instruction
stringclasses
5 values
input
stringlengths
10
4.2k
output
stringlengths
1
7.16k
Answer the following medical question with the correct letter choice:
<<Question:>> An endocrine surgeon wants to evaluate the risk of multiple endocrine neoplasia (MEN) type 2 syndromes in patients who experienced surgical hypertension during pheochromocytoma resection. She conducts a case-control study that identifies patients who experienced surgical hypertension and subsequently comp...
B
Answer the following medical question with the correct letter choice:
<<Question:>> A 3-year-old boy presents to the pediatrics clinic for follow-up. He has a history of severe pyogenic infections since birth. Further workup revealed a condition caused by a defect in CD40 ligand expressed on helper T cells. This congenital immunodeficiency has resulted in an inability to class switch and...
D
Answer the following medical question with the correct letter choice:
<<Question:>> A 25-year-old woman presents to her primary care clinic for a general checkup. She states she's been a bit more fatigued lately during finals season but is otherwise well. Her mother and sister have hypothyroidism. She denies fatigue, weight gain, cold intolerance, constipation, heavy or irregular menses,...
B
Answer the following medical question with the correct letter choice:
<<Question:>> A 69-year-old man presents to his dermatologist with an enlarging, scaly pink plaque on his face. It has been present for 5 weeks and is shown. Physical examination reveals a friable lesion that bleeds easily. Medical history is remarkable for type 1 diabetes mellitus complicated by end-stage kidney disea...
B
Answer the following medical question with the correct letter choice:
<<Question:>> A 48-year-old man comes to the physician because of severe joint pain and swelling involving different joints for 3 months. He has also been having loose stools and episodes of epigastric pain for 6 months. He reports a 10-kg (22-lb) weight loss during this period. He has type 2 diabetes mellitus. He does...
D
Answer the following medical question with the correct letter choice:
<<Question:>> A 6-year-old boy is brought to the pediatrician by his parents. He has been coughing extensively over the last 5 days, especially during the night. His mother is worried that he may have developed asthma, like his uncle, because he has been wheezing, too. The boy usually plays without supervision, and he ...
C
Answer the following medical question with the correct letter choice:
<<Question:>> A 30-year-old man comes to the physician for a follow-up examination 1 month after sustaining a chemical burn over the dorsum of his right hand and forearm. Physical examination shows hyperextension of the hand at the wrist. The skin over the dorsum of the wrist is tense and there is a thick, epithelializ...
D
Answer the following medical question with the correct letter choice:
<<Question:>> A 60-year-old man comes to the physician because of persistent fatigue over the past ten months. His previous annual health maintenance examination showed no abnormalities. He appears pale. Physical examination shows numerous petechial lesions over the abdomen and marked splenomegaly. His serum hemoglobin...
B
Answer the following medical question with the correct letter choice:
<<Question:>> A 29-year-old G1P0 presents to her obstetrician for her first prenatal care visit at 12 weeks gestation by last menstrual period. She states that her breasts are very tender and swollen, and her exercise endurance has declined. She otherwise feels well. She is concerned about preterm birth, as she heard t...
D
Answer the following medical question with the correct letter choice:
<<Question:>> A 55-year-old man presents to his primary care physician for knee pain. The patient has had left knee pain, which has been steadily worsening for the past year. He states that ice and rest has led to minor improvement in his symptoms. He recently bumped his knee; however, he says that it has not altered h...
D
Answer the following medical question with the correct letter choice:
<<Question:>> A 66-year-old woman comes to the emergency department because of a 1-day history of severe abdominal pain, nausea, and vomiting. She has also had profuse watery diarrhea with streaks of blood for the past 5 days. She had a urinary tract infection 3 weeks ago and was treated with a 14-day course of ciprofl...
A
Answer the following medical question with the correct letter choice:
<<Question:>> A 49-year-old woman comes to the physician because of a 4-month history of fatigue and recurrent pain in both of her wrists and her fingers. During this time, she has also had stiffness of her joints for about 80 minutes after waking up in the morning. Examination shows swelling and tenderness of the wris...
