question stringlengths 67 3.54k | answer stringlengths 1 136 | options dict | meta_info stringclasses 2
values | answer_idx stringclasses 5
values |
|---|---|---|---|---|
A 4-year-old child is rushed to the emergency department after developing sudden abdominal pain followed by nausea, vomiting, and dark, almost black-colored stool. Prior to the onset of symptoms, he was seen playing with his mother’s purse containing a bottle of vitamin supplements, which she takes for chronic microcyt... | Deferoxamine | {
"A": "Dimercaprol",
"B": "Penicillamine",
"C": "Deferoxamine",
"D": "Protamine",
"E": "Succimer"
} | step1 | C |
A 32-year-old woman comes to the physician because of fatigue, breast tenderness, increased urinary frequency, and intermittent nausea for 2 weeks. Her last menstrual period was 7 weeks ago. She has a history of a seizure disorder treated with carbamazepine. Physical examination shows no abnormalities. A urine pregnanc... | Meningocele | {
"A": "Renal dysplasia",
"B": "Meningocele",
"C": "Teeth discoloration",
"D": "Sensorineural hearing loss",
"E": "Vaginal clear cell carcinoma"
} | step1 | B |
Three patients present to the pediatrician for routine well-child visits. The first child’s mother reports that he seems to be breastfeeding well and voids at least eight times per day. His stools are a yellow color, and he does not seem to be straining. In the office, he can lift his head and chest when in the prone p... | Ages 2 months, 6 months, and 12 months | {
"A": "Ages 1 month, 4 months, and 9 months",
"B": "Ages 1 month, 6 months, and 9 months",
"C": "Ages 2 months, 4 months, and 12 months",
"D": "Ages 2 months, 6 months, and 9 months",
"E": "Ages 2 months, 6 months, and 12 months"
} | step2&3 | E |
A 75-year-old woman presents to the emergency department with 30 minutes of slurred speech and arm weakness. On the drive over to the hospital, her symptoms have resolved completely. The patient has a past medical history of hypertension, atrial fibrillation, diabetes, morbid obesity, gout, and vascular claudication. H... | CT angiogram | {
"A": "Alteplase",
"B": "CT angiogram",
"C": "Echocardiogram",
"D": "Heparin",
"E": "MRI"
} | step2&3 | B |
A 45-year-old man presents to the emergency department with weakness. He states that it started yesterday and has been progressively worsening. Initially, he noticed blurry vision and some trouble speaking and swallowing but thought he was just coming down with a cold. He then noticed weakness of his facial muscles and... | Antitoxin | {
"A": "Antitoxin",
"B": "Atropine",
"C": "Neostigmine",
"D": "Plasmapheresis",
"E": "Riluzole"
} | step2&3 | A |
A 79-year-old woman comes to the physician because of a 1-month history of difficulty starting urination and a vague sensation of fullness in the pelvis. Pelvic speculum examination in the lithotomy position shows a pink structure at the vaginal introitus that protrudes from the anterior vaginal wall when the patient i... | Cystocele | {
"A": "Uterine prolapse",
"B": "Vaginal rhabdomyosarcoma",
"C": "Cystocele",
"D": "Rectocele",
"E": "Uterine leiomyomata"
} | step1 | C |
A 30-year-old woman presents to the physician because of ongoing diarrhea for the past 1 month. She reports that diarrhea has been intermittently present for the past month. The stool is often loose and associated with blood and lower abdominal pain. She denies any recent travel history, and she works at a nursing home... | Crohn’s disease | {
"A": "Ulcerative colitis",
"B": "Crohn’s disease",
"C": "Acute infective colitis",
"D": "Pseudomembranous colitis",
"E": "Irritable bowel syndrome"
} | step2&3 | B |
A 45-year-old man presents to the emergency department after being stabbed 12 times in various parts of his body. Paramedics report extensive blood loss at the scene where he was found. Due to his Glasgow Coma Scale score of 3, an endotracheal airway and large-bore access are secured prior to arrival. He is aggressivel... | Cardiac tamponade | {
"A": "Cardiac tamponade",
"B": "Cervical spinal cord transection",
"C": "Occult hemorrhage",
"D": "Pulmonary embolism",
"E": "Undiagnosed pneumonia"
} | step2&3 | A |
A 71-year-old woman presents to her physician accompanied by her son. She has no complaints, but her son states that the patient has impaired memory and poor orientation in space. She is ambulatory and is capable of self-care, but she tends to forget newly introduced information. Also, she got lost on the way from the ... | Donepezil | {
"A": "Imipramine",
"B": "Sertraline",
"C": "Lithium",
"D": "Donepezil",
"E": "Sulpiride"
} | step2&3 | D |
A 16-year-old teenager presents to the emergency department with a sudden onset of severe pain in his right knee. He describes the pain as the worst pain he has ever felt. He denies any recent trauma or injury to the knee. The joint appears red and swollen and is hot to the touch. He denies any lower extremity numbness... | WBC/mm3 53,000; % PMN > 75%; Viscosity low | {
"A": "WBC/mm3 1,600; % PMN > 25%; Viscosity N",
"B": "WBC/mm3 53,000; % PMN > 75%; Viscosity low",
"C": "WBC/mm3 160; % PMN < 20%; Viscosity high",
"D": "WBC/mm3 2,400; % PMN < 20%; Viscosity low",
"E": "WBC/mm3 45,000; % PMN > 50%; Viscosity N"
} | step2&3 | B |
An otherwise healthy 49-year-old woman has a routine full blood count complete prior her elective cholecystectomy. The lab test results are as follows:
Laboratory test
Hemoglobin
12.1 g/dL
Mean corpuscular volume (MCV)
85 μm3
Mean corpuscular hemoglobin concentration (MCHC)
47%
Reticulocyte count
3.4 %
White blood cell... | Eosin-5-maleimide binding test | {
"A": "Eosin-5-maleimide binding test",
"B": "Flow cytometry for CD55/CD59",
"C": "Anti parvovirus B19 antibodies",
"D": "Bone marrow biopsy",
"E": "Liver function tests"
} | step2&3 | A |
A 39-year-old man is brought to the physician by his wife because of personality changes over the past year. He has become increasingly irritable, loud, aggressive, and impulsive. His wife also reports jerky movements of his limbs and trunk for the past few months. His father had dementia in his mid-40s, but the detail... | Atrophy of the striatum | {
"A": "Reduced hippocampal volume",
"B": "Multiple cortical and subcortical infarctions",
"C": "Degeneration of the frontal and temporal lobes",
"D": "Extra-axial tumor with dural attachments",
"E": "Atrophy of the striatum"
} | step1 | E |
A 45-year-old African-American woman comes to the physician after an episode of hemoptysis. Over the past 8 months, she has had a nonproductive cough, fatigue, and a 9-kg (20-lb) weight loss. She drinks a glass of wine every night and does not smoke. She has a history of hypertension and osteoarthritis. She does not ta... | Adenocarcinoma of the lung | {
