plays outside, where she enjoys chasing the neighborhood cats and dogs. She has had no rec...
D: Bartonella henselae infection
Answer the following medical question with one of the provided options:
Q:A 28-year-old G2P1 female with a history of hypertension presents to the emergency room at 33 weeks with headache and blurry vision. On exam, her vitals include BP 186/102 mmHg, HR 102 beats per minute, RR 15 breaths per minute, and T 98.9 degrees Fahrenheit. She undergoes an immediate Caesarian section, and although...
C: Brain MRI
Answer the following medical question with one of the provided options:
Q:A female child presents to her pediatrician for a well child visit. Her mother reports that she is eating well at home and sleeping well throughout the night. She can jump and walk up and down stairs with both feet on each step. In the doctor’s office, the patient builds a six-cube tower and imitates a circle. She se...
C: Follows two-step commands
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Q:A 51-year-old woman comes to the emergency department because of a 1-day history of severe pain in her left knee. To lose weight, she recently started jogging for 30 minutes a few times per week. She has type 2 diabetes mellitus and hypertension treated with metformin and chlorothiazide. Her sister has rheumatoid art...
B: Perform arthrocentesis
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Q:A 25-year-old man comes to the physician with intermittent bloody diarrhea over the past 2 months. He has occasional abdominal pain. His symptoms have not improved over this time. He has no history of a serious illness and takes no medications. His blood pressure is 110/70 mm Hg, pulse is 75/min, respirations are 14/...
E: Primary sclerosing cholangitis
Answer the following medical question with one of the provided options:
Q:A 48-year-old woman presents to her primary care physician with the complaints of persistent fatigue, dizziness, and weight loss for the past 3 months. She has hypothyroidism for 15 years and takes thyroxine replacement. Her blood pressure is 90/60 mm Hg in a supine position and 65/40 mm Hg while sitting, temperature...
C: Adrenocorticotropic hormone (ACTH) stimulation test
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Q:A 17-year-old girl comes to your outpatient clinic. She is sexually active with multiple partners and requests a prescription for oral contraceptive pills. A urine pregnancy test in your office is negative. Which of the following is the most appropriate next step?? {'A': "Contact the patient's parents to obtain conse...
B: Recommend sexually-transmitted infection screening and provide the requested prescription
Answer the following medical question with one of the provided options:
Q:A newborn infant presents with severe weakness. He was born to a G1P1 mother at 40 weeks gestation with the pregnancy attended by a midwife. The mother's past medical history is unremarkable. She took a prenatal vitamin and folic acid throughout the pregnancy. Since birth, the child has had trouble breastfeeding desp...
A: Acid maltase deficiency
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Q:A 2-week-old infant is brought to the emergency room because of 4 episodes of bilious vomiting and inconsolable crying for the past 3 hours. Abdominal examination shows no abnormalities. An upper GI contrast series shows the duodenojejunal junction to the right of the vertebral midline; an air-filled cecum is noted i...
B: Incomplete intestinal rotation
Answer the following medical question with one of the provided options:
Q:A 43-year-old male is admitted to the hospital for a left leg cellulitis. He is being treated with clindamycin and is recovering nicely. On the second day of his admission, a nurse incorrectly administers 100 mg of metoprolol which was intended for another patient with the same last name. The error is not discovered ...
A: Immediately disclose the error to the patient
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Q:A 42-year-old woman presents to her primary care physician with 2 weeks of abdominal pain. She says that the pain is squeezing in character and gets worse after she eats food. The pain is particularly bad after she eats dairy products so she has begun to avoid ice cream and cheese. Furthermore, she has noticed that s...
C: I cells
Answer the following medical question with one of the provided options:
Q:A 65-year-old woman comes to clinic complaining of pain with chewing solid foods. She reports that she has been feeling unwell lately, with pains in her shoulders and hips, and she has lost five pounds in the past few months. Her vital signs are T 39C, RR 18 breaths/min, HR 95 bpm, BP 120/65 mmHg. When you ask her to...
B: Blindness
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Q:An 1800-g (4.0-lb) male newborn is delivered to a 26-year-old woman, gravida 2, para 1, at 33 weeks' gestation. The Apgar scores are 7 at 1 minute and 8 at 5 minutes. The pregnancy was complicated by iron deficiency anemia. The mother has no other history of serious illness. She has smoked one-half pack of cigarettes...
E: Give first dose of diphtheria and tetanus toxoids, acellular pertussis (DTaP) vaccine at 2 months of chronological age
Answer the following medical question with one of the provided options:
Q:One day after undergoing a right hemicolectomy for colon cancer, a 55-year-old woman has back pain and numbness and difficulty moving her legs. Her initial postoperative course was uncomplicated. Current medications include prophylactic subcutaneous heparin. Her temperature is 37.2°C (98.9°F), pulse is 100/min, respi...
