Mehlman High Yield Practice Exam

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• In cystic fibrosis patients, which organism becomes the predominant pneumonia pathogen in adolescence compared with early childhood?
• In suspected cardiac ischemia, what is the first-line test for a patient who can exercise?
• The minimum age to start the killed influenza vaccine is
• Which statement best describes fibromuscular dysplasia in terms of curability?
• FSH stimulates which cells to promote follicle development and aromatase production?
• A patient with left facial droop, left-sided weakness, and Babinski on the left is most consistent with which lesion and mechanism?
• Which prostanoid is decreased by selective COX-2 inhibitors, contributing to an increased thrombotic risk?
• The anemia associated with chronic alcohol use is best described as:
• Crescent-shaped lesions in glomeruli define which renal pathology pattern?
• A patient develops fever, chills, flank pain, and hypotension shortly after a transfusion. This presentation is most consistent with which reaction?
• Beefy red, well-demarcated skin plaque is most consistent with which diagnosis?
• In immunocompromised patients, watery diarrhea is most likely caused by which organism?
• What is the recommended management for cubital tunnel syndrome?
• Hot tub lung is caused by inhalation of fumes from hot tubs and results in which condition?
• What is the recommended MMR dosing schedule?
• Tx for polyarteritis nodosa?
• Initial treatment for temporal arteritis to prevent blindness?
• Actinic keratosis is a precursor lesion for which skin cancer?
• In an adult with cognitive decline and microcytic anemia, which enzymes are inhibited by lead?
• In Cushing syndrome, which electrolyte abnormality is most likely to occur?
• Which antibody is historically associated with the diagnosis of celiac disease alongside anti-tTG?
• A patient presents with marked leukocytosis and a high leukocyte alkaline phosphatase score. The most likely diagnosis is:
• Patients with selective IgA deficiency are at risk of anaphylaxis during transfusion of blood products containing IgA. Which option reflects this risk?
• During an acute SLE flare, which change in complement is typical?
• Best initial management for febrile non-hemolytic transfusion reaction?
• Which medications commonly used in cardiovascular disease can cause hyperkalemia?
• Diagnosis of alpha or beta thalassemia is most accurately made with which test?
• Which small bowel biopsy finding would most strongly distinguish lactose intolerance from celiac disease?
• Recent cholecystectomy with fever and abdominal pain most strongly suggests which complication?
• Varicella vaccination timing: when should a child receive the vaccine?
• What best describes the role of IκB in NF-κB signaling?
• Which statement best distinguishes von Willebrand disease from hemophilia regarding joint bleeding?
• Waiter’s tip position in a child results from injury to which nerve roots?
• Delirium in a patient taking a thiazide diuretic may indicate which electrolyte disturbance?
• Which criterion indicates tympanostomy tube placement for recurrent otitis media?
• The SAD triad of syncope, angina, and dyspnea is most commonly associated with which condition?
• Which macronutrient provides the most calories per gram?
• In a patient with insulinoma, which pattern of laboratory values would you expect?
• What is one empiric regimen for endocarditis described in the material?
• What is the mechanism of action of nedocromil in allergy management?
• Which is a common side-effect of metformin?
• In Henoch-Schönlein purpura, which symptom is part of the classic tetrad along with IgA nephropathy?
• The combination of prosthetic joints, rheumatoid/osteoarthritis, and recent intense joint trauma indicates what level of risk for septic arthritis?
• First-line management for PCOS patient with high BMI?
• What is an appropriate treatment for erysipelas and cellulitis?
• Which AV block is most likely to require pacemaker therapy?
• For imaging to view the gallbladder, which modality is typically used?
• Viral infection with pancytopenia indicates which syndrome?
• In a patient with a history of GERD and dysphagia, what is the recommended next step to evaluate for cancer?
• If the baseline ECG is abnormal (for example, bundle-branch block), which test is preferred to evaluate ischemia?
• CSF findings in fungal meningitis most commonly include which pattern?
• Which finding helps distinguish beta-thalassemia trait from iron deficiency anemia?
• Which statement about hemophilia inheritance is true?
• Which pattern of emphysema is associated with alpha-1 antitrypsin deficiency?
• Mirtazapine used in anorexia with depression acts as what pharmacologic agent?
• Which is the initial imaging test for suspected achalasia?
• What is the first-line treatment for Giardia lamblia infection?
• Which antibiotic is appropriate for erysipelas or cellulitis to cover both Staphylococcus and Streptococcus?
• Which statement about febrile non-hemolytic transfusion reaction is true?
• If a mother’s hepatitis B status is unknown, what is the recommended handling for the newborn at birth?
• Clindamycin is effective for aspiration pneumonia above the diaphragm because it covers which type of organisms?
• Urge incontinence is commonly observed in individuals with multiple sclerosis or during the perimenopausal period. Which type is most likely?
• Von Willebrand disease is inherited in which pattern?
• A 42-year-old man presents with a painless lateral neck mass and hepatomegaly. The most likely diagnosis is:
• What is the first-line drug to start in type 2 diabetes mellitus?
• In third-degree heart block, there is complete AV dissociation between atria and ventricles.
• A patient with a pleural-based mass encasing the lungs: malignant cells derived from which cell type?
• A patient with progressive paresthesias and areflexia; CSF shows protein 70 mg/dL and cell count 5/µL. What is the mechanism behind this condition?
• Which disease is associated with antibodies to type IV collagen?
• Saddle anesthesia + urinary retention indicates which syndrome?
• Which marker is elevated in medullary thyroid carcinoma?
• Infection + RBC lacking central pallor + positive Coombs test indicate which diagnosis?
• Which dementia is characterized by visual hallucinations, Parkinsonism, and cognitive decline?
• In patients with hypocalcemia or hypokalemia unresponsive to supplementation, which deficiency should be suspected?
• Ciguatera poisoning is most commonly acquired from which category of fish?
• In a patient with radiculopathy after lifting, which diagnostic step is indicated?
• In a 72-year-old man with intermittent claudication, absent distal pulses, prior CABG, and long-standing hypertension, what is the likely diagnosis?
• In the testes, which cell type predominantly produces testosterone?
• Can a girl become pregnant without ever having a menstrual period?
• Which staining test highlights the Cryptococcus capsule producing a red color?
• Biggest risk factor for osteoarthritis is?
• Which therapy is commonly used to treat lupus nephritis?
• What is polyarteritis nodosa?
• A patient wakes up with facial droop and arm weakness; regarding tPA eligibility, which statement is most accurate?
• Which drug is commonly used for malaria prophylaxis in chloroquine-resistant areas?
• Donepezil inhibits which enzyme to increase cholinergic transmission?
• The sickle cell mutation involves substitution of which amino acid in the beta-globin chain?
• Hashimoto thyroiditis increases risk of which thyroid-associated malignancy?
• Which thyroid cancer is typically associated with a cold nodule on radionuclide uptake scanning?
• In a patient with varicose veins and a painful palpable cord by the ankle, the appropriate treatment is which of the following?
• Which organism causes psittacosis, a pneumonia linked to birds?
• Which histologic finding is more typical of Crohn disease than ulcerative colitis?
• Amiodarone is an example of which category of drug used to treat tachyarrhythmias?
• In a woman in the 30s-40s with random bruising at different stages of healing, what should you first rule out?
• Which of the following is NOT listed as a side effect of methotrexate?
• Otitis externa with mastoid involvement is most accurately described as malignant otitis externa. Which option best describes this condition?
• What is a common empiric therapy for community-acquired pneumonia?
• In hereditary hemochromatosis, what is the mechanism that leads to diabetes?
• During an ITP episode, what is the next best step in management?
• What histologic pattern is characteristic of diffuse proliferative lupus nephritis?
• After positive celiac serology, what is the next best step to confirm the diagnosis?
• In overflow incontinence, which statement is true about postvoid residual volume?
• What is the first-line management for stress incontinence?
• In premature ovarian failure and menopause, which hormonal pattern is typical?
• A 44-year-old man with alcohol withdrawal presents with agitation and tachycardia. Which medication is commonly used as first-line therapy for delirium tremens?
• Which medication is a nonselective beta-blocker commonly used for migraine prophylaxis, tachycardia in hyperthyroidism, and essential tremor?
• Which drug is associated with hypokalemia in patients with cardiovascular disease?
• Post-streptococcal glomerulonephritis can occur after which type of infection?
• Transfusional siderosis is treated with which therapy?
• Which class of drug does bortezomib belong to?
• If a patient on a ventilator shows improving oxygen saturation, what is the next best step?
• The infection Sporothrix schenckii is commonly treated with which antifungal?
• In sarcoidosis, which electrolyte disturbance is typical?
• Which treatment is used during an acute attack of acute intermittent porphyria?
• A patient with autoimmune disease on steroids presents with back pain and vertebral tenderness. What is the most likely diagnosis?
• Bronze diabetes is a classic presentation of which disease?
• PR depressions on ECG are highly specific for which condition?
• Leukocyte adhesion deficiency may present with delayed separation of the umbilical cord. Which statement best describes this condition?
• Which of the following is NOT part of the SAD triad?
• What kind of red blood cells are typical in thalassemia?
• Which feature best characterizes papillary thyroid carcinoma?
• What is the recommended enzyme replacement therapy for exocrine pancreatic insufficiency due to chronic pancreatitis?
• What is the product of the t(9;22) translocation?
• What diagnostic test is preferred for pulmonary embolism in pregnancy?
• Point tenderness over a vertebra in an older woman. Most likely diagnosis?
• Which imaging modality confirmed fibromuscular dysplasia in a patient with hypertension?
• In rhabdomyolysis, what is the mechanism of renal injury most commonly?
• Cystic hygroma is a lymphatic malformation commonly seen with which condition?
• Empiric antibiotic therapy for suspected bacterial meningitis typically includes which combination?
• What acid-base disturbance is typically seen with aspirin toxicity in the first 20 minutes?
• Which glomerular lesion is most likely in a patient with sickle cell disease and nephrotic-range proteinuria?
• Which statement best describes initial and definitive management for renovascular hypertension due to RAS or FMD?
• Which translocation is associated with APL?
• Which pharyngeal pouch gives rise to the superior parathyroid glands?
• In an intravenous drug user with focal vertebral tenderness, which diagnosis should be urgently considered?
• In sickle cell disease, nephrotic syndrome is most commonly associated with which histologic lesion?
• Which option represents first-line oral antibiotics for erysipelas or cellulitis?
• Which porphyria is inherited in an autosomal dominant fashion?
• Ankylosing spondylitis most commonly presents in which demographic group?
• Linear immunofluorescence on biopsy is classically associated with which condition that affects the kidneys and lungs?
• Radiographs of which region are used to support the diagnosis of ankylosing spondylitis?
• In pulmonary contusion, aggressive IV fluids can worsen oxygenation due to fluid overload. What outcome would you expect?
• A 74-year-old man with a pigmented lesion on the cheek; diagnosis?
• In Williams syndrome, which aortic pathology is typical?
• Which organism is primarily associated with invasive intestinal amebiasis and potential liver abscess, often treated with a tissue-active agent followed by a luminal agent?
• A woman in her 20s-40s with arthritis and thrombocytopenia most likely has which disease?
• In aspirin-exacerbated respiratory disease, which analgesic should be avoided?
• In aspirin overdose during the first 20 minutes, which acid-base disturbance is typically seen?
• In the management of Wilson disease, which agent is listed as the treatment?
• A patient lifts a heavy box and develops severe back pain with radiculopathy after lifting; which diagnosis is most likely?
• Which CSF profile is typical of bacterial meningitis?
• Which vessels are notably not affected in polyarteritis nodosa?
• In osteoarthritis management, which analgesic is typically used before NSAIDs due to renal safety concerns?
• A 17-year-old female who competed in a kickboxing tournament last weekend has a red, warm, tender knee. What is the recommended initial test?
• What is the next best step in diagnosing suspected viral-induced aplastic anemia?
• Gradual-onset dementia with no sensory or motor dysfunction is most consistent with which diagnosis?
• For PCOS patients who do not desire pregnancy, which medication is commonly used as first-line pharmacotherapy?
• What is the most specific eye finding in multiple sclerosis?
• Bleeding time is most affected by which component of hemostasis?
• Leukocyte adhesion deficiency type 1 is best explained by which mechanism?
• Which features characterize MEN2B?
• Regarding tPA use for pulmonary embolism, which statement is most accurate?
• When is tympanostomy tube placement indicated for recurrent otitis media?
• Which condition is classically associated with the triad gait disturbance, urinary incontinence, and cognitive impairment?
• Wernicke-Korsakoff syndrome has characteristic involvement of which brain structure?
• Which statement about third-trimester physiologic changes is correct?
• A patient presents with fatigue and labs showing normal sodium, hyperkalemia, and metabolic acidosis. The most likely diagnosis is Addison disease.
• Preoperative management of pheochromocytoma commonly uses which alpha-blocker?
• Prior to surgery in a patient with rheumatoid arthritis, which imaging study is recommended to assess for atlantoaxial subluxation?
• Viral infection with vertigo and hearing loss is termed which condition?
• Which medication is recommended acutely to decrease shear forces in suspected acute aortic dissection?
• A holosystolic murmur at the left sternal border with a diastolic rumble is most consistent with which defect?
• In beta-thalassemia trait, which hemoglobin fraction is typically elevated on electrophoresis?
• Which neurologic consequence is commonly associated with Sturge-Weber syndrome due to leptomeningeal angiomatosis?
• Ethyl alcohol provides how many calories per gram?
• Wide-complex tachycardia is most consistent with which rhythm?
• Dipyridamole, used in pharmacologic stress testing, exerts its effect primarily by which mechanism?
• Which hormone accounts for greater insulin secretion when glucose is given orally rather than by IV?