"A": "Carcinoid tumor",
"B": "Small cell lung cancer",
"C": "Sarcoidosis",
"D": "Squamous cell carcinoma of the lung",
"E": "Adenocarcinoma of the lung"
} | step2&3 | E |
A 70-year-old man with hyperlipidemia and hypertension returns to his cardiologist for ongoing blood pressure management. He reports feeling fine with no trouble with his medications. He exercises regularly and sleeps well without snoring or daytime somnolence. His blood pressure measurements in the past have ranged fr... | Stiffening of the aorta | {
"A": "Primary hyperaldosteronism",
"B": "Hypothyroidism",
"C": "Stiffening of the aorta",
"D": "Obstructive sleep apnea",
"E": "Aortic stenosis"
} | step1 | C |
An 11-month-old boy is brought to the physician for a well-child examination. He is growing along with the 75th percentile and meeting all milestones. Physical examination shows a poorly rugated scrotum. The palpation of the scrotum shows only 1 testicle. A 2nd testicle is palpated in the inguinal canal. The examinatio... | Orchiopexy | {
"A": "Chorionic gonadotropin therapy",
"B": "Exploratory laparoscopy",
"C": "Follow-up examination in 6 months",
"D": "Orchiectomy",
"E": "Orchiopexy"
} | step2&3 | E |
A 24-year-old woman comes to the physician because of 1-day history of nausea and weakness. She has no history of serious illness. She is sexually active with 2 male partners and uses an oral contraceptive; she uses condoms inconsistently. Her last menstrual period was 4 days ago. Her temperature is 37.8°C (100°F), pul... | Urinalysis | {
"A": "Urinalysis",
"B": "Cervical swab",
"C": "Abdominal ultrasound",
"D": "Blood culture",
"E": "CT scan of the abdomen\n\""
} | step2&3 | A |
A 65-year-old woman comes to the physician for a routine bone mineral density screening. She does not have any children. Menopause was at age 55. Her mother died of breast cancer at the age of 48 years. She has hypertension for which she takes ramipril. Dual-energy x-ray absorptiometry at the femoral neck shows a T-sco... | Pulmonary embolism | {
"A": "Pulmonary embolism",
"B": "Cellulitis",
"C": "Breast cancer",
"D": "Mandibular osteonecrosis",
"E": "Hypercholesterolemia"
} | step1 | A |
A multi-specialty physician practice is meeting to determine which compensation scheme would best serve the practice and its patient population. Which of the following are true in regards to physician compensation? | Fee-for-service may incentivize physicians to increase healthcare utilization irrespective of quality | {
"A": "Capitation poses the least financial risk to physicians",
"B": "Fee-for-service pays physicians a set amount of money per unit time for every patient under their care",
"C": "Fee-for-service may incentivize physicians to increase healthcare utilization irrespective of quality",
"D": "Fee-for-service pos... | step1 | C |
A 29-year-old woman presents to her primary care doctor for a prenatal visit. She has just learned that she is pregnant and estimates she is approximately 6 weeks pregnant given the timing of her last menstrual cycle. She has a history of recurrent fetal loss. In total, she has had 4 miscarriages between the gestationa... | Aspirin and heparin | {
"A": "Aspirin",
"B": "Aspirin and heparin",
"C": "Aspirin and warfarin",
"D": "No treatment indicated",
"E": "Rivaroxaban"
} | step2&3 | B |
A 17-year-old girl is brought to the physician because she has not attained menarche. There is no personal or family history of serious illness. She is 168 cm (5 ft 5 in) tall and weighs 63 kg (139 lb); BMI is 22.3 kg/m2. Examination shows normal breast development. Scant axillary hair is present. Abdominal examination... | Androgen insensitivity | {
"A": "Mullerian duct agenesis",
"B": "5-α reductase deficiency",
"C": "Sex chromosome mosaicism",
"D": "Sex chromosome monosomy",
"E": "Androgen insensitivity"
} | step2&3 | E |
A 68-year-old man presents with a 6-month history of worsening fatigue and weight loss. He is especially concerned about a recent episode in which he noticed a blurring of his vision and headache; he also notes that his “memory is not as good as it used to be,” which his wife confirms. Physical exam is notable only for... | Waldenstrom’s macroglobulinemia | {
"A": "IgM monoclonal gammopathy of undetermined significance (MGUS)",
"B": "Multiple myeloma",
"C": "Waldenstrom’s macroglobulinemia",
"D": "Non-Hodgkin’s lymphoma",
"E": "Chronic lymphocytic leukemia"
} | step2&3 | C |
A 73-year-old woman is brought to the physician by her daughter for evaluation of impaired memory and word-finding difficulties for 2 years. She was recently asked to step down from her position as volunteer accountant for a local charity organization because she was no longer able to coordinate her tasks. She reports ... | Hyperphosphorylated tau | {
"A": "Alpha-synuclein",
"B": "Viral ribonuclear proteins",
"C": "Amyloid-β",
"D": "Hyperphosphorylated tau",
"E": "Prion protein"
} | step1 | D |
A 27-year-old man presents to the emergency department due to a change in his skin color. The patient went on a long hike this morning, and his girlfriend noticed that his skin had changed color when they were driving home. The patient has a past medical history of marijuana use, IV drug use, alcohol use, and asthma. H... | Hyperpigmentation of the liver | {
"A": "A pathology responsive to sofosbuvir",
"B": "Decreased UDP-glucuronyl transferase activity",
"C": "Hyperpigmentation of the liver",
"D": "Increased consumption of beta-carotene",
"E": "Increased liver enzymes with AST > ALT"
} | step2&3 | C |
A 40-year-old woman presents to the emergency department with severe left upper quadrant pain (duration 3 hours, stabbing quality, 10/10 on the pain scale). Past medical history is significant for sickle cell anemia. Physical examination is significant for severe tenderness to palpation in the left upper quadrant. Sign... | X | {
"A": "VII",
"B": "XIIa",
"C": "VIIa",
"D": "X",
"E": "XII"
} | step1 | D |
A 47-year-old man with a history of HIV1 infection presents to his HIV clinic to discuss his antiretroviral medications. He is interested in including maraviroc in his maintenance regimen after seeing advertisements about the medication. On exam, his temperature is 98.8°F (37.1°C), blood pressure is 116/74 mmHg, pulse ... | gp120 | {
"A": "gp41",
"B": "gp120",
"C": "gp160",
"D": "p24",
"E": "Reverse transcriptase"
} | step1 | B |
A 16-year-old female presents to her physician’s office after noticing a round lump in her left breast 2 months ago. She reports that the lump seemed to enlarge and became tender just preceding her last 2 menses. It is otherwise painless, and the patient denies any discharge or skin changes. She has no past medical his... | This mass will most likely decrease in size or disappear over time | {