C
Answer the following medical question with the correct letter choice:
<<Question:>> A 73-year-old man presents to his primary care doctor with his son who reports that his father has been acting strangely. He has started staring into space throughout the day and has a limited attention span. He has been found talking to people who are not present and has gotten lost while driving twice. ...
A
Answer the following medical question with the correct letter choice:
<<Question:>> A 69-year-old man with aggressive metastatic cholangiocarcinoma presents after the second round of chemotherapy. He has suffered a great deal of pain from the metastasis to his spine, and he is experiencing side effects from the cytotoxic chemotherapy drugs. Imaging shows no change in the tumor mass and r...
A
Answer the following medical question with the correct letter choice:
<<Question:>> A 34-year-old woman is brought to the emergency department by fire and rescue after an apparent suicide attempt. She reports ingesting several pills 6 hours prior to presentation but cannot recall what they were. No pills were found on the scene. She complains of severe malaise, ringing in her ears, and a...
D
Answer the following medical question with the correct letter choice:
<<Question:>> A 19-year-old woman is diagnosed with metastatic Ewing sarcoma. She has undergone multiple treatments without improvement. She decides to stop treatment and pursue only palliative care. She is of sound mind and has weighed the benefits and risks of this decision. The patient’s mother objects and insists t...
B
Answer the following medical question with the correct letter choice:
<<Question:>> A 4-year-old girl is brought to the physician because of increasing swelling around her eyes and over both her feet for the past 4 days. During this period, she has had frothy light yellow urine. Her vital signs are within normal limits. Physical examination shows periorbital edema and 2+ pitting edema of...
C
Answer the following medical question with the correct letter choice:
<<Question:>> A 74-year-old woman is brought to the physician by her daughter for worsening memory for the past 1 month. She can no longer manage her bills and frequently forgets the names of her children. Her daughter is also concerned that her mother has a urinary tract infection because she has had increased urinary...
A
Answer the following medical question with the correct letter choice:
<<Question:>> A 42-year-old woman is brought to the emergency department because of a 5-day history of epigastric pain, fever, nausea, and malaise. Five weeks ago she had acute biliary pancreatitis and was treated with endoscopic retrograde cholangiopancreatography and subsequent cholecystectomy. Her maternal grandfath...
A
Answer the following medical question with the correct letter choice:
<<Question:>> A 38-year-old man is brought to the emergency department 35 minutes after an episode of loss of consciousness. He was having dinner with a client when his left arm suddenly became weak and numb. A few minutes later he became tense and his arms and legs began jerking violently, following which he lost cons...
D
Answer the following medical question with the correct letter choice:
<<Question:>> A 32-year-old man, otherwise healthy, presents with flank pain and severe nausea for the last 9 hours. He describes the pain as severe, intermittent, localized to the right flank, and radiates to the groin. His past medical history is significant for recurrent nephrolithiasis. The patient does not smoke a...
B
Answer the following medical question with the correct letter choice:
<<Question:>> A 37-year-old African-American man presents to his primary care provider with a history of fatigue and nausea that started about 6 months ago. His symptoms have slowly gotten worse and now he has trouble climbing the stairs to his 3rd floor apartment without resting. Past medical history is significant fo...
C
Answer the following medical question with the correct letter choice:
<<Question:>> A 24-year-old woman presents with episodic shortness of breath, chest tightness, and wheezing. She has noticed an increased frequency of such episodes in the spring season. She also has a history of urticaria. She has smoked a half pack of cigarettes per day over the last 5 years. Her mother also has simi...
C
Answer the following medical question with the correct letter choice:
<<Question:>> A 28-year-old woman presents with increased facial hair growth. She says she noticed a marked growth and darkening of hair on her face and feels embarrassed. Past medical history is significant for asthma, well-controlled by medication, and epilepsy diagnosed 6 months ago, managed with phenytoin. Her othe...
D
Answer the following medical question with the correct letter choice:
<<Question:>> A 14-year-old boy is brought to the physician by his parents for the evaluation of a skin rash for one day. The patient reports intense itching. He was born at 39 weeks' gestation and has a history of atopic dermatitis. He attends junior high school and went on a camping trip with his school the day befor...