• What test confirms the diagnosis of thalassemia?
• What is the primary pathophysiologic mechanism of venous insufficiency?
• What is the initial management step in a bleeding episode for Hemophilia A?
• What is the most effective way to decrease recurrence of ITP?
• The organism most commonly responsible for cellulitis is:
• In dermatitis herpetiformis, which immunoglobulin is deposited at the dermal papillae?
• Which clinical finding is most specific for endometriosis?
• What immunofluorescence pattern is seen on renal biopsy in Goodpasture syndrome?
• The enzyme deficiency in Lesch-Nyhan syndrome is?
• In suspected meningitis, which step is preferred first according to guidelines?
• In a 17-year-old with mononucleosis, what is the best method to reduce transmission?
• Which organism is responsible for Q fever transmitted from cattle?
• Which statement about sickle cell inheritance is true?
• A patient has lateral chest pain after a viral infection and elevated CK. Which diagnosis is most consistent?
• For nursemaid's elbow, which reduction technique is commonly used to regain radial head stability?
• Low calcium or potassium not responding to supplementation should prompt assessment of which electrolyte?
• A man with painful hands and DIP involvement on X-ray has which diagnosis?
• Parkinsonism occurring in an older patient is most likely which disease?
• Which antifungal is an echinocandin used to treat invasive aspergillosis?
• When should the killed IM influenza vaccine be given?
• Viral infection with low platelets suggests which diagnosis?
• In a young woman with unilateral resting tremor and hemolytic anemia, which test is next best to evaluate Wilson disease?
• Pneumonia after influenza infection which organism is USMLE wants?
• The mechanism of stress incontinence primarily involves weakness of which anatomical support?
• Which statement best describes follicular thyroid carcinoma?
• Heliotrope rash is best described as a violaceous eruption around which area?
• A mid-systolic crescendo-decrescendo murmur that does not change or softens with Valsalva indicates which lesion?
• Pink line tracking up the arm from the hand after a burn suggests which diagnosis?
• Which statement best differentiates polymyalgia rheumatica from polymyositis?
• Vomiting a few hours after ingestion of meat is most consistent with which toxin?
• A patient given an alpha-1 antagonist demonstrates which intracellular change due to blockade of alpha-1 signaling?
• Which description is characteristic of CMV ulcers in the colon?
• Ganciclovir is used to treat CMV infections. What is its primary mechanism of action?
• Pemphigus vulgaris is characterized by autoantibodies against which protein?
• Fracture at the surgical neck of the humerus injures which nerve?
• The finding of autoimmune disease in a patient or family with cholestasis points toward which diagnosis?
• In a patient with memory complaints but preserved daily functioning, which scenario is most likely?
• Pruritus after a warm shower is a feature most associated with which hematologic finding?
• Pattern: low hematocrit + normal MCV + low iron + normal or high ferritin is most consistent with which diagnosis?
• Which skin manifestation is commonly associated with SLE?
• In rhabdomyolysis, which electrolyte abnormality is most likely?
• Bleeding after circumcision in a neonate is most characteristic of which disorder?
• A patient develops dyspnea, hypoxemia, and bilateral pulmonary infiltrates within hours after a transfusion. What is the diagnosis?
• What is the most common presenting finding in SLE?
• Post-void residual >300 mL is most characteristic of which type of incontinence?
• Which disease is characterized by PAS-positive macrophages in the lamina propria and arthritis?
• Erysipelas is typically distinguished by which border feature?
• Which of the following is an anti-TNF-alpha agent used in RA?
• A patient with arthritis, mouth ulcers, and circular skin lesions most likely has which disease?
• Which nerve controls the external urethral sphincter?
• NOT a classic risk factor for cholelithiasis?
• Smudge cells on a smear together with autoimmune hemolytic anemia are most indicative of:
• Treatment for nail bed fungus is which of the following?
• Drug-induced lupus is most characteristically associated with autoantibodies to which antigen?
• Baclofen’s mechanism of action is best described as activation of which receptor?
• Which nematode is associated with pork consumption and trichinellosis?
• In aspirin-exacerbated respiratory disease, which statement is true?
• Back pain that is worse in the morning and improves with activity in a man aged 20-40 is most suggestive of which condition?
• Imatinib, used to treat chronic myeloid leukemia, is commonly associated with which adverse effect?
• Peutz-Jeghers syndrome features mucocutaneous hyperpigmentation and which type of GI polyps?
• Propranolol is not indicated for which of the following conditions?
• In Carney complex, endocrine hypersecretion classically presents as which condition due to bilateral pigmented zona fasciculata hyperplasia?
• Are varicose veins considered a form of venous insufficiency?
• Severe skin infection involving fascial planes with cutaneous crepitus is most commonly caused by which organism?
• Which two laboratory findings are typically elevated in cholestasis?
• Which of the following is a classic example of a Type IV hypersensitivity reaction?
• A young man on a tricyclic antidepressant develops hot, red skin and urinary retention. This is best explained by which pharmacologic effect of TCAs?
• Dark urine in sickle cell disease is most consistent with which pathology?
• A 17-year-old with cellulitis not improving on amoxicillin; which statement best describes the likely organism and outpatient management?
• Which oral antibiotics are appropriate for erysipelas and cellulitis?
• Naproxen belongs to which drug class?
• What is the recommended management for a strawberry hemangioma that is not life-threatening and is expected to regress spontaneously?
• Tx for pulmonary hypertension: most patients respond to which therapy?
• In individuals with asplenia or sickle cell disease, which vaccines are recommended to prevent infection with encapsulated organisms?
• Which of the following is an effective topical antifungal shampoo for seborrheic dermatitis?
• Injury at the midshaft of the humerus predominantly involves which nerve?
• In a patient with cough-variant asthma, approximately what fraction of asthmatics present with cough as the sole symptom?
• Which laboratory test is variably prolonged in von Willebrand disease due to factor VIII stabilization?
• A 17-year-old girl presents with a painless lateral neck mass and a mediastinal mass. This presentation is most suggestive of which lymphoma?
• Copper is normally excreted by the body through which organ/system?
• Urge incontinence is most commonly observed in which population group?
• Which mechanism describes the action of probenecid?
• Kasabach-Merritt syndrome is best described as a large vascular lesion with concomitant thrombocytopenia caused by what mechanism?
• Which histologic finding on small bowel biopsy would indicate celiac disease rather than isolated lactose intolerance?
• Hypercalcemia in sarcoidosis is due to activation of vitamin D by which cells?
• What is the biggest risk factor for osteoarthritis?
• Which hematologic finding is characteristic of CML?
• If CT shows a cystic lesion in the bile duct in a cholestatic patient, what is the most likely diagnosis?
• A patient with hypercalcemia and confusion most likely has which manifestation?
• Which demographic is most affected by SLE?
• A single cystic lesion on brain CT in a patient who recently traveled to Mexico most likely represents infection with which parasite?
• The hormonal state that increases endometrial cancer risk in PCOS is due to what?
• Which option represents the Swiss cheese appearance as a brain imaging finding?
• What type of granulomas characterize sarcoidosis?
• A 27-year-old man with fever and hemolytic anemia; splenectomy; from Pennsylvania; peripheral smear shows intraerythrocytic ring forms and Maltese crosses; diagnosis?
• If pericardiocentesis is not immediately available, what surgical option can relieve tamponade?
• What is the secondary function of von Willebrand factor?
• Prevention of otitis externa in someone with constant water exposure, such as a crew team, relies on which measure?
• In outpatient asthma management, what is the next step after using a short-acting beta-agonist if control is not adequate?
• Why is penicillin alone suboptimal for treating erysipelas or cellulitis?
• Buspirone is typically used as what in generalized anxiety disorder?
• What is the treatment of a new acute flare of multiple sclerosis?
• A pearly, translucent papule with visible telangiectasia on the face is most suggestive of which skin cancer?
• A patient with alkaline urine and renal tract calculi is most likely infected with which organism?
• Metastases to long bones from prostate cancer are typically what type, aiding in diagnosis?
• SLE with red urine most likely indicates which diagnosis?
• The combination of wet, wobbly, wacky signs with Parkinsonism most strongly suggests which diagnosis?
• For patients who cannot undergo surgery or are pregnant, what medical therapy is used for cholelithiasis?
• Zileuton exerts its pharmacologic effect by which mechanism?
• In vaginal candidiasis, what is the recommended initial treatment approach?
• Mini-mental state exam score low + patient tries to do well corresponds to which diagnosis?
• Pleural plaques on imaging suggest exposure to which substance?
• In multiple sclerosis, urinary incontinence is most often due to which type?
• A 13-year-old girl presents with irregular periods in the first year after menarche. The next best step is to?
• Which ECG finding is most characteristic of cardiac tamponade?
• Corticosteroids modulate NF-κB signaling by which mechanism?
• Which syndrome presents with ataxia, confusion, and ophthalmoplegia and is associated with thiamine deficiency?
• A 35-year-old woman with menorrhagia and signs of hypothyroidism asks what test to order next. Which is the most appropriate next step?
• A patient who has been taking high-dose vitamins reports cracked lips, rough/dry skin, and hair loss. Excess of which vitamin is most likely responsible?
• Compartment syndrome treatment?
• What is the treatment for esophageal candidiasis?
• Which statement about complement C3 levels is typical during a systemic lupus erythematosus flare?
• One month after treatment with atovaquone and proguanil, relapse occurs due to hepatic hypnozoites. Which species is most likely responsible?
• In Western countries, the most common underlying cause of bronchiectasis is which condition?
• Which pattern is most consistent with thalassemia?
• In an elderly patient with colonic diverticula, which part of the colon is most commonly involved?
• The combination of metamyelocytes and myelocytes in the peripheral smear with splenomegaly is most characteristic of which condition?
• Which drug is used to treat hereditary angioedema?
• Which malaria species is considered the most severe due to risk of cerebral malaria?
• Which statement about virginal breast hypertrophy during puberty is true?
• Which of the following is an example of a broad-spectrum antibiotic used in neutropenic fever?
• The diagnostic workup for suspected SBP includes which of the following?
• Which antibiotic is first-line for streptococcal pharyngitis?
• Which statement correctly identifies the organism most commonly implicated in secondary pneumonia after influenza infection?
• Which antiviral is used to treat herpes simplex virus infections?
• First-line treatment for hereditary hemochromatosis is which?
• During refeeding after prolonged starvation, which electrolyte is most at risk for severe deficiency?
• Which transcription factor is associated with Burkitt lymphoma?
• In a premenopausal patient with heavy menstrual bleeding, which type of anemia is most likely?
• A patient with new-onset murmur and fever should be evaluated for which diagnosis?
• Ciprofloxacin belongs to which class of antibiotics?
• Cerumen buildup is best treated with which of the following?
• Which demographic is most commonly affected by SLE?
• In asthma management, inhaled corticosteroids are primarily used for which purpose?
• Which CSF pattern suggests aseptic (viral) meningitis?
• Claw hand results from injury to which nerve root levels?
• Ticlopidine is an ADP2Y12 receptor blocker antiplatelet agent. Which of the following drugs also belongs to this class?
• If imaging is negative for pancreatic cancer but suspicion remains due to cholestasis, which malignancy should be considered?
• Which statement best describes the typical management of adolescent gynecomastia presenting as a breast mass?
• Actinic keratosis presents as a sun-exposed red, scaly lesion on the ear. What is the most likely diagnosis?
• In osteoarthritis, what is the best initial analgesic approach when BMI is normal?
• Administration of bortezomib has which effect on immune activity related to tumor antigen presentation?
• Rasburicase and pegloticase are examples of what type of agent that acts on uric acid?
• What is included in the diagnostic workup for polymyositis?
• Following a Group A Streptococcus infection, acute rheumatic fever most commonly causes which valvular lesion?
• First-line treatment for impetigo?
• What is the preferred antidote for ethylene glycol and methanol poisoning?
• Sickle cell disease presenting with red urine is most consistent with which diagnosis?
• A patient on warfarin presents with suspected pulmonary embolism. What is the recommended next step?
• In a vignette with suspected incarcerated groin hernia, what is the recommended initial management?
• Which of the following is true regarding tinea capitis management?
• Worldwide, the most common cause of bronchiectasis is which condition?
• Which patient group is most at risk for septic arthritis?
• Which imaging modality is used to diagnose pancreatic cancer?
• In suspected lumbosacral strain, which diagnostic action is recommended?
• Centriacinar emphysema is most strongly associated with which risk factor?
• A common metabolic feature often seen with PCOS due to insulin resistance is?
• In restrictive lung disease, FEV1/FVC is typically:
• Mobitz I is also known as Wenckebach.
• In an upright person, which region of the lung has the highest ventilation and perfusion?
• Which part of the clavicle is most commonly fractured?
• Lacunar infarcts causing pure motor stroke are most commonly due to lipohyalinosis of which arteries?
• In acute wound infection, which cell type is most responsible for the initial defense in the wound area?
• X-linked SCID is due to a mutation in which receptor subunit?
• Which therapy has no role in the acute management of asthma?
• Which finding is most specific to meningitis as opposed to encephalitis?
• Severe renal disease in Wegener, Goodpasture, or microscopic polyangiitis is most consistent with which condition?
• Pseudodementia is suggested by which pattern on testing and behavior?
• A 36-year-old man with a long-standing fracture develops petechiae on the chest. What is the most likely diagnosis?
• Which laboratory markers are unreliable for distinguishing polymyalgia rheumatica from polymyositis?
• Which acid-base disturbance is most characteristic after 20 minutes of aspirin overdose?
• Memantine is an antagonist of which receptor?
• In a patient with significant blood loss and oliguria, which diagnosis is most likely?
• A 44-year-old man with hematuria and hemoptysis is most likely to have which syndrome?