"A": "This mass will likely require excision",
"B": "This mass will decrease in size if the patient starts oral contraceptives",
"C": "This mass slightly increases this patient’s risk of breast cancer in the future",
"D": "This mass will most likely decrease in size or disappear over time",
"E": "If this ma... | step2&3 | D |
A 22-year-old woman presents to the emergency department with a headache. She has had episodic headaches like this in the past and states that her headache today is severe, worse when laying down, and not responding to ibuprofen. She also reports a transient episode of vision loss and current blurry vision. She states ... | Lumbar puncture | {
"A": "100% oxygen",
"B": "Ibuprofen",
"C": "Lumbar puncture",
"D": "MRI",
"E": "Tissue plasminogen activator"
} | step2&3 | C |
A 28-year-old woman presents to her primary care physician for evaluation of amenorrhea. Her last period occurred 4 months ago but she has not had sex in the last year and home pregnancy tests have come back negative. She first started having periods at age 13 and her periods have been unremarkable up until they stoppe... | Inhibition of gonadotropin-releasing hormone release | {
"A": "Excessive production of androgens",
"B": "Inhibition of gonadotropin-releasing hormone release",
"C": "Intrauterine scar tissue accumulation",
"D": "Nondisjunction of chromosomes",
"E": "Nutritional imbalance"
} | step1 | B |
A 57-year-old homeless man is brought to the emergency department because of several episodes of hematemesis in the past 24 hours. His vital signs include a temperature of 37.1°C (98.8°F), pulse of 95/min, and blood pressure of 85/60 mm Hg. On physical examination, he appears confused and unable to give a complete hist... | Substance abuse | {
"A": "Metabolic disorder",
"B": "Autoimmune liver disease",
"C": "Substance abuse",
"D": "Obesity",
"E": " Hepatic venous outflow obstruction"
} | step2&3 | C |
A 66-year-old man presents to the emergency department for a cough and fatigue. The patient was brought in from a nursing home with documentation stating that he has seemed confused for the past day according to the staff. The patient has a past medical history of diabetes and hypertension. He is currently taking insul... | Moxifloxacin and admission to the medical floor | {
"A": "Azithromycin and admission to the medical floor",
"B": "Azithromycin and discharge",
"C": "Azithromycin, moxifloxacin, and admission to the intensive care unit",
"D": "Ceftriaxone, azithromycin, and admission to the intensive care unit",
"E": "Moxifloxacin and admission to the medical floor"
} | step2&3 | E |
A 72-year-old man in a nursing home was brought to the emergency department with right hand and leg weakness for 1 hour. There has been a gradual increase in the degree of weakness. The patient is disoriented. The medical history includes ischemic heart disease diagnosed 2 months ago, and long histories of diabetes and... | Liquefactive necrosis | {
"A": "Gangrenous necrosis",
"B": "Liquefactive necrosis",
"C": "Caseous necrosis",
"D": "Fibrinoid necrosis",
"E": "Coagulative necrosis"
} | step1 | B |
An 11-year-old boy was brought in by his mother with red tender bumps on his legs. The patient’s mother says that his symptoms started 3 days ago with a low-grade fever, malaise, and joint pain. He began to improve over the next 2 days, but this morning, when he woke up, she noticed multiple painful red bumps on his sh... | Throat culture | {
"A": "Throat culture",
"B": "Chest radiograph",
"C": "p-ANCA serology",
"D": "Bone marrow biopsy",
"E": "Colonoscopy"
} | step2&3 | A |
Two hours after admission to the hospital for rupture of membranes, a 35-year-old woman, gravida 3, para 2, at 40 weeks’ gestation is evaluated for the sudden onset of chills, dyspnea, confusion, and hypotension. The patient successfully underwent combined spinal-epidural anesthesia 1 hour ago. Her pregnancy was uncomp... | Amniotic fluid entering the endocervical veins | {
"A": "Apical ballooning of the left ventricle",
"B": "Allergic reaction to anesthetic agent",
"C": "Amniotic fluid entering the endocervical veins",
"D": "Anesthetic agent entering the subarachnoid space",
"E": "Systemic bacterial infection"
} | step2&3 | C |
A 54-year-old male presents to his primary care physician complaining of fatigue. He reports that he recently went on a vacation to South America with his family but just wanted to stay in his hotel all day due to fatigue. His past medical history is notable for hyperlipidemia and hypertension. He takes lovastatin and ... | Tartrate-resistant acid phosphatase | {
"A": "Prussian Blue",
"B": "Ziehl-Neelsen",
"C": "Periodic acid-Schiff",
"D": "Tartrate-resistant acid phosphatase",
"E": "Giemsa"
} | step1 | D |
While on a teaching sabbatical in Uruguay, a pathologist examined the excised liver of an 18-year-old otherwise healthy female who passed away due to massive hepatic necrosis 5 days after she underwent general anesthesia to repair a fractured femur. Which of the following is a general anesthetic most likely responsible... | Halothane | {
"A": "Bupivacaine",
"B": "Lidocaine",
"C": "Midazolam",
"D": "Halothane",
"E": "Desflurane"
} | step1 | D |
A 45-year-old woman with hypothyroidism comes to the physician because of progressive fatigue, lethargy, and epigastric pain after eating. Physical examination shows pale conjunctivae. Laboratory studies show decreased serum hemoglobin levels and increased serum gastrin levels. Esophagogastroduodenoscopy shows inflamma... | Parietal cell destruction | {
"A": "Mucosal cell hyperplasia",
"B": "Enterochromaffin-like cell hyperplasia",
"C": "Parietal cell destruction",
"D": "Chief cell destruction",
"E": "I cell destruction"
} | step1 | C |
A 72-year-old anthropologist with long-standing hypertension visits your office for a routine exam. You notice an abnormality on his laboratory results caused by his regimen of captopril and triamterene. What abnormality did you most likely find? | Hyperkalemia | {
"A": "Hypercalcemia",
"B": "Hyperkalemia",
"C": "Hypernatremia",
"D": "Thrombocytopenia",
"E": "Anemia"
} | step1 | B |
A 56-year-old woman is brought to the emergency department by her husband because of increasing confusion, generalized fatigue, and irritability for the past week. She has been unable to recall her husband's name or their address. She has had insomnia and daytime sleepiness during this period. Her last bowel movement w... | Administer lactulose | {
"A": "Reversal of TIPS",