D
Answer the following medical question with the correct letter choice:
<<Question:>> A 23-year-old G1P0 primigravid woman at 28 weeks estimated gestational age presents for a prenatal checkup. She says she has been having occasional headaches but is otherwise fine. The patient says she feels regular fetal movements and mild abdominal pain at times. Her past medical history is unremarkable...
C
Answer the following medical question with the correct letter choice:
<<Question:>> A 55-year-old man comes to the physician because of a 2-month history of gradually worsening pain and burning in his feet that is impairing his ability to sleep. He also has a non-healing, painless ulcer on the bottom of his right toe, which has been progressively increasing in size despite the applicatio...
D
Answer the following medical question with the correct letter choice:
<<Question:>> A father brings his 3-year-old son to the pediatrician because he is concerned about his health. He states that throughout his son's life he has had recurrent infections despite proper treatment and hygiene. Upon reviewing the patient's chart, the pediatrician notices that the child has been infected mult...
A
Answer the following medical question with the correct letter choice:
<<Question:>> A researcher is currently working on developing new cholinergic receptor agonist drugs. He has formulated 2 new drugs: drug A, which is a selective muscarinic receptor agonist and has equal affinity for M1, M2, M3, M4, and M5 muscarinic receptors, and drug B, which is a selective nicotinic receptor agonis...
D
Answer the following medical question with the correct letter choice:
<<Question:>> A researcher is studying whether a new knee implant is better than existing alternatives in terms of pain after knee replacement. She designs the study so that it includes all the surgeries performed at a certain hospital. Interestingly, she notices that patients who underwent surgeries on Mondays and Thu...
D
Answer the following medical question with the correct letter choice:
<<Question:>> A 43-year-old woman presents to her physician’s office complaining of fatigue and light headedness for one month. She has regular periods but notes that they have become heavier in the last year. She endorses increased urination and feels that she has gained weight in her abdomen, but review of systems is...
A
Answer the following medical question with the correct letter choice:
<<Question:>> A 48-year-old woman comes to the physician because of an increasingly painful swelling behind her right knee for the past 2 months. During this time, she has also had intermittent low-grade fever and she has been more fatigued than usual. She has not had any trauma to the knee. Over the past year, she has...
C
Answer the following medical question with the correct letter choice:
<<Question:>> Although nucleotide addition during DNA replication in prokaryotes proceeds approximately 20-times faster than in eukaryotes, why can much larger amounts of DNA be replicated in eukaryotes in a time-effective manner? ---- <<Choices:>> A) Eukaryotes have less genetic material to transcribe B) Eukaryotes ha...
D
Answer the following medical question with the correct letter choice:
<<Question:>> A 33-year-old woman presents to her primary care physician complaining of right jaw pain for the last 3 weeks. She first noticed it while eating a steak dinner but generally feels that it is worse in the morning. She describes the pain as deep and dull, with occasional radiation to the ear and back of her...
A
Answer the following medical question with the correct letter choice:
<<Question:>> An autopsy is being performed on an elderly man who died from a myocardial infarction. Biopsy of the heart is likely to reveal necrosis most similar to necrosis seen in which of the following scenarios? ---- <<Choices:>> A) The central nervous system following a stroke B) Acute pancreatitis resulting from...
C
Answer the following medical question with the correct letter choice:
<<Question:>> In a healthy patient with no renal abnormalities, several mechanisms are responsible for moving various filtered substances into and out of the tubules. Para-aminohippurate (PAH) is frequently used to estimate renal blood flow when maintained at low plasma concentrations. The following table illustrates t...
A
Answer the following medical question with the correct letter choice:
<<Question:>> A husband returns from a three-month long business trip from Thailand, where he also engaged in extramarital affairs. He arrives back at home to find that his wife is distant and not as affectionate as she used to be. He then proceeds to argue with his wife stating that she must be cheating on him since s...
C
Answer the following medical question with the correct letter choice:
<<Question:>> A 36-year-old G4P1021 woman comes to the emergency room complaining of intense abdominal pain and vaginal bleeding. She is 9 weeks into her pregnancy and is very concerned as she experienced similar symptoms during her past pregnancy losses. Her pain is described as “stabbing, 10/10 pain that comes and go...