• Sporotrichosis is classically acquired after handling which plant material?
• Which condition is now named eosinophilic granulomatosis with polyangiitis?
• If endoscopy is negative for diabetic gastroparesis, what test should be used to confirm delayed gastric emptying?
• What is the most common cause of otitis externa?
• Acute intermittent porphyria is caused by deficiency of which enzyme?
• Which finding is most characteristic of asbestos exposure related to pleural involvement?
• Prothrombin time (PT) and activated partial thromboplastin time (aPTT) assess what aspect of hemostasis?
• Pneumonia with cattle exposure which organism is most likely?
• If a patient experiences stable angina after walking only a short distance (e.g., up a flight of stairs), what is the recommended next step?
• Back pain in an elderly patient with hypercalcemia is most suggestive of which diagnosis?
• For secondary hemochromatosis due to chronic transfusions, the indicated therapy is?
• Which description best fits hypertrophic obstructive cardiomyopathy (HOCM)?
• In a young adult with few or no prior symptoms, a presentation suggesting lactose intolerance is most consistent with which diagnosis?
• Which statement best describes anti-histone antibodies in drug-induced lupus?
• Which treatment promotes urinary excretion of salicylates during overdose?
• A 23-year-old woman presents with severe dysmenorrhea and pelvic pain. Pelvic examination reveals nodularity of the uterosacral ligaments. Which test is most definitive to confirm endometriosis?
• Dermatitis herpetiformis shows which characteristic finding on biopsy or immunofluorescence?
• Which drug is used to treat spasticity in multiple sclerosis?
• In adults with a heart tumor, which diagnosis is most likely before biopsy?
• Following massive hepatocellular injury, liver regeneration occurs primarily by which cellular mechanism?
• In sarcoidosis, which cell type is responsible for producing 1-alpha hydroxylase leading to hypercalcemia?
• Which statement best describes ursodeoxycholic acid therapy in cholelithiasis?
• Which nerve keeps the internal urethral sphincter closed?
• In secondary polycythemia due to chronic lung disease, erythropoietin levels are typically:
• Vitamin K deficiency results in deficiency of which coagulation factor set?
• What is the main function of von Willebrand factor?
• A 55-year-old man with hyperthyroidism develops absent pulses in the left leg. Which is the most likely cause of his acute limb ischemia?
• What is a standard treatment for sarcoidosis?
• Hyperviscosity syndrome is most commonly associated with which conditions?
• Inflammatory bowel disease is commonly associated with back pain due to which axial condition?
• Which statement correctly describes respiratory alkalosis?
• The histology of diffuse proliferative glomerulonephritis typically shows what?
• In arterial insufficiency, what is the recommended treatment sequence?
• In a severely cold-exposed alcoholic patient, rewarming raises concern for which electrolyte abnormality?
• In sarcoidosis-related hypercalcemia, what happens to PTH levels?
• After catheterization and medical therapy, what is the next step if overflow incontinence due to BPH persists?
• In rheumatoid arthritis, which cervical abnormality is of particular concern due to potential instability?
• Which diagnostic test is used to support the diagnosis of Guillain-Barré syndrome?
• A patient has a urine dipstick that shows positive for blood, but there are no red blood cells on microscopy. Which of the following is the most likely cause?
• Which cancer is classically associated with osteoblastic metastases to bone, particularly in the long bones?
• p-ANCA (anti-MPO) is most closely associated with which vasculitis?
• In the third trimester of pregnancy, which physiologic parameter is increased?
• In renovascular hypertension, which hormonal profile would you expect?
• Ulcers at the medial malleolus with hyperpigmentation of the lower legs most strongly suggest which diagnosis?
• A man in his 40s presents with hematuria and hemoptysis; what is the most likely diagnosis?
• What is the definitive surgical treatment for symptomatic cholelithiasis or cholecystitis?
• Hypertension in autosomal dominant polycystic kidney disease is most commonly due to which mechanism?
• What is the recommended regimen for Entamoeba histolytica?
• Ganciclovir inhibits which viral enzyme?
• In suspected scaphoid fracture with a negative initial X-ray, what should be done to prevent avascular necrosis risk?
• What is the mechanism of action of buspirone?
• An ulcerated lesion with visible telangiectasia is most consistent with which diagnosis?
• Which feature helps distinguish costochondritis from pericarditis?
• Which therapy is used to treat hereditary hemochromatosis?
• Which agent is an NMDA receptor antagonist?
• Hematuria plus hemoptysis and head-itis symptoms such as mastoiditis, sinusitis, otitis, and nasal septal perforation is most characteristic of which disease?
• Which antibiotic is commonly used for recurrent otitis media?
• Greasy, scaly scalp with itching and papules in an adult best describes which condition?
• Infective causes of third-degree AV block include which of the following?
• Which drug is a beta-3 agonist used to treat urge incontinence?
• Rhabdomyolysis risk in alcoholics—which condition is most likely to be elevated?
• Which statement best describes the genetic origin of a complete hydatidiform mole?
• For suspected primary biliary cholangitis, what is the initial diagnostic test?
• For stress incontinence due to pelvic floor weakness, the first-line management is which intervention?
• Bruton agammaglobulinemia is associated with a mutation in which molecule?
• Which disorder is characterized by self-mutilation behavior and red-orange crystals in the diaper due to uric acid accumulation?
• Two main causes of pseudogout are?
• For hypercalcemia with a calcium of 10.2-12 mg/dL, which initial therapy is recommended?
• In rhabdomyolysis, which urine finding best explains a dipstick positive for blood with no RBCs on microscopy?
• For a patient who cannot exercise, which pharmacologic stress test is used to evaluate ischemia?
• Which receptor agonism is associated with pain and itching?
• Not typically a first-line therapy for a newly diagnosed Crohn disease or ulcerative colitis?
• Costovertebral angle tenderness with fever indicates which condition?
• Which condition presents with microcytic anemia that does not improve with iron supplementation?
• In an 80-year-old patient with a catheter, what measure best decreases infection risk?
• Which statement about metformin is true?
• What is the normal post-void residual volume?
• Which statement best reflects the most common site of clavicle fracture?
• In suspected acute ischemic stroke, which imaging study must be obtained before giving tPA to exclude hemorrhage?
• A 46-year-old man with a history of heavy alcohol use presents with a peripheral smear showing hypersegmented neutrophils. Which vitamin deficiency is most likely?
• Incontinence in diabetes is most commonly due to which mechanism?
• A neonate with a condition described as homozygous gene deletion most likely shows which inheritance pattern?
• How is venous insufficiency best diagnosed?
• Which organism is the most common cause of otitis externa?
• A girl is Tanner stage 3. Which statement is true?
• Which antibody rises in acute SLE flares?
• Killed IM Influenza vaccine safe in pregnancy?
• Spironolactone is best described as which type of drug?
• A patient taking high-dose vitamins presents with cracked lips, rough/dry skin, and alopecia. Excess of which vitamin is responsible?
• In acute pulmonary embolism, what acid-base disturbance is typically observed?
• Which finding would favor a T-cell lymphoma over Hodgkin lymphoma?
• The sensory phenomenon 'hot feels cold' is associated with ciguatera poisoning caused by a toxin that blocks sodium channels. It is most commonly acquired from which fish category?
• After repairing a ventricular septal defect with a prosthetic patch, which change in pressures best describes LV, RV, and LA pressures?
• Detrusor muscle contraction is mediated by which nerves?
• In constitutional short stature, how does the growth curve typically appear relative to peers?
• AV nicking on fundoscopy indicates which condition?
• What is the standard surgical management for a choledochal cyst?
• Which biopsy method is used for neck lesions suspicious for skin cancer to ensure a full-thickness sample?
• Which pattern of emphysema is characteristic of alpha-1 antitrypsin deficiency?
• Which is a consequence of increased intestinal calcium absorption in sarcoidosis?
• Transfusion-related acute lung injury (TRALI) is best described as which mechanism?
• Bullous pemphigoid is associated with autoantibodies against which structure?
• Which sequence describes diagnosing polymyositis after antibody testing?
• What is the next best diagnostic step for suspected viral-induced aplastic anemia?
• Medullary thyroid carcinoma is a feature of which MEN syndromes?
• Peutz-Jeghers syndrome includes perioral hyperpigmentation and what type of GI polyps?
• Biliary colic with fever most likely represents which condition?
• Which of the following is a risk factor for cutaneous squamous cell carcinoma besides sun exposure?
• Which drug should be avoided in patients with a history of uric acid stones or uric acid overproduction?
• Hyperactive detrusor or detrusor instability is most closely associated with which type of urinary incontinence?
• Hereditary spherocytosis is inherited in autosomal dominant fashion due to deficiency of which proteins?
• The t(9;22) translocation results in a fusion gene that encodes a constitutively active tyrosine kinase. Which therapy specifically inhibits this kinase?
• Which procedure is designed to maximize tumor clearance while preserving surrounding tissue in skin cancer?
• To confirm suspected hemochromatosis, which tests are most informative?
• What is the first-line therapy for a flare of SLE?
• Heart defect is characteristic of Williams syndrome?
• Which scenario most strongly suggests osteoporosis-related compression fracture?
• The live-attenuated intranasal influenza vaccine is approved for which population?
• A 28-year-old non-smoker with a loud P2 and right ventricular hypertrophy is most likely to have which diagnosis?
• Which feature distinguishes toxic shock syndrome from endotoxic shock?
• Which lab changes accompany an acute SLE flare?
• Mobitz I (Wenckebach) is characterized by
• Polycythemia with hypercalcemia in a smoker and red urine most likely represents which malignancy with paraneoplastic features?
• Which therapy is commonly given to MS patients between flares as a disease-modifying agent?
• Which statement about basal cell carcinoma is true?
• Hx of surgery and high-pitched bowel sounds or acute-onset abdominal symptoms suggests which diagnosis?
• Which statement about donepezil is true?
• Which macronutrients provide 4 kcal per gram?
• What is an important point in the management of myocardial contusion?
• What is the recommended sequence of management for overflow incontinence due to BPH?
• Which antibody is most specific for rheumatoid arthritis?
• p-ANCA (anti-MPO) targets which enzyme?
• What acid-base disturbance is typically seen in acute pulmonary embolism?
• In euthyroid sick syndrome, which laboratory pattern is typical?
• Which two conditions are the most acceleratory risk factors for arterial insufficiency?
• A young African American woman presents with a dry cough and a normal chest X-ray. What is the most likely diagnosis?
• Renal artery angiogram in polyarteritis nodosa shows which appearance?
• In obstructive lung disease, the FEV1/FVC ratio is typically:
• Thiazide diuretics commonly cause which electrolyte disturbance?
• What is the standard treatment for varicose veins?
• In Addison disease, what electrolyte pattern is expected?
• In a dehydrated patient with low bicarbonate, what mechanism explains the development of lactic acidosis?
• Which histologic feature is described by the term 'wire looping' in lupus nephritis?
• Biochemical disturbances in Addison's disease include which of the following patterns?
• Which agent is used orally for nail bed fungus?
• Colon cancer in a first-degree relative (sibling or parent) changes the screening plan in which way?
• Which dementia is also known as Pick disease?
• Blurred vision after exposure to paint thinner most likely indicates poisoning with which substance?
• A 15-year-old male presents with a unilateral breast mass behind the nipple and mild tenderness. The most likely explanation is?
• A 38-year-old woman develops a facial rash after gardening. What is the most likely cause?
• Which statement best aligns with the imaging distinction between choledochal cysts and cholangiocarcinoma?
• In a patient undergoing chemotherapy with leukopenia, which agent is most likely to increase neutrophil count?
• Nursemaid's elbow most commonly presents in which age group?
• Which vaccines are included in the routine 2-, 4-, and 6-month infant immunization schedule?
• Which Plasmodium species is known for relapse due to dormant liver hypnozoites?
• Which treatment is used for von Willebrand disease?
• Which antibody is associated with granulomatosis with polyangiitis?
• A patient with fever, periorbital edema, and myalgias after a BBQ likely has infection with which parasite?
• Which imaging modality is referred to as the myocardial scintigraphic assay in noninvasive ischemia testing?
• The term 'Still disease' refers to which form of juvenile arthritis?
• A cholestatic pattern with autoimmune history most strongly suggests which diagnosis?
• Which statement about the pathophysiology of sickle cell disease is correct?
• Which smear finding is pathognomonic for Babesia infection?
• Which bisphosphonate is given as an example for hypercalcemia?
• A patient with secondary syphilis develops fever and tachycardia shortly after starting penicillin G. Which mechanism best explains this reaction?
• Tx of first-degree heart block or second-degree Mobitz I (Wenckebach) is to
• In the management of otitis externa, which is appropriate?
• What is the standard acute treatment for multiple sclerosis flares?
• Point tenderness over a vertebra in a younger patient on steroids. Most likely diagnosis?
• Mid-systolic click is most characteristic of which condition?
• Beta-lactam antibiotics given with rash and renal issues point to which condition?
• Which skin cancer is most likely to metastasize quickly?
• Which condition is most likely in a patient with hypercalcemia presenting with polyuria?
• What radiographic feature is commonly seen in sarcoidosis?
• As heart rate returns to baseline after exercise, which statement best describes changes in diastole and systole?
• Which is the most common aggressive non-Hodgkin lymphoma?
• Which antibodies are associated with Goodpasture syndrome?
• Post-streptococcal glomerulonephritis can follow which infection?
• Which comorbidity is a known risk with thiazide use due to hyperuricemia?
• Which pattern best distinguishes thalassemia from iron deficiency anemia?
• Which feature is more characteristic of meningitis than encephalitis?
• NSAIDs cause fluid retention by which mechanism?
• Which measure reduces the risk of transmission of tinea capitis?