"B": "Paracentesis",
"C": "Administer IV ceftriaxone",
"D": "Administer lactulose",
"E": "Administer vitamin B1"
} | step2&3 | D |
A 50-year-old woman is brought to the office by her daughter with a chief complaint of finger pain in her left hand. She is slightly confused and can’t remember when the pain started. Her daughter states that the pain has been present for approximately one month. She expresses concern that her mother has been progressi... | Hyperparathyroidism | {
"A": "Hyperparathyroidism",
"B": "Hypocalcemia",
"C": "Osteosarcoma",
"D": "Multiple myeloma",
"E": "Osteoporosis"
} | step1 | A |
A 48-year-old woman comes to the physician because of a 4-month history of lightheadedness, intermittent headaches, and easy bruising. Five months ago, she was treated for an episode of thrombophlebitis. Physical examination shows multiple bruises on her limbs. Laboratory studies show a platelet count of 900,000/mm3 an... | Increase in circulating fetal hemoglobin | {
"A": "Inhibition of thrombocyte aggregation",
"B": "Increase in circulating fetal hemoglobin",
"C": "Substitution of cofactors for DNA synthesis",
"D": "Inhibition of stem cell differentiation",
"E": "Restoration of the body's iron stores"
} | step1 | B |
Candida is injected into the skin of a 38-year-old female patient. Forty-eight hours later, there is a 14 mm raised, slightly hardened area at the injection site. What type of hypersensitivity reaction has occurred and what cell type plays a role? | Type IV hypersensitivity; CD4+ T cells | {
"A": "Type I hypersensitivty; eosinophils",
"B": "Type IV hypersensitivity; mast cells",
"C": "Type III hypersensitivity; CD4+ T cells",
"D": "Type IV hypersensitivity; CD4+ T cells",
"E": "Type I hypersensitivity; macrophages"
} | step1 | D |
On routine screening, a 62-year-old man is found to have positive fecal occult blood tests. He is asymptomatic, but his father died of large intestinal cancer. Abdominal and rectal exams are normal. A colonoscopy subsequently reveals a polyp in the descending colon but no other abnormalities. Excisional biopsy of the p... | Adenomatous polyp | {
"A": "Inflammatory polyp",
"B": "Adenomatous polyp",
"C": "Hamartomatous polyp",
"D": "Colorectal cancer",
"E": "Hemorrhoids"
} | step2&3 | B |
A 20-year-old male college student presents to the emergency room at 4 AM in the morning with complaints of abdominal cramps, nausea, vomiting, and diarrhea for the past 2 hours. He was studying for his exams last night when he became hungry and ate some food from the afternoon after heating it for a while. He says tha... | Bacillus cereus infection | {
"A": "Cryptosporidiosis",
"B": "C. difficile colitis",
"C": "Bacillus cereus infection",
"D": "Norovirus infection",
"E": "Rotavirus infection"
} | step2&3 | C |
A 79-year-old woman presents to her physician complaining of a persistent non-productive cough and dyspnea after contracting a cold in the past month. She describes herself as being “generally healthy” before the cold started. Medical history includes hypertension and hyperlipidemia. The patient takes hydrochlorothiazi... | Histoplasmosis | {
"A": "Coccidioidomycosis",
"B": "Blastomycosis",
"C": "Sporotrichosis",
"D": "Histoplasmosis",
"E": "Onychomycosis"
} | step2&3 | D |
A 14-year-old girl comes to the physician because she has not yet had her period. She is at the 10th percentile for height and 25th percentile for weight. Examination shows a broad chest with widely spaced nipples, a low posterior hairline, forearms angled 20° away from the body when fully extended, and shortened fourt... | Pregnancy success rate with donor oocytes is similar to patients with primary ovarian failure | {
"A": "Pregnancy success rate with donor oocytes is similar to patients with primary ovarian failure",
"B": "Administration of gonadotropins will increase the chances of conceiving",
"C": "Impaired tubal ciliary function will prevent natural fertilization",
"D": "The majority of patients become pregnant withou... | step1 | A |
An investigator is studying traumatic knee joint injuries in college athletes. Images and tissue samples are collected from 4 athletes with cartilaginous injury and 4 athletes with bone fractures. After 8 weeks, the athletes with bone fractures show almost complete resolution, while the athletes with cartilaginous inju... | Perichondrium | {
"A": "Perichondrium",
"B": "Proteoglycans",
"C": "Chondronectin",
"D": "Osteoblasts",
"E": "Mature chondrocytes"
} | step1 | A |
A 35-year-old woman comes to the physician for the evaluation of increasing weakness and numbness of the upper extremities for 5 days. During the past 2 days, she has had urinary incontinence not related to sneezing or laughing. Last summer, she had weakness and numbness of her right lower extremity that was worse when... | MRI of the brain and spine | {
"A": "Antinuclear antibody testing",
"B": "Muscle biopsy",
"C": "Rapid plasma reagin test",
"D": "MRI of the brain and spine",
"E": "Lumbar puncture"
} | step2&3 | D |
A 37-year-old woman presents to your office with heartburn. Following an extensive workup, you diagnose her with a duodenal ulcer secondary to H. pylori infection. You prescribe triple therapy of omeprazole, clarithromycin, and amoxicillin. Which of the following best describes the mechanism of action of omeprazole? | Inhibition of primary active transport | {
"A": "SST2 receptor agonist",
"B": "Parasympathetic inhibition",
"C": "Reversible block of H2 receptors",
"D": "Inhibition of primary active transport",
"E": "Inhibition of 50S ribosomal subunit"
} | step1 | D |
A 47-year-old woman comes to the emergency department because of worsening pain, discoloration, and swelling of her right hand. Two days ago, she was camping outdoors in Texas with her two young children. She was awoken in the middle of the night by “something crawling on my hand.” The following morning, she saw a woun... | Brown recluse spider | {
"A": "Bald-faced hornet",
"B": "Diamondback rattlesnake",
"C": "Brown recluse spider",
"D": "Striped bark scorpion",
"E": "Deer tick"
} | step2&3 | C |
Two weeks after starting chemotherapy with etoposide, a 66-year-old man with small cell lung cancer comes to the physician because of persistent nausea and vomiting. His symptoms improve significantly after the administration of metoclopramide. This patient's symptoms were most likely due to the effect of chemotherapy ... | Area postrema | {
"A": "Vestibular nerve",
"B": "Intestinal smooth muscle",
"C": "Vagus nerve",
"D": "Cerebral cortex",
"E": "Area postrema"
} | step1 | E |