C
Answer the following medical question with the correct letter choice:
<<Question:>> A 67-year-old woman presents to the infectious disease clinic after her PPD was found to be positive. A subsequent chest radiography shows a cavity in the apex of the right upper lobe, along with significant hilar adenopathy. The patient is diagnosed with tuberculosis and is started on the standard four-d...
A
Answer the following medical question with the correct letter choice:
<<Question:>> A 48-year-old woman presents with a sudden-onset severe headache that she describes as the worst in her life, followed by binocular horizontal diplopia and ptosis. Her past medical history is significant for hypertension. On admission, her vital signs include: blood pressure 130/70 mm Hg, heart rate 78/mi...
B
Answer the following medical question with the correct letter choice:
<<Question:>> A 21-year-old Caucasian male presents to your office with wheezing and rhinitis. Laboratory results show peripheral eosinophilia and antibodies against neutrophil myeloperoxidase. What is the most likely diagnosis? ---- <<Choices:>> A) Allergic bronchopulmonary aspergellosis B) Eosinophilic granulomatosis...
B
Answer the following medical question with the correct letter choice:
<<Question:>> A 7-year-old Caucasian girl with asthma presents to her pediatrician with recurrent sinusitis. The patient’s mother states that her asthma seems to be getting worse and notes that ‘lung problems run in the family’. The patient has had 2 episodes of pneumonia in the last year and continues to frequently ha...
B
Answer the following medical question with the correct letter choice:
<<Question:>> A 9-year-old boy is brought to the emergency department by his parents with a 2-day history of weakness and joint pain. He was adopted 3 weeks ago from an international adoption agency and this is his first week in the United States. He says that he has been healthy and that he had an episode of sore thro...
C
Answer the following medical question with the correct letter choice:
<<Question:>> A 17-year-old female presents to your office expressing concern that despite experiencing monthly pelvic pain for the past few years, she has not yet started her menstrual cycle. She is not taking oral contraceptive therapy and has never been sexually active. On physical exam the patient is of normal stat...
B
Answer the following medical question with the correct letter choice:
<<Question:>> An investigator is studying the normal process of shrinking of the thymus gland with increasing age in humans. Thymic size is found to gradually start decreasing during puberty. Which of the following enzymes is most likely involved in the process underlying the decline in thymus mass with aging? ---- <<C...
B
Answer the following medical question with the correct letter choice:
<<Question:>> A 57-year-old man comes to the physician because of tiredness and dyspnea on exertion for several months. Recently, he has also noticed changes of his fingernails. A photograph of his nails is shown. Which of the following is the most likely underlying cause of these findings? ---- <<Choices:>> A) Iron de...
A
Answer the following medical question with the correct letter choice:
<<Question:>> A 22-year-old female with a history of bipolar disease presents to the emergency room following an attempted suicide. She reports that she swallowed a bottle of pain reliever pills she found in the medicine cabinet five hours ago. She currently reports malaise, nausea, and anorexia. She has vomited severa...
D
Answer the following medical question with the correct letter choice:
<<Question:>> A 54-year-old woman presents with acute pain in her left toe. She says she hasn’t been able to wear closed shoes for 2 weeks. Past medical history is significant for gastroesophageal reflux disease, diagnosed 2 years ago. The patient is afebrile and vital signs are within normal limits. Her BMI is 31 kg/m...
B
Answer the following medical question with the correct letter choice:
<<Question:>> A 58-year-old man comes to the physician because of depressed mood for 6 months. He works as a store manager and cannot concentrate at work anymore. He experiences daytime sleepiness and fatigue because he repeatedly wakes up at night and has difficulties falling asleep again after 4 a.m. He reports no lo...
A
Answer the following medical question with the correct letter choice:
<<Question:>> A 76-year-old woman is brought to the physician by her daughter for evaluation of progressive cognitive decline and a 1-year history of incontinence. She was diagnosed with dementia, Alzheimer type, 5 years ago. The daughter has noticed that in the past 2 years, her mother has had increasing word-finding ...