• Which cardiac abnormality is classically associated with congenital rubella syndrome?
• What is the most common indolent non-Hodgkin lymphoma?
• Which disease is potentially cured by colectomy?
• What mechanism explains low blood cell lines in SLE?
• In NSAID-induced interstitial nephropathy, the BUN/Cr ratio is typically greater than what?
• Treatment for tinea corporis is which?
• In autosomal dominant polycystic kidney disease, which screening strategy is routinely used for monitoring hypertension?
• Fibromuscular dysplasia involves proliferation of which arterial wall layer?
• Which of the following is a clotting-factor related manifestation of von Willebrand disease?
• Hypopigmentation on the upper back and trunk is most consistent with which fungal condition?
• Amenorrhea in anorexia is best explained by which hormonal pattern?
• What histologic finding is classically seen in the small intestine of patients with celiac disease?
• Which intervention is considered definitive for renovascular hypertension due to renal artery stenosis?
• Which pattern most strongly supports iron deficiency anemia over anemia of chronic disease?
• Which laboratory finding is most suggestive of drug-induced lupus compared to idiopathic SLE?
• In the setting of severe ischemia on stress testing or myocardial perfusion scan, what is the next step in management?
• If the mother is known to be Hepatitis B positive, what prophylaxis is given to the newborn?
• To support the diagnosis of ankylosing spondylitis, which imaging study is typically used to assess the sacroiliac joints?
• Neonate born to a mother with systemic lupus erythematosus (SLE) is at risk for which conduction abnormality?
• Which agent inhibits leukotriene synthesis to reduce disease activity in aspirin-exacerbated respiratory disease?
• Management of serotonin syndrome includes which of the following?
• Which antibody is associated with drug-induced lupus?
• A 40-year-old man develops linear vesicular rash after hiking. What is the most likely immunologic mechanism?
• In an adult with recurrent sinopulmonary infections and atopy, which immunodeficiency is most likely?
• In a hypertensive patient who has had a stroke, which diagnostic step is most appropriate to evaluate for carotid disease?
• What is the initial antibiotic of choice for uncomplicated otitis media?
• What is the most common cause of acute otitis media?
• A 2-year-old with cardiac myxoma, perioral melanosis, and endocrine hypersecretion suggests which syndrome?
• Weakened elbow flexion with sensory loss over the lateral forearm indicates injury to which nerve?
• What unique finding is seen on blood smear in APL?
• In a patient with SLE and red urine, which form of lupus nephritis is most likely?
• A patient has a family history of a hereditary hemolytic condition treated with splenectomy. Which condition is most likely?
• Bortezomib is used primarily in which disease?
• A 16-year-old girl presents with short stature, Tanner stage II, and a wide neck. Her bone age is equal to her chronological age. What diagnosis is most likely?
• An 82-year-old man presents with dribbling, hesitancy, interrupted urinary stream and a suprapubic mass. What is the initial management?
• Which of the following is a classic drug with the potential to cause drug-induced lupus?
• 12-month-old with red urine 1-3 days after a URI most likely has which condition?
• The figure-of-8 strap is classically used for which fracture?
• Multiple pregnancies with downward movement of the vesicourethral junction leads to which type of urinary incontinence?
• c-ANCA positivity is most associated with which disease?
• Fracture at the midshaft of the humerus commonly injures which nerve?
• Which population is at highest risk for malignant otitis externa?
• In a patient with rheumatoid arthritis on infliximab therapy, which immune mediator is most likely contributing to ongoing inflammation?
• Which lab pattern is consistent with iron deficiency anemia presenting with high transferrin and high TIBC and transferrin saturation very low?
• Bleeding from a finger cut stops rapidly due to which vascular mechanism?
• What is the mechanism of action of methotrexate used in RA?
• In carcinoid syndrome, when the tumor is located in the GI tract with liver metastasis, serotonin reaches systemic circulation; if there is no liver metastasis, what is true about serotonin?
• The shawl sign in dermatomyositis refers to a rash distribution over which area?
• Guyon canal syndrome is entrapment of which nerve at the wrist, commonly due to hook of hamate fracture or chronic handlebar impaction in cyclists?
• Claw hand is associated with injury to which nerve roots?
• A patient with polycythemia, hypercalcemia, smoking history, and red urine most likely has tumors producing which substances?
• In a patient with marked leukocytosis due to infection, which mechanism explains a leukemoid reaction?
• Which statement is true about polyarteritis nodosa?
• How often should colonoscopy be repeated after initial screening if a relative has colon cancer?
• First-line topical therapy for seborrheic dermatitis of the scalp includes which of the following?
• After induction therapy for cryptococcal meningitis, what is the recommended maintenance approach?
• Which organism is most commonly associated with preformed toxins in custards and potato salad?
• Gas production in soft tissue infection is most classically associated with which organism?
• Which cytopenia is most commonly observed in SLE due to antibody-mediated destruction?
• Initial nonoperative management for carpal tunnel syndrome typically includes which option?
• Overflow incontinence due to benign prostatic hyperplasia is primarily caused by which mechanism?
• Community-acquired pneumonia with right lower lobe consolidation and dullness to percussion is most likely caused by which organism?
• Violaceous papules in the temporal region are most consistent with which syndrome?
• Which statement best describes the tympanostomy tube criterion?
• In X-linked sideroblastic anemia with decreased delta-ALA synthase, administration of which vitamin might improve the condition?
• Which statement is true about antibodies in SLE?
• Which nerve injury classically presents with weakened elbow flexion and sensory loss over the lateral forearm?
• A patient with immune thrombocytopenia had splenectomy; six months later platelets drop again. What is the most likely cause?
• Which property of spironolactone makes it useful after furosemide therapy to balance potassium levels?
• An adult male is 4 feet tall, with head and trunk proportional to limbs. Which condition best fits this description?
• In suspected dermatomyositis, which finding is most helpful as an initial diagnostic test?
• A bicuspid aortic valve is most commonly associated with which condition?
• Which test is most likely to establish a pheochromocytoma in a patient with hypertension and compatible history?
• Which ovarian morphology is commonly associated with PCOS on ultrasound?
• What type of organism are nematodes?
• Black widow spider bite treatment involves addressing which electrolyte disturbance?
• Which gene is associated with follicular lymphoma as an anti-apoptotic molecule?
• Nutrition calorie counts: which macronutrient provides 9 kcal per gram?
• In severe ischemia, which disease pattern would prompt consideration of coronary artery bypass grafting as the revascularization strategy?
• Which drug is not included in the HIPP mnemonic for drugs that cause drug-induced lupus?
• What is the mechanism most commonly responsible for low blood cell counts in SLE?
• Which pharmacologic agent is commonly added after an initial exercise program for arterial insufficiency?
• Which organism is NOT typically associated with reactive arthritis after GI infection?
• If NSAIDs and steroids are not used in an acute gout attack, what is an alternative treatment?
• Temporal arteritis is associated with which condition?
• A 40-year-old woman with hypothermia who is rewarmed in hospital develops concerns about electrolyte disturbances. Which electrolyte abnormality is most worrisome in this scenario?
• What is the appropriate sequence of management for a patient with suspected pulmonary embolism who is already on warfarin?
• During an acute MS relapse, which regimen is most commonly used?
• In a CF patient older than 10 with pneumonia, which organism predominates?
• What is the modern name for Churg-Strauss syndrome?
• A child with marked lymphocytosis should raise suspicion for which two conditions, one of which is a malignant process?
• In the setting of a viral infection with pancytopenia affecting all three cell lines, what is the diagnosis?
• Which test best confirms lactose intolerance after a positive hydrogen breath test, if needed?
• What is the current name for Wegener granulomatosis?
• When is a LABA typically added in the stepwise management of asthma?
• Positive Coombs test helps distinguish autoimmune hemolytic anemia from hereditary spherocytosis; which statement is true?
• Which organism is now the most common cause of impetigo?
• In asthma, progression from type I to type II respiratory failure is associated with what change in CO2?
• ST-segment depressions in the anterior ECG leads most strongly suggest which diagnosis?
• What is the most diagnostic test for Pneumocystis jirovecii pneumonia?
• Which statement best differentiates Type III and Type IV hypersensitivity?
• In a patient with rheumatoid arthritis who develops bilateral arm paresthesias, which cervical complication must be considered?
• Which statement is true about PCOS?
• In a patient with high ALP, high direct bilirubin, normal amylase/lipase after remote cholecystectomy, which diagnosis is most likely?
• Which imaging modality provides detailed arterial mapping for potential revascularization after noninvasive tests?
• An ECG showing electrical alternans most likely indicates which condition?
• Which statement about erysipelas and cellulitis is true?
• High-anion gap metabolic acidosis is classically caused by which mnemonic?
• What is the first-line treatment for venous insufficiency?
• Which drug is used to treat CML by inhibiting BCR-ABL tyrosine kinase?
• In the symptom-relief phase, steroids provide what effect on disease progression?
• In a patient with insulinoma, why are ketone bodies typically low during fasting?
• In a young adult with emphysema but no smoking history and a family history of hepatic cirrhosis, testing should target which deficiency?
• Diffuse ST-segment elevations on ECG are most consistent with which diagnosis?
• Hematuria in isolation with p-ANCA in serum points to which disease?
• A study reports sugar consumption and prostate cancer with p = 0.07. Which statement best reflects the result?
• In suspected aortic dissection, which chest imaging finding is commonly observed?
• Dyspnea in the second trimester of pregnancy indicates which valvular disease?
• Which history factor increases suspicion for ARDS in a trauma patient?
• Holosystolic murmur at the left sternal border plus either a parasternal heave or palpable thrill indicates which defect?
• Which statement best describes ARDS ventilation strategy?
• Riedel thyroiditis presents with which classic finding?
• Which statement about polyarteritis nodosa is true?
• Which presentation is most typical of pemphigus vulgaris?
• Gynecomastia is a side effect of which medication commonly used in heart failure?
• Guillain-Barré syndrome is associated with albuminocytologic dissociation. Which statement describes this CSF pattern?
• Halitosis plus a gurgling sound when swallowing and regurgitation of undigested food is most characteristic of which condition?
• On biopsy, which immunofluorescence pattern is characteristic of pemphigus vulgaris?
• After initiating steroids for temporal arteritis, which diagnostic test is used to confirm?
• Which antifungal is used for simple fungal pneumonia?
• CNS disturbance due to an electrolyte problem is most commonly caused by abnormalities of which electrolyte?
• Bird’s beak appearance on imaging is classically associated with which condition?
• In a patient with SVT or VT presenting with coma or unconsciousness, the initial rhythm-control treatment is
• Marfan or Ehlers-Danlos syndrome is associated with which valve/pathology?
• A punched-out ulcer on the foot with intermittent claudication is most consistent with which vascular diagnosis?
• Pronated arm with wrist drop indicates injury to which nerve?
• Which site is the most common origin for carcinoid tumors that cause carcinoid syndrome?
• What is an appropriate initial management for hypercalcemia?
• What measure is recommended to prevent contrast-induced nephropathy?
• Cherry red lips are a classic clinical clue for which type of poisoning?
• Beck triad, consisting of hypotension, muffled heart sounds, and jugular venous distension, is associated with which condition?
• Which of the following best describes the hemostasis test results typically seen in ITP?
• In pemphigus vulgaris, autoantibodies against desmoglein disrupt adhesion between which cells?
• Pelvic floor exercises are used to treat which type of incontinence?
• A BUN/Cr ratio greater than 20 most classically indicates which pattern?
• In suspected diabetic gastroparesis, what test should be performed before initiating pharmacologic therapy to exclude mechanical obstruction?
• What radiographic finding corresponds to emphysema?
• Worm in the eye is most commonly caused by which parasite?
• A circular lesion seen on imaging in pancreatitis that is described as a pseudoabscess is best managed with which intervention?
• Cutaneous candida infection is treated with which?
• Desmopressin challenge in nephrogenic diabetes insipidus: how does urine osmolality respond?
• Which murmur pattern is associated with a congenital defect that may be described as pan-systolic-pan-diastolic and as continuous machinery-like?
• Which serious complication is associated with untreated celiac disease?
• If there is tenderness in the snuffbox but initial radiographs are negative, what is the recommended management?
• Bleeding time is primarily a reflection of what part of hemostasis?
• After induction therapy for cryptococcal meningitis, what is the recommended consolidation/maintenance therapy?
• Which dementia tends to show early behavioral changes with relatively preserved memory?
• In immune thrombocytopenia (ITP), what is the initial treatment?
• Which finding on the hands is a hallmark of dermatomyositis?
• How will agranulocytosis present on USMLE?
• What is the mechanism of viral-induced aplastic anemia?
• Mobitz II is defined by
• Ring sideroblasts in sideroblastic anemia show iron accumulation localized around which cellular structure?
• Which drug is classically associated with drug-induced lupus?
• Which imaging modality is used to diagnose atlantoaxial subluxation in rheumatoid arthritis?
• Which class of receptor mediates the action of insulin signaling?
• Which statement best contrasts the hematopoietic effects of viral-induced aplastic anemia with SLE?
• If a pneumonia presents with a lobar pattern but is described as interstitial in the vignette, which organism is most likely?
• What is the treatment of impetigo?
• If a patient with osteoarthritis or rheumatoid arthritis develops a red, warm knee, what action should be taken to evaluate for septic arthritis?
• A 14-year-old boy is at the 3rd percentile for height, and his bone age is delayed relative to his chronological age. What is the most likely diagnosis?
• Which procedure is routinely used to plan revascularization after noninvasive testing shows severe ischemia?
• In temporal arteritis presenting with proximal muscle stiffness, which additional diagnosis is commonly considered?
• After a diarrheal illness, Guillain-Barré syndrome is most classically associated with which organism?