B: Perform surgical decompression
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Q:A 10-month-old boy is brought to the physician by his mother because of a 2-day history of rhinorrhea, nasal congestion, and cough. He has been feeding normally and has not had vomiting or diarrhea. The infant was born at term via uncomplicated spontaneous vaginal delivery. Immunizations are up-to-date. Eight months ...
A: Provide reassurance
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Q:A 73-year-old man presents to his primary care physician with chest pain. He noticed the pain after walking several blocks, and the pain is relieved by sitting. On exam, he has a BP 155/89 mmHg, HR 79 bpm, and T 98.9 F. The physician refers the patient to a cardiologist and offers prescriptions for carvedilol and nit...
C: Decreased cAMP; Increased cGMP
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Q:An 84-year-old man comes to the emergency department because of lower back pain and lower extremity weakness for 3 weeks. Over the past week, he has also found it increasingly difficult to urinate. He has a history of prostate cancer, for which he underwent radical prostatectomy 8 years ago. His prostate-specific ant...
D: Generation of hydroxyl radicals
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Q:A 33-year-old man presents to the emergency department with severe anxiety. He has had multiple episodes in the past treated with low dose lorazepam. The patient states that he feels as if he is going to die and that he cannot breathe. His past medical history is notable for depression and anxiety. His temperature is...
B: Electrophysiological studies
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Q:A 74-year-old male presents to his primary care physician complaining of left lower back pain. He reports a four-month history of worsening left flank pain. More recently, he has started to notice that his urine appears brown. His past medical history is notable for gout, hypertension, hyperlipidemia, and myocardial ...
A: Proximal tubule cells
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Q:A 62-year-old man is brought to the emergency department by his wife for high blood pressure readings at home. He is asymptomatic. He has a history of hypertension and hyperlipidemia for which he takes atenolol and atorvastatin, however, his wife reports that he recently ran out of atenolol and has not been able to r...
A: Start or restart low-dose medication to reduce blood pressure gradually over the next 24–48 hours
Answer the following medical question with one of the provided options:
Q:A 45-year-old woman is in a high-speed motor vehicle accident and suffers multiple injuries to her extremities and abdomen. In the field, she was bleeding profusely bleeding and, upon arrival to the emergency department, she is lethargic and unable to speak. Her blood pressure on presentation is 70/40 mmHg. The traum...
A: Provide transfusions as needed
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Q:A 21-year-old woman presents to her primary care physician for evaluation of malaise, joint pains, and rash. She has developed joint pain in her hands over the last month, and has noted a rash over her face that gets worse with sun exposure. She is taking no medication at the present time. On further physical examina...
D: I, II, IV, V
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Q:A 33-year-old woman comes to the physician for a follow-up examination. She has a history of Crohn disease, for which she takes methotrexate. She and her husband would like to start trying to have a child. Because of the teratogenicity of methotrexate, the physician switches the patient from methotrexate to a purine ...
A: Febuxostat
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Q:Antituberculosis treatment is started. Two months later, the patient comes to the physician for a follow-up examination. The patient feels well. She reports that she has had tingling and bilateral numbness of her feet for the past 6 days. Her vital signs are within normal limits. Her lips are dry, scaly, and slightly...
C: Pyridoxine
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Q:Before starting a new job at a law firm, a 33-year-old woman speaks to a representative about the health insurance plan offered by the firm. The representative explains that treatment is provided by primary health care physicians who focus on preventive care. Patients require a referral by the primary care physician ...
E: Capitation
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Q:A 73-year-old man with a 50-year history of type 2 diabetes and stage 3 chronic kidney disease presents to his primary care doctor for a scheduled follow-up and routine labs. He states that he has had no real change in his health except that he feels like he has had bouts of lightheadedness and almost passing out, wh...
D: Normocytic anemia with decreased reticulocyte count
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Q:A 72-year-old man presents to the physician with severe lower back pain and fatigue for 3 months. The pain increases with activity. He has no history of a serious illness. He takes ibuprofen for pain relief. He does not smoke. The blood pressure is 105/65 mm Hg, the pulse is 86/min, the respirations are 16/min, and t...
B: Multiple myeloma
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Q:A 28-year-old man visits his physician complaining of hematochezia over the last several days. He also has tenesmus and bowel urgency without any abdominal pain. He has had several milder episodes over the past several years that resolved on their own. He has no history of a serious illness and takes no medications. ...
C: Mesalamine
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Q:A 4-year-old girl is brought to the physician for a well-child examination. She has been healthy apart from an episode of bronchiolitis as an infant. Her 6-year-old sister recently underwent surgery for ventricular septal defect closure. She is at the 60th percentile for height and weight. Her mother is concerned abo...
C: A grade 2/6 continuous murmur heard at the right supraclavicular region
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Q:A mother with HIV has given birth to a healthy boy 2 days ago. She takes her antiretroviral medication regularly and is compliant with the therapy. Before being discharged, her doctor explains that she cannot breastfeed the child since there is a risk of infection through breastfeeding and stresses that the child can...
C: Collagen synthesis
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Q:A healthy 33-year-old gravida 1, para 0, at 15 weeks' gestation comes to the genetic counselor for a follow-up visit. Her uncle had recurrent pulmonary infections, chronic diarrhea, and infertility, and died at the age of 28 years. She does not smoke or drink alcohol. The results of an amniotic karyotype analysis sho...
D: Meconium ileus
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Q:Four days after being admitted to the intensive care unit for acute substernal chest pain and dyspnea, an 80-year-old man is evaluated for hypotension. Coronary angiography on admission showed an occlusion in the left anterior descending artery, and a drug-eluting stent was placed successfully. The patient has a hist...
E: Interventricular septum rupture
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Q:A 68-year-old right hand-dominant man presents to the emergency room complaining of severe right arm pain after falling down a flight of stairs. He landed on his shoulder and developed immediate severe upper arm pain. Physical examination reveals a 2-cm laceration in the patient’s anterior right upper arm. Bone is vi...
C: Lateral forearm skin sensation
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Q:A first-year medical student is conducting a summer project with his medical school's pediatrics department using adolescent IQ data from a database of 1,252 patients. He observes that the mean IQ of the dataset is 100. The standard deviation was calculated to be 10. Assuming that the values are normally distributed,...
C: 85–115
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Q:The the mean, median, and mode weight of 37 newborns in a hospital nursery is 7 lbs 2 oz. In fact, there are 7 infants in the nursery that weigh exactly 7 lbs 2 oz. The standard deviation of the weights is 2 oz. The weights follow a normal distribution. A newborn delivered at 10 lbs 2 oz is added to the data set. Wha...
D: The mean will increase; the median will stay the same; the mode will stay the same
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Q:A 10-month-old boy is brought to the emergency department by his parents because he has a high fever and severe cough. His fever started 2 days ago and his parents are concerned as he is now listless and fatigued. He had a similar presentation 5 months ago and was diagnosed with pneumonia caused by Staphyloccocus aur...
D: NADPH oxidase activity
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Q:A 46-year-old woman comes to the physician for a routine health examination. She was last seen by a physician 3 years ago. She has been healthy aside from occasional mild flank pain. Her only medication is a multivitamin. Her blood pressure is 154/90 mm Hg. Physical examination shows no abnormalities. Serum studies s...
A: Refer to surgery for parathyroidectomy
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Q:A 12-year-old boy is brought in by his mother to the emergency department. He has had abdominal pain, fever, nausea, vomiting, and loss of appetite since yesterday. At first, the mother believed it was just a "stomach flu," but she is growing concerned about his progressive decline. Vitals include: T 102.3 F, HR 110 ...
D: Right lower quadrant ultrasound
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Q:A 48-year-old man with a long history of mild persistent asthma on daily fluticasone therapy has been using his albuterol inhaler every day for the past month and presents requesting a refill. He denies any recent upper respiratory infections, but he says he has felt much more short of breath throughout this time fra...
B: Add salmeterol to current regimen
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Q:A 3500-g (7 lb 11 oz) healthy female newborn is delivered at 38 weeks' gestation. Chorionic villus sampling (CVS) in the first trimester showed a trisomy of chromosome 21 but the pregnancy was otherwise uncomplicated. Physical examination of the newborn is normal. Chromosomal analysis at birth shows a 46, XX karyotyp...
E: Placental mosaicism
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Q:An 11-year-old girl presents with a 1-day history of frothy brown urine. She has no significant medical history and takes no medications. She reports that several of her classmates have been sick, and she notes that she had a very sore throat with a fever approx. 2 weeks ago. Her blood pressure is 146/94 mm Hg, heart...
D: Poststreptococcal glomerulonephritis
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Q:A 16-year-old male adolescent presents to his pediatrician with increasing fatigue and breathlessness with exercise. His parents inform the doctor that they have recently migrated from a developing country, where he was diagnosed as having a large ventricular septal defect (VSD). However, due to their poor economic c...
C: Right ventricular heave
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Q:A 59-year-old man presents to the emergency department with right-sided weakness and an inability to speak for the past 2 hours. His wife says he was gardening in his backyard when he suddenly lost balance and fell down. The patient has a past medical history of hypertension, diabetes mellitus, and coronary artery di...
D: ECG
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Q:A 3-year-old boy is brought to the emergency department because of worsening pain and swelling in both of his hands for 1 week. He appears distressed. His temperature is 38.5°C (101.4°F). Examination shows erythema, swelling, warmth, and tenderness on the dorsum of his hands. His hemoglobin concentration is 9.1 g/dL....
E: Polycythemia vera
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Q:A 30-year-old primigravid woman at 14 weeks' gestation comes to the physician for her first prenatal visit. She reports some nausea and fatigue. She takes lithium for bipolar disorder and completed a course of clindamycin for bacterial vaginosis 12 weeks ago. She works as a teacher at a local school. She smoked a pac...
B: Atrialized right ventricle
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Q:A 65-year-old woman with COPD comes to the emergency department with 2-day history of worsening shortness of breath and cough. She often has a mild productive cough, but she noticed that her sputum is more yellow than usual. She has not had any recent fevers, chills, sore throat, or a runny nose. Her only medication ...
E: Prednisone and albuterol
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Q:A 30-year-old woman comes to the emergency department because of weakness and fatigue for 2 days. She has also noticed that her urine is darker than usual. For the past week, she has had a persistent non-productive cough and low-grade fever. She has seasonal allergies. She drinks one to two glasses of wine on social ...
B: Direct Coombs test
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Q:A 46-year-old woman comes to the physician for a follow-up examination. She had a blood pressure recording of 148/94 mm Hg on her previous visit one week ago. Her home blood pressure log shows readings of 151/97 and 146/92 mm Hg in the past week. She has no history of serious illness and takes no medications. She is ...
A: Electrocardiogram
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Q:A sample is taken of an ulcer in the inguinal region of a 29-year-old Malaysian male who has had unprotected sex in the past few months. Intracytoplasmic inclusions are seen in the Giemsa staining in Image A. On which of the following can the organism in the staining be grown?? {'A': 'Bordet-Gengou agar', 'B': 'Löwen...
E: Yolk sac of a chick embryo
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Q:A 32-year-old man who recently emigrated from Colombia comes to the physician because of a 3-month history of shortness of breath and fatigue. Physical examination shows jugular venous distention and an additional late diastolic heart sound. Crackles are heard at the lung bases bilaterally. Cardiac catheterization is...
C: Cardiac sarcoidosis
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Q:A 23-year-old female college basketball player presents in Sports Clinic after she felt a "pop" in her knee after coming down with a rebound. To examine the patient, you have her lie down on the table with her knees flexed 90 degrees. With your hand around her knee you are able to draw the tibia toward you from under...
B: The anterior intercondylar area of tibia and the posteromedial aspect of the lateral femur
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Q:A 42-year-old man is brought to the emergency department after having a seizure. His wife states that the patient has been struggling with alcohol abuse and has recently decided to "quit once and for all". Physical exam is notable for a malnourished patient responsive to verbal stimuli. He has moderate extremity weak...
D: Magnesium
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Q:A 22-year-old man presents to his physician with a chronic cough which he has had for the last five years. He mentions that his cough is usually productive; however, sometimes it is dry. His past medical records show seven episodes of sinusitis over the last two years and two episodes of community acquired pneumonia....
C: Measurement of sweat chloride levels
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Q:A 64-year-old male with a past medical history of obesity, diabetes, hypertension, and hyperlipidemia presents with an acute onset of nausea, vomiting, diaphoresis, and crushing substernal chest pain. Vital signs are temperature 37° C, HR 110, BP 149/87, and RR of 22 with an oxygen saturation of 99% on room air. Phys...
B: A fully obstructive thrombus at the site of a ruptured, ulcerated atherosclerotic plaque
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Q:A 60-year-old man is brought to the emergency room because of fever and increasing confusion for the past 2 days. He has paranoid schizophrenia and hypertension. His current medications are chlorpromazine and amlodipine. He appears ill. He is not oriented to time, place, or person. His temperature is 40°C (104°F), pu...
A: Dantrolene
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Q:A 67-year-old man comes to the emergency department because of decreased vision and black spots in front of his left eye for the past 24 hours. He states that it feels as if 'a curtain is hanging over his eye.' He sees flashes of light intermittently. He has no pain or diplopia. He underwent cataract surgery on the l...
B: Retinal detachment
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Q:A 65-year-old woman presents to her physician with the complaint of ringing in her right ear. She says it started about 3 months ago with associated progressive difficulty in hearing on the same side. Past medical history is significant for a hysterectomy 5 years ago due to dysfunctional uterine bleeding. She is curr...
B: Cranial nerves IX, X
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Q:A 3-year-old boy presents to a geneticist for generalized developmental delay. Upon presentation he is found to have a distinctive facial structure with prominent epicanthal folds and macroglossia. Further physical examination reveals a simian crease on his palms bilaterally. Based on these findings, the physician st...
C: Robertsonian translocation
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Q:A 6-month-old infant male is brought to the emergency department with a 1-hour history of vomiting and convulsions. He was born at home and had sporadic prenatal care though his parents say that he appeared healthy at birth. He initially fed well; however, his parents have noticed that he has been feeding poorly and ...
A: Aldolase B