B
Answer the following medical question with the correct letter choice:
<<Question:>> A 5-year-old is brought into the emergency department for trouble breathing. He was at a family picnic playing when his symptoms began. The patient is currently struggling to breathe and has red, warm extremities. The patient has an unknown medical history and his only medications include herbs that his p...
B
Answer the following medical question with the correct letter choice:
<<Question:>> A 19-year-old woman comes to the physician because of recent weight gain. She started a combined oral contraceptive for dysmenorrhea and acne six months ago. She has been taking the medication consistently and experiences withdrawal bleeding on the 4th week of each pill pack. Her acne and dysmenorrhea hav...
A
Answer the following medical question with the correct letter choice:
<<Question:>> A 25-year-old man presents to the emergency department for severe abdominal pain. The patient states that for the past week he has felt fatigued and had a fever. He states that he has had crampy lower abdominal pain and has experienced several bouts of diarrhea. The patient states that his pain is somewha...
D
Answer the following medical question with the correct letter choice:
<<Question:>> A 72-year-old man presents to the emergency department with a 1 hour history of bruising and bleeding. He says that he fell and scraped his knee on the ground. Since then, he has been unable to stop the bleeding and has developed extensive bruising around the area. He has a history of gastroesophageal ref...
D
Answer the following medical question with the correct letter choice:
<<Question:>> A 27-year-old woman who recently emigrated from Brazil comes to the physician because of fever, fatigue, decreased appetite, and mild abdominal discomfort. She has not seen a physician in several years and her immunization status is unknown. She drinks 2 alcoholic beverages on the weekends and does not us...
C
Answer the following medical question with the correct letter choice:
<<Question:>> A 3175-g (7-lb) female newborn is delivered at term. Initial examination shows a distended abdomen and a flat perineal region without an opening. A dark green discharge is coming out of the vulva. Which of the following is the most likely diagnosis? ---- <<Choices:>> A) Meconium ileus B) Hirschsprung dise...
C
Answer the following medical question with the correct letter choice:
<<Question:>> A 20-year-old woman visits the clinic for her annual physical examination. She does not have any complaints during this visit. The past medical history is insignificant. She follows a healthy lifestyle with a balanced diet and moderate exercise schedule. She does not smoke or drink alcohol. She does not t...
B
Answer the following medical question with the correct letter choice:
<<Question:>> A 9-month-old girl is brought to the physician by her parents for multiple episodes of unresponsiveness in which she stares blankly and her eyelids flutter. She has gradually lost control of her neck and ability to roll over during the past 2 months. She is startled by loud noises and does not maintain ey...
D
Answer the following medical question with the correct letter choice:
<<Question:>> A 74-year-old man is brought to the physician by his wife for progressively worsening confusion and forgetfulness. Vital signs are within normal limits. Physical examination shows a flat affect and impaired short-term memory. An MRI of the brain is shown. Further evaluation of this patient is most likely ...
A
Answer the following medical question with the correct letter choice:
<<Question:>> A 62-year-old woman with type 2 diabetes mellitus is brought to the emergency department by her husband because of fever, chills, and purulent drainage from a foot ulcer for 2 days. Her hemoglobin A1c was 15.4% 16 weeks ago. Physical examination shows a 2-cm ulcer on the plantar surface of the left foot w...
D
Answer the following medical question with the correct letter choice:
<<Question:>> A 1-year-old boy is brought to the emergency room by his parents because of inconsolable crying and diarrhea for the past 6 hours. As the physician is concerned about acute appendicitis, she consults the literature base. She finds a paper with a table that summarizes data regarding the diagnostic accuracy...
B
Answer the following medical question with the correct letter choice:
<<Question:>> An investigator is studying the effect of different cytokines on the growth and differentiation of B cells. The investigator isolates a population of B cells from the germinal center of a lymph node. After exposure to a particular cytokine, these B cells begin to produce an antibody that prevents attachme...
A
Answer the following medical question with the correct letter choice:
<<Question:>> A 20-year-old woman is brought to the emergency department 6 hours after the onset of colicky lower abdominal pain that has been progressively worsening. The pain is associated with nausea and vomiting. She has stable inflammatory bowel disease treated with 5-aminosalicylic acid. She is sexually active wi...