• Outbreaks from recreational water and resistance to chlorine are most commonly associated with which parasite?
• A dental care worker with vesicle on the finger most likely has which diagnosis?
• Which statement explains why facial nerve movement may recover after injury while vision does not?
• Why is diabetic ketoacidosis less common in type II diabetes compared to type I?
• Which procedure involves peritoneal aspiration to evaluate ascitic fluid?
• After a fall on an outstretched hand with tenderness in the anatomical snuffbox, which fracture is most likely?
• What is the inheritance pattern of von Willebrand disease?
• Which immunosuppressive agent is commonly used to treat lupus nephritis?
• Which chromosomal translocation is NOT associated with Burkitt lymphoma?
• In Tanner staging, which stage is associated with imminent menarche?
• Which ulcerative skin lesion is classically associated with ulcerative colitis?
• For stress incontinence due to weakened pelvic floor, what is the next best management step?
• A 14-year-old girl has a massive unilateral breast mass. The recommended management is to...
• Apathy, disinhibition, and personality changes with cognitive impairment are typical features of which dementia?
• Why does amoxicillin or penicillin fail to cover common community Staphylococcus aureus infections?
• Why is FEV1/FVC normal or high in restrictive lung disease?
• Cubital tunnel syndrome is caused by entrapment of which nerve at which location?
• Which sign best suggests a toxic aspirin dose in a child who found an open bottle?
• During an acute asthma attack, which acid-base disturbance is most typical due to hyperventilation?
• Which of the following is ineffective for treating esophageal candidiasis?
• A child develops delirium after ingestion of an over-the-counter cold medicine given by a parent. What is the most likely diagnosis?
• Which statement best differentiates scombroid poisoning from shellfish allergy?
• Injury to the medial epicondyle region most commonly damages which nerve?
• Erysipelas is best described as an infection of which layer?
• Urge incontinence is best described by which of the following?
• Perianal anesthesia + urinary retention or incontinence indicates which syndrome?
• Chelation therapy is used to treat which condition?
• Trichotillomania (hair pulling) with GI symptoms is most likely to cause which condition?
• Severe renal disease in GPA, Goodpasture, or MP is best termed?
• Which diagnosis is most likely in a 32-year-old woman presenting with arthritis and low platelets?
• If pelvic floor exercises fail to control stress incontinence, the next step is:
• Which medication is a muscarinic cholinergic antagonist used to treat urge incontinence?
• Myxomatous degeneration of the mitral valve causes which condition?
• When evaluating pediatric knee swelling, which test is essential to exclude infection in the differential diagnosis?
• A child presents with recurrent knee redness, warmth, and pain plus fever. The most likely diagnosis is:
• Which statement about tinea capitis management is accurate?
• In an MVA patient with no rib fractures but chest pain and pulmonary infiltrates underlying the painful area, what is the most likely diagnosis?
• Bullous impetigo is predominantly caused by which organism?
• What is the most important prognostic factor for melanoma?
• Lesch-Nyhan syndrome is inherited in which pattern?
• Which finding best describes the clinical presentation of acute mesenteric ischemia?
• In polycythemia vera, which best describes the typical erythropoietin level?
• Which combination of screenings is recommended for average-risk individuals starting at age 50?
• In a biostatistics question, increasing the number of participants affects what?
• Pleurodynia is characterized by which of the following?
• Which laboratory finding most supports anemia of chronic disease?
• Strawberry hemangiomas in newborns are best described as which type of lesion?
• Which combination of findings is most consistent with juvenile arthritis in a child?
• In Bruton, which immunoglobulin pattern is expected?
• On hand radiographs, which joints are typically involved in rheumatoid arthritis?
• Which medication is used to treat cysticercosis?
• In anemia of chronic disease, which statement about iron is most accurate?
• Fournier gangrene in a diabetic patient requires which urgent intervention?
• PTU and methimazole are used for the treatment of which thyroid condition?
• Which of the following best describes the initial management of necrotizing fasciitis?
• In premature ovarian failure, inhibin levels are typically what?
• In pregnancy, which imaging modality is preferred to evaluate suspected pulmonary embolism?
• A child has recurrent joint pain, elevated ESR, and a rash. The most likely diagnosis is:
• A 2-year-old boy has writhing movements during sleep and periventricular nodules on MRI. Which associated finding would support a diagnosis of tuberous sclerosis complex?
• What is the confirmatory test for Goodpasture syndrome?
• Which renal effect contributes to edema during NSAID therapy in osteoarthritis?
• Which lab pattern is consistent with gallstone pancreatitis (choledocholithiasis)?
• Which finding is associated with herpes simplex encephalitis?
• Goodpasture syndrome involves antibodies against which component?
• The initial pharmacologic treatment for VT is:
• A 25-year-old woman with BMI 32 presents with irregular menses and hirsutism. Which syndrome best explains this combination?
• What best describes metformin's mechanism?
• A 22-year-old man presents with nystagmus and aggressive behavior after drug use. What is the most likely diagnosis?
• Which of the following would most likely disturb Hardy-Weinberg equilibrium?
• Lymphoid malignancies are almost always derived from which immune cell lineage?
• Which gynecologic condition presents with diffusely enlarged uterus and abnormal vaginal bleeding?
• A drug that increases insulin release; what is MOA?
• Which serologic test is commonly used to screen for celiac disease?
• After a motorcycle accident, a patient cannot dorsiflex the foot but eversion is preserved. Which nerve is injured?
• Suspected skin cancer on the face is best treated with which procedure?
• Which symptom triad is associated with acute intermittent porphyria?
• Translocation t(15;17) is characteristic of which leukemia subtype?
• Which is the correct treatment for earwax buildup?
• High hemoglobin with low erythropoietin levels is most characteristic of which condition?
• Point tenderness over a vertebra in patient with autoimmune disease recognize patient is on steroids. Most likely diagnosis?
• In overflow incontinence due to diabetic neuropathy, which drug is used to stimulate detrusor contraction?
• Turner syndrome is most commonly associated with which karyotype?
• For hypercalcemia with a calcium of 12-14 mg/dL, what is recommended if asymptomatic vs symptomatic?
• A chronically alcoholic patient has potassium 3.2 mEq/L; after potassium supplementation, the potassium remains low. What is the most likely accompanying electrolyte abnormality?
• Which nonalcohol substance is commonly associated with cerebellar ataxia and cognitive decline in adolescents?
• The recommended initial treatment for otitis externa is:
• Stepwise progression of dementia with a history of vascular risk factors is most consistent with which type of dementia?
• Pericarditis treatment options include which of the following?
• Which prophylactic treatment is recommended for otitis externa in patients with repeated water exposure?
• Mantle cell lymphoma is characteristically associated with which translocation?
• Radiculopathy down an arm is most commonly caused by which cervical pathology?
• Which test is used to diagnose carcinoid syndrome by detecting serotonin metabolite?
• Which adverse effect is most commonly associated with spironolactone use?
• How is compartment syndrome diagnosed?
• What is the recommended induction therapy for cryptococcal meningitis?
• Which antibody is most specific for systemic lupus erythematosus?
• A patient with no prior atopy eats meaty fish in a sketch location (e.g., Bali) and develops dyspnea and an allergic-like reaction. The most likely diagnosis is?
• Which autoantibody typically rises during acute SLE flares?
• What is the mechanism of action of spironolactone?
• What is considered first-line treatment for an acute gout attack?
• Tx of second-degree Mobitz II or third-degree heart block is a
• Increasing the number of participants in a study primarily increases which statistical property?
• Pseudogout presents in two patterns: one is monoarthritis of a large joint such as the knee; the other is an osteoarthritis-like presentation in someone with which conditions?
• A traveler with bloody diarrhea and right upper quadrant pain most likely has a liver abscess due to which organism?
• Unilateral hydronephrosis due to ureteral compression by a vascular structure is most commonly caused by which artery?
• If left untreated, a strawberry hemangioma typically demonstrates which course?
• A child with red urine, abdominal pain, arthralgia, and violaceous lesions on the buttocks and thighs most likely has which diagnosis?
• Back pain in a patient with a history of cancer at a different site is most likely due to which finding?
• Parkinsonism with axial dystonia is most characteristic of which disorder?
• A patient presents with recurrent oral and genital ulcers and ocular inflammation; the most likely diagnosis is?
• Most lymphoid malignancies are derived from which cell lineage?
• Which antifungal is preferred for CNS fungal infection or fungemia presenting with rigors?
• Trigeminal neuralgia originates from which brain structure?
• What is the treatment for an SLE flare?
• What is the correct order of initiating therapies in heart failure according to the material?
• Atenolol is commonly used for which condition?
• In a neonate with a large vascular lesion and thrombocytopenia, what is the mechanism behind the low platelet count?
• Which test confirms the diagnosis of achalasia after imaging suggests it?
• Which rash is most characteristic of dermatomyositis and should not be confused with the malar rash of SLE?
• Which disorder is associated with vertical gaze palsy and axial dystonia?
• Von Willebrand disease is defined by a deficiency of which factor?
• What test confirms the diagnosis of sickle cell disease?
• What is the recommended age range for initiating HPV vaccination?
• An adult male is 4 feet tall with a large head and trunk relative to limbs. What is the most likely diagnosis?
• What is the most common cause of death in anorexia nervosa?
• Back pain that worsens with standing or walking for long periods is most typical of which condition?
• Which skin condition is characterized by vesicular eruptions and is strongly associated with celiac disease?
• In alcohol use, retrograde amnesia with confabulation suggests which condition?
• Which drug is used to eradicate intraluminal Giardia after metronidazole therapy?
• Which disease is classically associated with a bamboo spine on X-ray?
• For PCOS patients who wish to conceive, which medication is commonly used to induce ovulation?
• Which autoimmune disease is commonly associated with pericarditis?
• In sarcoidosis, increased intestinal calcium absorption leads to what change in fecal calcium?
• What is the initial diagnostic test for suspected arterial insufficiency?
• Sickle cell disease with nephrotic-range proteinuria most commonly shows which glomerular lesion?
• Which imaging modality confirms cholelithiasis?
• Zenker plus achalasia initial diagnostic modality is which test?
• What is a first-line treatment for tinea versicolor?
• Which therapy is used to reduce relapse risk between MS flares?
• Which medication is commonly used for essential tremor?
• In hypothyroid myopathy, which laboratory finding is commonly elevated?
• Which statement best defines the shawl sign in dermatomyositis?
• Which enzyme in granulosa cells is responsible for estrogen production by converting androgens?
• In sickle cell disease, nephrotic syndrome is most strongly associated with which histologic lesion?
• Mini-mental state exam score low with apathy and poor performance on reverse serial 7s suggests which condition?
• Which statement best describes the role of the tRNA anticodon during translation?
• If polymyalgia rheumatica occurs without temporal arteritis, what is the recommended treatment?
• In uremic pericarditis associated with renal failure and a friction rub over the chest, what is the definitive management?
• An immunocompromised patient has a nodular density in the upper lobe on imaging. The most likely diagnosis is aspergilloma. What is the next best diagnostic step?
• In a patient with a red, warm, tender knee, what is the initial diagnostic step to evaluate for septic arthritis?
• In Guillain-Barré syndrome, CSF typically shows which finding?
• Which medication is used to treat discoid lupus?
• Which inheritance pattern best describes X-linked SCID?
• A sharply demarcated fiery red lesion extending from knee to ankle with fever is most consistent with infection of which layer?
• Holysystolic murmur at the left sternal border with a parasternal heave or palpable thrill most strongly indicates which defect?
• In heart failure management, when is spironolactone typically added?
• Bosentan MOA?
• Propranolol is used to prevent bleeding from which condition?
• Which beta-blocker is commonly used to increase preload in hypertrophic cardiomyopathy (to reduce LVOT obstruction)?
• In diabetic ketoacidosis, what is the pattern of potassium balance?
• In the glucose clearance study, which hormone explains faster clearance when nutrients are eaten with meals?
• Why is primaquine prescribed in malaria treatment?
• Which statement about pericarditis treatment is true?
• Biopsy of small bowel in lactose intolerance typically shows what?
• Erysipelas is more likely to have which border characteristic compared with cellulitis?
• A 27-year-old man with infertility presents with high testosterone and low LH/FSH; most likely cause?
• Taenia solium class?
• If a patient has an abnormal baseline ECG (for example, a bundle branch block), which stress test is preferred?
• If the cholestatic labs persist with negative CT for pancreatic cancer, what is the most likely diagnosis?
• A patient presents with high hemoglobin, pruritus after a shower, plethora, and splenomegaly. Which diagnosis is most likely?
• Which hereditary condition is a known risk factor for aortic dissection?
• Which statement about lumbosacral strain management is true?
• What is the most common cause of postoperative fever?
• Acute myeloid leukemia is most directly associated with the presence of which cellular inclusion?
• Which toxicity is associated with ganciclovir?
• Which drug is a serotonin receptor antagonist used in the treatment of serotonin syndrome?
• What is the predominant mode of transmission for Giardia lamblia?
• Which treatment is appropriate for otitis externa?
• A patient has marked leukocytosis with a low leukocyte alkaline phosphatase score. The most probable diagnosis is:
• A patient with ulcerative colitis who has elevated bilirubin and alkaline phosphatase most likely has which complication?
• Brown recluse spider bite is associated with which presenting symptom and management approach?
• Visceral larva migrans is caused by which parasite?
• A child with suspected JRA has a sore knee. What must be done to rule out septic arthritis?
• If renal failure is not the cause of anemia of chronic disease (as in IBD, RA, SLE), what is the recommended approach?
• A net-like pattern of IgG on immunofluorescence suggests which diagnosis?
• Which prostaglandin is primarily involved in the pathophysiology of primary dysmenorrhea?
• Which serum marker is typically elevated in medullary thyroid carcinoma?