A 55-year-old construction worker is struck by a high-voltage power line while on duty. According to bystanders, the cable struck him on his right arm, after which the man slumped to the ground with his arms and legs shaking. In the emergency department, the man is alert but in severe pain localizing bilaterally in the... | Urinalysis | {
"A": "FAST ultrasound assessment",
"B": "Urine dipstick",
"C": "Urinalysis",
"D": "X-ray of the arm and shoulder",
"E": "EEG"
} | step1 | C |
A 69-year-old male presents to the emergency department with shortness of breath. The patient has presented three times this past month with similar complaints. The patient sees no primary care physician and is currently not taking any medications. The patient states his shortness of breath started when he was walking ... | High BNP, high ADH, low sodium, low potassium | {
"A": "High BNP, high ADH, high sodium, high potassium",
"B": "High BNP, low ADH, normal sodium, low potassium",
"C": "High BNP, high ADH, low sodium, low potassium",
"D": "Low BNP, high ADH, low sodium, low potassium",
"E": "Low BNP, low ADH, normal sodium, normal potassium"
} | step2&3 | C |
A 48-year-old man presents to the clinic with nausea, vomiting, fever, and pain in the right upper quadrant of his abdomen for the past 18 hours. He mentions that he has been experiencing intermittent episodes of pain at the same location over the last 3 months and that these episodes usually occur after a heavy meal a... | Urgent endoscopic retrograde cholangiopancreatography (ECRP) | {
"A": "Urgent laparoscopic cholecystectomy",
"B": "Medical management followed by elective laparoscopic cholecystectomy",
"C": "Medical management followed by elective open cholecystectomy",
"D": "Urgent endoscopic retrograde cholangiopancreatography (ECRP)",
"E": "Cholecystotomy"
} | step2&3 | D |
A 22-year-old man is brought to the emergency department by police after he was found undressing himself outside in 110°F weather. The patient refuses to answer any questions as he suspects that his care team is spying on him. The patient recently started college and has presented to the emergency department once befor... | Neuroleptic malignant syndrome | {
"A": "Catatonic schizophrenia",
"B": "Heat stroke",
"C": "Malignant hyperthermia",
"D": "Neuroleptic malignant syndrome",
"E": "Oversedation"
} | step2&3 | D |
A 32-year-old woman presents to the emergency department with abdominal pain and vaginal discharge. She gave birth to a healthy baby boy three days prior to presentation. Since then, she has been feeling sick, and she is concerned that she has been getting worse over time. On presentation, her temperature is 100.7°F (3... | Beta-hemolytic cocci in chains | {
"A": "Alpha-hemolytic cocci in chains",
"B": "Beta-hemolytic cocci in chains",
"C": "Coagulase-negative cocci in clusters",
"D": "Coagulase-positive cocci in clusters",
"E": "Gamma-hemolytic cocci in chains"
} | step1 | B |
An 18-month-old boy is brought to his pediatrician because his mother is concerned about his walking. The boy was born at 37 weeks’ gestation and spent 1 night in the neonatal intensive care unit for respiratory distress. He otherwise has been healthy and started walking independently at 12 months. However, his mother ... | Arylsulfatase A | {
"A": "Alpha-galactosidase A",
"B": "Arylsulfatase A",
"C": "Beta-galactocerebrosidase",
"D": "Beta-glucocerebrosidase",
"E": "Hexosaminidase A"
} | step1 | B |
A 45-year-old man presents to his primary care provider for two weeks of low-grade fever and sore throat. Upon further questioning, the patient is found to have unprotected sex with both men and women with 3-5 partners per month. On workup, he is found to have an HIV viral load of 15,000 copies/mL with a CD4+ of 170 ce... | Folinic acid | {
"A": "Azithromycin",
"B": "Dapsone",
"C": "Fluconazole",
"D": "Folinic acid",
"E": "Tetrahydrofolic acid"
} | step1 | D |
A 71-year-old woman comes to the physician for evaluation of a pigmented lesion on her left foot. She has had decreased appetite and a 6-kg (13-lb) weight loss in the past 2 months. Physical examination shows that on the left medial ankle there is a 2-cm reddish-black nodule with a verrucous surface. A full-thickness e... | Activating natural killer cells and cytotoxic T cells | {
"A": "Stimulating release of acute-phase reactants",
"B": "Stimulating antigen-processing cells",
"C": "Inhibiting expression of MHC II and Th1 cytokines",
"D": "Activating natural killer cells and cytotoxic T cells",
"E": "Supporting growth of bone marrow stem cells"
} | step1 | D |
A 27-year-old female presents to her physician with a palpable thyroid nodule. Iodine uptake testing shows that the nodule has decreased iodine uptake compared with the rest of the thyroid gland. A fine-needle aspiration is performed and the physician calls telling the patient that she has a neoplasm of the thyroid. Wh... | Papillary carcinoma | {
"A": "Papillary carcinoma",
"B": "Medullary carcinoma",
"C": "Follicular carcinoma",
"D": "Anaplastic carcinoma",
"E": "Hurthle cell carcinoma"
} | step1 | A |
A 58-year-old male presents with an acutely elevated blood pressure of 220/140 mmHg. The patient complains of a headache and chest pain, and he has been vomiting for the last several hours. Physical exam demonstrates papilledema and a depressed level of consciousness. To treat this patient's hypertensive emergency, he ... | Decreased pulmonary capillary wedge pressure | {
"A": "Decreased cardiac contractility",
"B": "Increased left ventricular end-diastolic pressure",
"C": "Decreased stroke volume",
"D": "Decreased pulmonary capillary wedge pressure",
"E": "Increased systemic vascular resistance"
} | step1 | D |
A 24-year-old woman delivers a baby at term. The Apgar counts are 9 and 10 at 1 and 5 minutes, respectively. Thirty minutes after delivery, the mother’s blood pressure drops to 80/60 mm Hg and her pulse is 124/min. On physical examination, her distal extremities are clammy and cold, and the uterus is boggy. Aggressive ... | Pituitary infarction | {
"A": "Pituitary tumor",
"B": "Postpartum blues",
"C": "Remains of placenta in uterus",
"D": "Pituitary infarction",
"E": "Pituitary hemorrhage"
} | step1 | D |
A 3-year-old boy is brought to the physician because of a 3-day history of fatigue and yellow discoloration of his skin. One week ago, he had an upper respiratory tract infection. Examination shows jaundice of the skin and conjunctivae. The spleen tip is palpated 2 cm below the left costal margin. His hemoglobin concen... | Cholecystitis | {
"A": "Malaria",
"B": "Acute myelogenous leukemia",
"C": "Cholecystitis",
"D": "Renal papillary necrosis",
"E": "Splenic sequestration crisis"
} | step1 | C |