D
Answer the following medical question with the correct letter choice:
<<Question:>> A 27-year-old male arrives to your walk-in clinic complaining of neck pain. He reports that the discomfort began two hours ago, and now he feels like he can’t move his neck. He also thinks he is having hot flashes, but he denies dyspnea or trouble swallowing. The patient’s temperature is 99°F (37.2°C), bl...
C
Answer the following medical question with the correct letter choice:
<<Question:>> An 18-year-old woman presents to the emergency department with a complaint of severe abdominal pain for the past 6 hours. She is anorexic and nauseous and has vomited twice since last night. She also states that her pain initially began in the epigastric region, then migrated to the right iliac fossa. Her...
A
Answer the following medical question with the correct letter choice:
<<Question:>> A 26-year-old woman is brought to the emergency department by her husband due to her disturbing behavior over the past 24 hours. Her husband says that he has noticed his wife talking to herself and staying in a corner of a room throughout the day without eating or drinking anything. She gave birth to thei...
D
Answer the following medical question with the correct letter choice:
<<Question:>> A 60-year-old man comes to the physician for the evaluation of nausea over the past week. During this period, he has also had several episodes of non-bloody vomiting. Last month, he was diagnosed with stage II Hodgkin lymphoma and was started on adriamycin, bleomycin, vinblastine, and dacarbazine. His tem...
D
Answer the following medical question with the correct letter choice:
<<Question:>> A 24-year-old woman is brought to the emergency department by friends because of an episode of jerking movements of the whole body that lasted for one minute. She reports a 2-week history of fever, headache, and altered sensorium. Her fever ranges from 38.3°C (101.0°F) to 38.9°C (102.0°F). Her past medica...
D
Answer the following medical question with the correct letter choice:
<<Question:>> Four hours after undergoing an abdominal hysterectomy, a 43-year-old woman is evaluated in the post-anesthesia care unit because she has only had a urine output of 5 mL of blue-tinged urine since surgery. The operation went smoothly and ureter patency was checked via retrograde injection of methylene blue...
B
Answer the following medical question with the correct letter choice:
<<Question:>> A 3-month-old African American boy presents to his pediatrician’s office for his routine well visit. He was born full-term from an uncomplicated vaginal delivery. He is exclusively breastfeeding and not receiving any medications or supplements. Today, his parents report no issues or concerns with their ch...
B
Answer the following medical question with the correct letter choice:
<<Question:>> A 53-year-old woman presents to the emergency room with severe chest pain radiating to the back. She was diagnosed with acute aortic dissection. A few hours into the resuscitation, she was having oliguria. Laboratory findings show a serum creatinine level of 5.3 mg/dL. Which of the following casts are mos...
A
Answer the following medical question with the correct letter choice:
<<Question:>> A 20-year-old man comes to the physician because of recurrent episodes of shortness of breath and a nonproductive cough for the past 4 months. He has two episodes per week, which resolve spontaneously with rest. Twice a month, he wakes up at night with shortness of breath. His pulse is 73/min, respiration...
A
Answer the following medical question with the correct letter choice:
<<Question:>> A 72-year-old nursing home resident is complaining of pruritis. She is noted to have multiple, tense blisters on her trunk as well as the flexor surfaces of her extremities. The blisters have an erythematous base. You are unable to extend the blisters when you apply lateral traction. You suspect an autoim...
A
Answer the following medical question with the correct letter choice:
<<Question:>> A 28-year-old man comes to the physician because of a 3-month history of a recurrent pruritic rash on his face and scalp. He reports that he has been using a new shaving cream once a week for the past 5 months. A year ago, he was diagnosed with HIV and is currently receiving triple antiretroviral therapy....
D
Answer the following medical question with the correct letter choice:
<<Question:>> A 63-year-old African American man presents to the physician for a follow-up examination. He has a history of chronic hypertension and type 2 diabetes mellitus. He has no history of coronary artery disease. His medications include aspirin, hydrochlorothiazide, losartan, and metformin. He exercises every d...
A
Answer the following medical question with the correct letter choice:
<<Question:>> A 45-year-old man is brought to the emergency department because of a 1-day history of malaise and abdominal pain. Six weeks ago, he had vomiting and watery diarrhea for 2 days that resolved without treatment. Twelve weeks ago, he underwent orthotopic liver transplantation for alcoholic cirrhosis. At the ...
D
Answer the following medical question with the correct letter choice:
<<Question:>> A 45-year-old woman presents to a physician with repeated episodes of vertigo for the last 6 months. The episodes usually last for 20–30 minutes, but 2 episodes persisted for more than an hour. The episodes are often associated with severe nausea and vomiting. She has experienced falls after losing her ba...
C
Answer the following medical question with the correct letter choice:
<<Question:>> Please refer to the summary above to answer this question This patient is at greatest risk of damage to which of the following cardiovascular structures?" "Patient Information Age: 44 years Gender: M, self-identified Ethnicity: Caucasian Site of Care: office History Reason for Visit/Chief Concern: “I am t...
A
Answer the following medical question with the correct letter choice:
<<Question:>> A 68-year-old woman comes to the physician for a follow-up examination. Three months ago, she underwent heart transplantation for restrictive cardiomyopathy and was started on transplant rejection prophylaxis. Her pulse is 76/min and blood pressure is 148/82 mm Hg. Physical examination shows enlargement o...
C
Answer the following medical question with the correct letter choice:
<<Question:>> A 27-year-old man presents to the family medicine clinic for a routine check-up. The patient recently accepted a new job at a childcare center and the employer is requesting his vaccination history. After checking the records from the patient’s childhood, the physician realizes that the patient never had ...
A
Answer the following medical question with the correct letter choice:
<<Question:>> A 33-year-old Hispanic woman who recently immigrated to the United States with her newborn daughter is presenting to a free clinic for a wellness checkup for her baby. As part of screening for those immigrating or seeking refuge in the United States, she and her child are both evaluated for tuberculosis. ...
D
Answer the following medical question with the correct letter choice:
<<Question:>> Please refer to the summary above to answer this question Which of the following is the most likely diagnosis?" "Patient information Age: 61 years Gender: F, self-identified Ethnicity: unspecified Site of care: emergency department History Reason for Visit/Chief Concern: “My belly really hurts.” History o...
D
Answer the following medical question with the correct letter choice:
<<Question:>> A 34-year-old woman comes to the fertility clinic with her husband for infertility treatment. The couple has been having unprotected intercourse for the past 2 years without any pregnancies. This is their first time seeking fertility treatment. The patient’s past medical history includes asthma. She denie...
A
Answer the following medical question with the correct letter choice:
<<Question:>> A 20-year-old male is brought by ambulance to the emergency room in extremis. He is minimally conscious, hypotensive, and tachypneic, and his breath gives off a "fruity" odor. An arterial blood gas and metabolic panel show anion gap metabolic acidosis. This patient is most likely deficient in which of the...
D
Answer the following medical question with the correct letter choice:
<<Question:>> A 38-year-old woman presents to a physician’s office for progressive weakness and pallor during the last few weeks. She also complains of shortness of breath during her yoga class. She denies fevers, cough, rhinorrhea, or changes in appetite or bowel and bladder habits. She is generally healthy except for...
D
Answer the following medical question with the correct letter choice:
<<Question:>> A 35-year-old male has been arrested on suspicion of arson. He has a history of criminal activity, having been jailed several times for assault and robbery. When asked why he burned down his ex-girlfriend's apartment, he just smiled. Which of the following would the male most likely have exhibited during ...
A
Answer the following medical question with the correct letter choice:
<<Question:>> A 54-year-old woman comes to the physician because she has not had her menstrual period for the last 5 months. Menarche occurred at the age of 11 years, and menses occurred at regular 28-day intervals until they became irregular at 30- to 45-day intervals with light flow 2 years ago. She does not have vag...
B
Answer the following medical question with the correct letter choice:
<<Question:>> Three weeks after starting a new medication for hyperlipidemia, a 54-year-old man comes to the physician because of pain and swelling in his left great toe. Examination shows swelling and erythema over the metatarsophalangeal joint of the toe. Analysis of fluid from the affected joint shows needle-shaped,...
C
Answer the following medical question with the correct letter choice:
<<Question:>> A researcher is studying the circulating factors that are released when immune cells are exposed to antigens. Specifically, she is studying a population of CD2+ cells that have been activated acutely. In order to determine which factors are secreted by these cells, she cultures the cells in media and coll...
B
Answer the following medical question with the correct letter choice:
<<Question:>> A 63-year-old man comes to the physician because of shortness of breath and swollen extremities for 2 weeks. He has had excessive night sweats and a 4-kg (8.8-lb) weight loss over the last 8 weeks. He had an anterior myocardial infarction 3 years ago. He has type 2 diabetes mellitus and hypertension. He i...
B
Answer the following medical question with the correct letter choice:
<<Question:>> A 42-year-old man with non-small cell lung cancer is enrolled in a clinical trial for a new chemotherapeutic drug. The drug prevents microtubule depolymerization by binding to the beta subunit of tubulin. The mechanism of action of this new drug is most similar to which of the following? ---- <<Choices:>>...
B
Answer the following medical question with the correct letter choice:
<<Question:>> A 29-year-old female presents to her gynecologist complaining of a painful rash around her genitals. She has multiple sexual partners and uses condoms intermittently. Her last STD screen one year ago was negative. On examination, she has bilateral erosive vesicles on her labia majora and painful inguinal ...
C
Answer the following medical question with the correct letter choice:
<<Question:>> A 72-year-old man comes to the physician because of a 6-month history of intermittent dull abdominal pain that radiates to the back. He has smoked one pack of cigarettes daily for 50 years. His blood pressure is 145/80 mm Hg. Abdominal examination shows generalized tenderness and a pulsatile mass in the p...
A
Answer the following medical question with the correct letter choice:
<<Question:>> A 31-year-old man with untreated HIV infection is admitted to the hospital because of a 3-day history of blurred vision and flashing lights in his left eye. Indirect ophthalmoscopy shows retinal hemorrhages of the left eye. Treatment with a drug that directly inhibits viral DNA polymerases by binding to p...
B
Answer the following medical question with the correct letter choice:
<<Question:>> A 62-year-old man is brought to the emergency department with fatigue, dry cough, and shortness of breath for 3 days. He reports a slight fever and has also had 3 episodes of watery diarrhea earlier that morning. Last week, he attended a business meeting at a hotel and notes some of his coworkers have als...
D
Answer the following medical question with the correct letter choice:
<<Question:>> A 65-year-old African American man presents for follow-up examination with a 6-month history of urinary hesitancy, weak stream, and terminal dribbling, which is refractory to a combination therapy of finasteride and tamsulosin. The patient’s past medical history is otherwise unremarkable. His father and b...
B
Answer the following medical question with the correct letter choice:
<<Question:>> A 7-year-old boy presents with right hip pain for the past 2 days. He reports gradual onset of pain and states it hurts to walk. He had a recent cold last week but is otherwise healthy. His temperature is 98.2°F (36.8°C), blood pressure is 107/70 mm Hg, pulse is 90/min, respiratory rate is 19/min, and oxy...
B
Answer the following medical question with the correct letter choice:
<<Question:>> A 70-year-old man comes to the physician because of episodes of watery stools for the past 6 weeks. During this period, he has also had recurrent episodes of reddening of the face, neck, and chest that last up to 30 minutes, especially following alcohol consumption. He has hypertension. He smoked one pack...
D
Answer the following medical question with the correct letter choice:
<<Question:>> A 4-year-old boy is brought to the physician for the evaluation of fatigue since he returned from visiting family in South Africa one week ago. The day after he returned, he had fever, chills, and diffuse joint pain for 3 days. His symptoms improved with acetaminophen. He was born at term and has been hea...
C
Answer the following medical question with the correct letter choice:
<<Question:>> A 15-year-old African American boy presents to a pediatrician with complaints of yellow discoloration of the sclerae for the last 3 days. His mother informs the pediatrician that the boy developed prolonged jaundice during the neonatal period. On physical examination, vital signs are stable and general ex...
B