• Auer rods are composed of which enzyme?
• What is the biggest risk factor for septic arthritis?
• A typical triad for aspirin-exacerbated respiratory disease includes asthma, nasal polyps, and sensitivity to NSAIDs such as aspirin.
• First-degree heart block is defined by PR interval longer than 200 milliseconds.
• Which antibiotic is associated with poor skin penetration for MRSA skin infections?
• Classic risk factors for cholelithiasis are described as fat, forty, female, and fertile. Which option lists these factors correctly?
• For Crohn disease with perianal involvement, which local therapy can be used?
• A patient with stab wound to chest who develops hypotension and JVD. Which description most accurately fits cardiac tamponade?
• In Hodgkin lymphoma, which statement about mediastinal involvement is true?
• Which option correctly lists the caloric content per gram for fat, carbohydrate, protein, and ethanol?
• Which imaging modality is noninvasive and uses magnetic resonance to visualize the bile ducts?
• Which feature differentiates MEN2B from MEN2A?
• Taenia solium can cause which condition?
• Which malaria species is associated with fever spikes every 48 hours?
• Amenorrhea in anorexia is an example of what type of hypogonadism?
• Supracondylar fracture of the humerus is classically associated with injury to which nerve?
• Augmentin is preferred in which otitis media scenario?
• Mucicarmine staining in cryptococcal organisms highlights which structure?
• Which hormone is produced by theca interna cells under LH stimulation?
• Which test is most definitive for diagnosing thalassemia by identifying globin chain abnormalities?
• Which statement best describes the two-armed approach to treating rheumatoid arthritis?
• In community-acquired pneumonia with bilateral chest X-ray infiltrates, which organism is most likely?
• The etiologic agent of cysticercosis is which parasite?
• Anovulation in PCOS typical?
• Heparin anticoagulation works primarily by which mechanism?
• What is the recommended initial management for Entamoeba histolytica liver abscess?
• What distinguishes polymyositis from dermatomyositis?
• What is the induction therapy for cryptococcal meningitis?
• A high hemoglobin level in the setting of lung disease or low oxygen tension indicates which form of polycythemia?
• Which lung cancer subtype is most classically associated with cavitating lesions in smokers?
• What is an appropriate regimen for osteomyelitis?
• Which imaging modality provides diagnostic and potential therapeutic access to the biliary tree?
• Which condition is suggested by a cholestatic pattern with diffuse pruritus and high cholesterol?
• In evaluating tPA eligibility for stroke, which timing concept is used?
• Late-peaking systolic murmur with an ejection click describes which condition?
• What is a common cause of vitamin K deficiency in adults?
• A patient with diabetic gastroparesis is started on metoclopramide. What is its primary pharmacologic mechanism of action?
• What is the initial management step in suspected pulmonary embolism before imaging?
• Abciximab acts by which mechanism?
• What best describes the primary mechanism of transfusion-related acute lung injury (TRALI)?
• In an HIV patient with lobar pneumonia, which organism is most likely?
• A pregnant woman with low serum iron that does not improve with iron therapy should be evaluated for which condition?
• A patient on a tricyclic antidepressant presents with coma, seizures, and ECG abnormalities. Which ECG change is most characteristic?
• Translocation associated with APL is?
• The leukotriene modifiers (the -lukasts) act by which mechanism?
• A patient with trauma presents with signs suggesting tension pneumothorax, including decreased breath sounds on one side and hypotension. What is the initial management?
• Which intervention more significantly reduces stroke risk?
• If vagal maneuvers fail to terminate SVT, the next commonly used medication is:
• Which brain imaging finding is described as the Swiss cheese appearance?
• In an alcoholic patient, the anemia described is best characterized as:
• In thyroid physiology, what happens to reverse T3 when T4 levels rise?
• Dyspnea late in pregnancy is most consistent with which diagnosis?
• Duplex ultrasound in venous insufficiency most commonly demonstrates which finding?
• Common adverse effect of imatinib includes?
• GIP secretion is stimulated by ingestion of which substances?
• What is the mechanism of viral-induced aplastic anemia?
• What is the mechanism of action of chloroquine?
• The hematologic abnormality in ITP is characterized by which primary lab finding?
• What is a common initial treatment for pemphigus vulgaris and bullous pemphigoid?
• In overflow incontinence, what postvoid residual volume is typical?
• Leg swelling plus pain plus shortness of breath most likely indicates which diagnosis?
• A child has recurrent joint pain and anemia. The most likely diagnosis is:
• Which of the following lists contains only beta-blockers associated with mortality benefit in heart failure?
• G-CSF therapy commonly causes which adverse effect?
• Incontinence in men with BPH is usually due to which mechanism?
• What is the cause of hemophilia with respect to inheritance and deficient factors?
• Suspected skin cancer in a non-cosmetically sensitive area is best treated with which procedure?
• Breast imaging (if performed) is recommended as follows by age: under 30 and over 30?
• What is the first-line pharmacologic treatment for Alzheimer disease?
• Hematuria in isolation with p-ANCA positivity indicates which vasculitis?
• Which scenario is most consistent with normal aging rather than Alzheimer disease?
• Which pattern of bruising is described as typical for ITP?
• Nitrofurantoin is used to treat cystitis in which patient group?
• After initial treatment of a pediatric acute asthma attack, if O2 remains low but CO2 and pH are normal, what is the next best step?
• After ruling out obstruction, which test quantifies gastric emptying to diagnose gastroparesis?
• Danazol increases production of C1 esterase inhibitor by stimulating which organ?
• After a sensory nerve injury, the rate-limiting step in restoring normal sensation during regeneration is which process?
• Which regimen is considered first-line therapy for uncomplicated urinary tract infection (UTI)?
• Newborn with chorioretinitis and microcephaly is most consistent with infection by which congenital pathogen?
• What is the current name for Churg-Strauss syndrome?
• Mucosal neuromas and Marfanoid habitus are characteristic of which MEN syndrome?
• The most common origin of tumors causing carcinoid syndrome is which of the following?
• Lymphatic streaking after a hand infection is most consistent with which diagnosis?
• Pulsus paradoxus is most characteristic of which condition?
• A 25-year-old with intermittent bloody diarrhea, fever, and weight loss is most consistent with which condition?
• Which vitamin deficiency is classically implicated in Wernicke encephalopathy?
• Cardiac disturbance (arrhythmia) due to an electrolyte problem is most compatible with abnormalities of which electrolytes?
• Fixed splitting of S2 corresponds to which congenital defect?
• Which scenario most strongly supports pulmonary contusion?
• Medullary thyroid carcinoma shows amyloid deposition with apple-green birefringence under polarized light when stained with which dye?
• In prostate cancer management, which sequence is commonly used when combining therapies?
• Initial screening test for suspected multiple myeloma is which?
• A 25-year-old woman has arthritis, mouth ulcers, and circular skin lesions. Which diagnosis is most likely?
• Samter triad refers to which combination of conditions?
• Reperfusion injury can increase the risk of rhabdomyolysis in which patient population?
• Alcoholic with low calcium or potassium despite supplementation should prompt evaluation for which deficiency?
• Which ANCA is typically positive in Wegener granulomatosis?
• Pan-systolic-pan-diastolic murmur indicates which defect?
• Which urine finding is characteristic of interstitial nephritis?
• A patient presents with hemoptysis, hematuria, and chronic sinusitis with nasal septal perforation. Which disease is most likely?
• In young adults with pneumonia and bilateral interstitial infiltrates, which organism is most likely?
• What is the most common clinical finding in systemic lupus erythematosus (SLE)?
• Third-degree AV block typically presents with a ventricular rate of
• Which hemostasis test pattern is typical of hemophilia?
• Which electrolyte abnormality is common in anorexia?
• During bladder storage, detrusor relaxation is primarily mediated by which nerve input?
• Which statement best describes a strawberry hemangioma?
• A BUN/Cr ratio less than 20 makes prerenal azotemia unlikely. Which etiology would be more likely instead?
• Which of the following describes the platelet-related manifestations of von Willebrand disease?
• A patient with MVA shows bruising or pain over the sternum with or without rib fractures. What is the diagnosis?
• Steatorrhea after swimming or scuba diving is most suggestive of infection with which parasite?
• Which statement about symmetry is true for rheumatoid arthritis versus osteoarthritis?
• Reverse T3 is best described as which of the following?
• A 17-year-old with autoimmune thyroiditis and type 1 diabetes since childhood presents with chronic candidal infections. What is the most likely diagnosis?
• Which therapy is commonly used in Guillain-Barré syndrome?
• Polyarteritis nodosa is associated with which infection?
• Brown or chocolate-colored blood is characteristic of which condition?
• Which immunodeficiency is the most common in humans?
• The levator ani muscle group comprises which of the following muscles?
• DPGN stands for which condition?
• If renal failure is the cause of anemia of chronic disease, what is an appropriate treatment?
• In anorexia, hypokalemia increases the risk of which complication?
• Third-degree heart block is characterized by
• Which is the most common risk factor for mesothelioma?
• In selective IgA deficiency, which celiac serology is unreliable?
• Hereditary angioedema is due to deficiency of which protein?
• Which cardiac abnormality, besides PDA, can be seen with congenital rubella syndrome?
• A 13-year-old girl has never had a period and presents with suprapubic mass and nausea. The next best step is to?
• Which of the following is a vector for Loa loa?
• Which laboratory finding is most characteristic of immune thrombocytopenia (ITP)?
• Brisk upstroke + precipitous downstroke of pulse indicates which condition?
• A young patient with a vesicular, painful rash along a flank and multinucleated giant cells. Which infection should be considered for HIV screening?
• Sertoli-Leydig cell tumors in females commonly cause which hormonal effect?
• In salicylate poisoning, what is the earliest acid-base disturbance?
• Autosomal recessive SCID is due to deficiency of which enzyme?
• Which disorder presents with bacterial, fungal, protozoal, and viral infections since birth?
• Screening at age 50 includes which of the following combinations?
• Which medication treats overflow incontinence due to neurogenic bladder in diabetes?
• In diagnosing multiple sclerosis, which test is preferred when both MRI and CSF IgG oligoclonal bands are listed?
• Urine dipstick shows blood, but microscopic examination reveals 0-4 red blood cells per high-power field. This finding most strongly points to which diagnosis?
• In Western countries, Burkitt lymphoma most commonly presents as which type of mass?
• Which class of antibiotics is commonly used as initial empiric therapy for community-acquired pneumonia with suspected atypical pathogens?
• Which disease is classically associated with a bamboo spine on X-ray?
• The anemia seen in juvenile arthritis is best described as:
• An ulcerated lesion emerging within a background of a red, scaly lesion is most consistent with which diagnosis?
• Porphyria cutanea tarda results from deficiency of which enzyme?
• Which organism is most commonly responsible for cellulitis?
• What is the initial pharmacologic treatment for hemophilia A to increase endogenous factor VIII release?
• Which condition is most likely in a young adult with emphysema who is a non-smoker and has a relative who died of hepatic cirrhosis?
• Narrow-complex tachycardia most likely represents:
• The infertility with exogenous testosterone implies suppression of which axis?
• For diagnosing Aspergilloma, which is listed as the definitive method in the source?
• A patient on tramadol who recently stopped an SSRI presents with tachycardia, diaphoresis, and diarrhea. This presentation is most consistent with which syndrome?
• A 72-year-old woman with a history of radical mastectomy presents with hard, raised purple lesions on the arm. Dx?
• Overflow incontinence is suggested by a high post-void residual volume, typically around 300-400 mL. Which type of incontinence does this indicate?
• Exposure to benzene is most strongly associated with which hematologic malignancy?
• A 40-year-old man with Hodgkin lymphoma has an accompanying nephrotic syndrome. Which condition is classically associated?
• An 80-year-old man with atrial fibrillation presents with severe abdominal pain but mild physical findings. What is the most likely diagnosis?
• Urge incontinence is characterized by which mechanism and treatment?
• In an older patient who is normotensive and has had a TIA or stroke or retinal artery occlusion, which condition is most likely?
• Which CSF finding is most characteristic of Guillain-Barré syndrome?
• Which antiviral is the first-line therapy for CMV colitis?
• Sertoli cells in the testes have multiple roles. Which product is produced by these cells?
• An AIDS patient with a CD4 count of 47 cells per microliter presents with confluent ulcers on colonoscopy. What is the most likely diagnosis?
• Odynophagia in an immunocompromised patient should raise suspicion for which diagnosis until proven otherwise?
• A bicuspid aortic valve is commonly associated with which valvular disease?
• A patient developed pedal edema after starting an antihypertensive agent. Which class is the most likely cause?
• Which coagulation parameter pattern is typical of vitamin K deficiency?
• Auer rods on peripheral smear are most diagnostic of:
• A 2-year-old child presents after a fall with the forearm held in a pronated position and refuses to use the arm. What is the most likely diagnosis?
• Which renal mechanism explains edema during NSAID therapy?
• Chronic scar or burn with a new ulcerated lesion is best described as which condition?
• The diagnosis of ITP is best supported by which laboratory finding?
• Anuria after removal of a urinary catheter most strongly suggests which cause?
• Chronic mucocutaneous candidiasis is primarily due to dysfunction in which part of the immune system?
• Which organism is typically transmitted via water or fecal-oral routes and causes malabsorption and steatorrhea?
• Non-visualization of the gallbladder on a HIDA scan is most consistent with which diagnosis?
• For chronic gout to reduce recurrence, which class of drugs is used?
• For evaluating suspected spinal metastases, which imaging modality is most sensitive for vertebral involvement?
• What is the initial management for suspected pulmonary embolism before diagnostic imaging?
• For recurrent otitis media, which antibiotic regimen is recommended?
• Type III hypersensitivity is best characterized by which immunologic mechanism?