A 27-year-old woman presents to her primary care physician for a general checkup. She has been doing well in school and has no complaints. The patient has a past medical history of asthma which is controlled with albuterol. She is currently sexually active but states that she uses birth control. She has many friends an... | Discontinue birth control and place an intrauterine device | {
"A": "Colonoscopy",
"B": "Discontinue birth control and place an intrauterine device",
"C": "Pap smear",
"D": "Pregnancy test",
"E": "Recommend weight loss"
} | step2&3 | B |
A 25-year-old woman presents generalized abdominal pain and vomiting for the past hour. She has also had watery diarrhea for several days with no blood or pus in the stools. She is taking an over-the-counter anti-diarrheal medication, which she cannot remember the name of, and drinking oral rehydration solution, which ... | Administer naloxone | {
"A": "Administer naloxone",
"B": "Administer opioid analgesics",
"C": "Scopolamine patch",
"D": "Start dextrose infusion",
"E": "Perform a gastric lavage"
} | step1 | A |
A 26-year-old man with no significant past medical history presents to the ED following a motor vehicle accident. Vital signs on presentation are T 99.0 F, BP 100/60 mmHg, HR 125 bpm, RR 16/min, SpO2 98% on room air. He complains of extreme abdominal pain worse in the left upper quadrant which has worsened over the pas... | Exploratory laparotomy | {
"A": "Normal saline bolus and re-evaluation of hemodynamics after infusion",
"B": "CT abdomen and pelvis",
"C": "Morphine",
"D": "Abdominal plain film",
"E": "Exploratory laparotomy"
} | step2&3 | E |
A 74-year-old man undergoes an open cholecystectomy. Surgery is performed under general anesthesia for which the patient is intubated with an endotracheal tube. Directly following the procedure, his temperature is 37°C (98.6°F), pulse is 80/min, and blood pressure is 110/80 mm Hg. He is extubated as soon as he showed s... | Reintubate | {
"A": "Perform tracheostomy",
"B": "Continue using the non-rebreather mask",
"C": "Reintubate",
"D": "Close observation only",
"E": "Start BiPAP"
} | step2&3 | C |
An 11-month-old male infant is brought to his pediatrician by his mother. She is concerned about his leg and his inability to stand. He was born vaginally to a 33-year-old woman (gravida 3, para 2) from an uncomplicated pregnancy at 39 weeks. He has met all developmental milestones and is up to date on all vaccinations... | Insufficient production of procollagen type 1 | {
"A": "Child abuse",
"B": "Insufficient production of procollagen type 1",
"C": "Mutation in the gene encoding fibrillin-1",
"D": "Defective collagen type 3",
"E": "Dysfunctional structure of laminins"
} | step1 | B |
A 21-year-old man comes to the emergency room with swelling and severe pain in his left lower leg that started 2 hours ago. He has no history of serious illness or trauma. His father has a history of pulmonary embolism. He has smoked one pack of cigarettes daily since he started college 3 years ago. He appears very dis... | Antithrombin III deficiency | {
"A": "Hyperhomocysteinemia",
"B": "Antithrombin III deficiency",
"C": "Factor V Leiden",
"D": "Protein C deficiency",
"E": "Antiphospholipid syndrome"
} | step2&3 | B |
An 80-year-old man is brought to the emergency department because of fatigue and lightheadedness. He does not have chest pain, palpitations, or difficulty breathing. He has a history of hyperlipidemia, type 2 diabetes mellitus, hypertension, osteoarthritis, and asthma. Current medications include simvastatin, metformin... | Cardiac pacing | {
"A": "Dopamine",
"B": "Dobutamine",
"C": "Norepinephrine",
"D": "Cardiac pacing",
"E": "Epinephrine"
} | step2&3 | D |
In a small town with a population of 10,000 people, the prevalence of alcohol use is estimated to be 30%. A study is done with a null hypothesis that there is no association between alcohol use and gastro-oesophageal reflux disease (GERD). The data obtained shows, of the 200 alcoholics who were followed-up, 30 develope... | 45/195 | {
"A": "45/195",
"B": "39/400",
"C": "30/400",
"D": "(30/200) / (30/400)",
"E": "30/200"
} | step1 | A |
A 41-year-old man presents to the clinic with the complaints of abdominal discomfort and cramping for the past 4 months. He also mentions that he has grossly bloody stool and most of the time an urge to defecate. He has a history of bulimia with laxative abuse several years ago. He admits having lost about 5 lb in the ... | Ulcerative colitis | {
"A": "Ulcerative colitis",
"B": "Celiac disease",
"C": "Irritable bowel syndrome",
"D": "Crohn’s disease",
"E": "Laxative abuse"
} | step2&3 | A |
A 45-year-old man presents to your office with a 2-year history of moderate-to-severe pelvic pain, irritative voiding urinary symptoms (frequency and dysuria), and occasional frank blood in his semen with painful ejaculation. He has been evaluated by several practitioners, who have all prescribed antimicrobial therapy,... | Chronic, non-bacterial prostatitis | {
"A": "Benign prostatic hyperplasia",
"B": "Chronic, non-bacterial prostatitis",
"C": "Acute prostatitis by Chlamydia trachomatis",
"D": "Chronic prostatitis by resistant Escherichia coli",
"E": "Interstitial cystitis"
} | step1 | B |
An 18-year-old male presents to the emergency department trauma bay with a gunshot wound to the abdomen. The patient undergoes an exploratory laparotomy, during which, it is discovered that his splenic artery was damaged at its origin from the celiac trunk. The surgeon ligates the splenic artery at its origin. Which of... | Left gastroepiploic artery | {
"A": "Left gastric artery",
"B": "Gastroduodenal artery",
"C": "Right gastroepiploic artery",
"D": "Left gastroepiploic artery",
"E": "Common hepatic artery"
} | step1 | D |
A 2-hour-old, 3.2 kg (7.0 lb) newborn boy born by cesarean delivery is being evaluated by the resident on-call. The child was born to a gravida 2, para 0 mother with known hepatitis B. The mother made it to all of her prenatal appointments and took the recommended dose of folic acid since conception. She gave up smokin... | Administer hepatitis B vaccine and HBIG | {
"A": "Administer hepatitis B vaccine",
"B": "Administer hepatitis B immunoglobulin (HBIG)",
"C": "Administer hepatitis B vaccine and HBIG",
"D": "Check hepatitis B serology",
"E": "Check liver enzymes"
} | step2&3 | C |
A 33-year-old man presents to the emergency department with a cough. He states that 2 weeks ago, he had a fever, chills, and a cough, which his primary doctor treated with acetaminophen, ibuprofen, and rest. Since then, the patient’s symptoms have resolved with the exception of a chronic cough and a small amount of cle... | Supportive care | {
"A": "Chest radiograph",
"B": "CT angiogram",
"C": "D-dimer",
"D": "Sputum culture",
"E": "Supportive care"
} | step2&3 | E |
A 64-year-old man with multiple sclerosis comes to the physician because of a 4-month history of urinary incontinence. The urge to urinate occurs suddenly, and he often is unable to make it to the bathroom before leaking urine. He has no incontinence with coughing or laughing. Digital rectal examination shows no abnorm... | Tolterodine | {
"A": "Doxazosin",
"B": "Midodrine",
"C": "Rivastigmine",
"D": "Mirtazapine",
"E": "Tolterodine"
} | step1 | E |
A 42-year-old woman with a history of depression and headaches presents to the emergency room with severe, pulsating pain around the crown of her head beginning 12 hours ago. She last took ibuprofen 2 hours ago but did not feel any improvement in the pain. She has been nauseous and unable to get out of bed and is curre... | Sumatriptan | {
"A": "No treatment necessary",
"B": "100% oxygen",
"C": "Propranolol",
"D": "Sumatriptan",
"E": "Amitriptyline"
} | step1 | D |
A pulmonologist is analyzing the vital signs of patients with chronic obstructive pulmonary disease (COPD) who presented to an emergency room with respiratory distress and subsequently required intubation. The respiratory rates of 7 patients with COPD during their initial visit to the emergency room are shown:
Patient ... | 32 breaths per minute | {
"A": "30 breaths per minute",
"B": "32 breaths per minute",
"C": "10 breaths per minute",
"D": "27.7 breaths per minute",
"E": "26 breaths per minute"
} | step1 | B |
A 17-year-old high school student was in shop class when he accidentally sawed off his pointer finger while making a bird house. He fainted when he realized his finger had been cut off. The teacher immediately transported the patient to the emergency department and he arrived within 20 minutes. He has a past medical hi... | Wrap finger in moist gauze, put in a plastic bag, and place on ice | {
"A": "Submerge the finger in ice water",
"B": "Wrap the finger in moist gauze",
"C": "Wrap the finger in moist gauze and place on ice",
"D": "Wrap finger in moist gauze, put in a plastic bag, and place on ice",
"E": "Wrap the finger in moist gauze and submerge in ice water"
} | step2&3 | D |
A 15-year-old girl comes to the physician because she has not had menstrual bleeding for the past 3 months. Menses had previously occurred at irregular 15–45 day intervals with moderate to heavy flow. Menarche was at the age of 14 years. She started having sexual intercourse with her boyfriend about 3 months ago. Six m... | Anovulation | {
"A": "Uterine fibroids",
"B": "Congenital defect of the Mullerian ducts",
"C": "Purging behavior",
"D": "Polycystic ovaries",
"E": "Anovulation"
} | step2&3 | E |
A 21-year-old woman presents with sudden onset of high blood pressure. She is concerned about her health especially after her colleagues noticed that her face gets red at times while at work. She has even started to use blankets to cover her feet, even on the warmest days in the summer, even though her hands feel warm ... | Turner syndrome | {
"A": "Fibromuscular dysplasia",
"B": "Marfan syndrome",
"C": "Turner syndrome",
"D": "Pheochromocytoma",
"E": "Takayasu's arteritis"
} | step2&3 | C |
A 52-year-old man presents to the physician with a 6-month history of shortness of breath and nonproductive cough. He was recently diagnosed with stage 3 embryonal carcinoma testicular cancer. Following an orchiectomy, he was placed on chemotherapy. Cardiopulmonary examination shows fine inspiratory crackles bilaterall... | Bleomycin | {
"A": "Bleomycin",
"B": "Carboplatin",
"C": "Cisplatin",
"D": "Ifosfamide",
"E": "Methotrexate"
} | step2&3 | A |
A 72-year-old man develops reduced urine output and a serum creatinine concentration of 2.9 mg/dL three days after being hospitalized for acute diverticulitis. On admission, a complete blood count showed a hemoglobin concentration of 15.5 g/dL and a leukocyte count of 14,000/mm3. Urinalysis showed 2+ proteinuria, and s... | Contrast administration | {
"A": "Gastrointestinal blood loss",
"B": "Adverse drug reaction",
"C": "Dehydration",
"D": "Contrast administration",
"E": "Chronic hypertension\n\""
} | step2&3 | D |
An immunology expert is delivering a talk on innate immunity. While talking about inflammasomes, he describes the process via an example: products of cellular stress are detected by NLRP3, which includes NOD-, LRR-, and pyrin domain-containing 3; the latter interacts with apoptosis-associated speck-like protein contain... | Caspase 1 | {
"A": "Adenosine deaminase",
"B": "Caspase 1",
"C": "Protein kinase C",
"D": "Protein phosphatase",
"E": "Tyrosine kinase"
} | step1 | B |
The ribosome is an essential organelle that plays an important role in the synthesis of new proteins. The location of the ribosome within the cell can vary and provides a clue to the function of the particular cell. What ribosome location is essential for protein-secreting cells? | Rough endoplasmic reticulum | {
"A": "Rough endoplasmic reticulum",
"B": "Smooth endoplasmic reticulum",
"C": "Cytosol",
"D": "Cell membrane",
"E": "Nucleus"
} | step1 | A |
A patient presents to the emergency department with severe pain in her head. She states that the pain started 1 hour ago after rugby practice. Typically, she takes a special medication for bad headaches, but this time she took 2 doses and noticed no improvement in her symptoms. The patient's current medications that sh... | Medication reaction | {
"A": "Hemorrhagic stroke",
"B": "Ischemic stroke secondary to a thrombus",
"C": "Medication reaction",
"D": "Psychogenic symptoms",
"E": "Subarachnoid hemorrhage"
} | step2&3 | C |
A 24-year-old woman comes to the physician for a routine gynecological examination and to refill her birth control pills. Her last pap smear at age 22 showed no intraepithelial lesions nor malignancy of the cervical cells. Menses occur at regular 28-day intervals and last 4 days. Her last menstrual period was 2 weeks a... | Neisseria gonorrhoeae and Chlamydia trachomatis screening | {
"A": "Neisseria gonorrhoeae and Chlamydia trachomatis screening",
"B": "Beta-hCG urine test",
"C": "Repeat Pap smear",
"D": "Mammography",
"E": "No further testing is necessary"
} | step2&3 | A |
A 27-year-old man presents to the emergency department after a motor vehicle accident. The patient has a past medical history of asthma and cocaine use. His current medications include albuterol and ibuprofen. His temperature is 99.5°F (37.5°C), blood pressure is 70/35 mmHg, pulse is 150/min, respirations are 19/min, a... | Hemolytic anemia and ataxia | {
"A": "Hemolytic anemia and ataxia",
"B": "Gum disease and poor wound healing",
"C": "Irregularly irregular heart rhythm",
"D": "Hepatitis C infection",
"E": "Anti-A, B, or O antibodies in the serum"
} | step2&3 | A |
An academic obstetrician is conducting a retrospective cohort study that evaluates the risk of placenta accreta at all statewide medical centers. Per chart review he finds that a prior cesarian birth is associated with a statistically significant increased risk of placenta accreta. The relative risk associated with thi... | The 99% confidence interval includes the null hypothesis. | {
"A": "The 99% confidence interval includes the null hypothesis.",
"B": "The chance of bias in favor of the alternative hypothesis is 3%.",
"C": "The p-value represents the likelihood of seeing an increased risk of placenta accreta in women with prior cesarian birth, assuming the alternative hypothesis is true."... | step2&3 | A |
A 23-year-old man presents to his primary care physician after bleeding from his gums while brushing his teeth for the past week. Although he has had gum bleeding in the past, it has never been this severe. He has no family history available as he was adopted. He does not have any significant past medical history. His ... | Gp Ib | {
"A": "Factor IX",
"B": "Gp Ib",
"C": "Factor XI",
"D": "Vitamin K",
"E": "Antithrombin III"
} | step1 | B |
A 51-year-old Caucasian woman presents to the physician for a routine health maintenance examination. She had a Colles' fracture 2 years ago. The rest of her past medical history is unremarkable. She has a sedentary lifestyle. She has been smoking 1 pack of cigarettes daily for 30 years. She drinks alcohol moderately. ... | Alendronate | {
"A": "Alendronate",
"B": "Calcitonin",
"C": "Estrogen",
"D": "Tamoxifen",
"E": "No pharmacotherapy at this time"
} | step2&3 | A |
A 33-year-old woman, gravida 2, para 1, at 26 weeks' gestation presents to the emergency department because of frequent contractions. The contractions last 40 seconds, occur every 2 minutes, and are increasing in intensity. She has a history of recurrent painful ulcers on her vulva, but she currently does not have them... | Allow vaginal delivery | {
"A": "Allow vaginal delivery",
"B": "Initiate misoprostol therapy",
"C": "Initiate nifedipine therapy",
"D": "Perform cesarean delivery",
"E": "Perform dilation and evacuation"
} | step2&3 | A |
A 55-year-old man presents with complaints of exertional dyspnea and dry cough. He reports using extra pillows at night to sleep and two nighttime awakenings to catch his breath in the last month. The patient lives in a homeless shelter and has not seen a doctor in the last 20 years. He has been drinking 5-8 drinks of ... | Increased renal tubular sodium reabsorption | {
"A": "Decreased glomerular filtration rate (GFR)",
"B": "Decreased vascular smooth muscle tone",
"C": "Decreased extracellular fluid (ECF) volume",
"D": "Increased renal blood flow",
"E": "Increased renal tubular sodium reabsorption"
} | step2&3 | E |
A 22-year-old man presents to the medical clinic after getting bit in the hand by a stray dog 2 days ago. The patient has no past medical history and takes no prescription medications. He does not drink alcohol or smoke cigarettes. The patient’s vitals are currently within normal limits. On examination, the physician n... | Amoxicillin-clavulanate | {
"A": "Amoxicillin",
"B": "Amoxicillin-clavulanate",
"C": "Clindamycin",
"D": "Doxycycline",
"E": "Azithromycin"
} | step2&3 | B |
A 3-year-old refugee with increasing pitting edema and abdominal swelling over the past 2 months is brought to the physician. Her family has been displaced several times over the last few years. Nutrition and housing were frequently inadequate. At the physician’s clinic, the boy appears irritated and drowsy. He is diff... | Kwashiorkor | {
"A": "Kwashiorkor",
"B": "Marasmus",
"C": "Beriberi",
"D": "Rickets",
"E": "Scurvy"
} | step2&3 | A |
A 2-year-old boy is brought to his pediatrician by his parents for a routine visit. Since his 18-month visit, the parents have become concerned that his speech does not seem to be developing appropriately. The parents report that the patient’s vocabulary is still limited to fewer than 10 words, and he is still only usi... | X-linked dominant | {
"A": "Autosomal dominant",
"B": "Autosomal recessive",
"C": "Noninherited somatic mutation",
"D": "X-linked dominant",
"E": "X-linked recessive"
} | step1 | D |
A 23-year-old man is brought to the emergency department by his mother because of a change in his personality. The mother reports that over the past 7 months her son has become increasingly withdrawn; he has not answered any phone calls or visited his family and friends. He had always been a quiet boy, who needed some ... | Schizophrenia | {
"A": "Brief psychotic disorder",
"B": "Delusional disorder",
"C": "Mood disorder with psychotic features",
"D": "Schizoid personality disorder",
"E": "Schizophrenia"
} | step2&3 | E |
A 37-year-old woman presents to the clinic with pain and swelling of her legs. She states that she first noticed the swelling 6 weeks ago. Initially, the swelling was minimal, but now she is finding it difficult to walk and she can’t fit into any of her shoes. Her medical history is significant for systemic lupus eryth... | Mesna | {
"A": "Ifosfamide",
"B": "Mesna",
"C": "Methotrexate",
"D": "Nitrofurantoin",
"E": "Prednisone"
} | step2&3 | B |
A 38-year-old woman presents to the office for a routine examination. She has no complaints and offers very little information voluntarily. She answers each question with soft, short sentences and avoids eye contact. She appears timid, anxious and admits that this is one of the very few times she has left the house in ... | Avoidant personality disorder | {
"A": "Body dysmorphic disorder",
"B": "Schizoid personality disorder",
"C": "Avoidant personality disorder",
"D": "Antisocial personality disorder",
"E": "Agoraphobia"
} | step1 | C |
A 3-year-old boy is brought to the emergency room by his mother after she found him somnolent at home next to multiple open pill bottles. The boy had seemingly opened several different pill bottles that were in a cabinet in his parent’s bathroom. The mother has brought the empty bottles to the emergency room, and they ... | pH 7.36, PCO2 22 mmHg, and HCO3- 16 mEq/L | {
"A": "pH 7.29, PCO2 47 mmHg, and HCO3- 22 mEq/L",
"B": "pH 7.35, PCO2 29 mmHg, and HCO3- 15 mEq/L",
"C": "pH 7.36, PCO2 22 mmHg, and HCO3- 16 mEq/L",
"D": "pH 7.47, PCO2 41 mmHg, and HCO3- 29 mEq/L",
"E": "pH 7.48, PCO2 24 mmHg, and HCO3- 25 mEq/L"
} | step1 | C |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.