• Which of the following is a major risk factor for aortic dissection?
• Which ANCA is typically positive in eosinophilic granulomatosis with polyangiitis?
• An 82-year-old woman found at home has 2+ blood in urine and 3-4 red blood cells per high-power field on microscopy after a fall. Which diagnosis is most likely?
• Propranolol helps with tachycardia in hyperthyroidism primarily by which mechanism?
• What histologic findings are seen in basal cell carcinoma?
• What is the preferred antibiotic in sepsis?
• Which of the following is a classic feature of hemophilia in a pediatric patient?
• In community-acquired pneumonia in a patient who has received antibiotics within the past three months, which antibiotic is preferred?
• Which statement best describes the hemostasis test findings in von Willebrand disease?
• In a preterm infant born at 28 weeks with respiratory distress syndrome due to surfactant deficiency, which organelle is deficient in type II pneumocytes?
• What acid-base disturbance is typically seen in an acute asthma attack?
• Acute pseudogout is typically treated similarly to acute gout; which is a common first-line approach?
• Parkinsonism in a young patient due to copper accumulation suggests which disease?
• Carcinoid tumors originate from neural crest cells and typically express which histologic marker?
• In a cross-sectional study of 500 factory workers assessing smoking status and COPD prevalence, which statement is true?
• After a blood transfusion, fever and chills occur with a negative Coombs test. Which transfusion reaction is most likely?
• Which chromosome carries the gene for autosomal recessive polycystic kidney disease?
• Which option best describes actinic keratosis?
• Which statement best characterizes primary dysmenorrhea in the adolescent?
• Which hematologic pattern is most consistent with thalassemia?
• For imaging to view the liver or pancreas, which modality with contrast is preferred?
• Urinary incontinence with ataxia and signs of CNS dysfunction described as the wet, wobbly, wacky triad points to which condition?
• What is the mechanism of ITP?
• Biochemical disturbances in Conn syndrome include which of the following patterns?
• Before starting an exercise regimen for the treatment of arterial insufficiency, which test should be performed to assess the patient's exercise tolerance?
• In Bruton, which of the following is true about B cells?
• Golden crusted lesions around the mouth in a school-age child are most consistent with which diagnosis?
• What is the normal calcium range provided?
• Bounding pulses + massively wide pulse pressure indicate which condition?
• A young African American woman with a dry cough has nodularity on chest X-ray. What is the most likely diagnosis?
• Normal postvoid residual volume is less than which amount?
• Which combination is used as induction therapy for cryptococcal meningitis?
• In a woman aged 20–40 presenting with arthritis and thrombocytopenia, which diagnosis is most likely?
• Which statement about pericarditis management is true?
• Which chromosomal translocation is classically associated with Burkitt lymphoma?
• In a diabetic patient with new-onset GERD, what is the most likely diagnosis?
• A vaginal episiotomy is performed posteriorly; if the incision extends too far, which structure is at risk?
• What is the best approach to prevent melanoma?
• Which presentation most distinguishes myocardial contusion from pulmonary contusion?
• Which antibiotic is listed as a treatment for prostatitis?
• What is a major side effect of naproxen?
• Which statement about Type I hypersensitivity is true?
• What is the treatment for earwax buildup?
• Which of the following is among common drugs that can cause agranulocytosis?
• Which trio is associated with MEN2A?
• Translocation associated with follicular lymphoma is?
• What histologic features on biopsy confirm squamous cell carcinoma?
• For a 32-year-old undergoing breast screening, which imaging combination is appropriate?
• Fixed splitting of S2 is most associated with which defect?
• Under what circumstance is an IVC filter indicated after pulmonary embolism confirmed in a patient on anticoagulation?
• In patients with diabetes, thiazide diuretics may worsen glycemic control due to their effect on glucose levels. Which statement is true?
• If fluid overload persists after starting furosemide, which diuretic is commonly added to balance potassium loss?
• Which feature best differentiates thalassemia trait from iron deficiency anemia among a patient with microcytosis?
• A patient develops an allergic-like reaction after eating shellfish. This is most consistent with which diagnosis?
• What mechanism explains aspirin-induced bronchoconstriction in aspirin-exacerbated respiratory disease?
• In bulimia nervosa or anorexia, which antidepressant is contraindicated due to seizure risk?
• What is the treatment for hemophilia B?
• Which medication is used to treat spasticity in multiple sclerosis?
• Sickle cell trait provides partial protection against malaria due to which mechanism?
• Elevated ALP + direct bilirubin + amylase/lipase with remote cholecystectomy suggests which diagnosis?
• Which histologic feature is classically associated with DPGN?
• Acute rheumatic heart disease after Group A Streptococcus infection typically presents with which valvular lesion?
• Which vasculitis is defined by asthma and eosinophilia?
• Diagnosis of multiple myeloma is usually established with which tests in sequence?
• Which group is most at risk for magnesium deficiency?
• In polycystic ovary syndrome (PCOS), there is an increased risk of which type of cancer due to unopposed estrogen?
• When MRSA is suspected in osteomyelitis, which agent should be added?
• Which of the following is a cestode parasite that can cause cysticercosis in humans?
• In which situation is tissue plasminogen activator (tPA) recommended for acute ischemic stroke?
• If spinal metastases are suspected, which imaging modality provides the most comprehensive assessment?
• Which agent is listed for Wilson disease treatment?
• What is the inheritance pattern of acute intermittent porphyria?
• Which toxicity is associated with acyclovir?
• Which age group is most commonly associated with inhalant abuse such as 'dusters'?
• In PCOS, insulin resistance contributes to abnormal GnRH pulsatility, resulting in what pattern of LH to FSH?
• During rest and during running, when do the coronary arteries primarily fill?
• A 30-year-old woman with a last menstrual period 8 weeks ago shows no fetus on ultrasound, trophoblastic proliferation on curettage, and chromosomal analysis 46XX. What is the diagnosis?
• Stewart-Treves syndrome is most closely associated with which condition?
• Which type of urinary incontinence is characterized by sudden urgency and inability to defer voiding?
• In a patient with high ALP and direct bilirubin, normal amylase/lipase, and recent cholecystectomy, what is the most likely diagnosis?
• Which of the following is a major side effect of beta-blockers?
• In a patient with renal artery stenosis, which drug class is associated with a rise in creatinine?
• A patient with osteoarthritis on naproxen develops peripheral edema. Which mechanism best explains this edema?
• Which enzyme deficiency causes the autosomal recessive form of SCID?
• Which finding is characteristic of familial medullary thyroid carcinoma?
• Which test is commonly used to diagnose cryptococcal meningitis?
• Lymph node biopsy in Hodgkin lymphoma typically reveals which malignant cell?
• Which parasite infection is commonly associated with selective IgA deficiency according to the material?
• A man presents after lifting a heavy box with severe lower back pain and muscle spasm but no radiculopathy. What is the most likely diagnosis?
• Ulcerated lesion on the nose or ear with rolled or heaped-up edges is most characteristic of which skin cancer?
• What is the first-line treatment for a flare of polymyositis or dermatomyositis?
• First-line therapy for chronic myeloid leukemia is:
• In inflammatory myopathies, what does the term 'mechanic's hands' refer to?
• Dysphagia to solids that progresses to solids and liquids is most characteristic of which condition?
• In suspected compartment syndrome, which finding confirms the diagnosis?
• Which antibiotic is NOT recommended as initial therapy for uncomplicated otitis media?
• Which of the following is a trematode (fluke)?
• Following resolution of ARDS in a patient with pancreatitis, which inflammatory marker is most likely increased in the lungs as a sign of prior injury?
• In sickle cell nephrotic syndrome, which histology is most common?
• Which pattern best fits anemia of chronic disease?
• Which organism is most likely responsible for non-bullous impetigo?
• First-line therapy for CML is?
• Which disease is now called granulomatosis with polyangiitis?
• Elevated HbA2 level is most consistent with which condition?
• Massive blood loss during labor or delivery can lead to which renal finding?
• LH stimulates which cells in females to produce androgens?
• Neonate presents with a spongy, 1-cm red lesion on the chest. Dx?
• Which organism causes tinea versicolor?
• If pelvic floor exercises fail to treat stress incontinence, what is the next step?
• Which option is an appropriate inpatient treatment option for MSSA infections?
• What test is used to diagnose lactose intolerance?
• Suspected skin cancer on the neck is evaluated with which diagnostic procedure?
• Which biologic is an anti-IgE monoclonal antibody used for severe asthma?
• Gallstones in pregnancy are promoted by which hormonal changes?
• Which cardiac tumor classically causes a diastolic murmur that is influenced by position and is described as a ball-in-valve left atrial tumor?
• In a cystic fibrosis patient younger than 10 with pneumonia, which organism predominates?
• Laron dwarfism is caused by a defect in which receptor, leading to insensitivity to growth hormone?
• Which is the most common blood transfusion reaction?
• A 65-year-old man with long-standing diabetes, prior CABG, and intermittent claudication presents with abdominal pain 1–2 hours after meals. The most likely diagnosis is:
• Which translocation is associated with follicular lymphoma?
• The most common etiologic organism causing erysipelas is:
• Which disease process most commonly causes arterial insufficiency?
• Which ECG finding is most consistent with acute pericarditis?
• Which vessel size is predominantly affected in polyarteritis nodosa?
• Tx of pseudogout is best described how?
• What is the mechanism of action of leflunomide?
• Polycythemia vera typically shows which combination of erythropoietin level and arterial oxygen content?
• Production of foul-smelling sputum is most characteristic of bronchiectasis in patients with COPD, TB, or CF. Which option lists the correct diagnosis?
• In septic shock caused by gram-negative bacteria, which receptor complex recognizes endotoxin and triggers cytokine release?
• A 57-year-old woman with suspected TCA overdose and a prolonged QRS. What is the most appropriate initial treatment?
• When should furosemide be started in heart failure management?
• In portal hypertension with esophageal varices, which vein has increased blood flow?
• Vomiting after custards, creams, or potato salad is most likely due to preformed enterotoxins from which organism?
• Which organism is most commonly associated with lobar pneumonia in adults?
• Which vaccine is routinely given at birth?
• Nasal septal perforation with sinusitis is most characteristic of which disease?
• To view the bile ducts, which imaging modality is used, and which is preferred when both are listed?
• In a patient with cellulitis admitted for IV antibiotics, which regimen is appropriate?
• A microcytic anemia in a pregnant patient that does not correct with iron therapy on exam raises suspicion for which diagnosis confirmed by electrophoresis?
• What is the primary goal of DMARD therapy in rheumatoid arthritis?
• External compression of the left renal artery with preserved perfusion pressure is explained by which arteriolar adjustment?
• Temporal arteritis and polymyalgia rheumatica share which relationship?
• What is the first-line treatment for impetigo?
• Which statement describes the tympanostomy tube criterion?
• What is a standard treatment for ARDS to minimize ventilator-induced lung injury?
• A more diffuse pink skin lesion with tenderness and fever most likely indicates:
• Rasburicase is used to treat hyperuricemia in which condition?
• In diabetic ketoacidosis, which of the following patterns best describes the electrolyte and acid-base disturbances?
• What is considered first-line therapy for both Crohn disease and ulcerative colitis (before steroids in many cases)?
• Which treatment is typically used to remove iron stores in hereditary hemochromatosis?
• Which antifungal is first-line for invasive aspergillosis?
• In a cancer patient with fever 103F, Hb 7 g/dL, platelets 50,000 and neutropenia, the next best step is?
• In aspirin-exacerbated respiratory disease, which finding is most likely to be seen on exam?
• What is the most common organism causing erysipelas?
• First-line topical therapy for tinea pedis includes which?
• Holosystolic murmur at the left sternal border plus a diastolic rumble indicates which defect?
• A teenage patient is found unconscious after suspected inhalant use with normal vital signs and no specific ocular findings. This presentation is most consistent with exposure to which agent?
• In a child with a heart tumor, which diagnosis is most likely until proven otherwise?
• What is the initial management for carpal tunnel syndrome in a patient who cannot avoid aggravating activities?
• Tx for spontaneous bacterial peritonitis?
• Whom should you never give thiazides to?
• What is the diagnostic and therapeutic procedure of choice for suspected choledocholithiasis?
• Which risk factor is most commonly associated with arterial insufficiency?
• Dermatomyositis carries an increased risk of which malignancy?
• MEN1 gene mutation is associated with tumors in which glands?
• Mechanism of nephrogenic diabetes insipidus?
• In early RA, what is the recommended step if methotrexate alone is insufficient?
• Oropharyngeal candidiasis is treated with which?
• Rotavirus vaccine should be given during infancy at which ages?
• In a random ventilator question, which adjustment is almost always correct?
• Autosomal dominant polycystic kidney disease is most commonly caused by mutations in which protein?
• In sepsis treatment for young children, which antibiotic is preferred?
• Tx of osteoarthritis, when BMI is normal, should begin with?
• What is the preferred pharmacologic treatment for delirium tremens in USMLE-style questions?
• Aspiration pneumonia or pulmonary abscess due to anaerobes above the diaphragm is best treated with which antibiotic?
• Pneumonia with birds which organism is most likely?
• Which saline concentration is used for initial management of hypercalcemia?
• In fibromuscular dysplasia with a normal GFR, which arteriolar change helps maintain GFR?
• Reed-Sternberg cells immunophenotype in Hodgkin lymphoma typically includes which markers?
• What mechanism explains the pulmonary edema in this patient with normal ejection fraction and ascites?
• A history of hypertension with dementia and sensory or motor disturbances is most suggestive of which dementia?
• In Hyper IgM syndrome, which immunoglobulin pattern is typical?
• In polycystic kidney disease, what is the most common extrarenal location for cysts?
• Which therapy is used to treat secondary hemochromatosis (transfusional siderosis)?
• A patient presents with polyuria, dilute urine, and hypercalcemia. Which diagnosis best explains renal insensitivity to antidiuretic hormone?
• Wernicke-Korsakoff syndrome is associated with damage to which brain structure?
• In hypercalcemia management, when is adding a bisphosphonate recommended?
• A 42-year-old man develops restlessness, tremulousness, tachycardia, and diaphoresis two days after surgery. What is the most likely diagnosis?
• Fracture at the surgical neck of the humerus most often injures which nerve?
• The hormonal mechanism behind gallstone formation in pregnancy involves:
• In delirium tremens, tremor is explained by sympathetic activation due to stimulation of which system?
• Which cutaneous manifestation is commonly associated with Crohn disease?
• In trauma, paradoxical chest movement with outward movement on exhalation and inward movement on inhalation indicates which injury?
• Tuberous sclerosis complex is inherited in which pattern?
• Which drug is used to eradicate hepatic hypnozoites to prevent relapse in P. vivax/ovale infections?
• In iron deficiency anemia with increased red cell distribution width, which of the following patterns applies?
• An adult male presents with abdominal pain, a history of alcohol use, diffuse pulmonary infiltrates, and low O2 saturations after trauma. What is the most likely diagnosis?
• Which drug is commonly used to treat urge incontinence?
• Parkinsonism in a young patient should prompt consideration of which disease until proven otherwise?
• What is the treatment for aspirin toxicity?
• In rheumatoid arthritis, what is the typical initial agent used for symptom relief?
• Refeeding syndrome raises concern for which electrolyte disturbance?
• Which cestode is transmitted via pork and can cause cysticercosis?
• Splenectomy is a treatment option for which hereditary red blood cell membrane disorder?
• Which disease is more likely to present with oral mucosal involvement and a positive Nikolsky sign due to fragile bullae that rupture easily?
• What acid-base disturbance is seen in aspirin toxicity after 20 minutes?
• What type of organism is Trichinella spiralis?
• Which drug is generally the first-line DMARD in early rheumatoid arthritis?
• Which patients should be cautious with naproxen due to potential renal effects?
• Which congenital infection is classically associated with patent ductus arteriosus?
• Which immunosuppressive agent is commonly added to steroids for lupus nephritis management?
• In an upright person, how do ventilation and perfusion change from apex to base?
• Neonate with persistent cyanosis and normal red cell indices, with a specific enzymatic deficiency, most likely has which diagnosis?
• Rheumatic heart disease that develops years after the initial infection most commonly causes which lesion?
• Which finding is not typically associated with PCOS?
• Which antidepressant is used to treat anorexia with accompanying depression to stimulate appetite?
• In Pneumocystis jirovecii pneumonia, when should adjunctive corticosteroids be added to TMP-SMX?
• Which combination of findings is most supportive for diagnosing Guillain-Barré syndrome?
• Gottron papules are a hallmark of which disease and are located on which area?
• Hyper IgM syndrome results from deficiency of which molecule on T cells, preventing activation of B cells for isotype class switching?
• Apart from hypertension control, thiazide diuretics reduce the risk of kidney stones due to hypocalciuria. This protective effect is primarily against which condition?
• Which WBC threshold in ascitic fluid defines spontaneous bacterial peritonitis?
• In von Willebrand disease, the clinical presentation is best described as which of the following?
• Which drug is both an anti-platelet agent and a vasodilator?
• Sturge-Weber syndrome is classically associated with seizures due to leptomeningeal angiomatosis. Which facial vascular finding is commonly present?
• Treatment of carcinoid syndrome primarily targets which of the following?
• Temporary external compression of the carotid sinuses for 10 seconds is most likely to cause which combination of autonomic changes?
• Which empiric therapy for endocarditis is listed in the material?
• In a biostatistics scenario, p = 0.02 when comparing two groups and the study concludes no difference. What does this p-value primarily indicate?
• Viral infection with tinnitus and vertigo with possible neurosensory hearing loss suggests which condition?
• Which thyroid cancer type predominantly metastasizes via hematogenous spread?
• Nursemaid's elbow typically presents with which of the following findings?
• What is the effect of sodium bicarbonate in tricyclic antidepressant (TCA) toxicity?
• If a first-degree relative has colon cancer diagnosed at age 50, when should you begin screening?
• What is the mechanism of action of desmopressin in treating von Willebrand disease?
• Paresthesias + pain following burn or casting suggests which condition?
• Which antibody is most specific for systemic lupus erythematosus?
• Which statement best describes the initial management of febrile neutropenia?
• Which muscle is not strengthened by Kegel exercises?
• For adults aged 65 and older, what is the recommended pneumococcal vaccination sequence?
• Which drug class should be avoided in hereditary angioedema due to risk of angioedema?
• Guyon canal syndrome is commonly associated with which activity or injury?
• Naproxen is commonly associated with which condition in typical exam vignettes?
• The t(11;14) translocation seen in mantle cell lymphoma leads to overexpression of which cell cycle regulator?
• RPGN with crescent formation is seen in which conditions?
• In multiple sclerosis evaluation, which statement is true about test selection when both MRI and CSF oligoclonal bands are available?
• Which statement about the MMR vaccination schedule is correct?
• Chronic mesenteric ischemia typically presents with which symptom pattern?
• Which physical examination finding is most typical of uremic pericarditis?
• Which finding is most suggestive of tubulointerstitial nephritis due to a beta-lactam antibiotic?
• What is the diagnostic approach for polymyalgia rheumatica?
• A mid-systolic crescendo-decrescendo murmur that worsens with Valsalva is most characteristic of which condition?
• In a postoperative patient, which finding most indicates good recovery?
• Disseminated intravascular coagulation can be a complication of acute myeloid leukemia due to release of what from leukemic cells?
• Which condition typically occurs 1-2 weeks after a streptococcal infection?
• Which statement about SLE is true?
• A pregnant woman contracts toxoplasmosis. If cats are not listed as a source, which dietary source is responsible?
• Initial treatment for Idiopathic Thrombocytopenic Purpura (ITP) typically begins with which therapy?
• A wrist drop is most commonly due to injury of which nerve?
• A 30-year-old woman takes diphenhydramine to prevent motion sickness during a flight. The anti-motion effect is achieved primarily by blockade of which receptor?
• ARDS must have a PaO2/FiO2 ratio of less than what value?
• A 42-year-old man develops restlessness and tactile/visual hallucinations two days after surgery. The most likely diagnosis is alcoholic hallucinosis, and the recommended treatment is a long-acting benzodiazepine. Which option best reflects this management?
• A patient with a flank mass and hypercalcemia has elevated hematocrit. Which paraneoplastic mechanism best explains these findings?
• Viral infection with vertigo but without hearing loss is most consistent with which condition?
• An elderly patient with unilateral temporal headache and blurry vision suggests which diagnosis?
• The term bronze diabetes refers to iron overload in which disorder?
• Which tumor constellation is characteristic of MEN 2A?
• Which presentation is commonly associated with pseudogout?
• In evaluating a child with short stature, if parental heights are average, what is the most appropriate next step to evaluate growth potential?
• Which vasculitis is classically associated with asthma and eosinophilia?
• In a patient with high blood pressure, smoking, and a history of TIA or stroke or retinal artery occlusion, what is the best strategy to decrease stroke risk?
• What is the strongest indication for long-term anticoagulation?
• After a barium swallow shows bird’s beak appearance, the next step to confirm the diagnosis of achalasia is?
• IBD that includes psoriasis and joint symptoms is most consistent with which arthropathy?
• Which glycoprotein is the major target of autoantibodies in ITP?
• What is the recommended treatment for tinea capitis?
• Dysphagia to solids and liquids at the same time suggests which neurogenic cause?
• Which immunofluorescence pattern is seen in bullous pemphigoid?
• If an abdominal ultrasound is negative but cholecystitis is still suspected, which test is most helpful?
• For a rheumatoid arthritis patient with new neurologic symptoms, which imaging modality is most informative for detecting atlantoaxial subluxation?
• In a pregnant woman on iron supplements with low MCV, what is the most likely diagnosis?
• A patient develops tachycardia, diaphoresis, diarrhea, and has a right‑sided heart valve lesion. This constellation most likely represents which syndrome?
• What is the first-line treatment for uncomplicated acute otitis media?
• Hirsutism in PCOS due to hormonal imbalance?
• Which hormonal therapy combination is used for prostate cancer, typically given together?
• What is the best diagnostic test for malaria?
• Central chest pain worse when supine and better when leaning forward is characteristic of which condition?
• Pneumonia with exposure to rabbits which organism is most likely?
• Which neurotransmitter system is targeted by the first-line Alzheimer medication?
• Which histologic feature is classically described as having 'owl eyes' in Hodgkin lymphoma?
• Lead poisoning on peripheral smear commonly shows which finding?
• Delayed transfusion reaction occurs how long after transfusion and is due to what?
• Why might chloroquine prophylaxis fail in a traveler to Africa?
• Crohn disease characteristically shows which histologic features?
• The treatment of cardiac tamponade typically includes which intervention?
• Which finding on digital rectal examination is most indicative of prostatitis?
• For diabetic gastroparesis management, which medication is preferred as initial therapy?
• A 44-year-old man with hematuria, hemoptysis, and head-itis is most likely to have which disease?
• Metoprolol is classically first-line for rate control in which arrhythmia?
• Which chromosomal translocation is characteristic of CML?
• Pulsus paradoxus is most characteristic of which condition?
• Diabetic patient on HCTZ for hypertension; the preferred replacement is?
• A 50-year-old man presents with severe upper back pain described as tearing, and a loud holo-diastolic murmur best heard after S2. What is the most likely diagnosis?
• Discoid lupus erythematosus is typically treated with which medication?
• Diffuse cortical necrosis is most strongly associated with which clinical scenario?
• A 13-year-old girl with an acute asthma attack is treated with albuterol. The tremor that follows is most likely due to stimulation of which receptor?
• In pseudogout, which crystal type is deposited in the joints?
• In fibromuscular dysplasia, what are the typical levels of angiotensin II (AT-II) and aldosterone?
• During rewarming after hypothermia, which electrolyte abnormality is most concerning?
• A 32-year-old man presents with dark skin on the forearms and increased fasting glucose. Which condition is most likely?
• Staphylococcus aureus preformed enterotoxin typically causes vomiting within what time frame after ingestion?
• Which of the following beta-blockers is NOT listed as decreasing mortality in heart failure?
• Celecoxib increases cardiovascular risk because it selectively inhibits COX-2, reducing prostacyclin synthesis without significantly inhibiting which other prostanoid?
• Which condition causes steatorrhea due to exocrine pancreatic insufficiency and is treated with pancrelipase?
• Scombroid poisoning results from histamine formation due to bacterial histidine decarboxylase in decaying fish. Which description matches this mechanism?
• Which type of urinary incontinence is most commonly seen in multiple sclerosis?
• After a motor vehicle accident, a patient with rib fractures and underlying lung infiltrates presents with low oxygen saturation. What is the most likely diagnosis?
• A patient with cirrhosis or recent peritoneal dialysis or nephrotic syndrome presents with fever and abdominal pain. The most likely diagnosis is?
• Which test pattern is typical of hemophilia?
• Which diagnosis is most likely in a 32-year-old woman with resistant hypertension and high renin?
• In an acute gout attack in a patient with renal insufficiency or prior renal transplant, which treatment is preferred?
• CREST syndrome can cause which lung pathology?
• In leukemoid reaction, which laboratory finding is typically increased?
• In the acute management of asthma, which therapy should be started first?
• If ultrasound is negative but cholecystitis is suspected, which imaging test is recommended next?
• Which condition involves a T cell attack against oligodendrocytes in white matter?
• What is the first-line treatment for acute otitis media?
• Which joint group is more characteristic of osteoarthritis rather than rheumatoid arthritis?
• In Fournier gangrene, which management description best captures the standard approach?
• Calcitonin lowers serum calcium primarily by which mechanism?
• Congenital methemoglobinemia is caused by deficiency of which enzyme?
• Continuous, machinery-like murmur indicates which defect?
• Auer rods are composed of which enzyme?
• Diffuse cortical necrosis is most strongly associated with which clinical scenario?
• Renal papillary necrosis is classically associated with which disease?
• Dry cough in winter is most consistent with which entity, which can present with cough as the only symptom in a subset of patients?
• Which syndrome is suggested by blurred vision, Raynaud phenomenon, finger pain, or headaches in the context of polycythemia?
• During resuscitation after an MVA, a patient has pulmonary infiltrates and low oxygen saturation; administration of a bolus of normal saline leads to worsening of oxygen saturation. What is the most likely diagnosis?
• Pneumocystis jirovecii pneumonia typically shows what pattern on chest radiograph in an immunocompromised patient?
• Which treatment is appropriate for lumbosacral strain?
• Which condition presents with a globular uterus and per vaginum bleeding?
• In osteomyelitis for a patient with sickle cell disease, which antibiotic should be added?
• In cystic fibrosis, the statement that the pneumonia pathogen shifts from Staphylococcus aureus in children to Pseudomonas aeruginosa in older patients is true.
• First-line management for stable SVT is:
• What is an appropriate inpatient treatment for MSSA infections?
• Sulfasalazine is metabolized in the gut by bacteria into which two components?
• A 27-year-old female with intermittent headaches and blurry vision is most consistent with which diagnosis?
• Which is NOT a classic metabolic side effect of thiazide diuretics?
• Which laboratory finding is characteristic of vitamin K deficiency?
• What condition is suggested by a palpable step-off of one vertebra relative to the one below?
• If the patient cannot exercise, which stress testing modality is recommended?
• Systemic juvenile idiopathic arthritis is also known as: