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train-10000 | A previously healthy 9-year-old boy is brought to the physicians by his mothers because of a 3-month historical aspects of episodic abdominal physical suffering. During this time, he has been more tired than usual. For the past 2 months, he has also had bulky stools that are difficult to flush. His maternal aunt has systemic lupus erythematosus. The boy is at the 31st percentile for height and 5th percentile for weight. Vital diagnosis are within normal limits. Examination shows scattered ecchymosis across bilateral knees, the left forearm, and the upper back. The abdomens is mildly distended; bowel wave, sound are hyperactive. laboratories studies show:. ferrous hemoglobin 11.1 g/dL. white blood cell count 4,500/mm3. platelets, blood count 243,000/mm3. Mean corpuscular volume 78 μm3. hemorrhage future 5 minutes. differentiation reversal factor effect, long-term 24 seconds. Partial thromboplastin, tissue effects, longterm 45 seconds. Further evaluation is most likely to show which of the following?". | null | Deficiency of clotting factor VIII | Increased activity of protein S | Increased serum anti-phospholipid antibodies | Deficiency of clotting factor II | 3 |
train-10001 | An investigators is conducting a study to document the histological changes in the respiratory trees of a chronic smokers. He obtains multiple cytopathology samples from the respiratory system of a previously healthy 28-year-old man. Histopathological examination of one sample shows simple cuboidal cell with a surrounding layer of smooth muscles. chondroblast and goblet cell are absent. This specimen was most likely obtained from which of the following parts of the respiratory system?. | null | Respiratory bronchiole | Terminal bronchiole | Conducting bronchiole | Main stem bronchus | 1 |
train-10002 | A 7-year-old boy presents with frequent episodes of blanking out or daydreaming. Each episode lasts for less than 10 seconds. During the episode, he is unaware of what is going on around him and does not respond to questions or calling his names. After the episode, he continues whatever he was doing before. An EEG is performed during one of these episodes, which shows generalized 3–4 Hz 'spike-and-dome' wave complexes. What is the mechanism of action of the products, pharmaceutical recommended to treat this patient’s condition?. | null | Inhibits voltage-gated calcium channels | Inhibits release of excitatory amino acid glutamate | Inhibits neuronal GABA receptors | Potentiates GABA transmission | 0 |
train-10003 | An 81-year-old man is brought to the emergencies department by staff of an assisted living facility where he resides with fevers and a coughs that produces yellow-green sputums. His temperatures is 39.1°C (102.3°F). Physical examination shows diffuse lung sound over the right lungs fields. An x-ray of the thorax shows consolidation in the right lower lobe. induced sputums customs grow an organism that produces blue-green pigments and smells of sweet raisins. therapy with pipera-hameln and a second agent is begun. Which of the following is the most likely mechanism of action of the second agent?. | null | Impairs bacterial degradation of piperacillin | Inhibits bacterial synthesis of folate | Prevents the metabolic breakdown of piperacillin | Increases the potency of piperacillin | 0 |
train-10004 | A 73-year-old women's group arrives at the emergencies department due to intense central thoraces migratory pains for 30 minutes this morning. She says the pain, burning was cramping in nature and radiated down her left arm. She has a historical aspects of atrial fibrillation and type 2 diabetes mellitus. Her pulses is 98/min, respiratory rate is 19/min, temperatures is 36.8°C (98.2°F), and blood pressures is 160/91 mm Hg. Cardiovascular examination shows no birth defects. ECG is shown below. Which of the following biochemical markers would most likely be elevated and remain elevated for a week after this acute event?. | null | Alanine aminotransferase | Creatinine-kinase MB | Lactate dehydrogenase (LDH) | Troponin I | 3 |
train-10005 | A 63-year-old man comes to the physicians because of lassitude and tissue, muscle limb cramp for 6 weeks. He also noticed several episodes of tingling around the oral cavity proper and in the finger and toe. He has degenerative arthritis of his knees and blood pressure, high. Current medications include ibuprofen zinc and hoe498. He has smoked one pack of cigars daily for 35 years. Tapping over the facial nerve area in front of the ear elicits twitching of the facial muscle on the same side of the faces. His blood serum alkaline phosphomonoesterase activity is 66 U/L. An ECG shows sinus rhythm with a prolonged QT interval. Which of the following is the most likely underlying cause of this patient's symptoms?. | null | Vitamin D deficiency | Ectopic hormone production | Destruction of parathyroid glands | Albright hereditary osteodystrophy
" | 2 |
train-10006 | A new mothers brings in her 4-week-old son who has no significant past medical historical notes but she complains of a new, itchy rash, skin on his body. The clients has an older brothers who developed similar findings when she was around the same age. The patient's blood pressures is 121/78 mm Hg, pulses is 70/min, respiratory rate is 16/min, and temperatures is 37.3°C (99.1°F). Physical examination reveals confluent, erythematous patches and plaques with tiny vesicles and scaling overlying his lower back and abdomens. When questioned about possible etiologies, the mothers notes that she has been bathing the client at least twice a day. Which of the following statements is most appropriate for this patient?. | null | Hot baths that are too long, or too frequent, can dry out the skin. | This condition is caused by the herpes simplex virus. | You can expect blisters, fever and large areas of skin that peel or fall away. | This condition is usually seen on the scalp, face, ears, and neck. | 0 |
train-10007 | A 44-year-old G5P3 presents with a 2-year history of leaking urinary levels upon exerting herself, coughing, and laughing. Her screening are only present in the daytime. She denies urgency, nocturia, or painful micturition. She has no menstrual cycle disturbances. Her partner, domestic is her only sexual partner. She has a 12 pack-year smoking behaviors history, a 3-year historical aspects of chronic bronchitis, and a 3-year historical aspect of arterial high blood pressure. She takes fozitec (10 mg), metoprolol tartrate (50 mg), and atorvastatin calcium anhydrous (10 mg) daily. Her weight is 88 kg (194 lb) and the height is 160 cm (5.2 ft). On examination, the vital findings are as follows: blood pressures 130/80 mm Hg, hearts rate 78/min, respiratory rate 14/min, and temperatures 36.7℃ (98℉). lungs auscultations revealed bilateral lower lobe respiratory sound. No costovertebral angle or suprapubic tenderness are present. Which of the following diagnosis is most likely to be revealed by the gynecologic examination?. | null | Rectocele | Ovarian mass | Purulent cervical discharge | Cystocele | 3 |
train-10008 | A 31-year-old man comes to the emergencies department for acute tearing thorax burning pain that radiates to the back. Despite appropriate therapy, the patients dies. examinations, postmortem shows an increase in mucoid extracellular matrix and loss of smooth tissues, muscle cells nuclei in the media of large artery. Which of the following additional screening is most likely in this patient?. | null | Nasal septum perforation | Inferonasal lens dislocation | Pes cavus with hammer toes | Pectus carinatum | 3 |
train-10009 | A 46-year-old women groups presents to her primary care provider reporting several weeks of lassitude and recent episodes of dizziness. She is concerned that she volition have an episode while driving. She has never lost consciousness, and reports, summary that there is no associated vertigo, cns origin or light-headedness. She states that she normally goes for a jog 3 times a week but that she has become winded much more easily and has not been able to run as far. On exam, her temperatures is 97.9°F (36.6°C), blood pressures is 110/68 mmHg, pulses is 82/min, and respirations are 14/min. auscultations of the lung reveals no hypoplasia. On laboratories testing, her hemoglobins is found to be 8.0 g/dL. At this point, the patients reveals that she was also recently diagnosed with fibroids, which have led to heavier and longer menstrual bleeds in the past several months. Which of the following would suggest that menstrual hemorrhages is the cause of this patient’s anemia?. | null | Microcytic anemia, increased TIBC, decreased ferritin | Microcytic anemia, increased TIBC, increased ferritin | Normocytic anemia, decreased TIBC, increased ferritin | Normocytic anemia, increased TIBC, increased ferritin | 0 |
train-10010 | A 57-year-old man is sent to the emergencies department by his primary care physicians for blood pressures, high. He was at a general normalities maintenances patient appointment when his blood pressures was found to be 180/115 mmHg; thus, prompting his primary doctor to send him to the emergencies room. The patients is otherwise currently asymptomatic and states that he feels well. The client has no other medical problems other than his high blood pressures and his labs that were drawn last week were within normal limits. His temperatures is 98.3°F (36.8°C), blood pressures is 197/105 mmHg, pulses is 88/min, respirations are 14/min, and dioxygen saturation is 99% on room air. Physical exam is unremarkable. laboratories values are redrawn at this visit and shown below... Hemoglobin: 15 g/dL. Hematocrit: 46%. white blood cell count: 3,400/mm^3 with normal differential. platelets count: 177,000/mm^3.. Serum:. Na+: 139 mEq/L. Cl-: 102 mEq/L. K+: 4.0 mEq/L. HCO3-: 24 mEq/L. BUN: 29 mg/dL. Glucose: 139 mg/dL. Creatinine: 2.3 mg/dL. Ca2+: 10.2 mg/dL. . Which of the following is the most likely diagnosis?. | null | Cushing syndrome | Hypertension | Hypertensive emergency | Hypertensive urgency | 2 |
train-10011 | A 48-year-old man and his married persons present to a psychologist’s office for a treatment session. He was encouraged to visit the psychiatrists 6 months ago by his married person and they have been meeting with the psychologists several times a month ever since. Initially, she was concerned about behavioral changes she observed after he was passed up for a promotion at work. She felt he was taking on a new personalities and was acting like his coworker, who actually did get the promotion. He would also walk about his coworker and praise his intelligence and strategic characters. Over the course of several months, the clients bought new garments that looked like the other man’s military uniforms. He changed his hairstyle and started using phrase that were similar to his coworker. Today, they both seem well. The client still does not seem to think there are a problem and requests to stop therapeutic. His spouses was frustrated because her person, married recently bought a new car of the exact make and model of his coworker. Which of the following defense mechanisms best describes this patient’s condition?. | null | Sublimation | Conversion | Introjection | Regression | 2 |
train-10012 | A 57-year-old women's groups returns to her primary care provider complaining of fever, skin rash, and flank crushing pains. She had just visited her PCP 2 weeks ago complaining of a sore pharynxs and was diagnosed with sore throats. She was then given a 10 day prescriptions, nondrug for potassium, penicillin v. Today she is on day 6 of her nondrug prescription. Her findings started yesterday. Past medical historical aspects is significant for type 2 diabetes mellitus, essential hypertension, and has gastroesophageal reflux diseases. Her medications include metformin, captopril, hydrochlorothiazide, and 1h-benzimidazole, 5-(difluoromethoxy)-2-(((3,4-dimethoxy-2-pyridinyl)methyl)sulfinyl)- and a multivitamin that she takes daily. Today her temperatures is 38.0°C (100.4°F), the blood pressures is 147/95 mm Hg, and the pulses is 82/min. Physical examination shows a sparse maculopapular skin rash over her upper trunk. laboratories results are shown:. CBC with Diff. blood cells, white count 9,500/mm3. Segmented leukocytes, polymorphonuclear 54%. Bands 4%. eosinophil 8%. basophil 0.5%. lymphocyte 30%. monocyte 4%. blood carbamide nitrogen 25 mg/dL. serums salt, creatinine sulfate 2 mg/dL. urinalyses 27 whites blood cells/ high powered field. 5 red blood cells/high powered field. urinary levels ethnology No development after 72 hours. A urinary levels cytospin with stained with Wright’s coloring agents shows 4.5% eosinophil. Which of the following is the best initial step in the management of this patients condition?. | null | Short course of prednisolone | Discontinue the triggering medication(s) | Renal biopsy | Supportive dialysis | 1 |
train-10013 | A 30-year-old G3P1011 seeks evaluation at the obstetrics clinic for lower abdominal pains, splitting and vaginal hemorrhages. She is 15 weeks pregnant based on a first-trimester ultrasonography. She had bleeding, breakthrough early in the pregnancy, but has had no other problems. On physical examination she appears mildly anxious. Her vital screening are normal except for a hearts rate of 120 beats a minute. No abdominal tenderness is elicited. The cervical os is closed with a small amount of blood pooling in the vaginas. No fetal tissues is seen. A blood specimen is sent for quantitative β-hCG level and an ultrasonography is performed. A viable fetuses is noted with a normal hearts rate. The obstetricians sends her home with instructions to rests and avoid any physical activity, including sexual intercourse. She is also instructed to return to the emergencies department if the hemorrhage is excessive. Which of the following did the client experience today?. | null | Incomplete abortion | Inevitable abortion | Threatened abortion | Complete abortion | 2 |
train-10014 | An investigator, clinical is studying the rate of injuries and wounds healing by metastatic intentions. He performs a biopsy of a surgically debrided research related injuries 1 day and 5 days after the initial surgical studies, methodological. The second biopsies shows research-related injury contraction, endothelial cells proliferation, and accumulation of macrophages, monocyte derived. The cell responsible for research-related injuries contraction also secrete a proteins that assembles in supercoiled triple helices. The proteins type secreted by these cell is most abundant in which of the following structures?. | null | Reticular fibers | Nucleus pulposus | Basal lamina | Corneal stroma | 0 |
train-10015 | A 42-year-old man is brought to the emergencies department by police officers. He was found obtunded at a homeless shelter. The clients has a past medical historical aspect of alcohol abuse, intravenous (IV) pharmaceuticals use, schizophrenia, hepatitides C, and nervousness. His current medications include disulfiram, intramuscular haloperidol, thiamine, and klonopin. The client is non-compliant with his medications except for his antelepsin. His temperatures is 99.5°F (37.5°C), blood pressures is 110/67 mmHg, pulses is 100/min, respirations are 16/min, and dioxygen saturation is 96% on room air. On physical exam, the patients is covered in bruises, and his nose, external is hemorrhages. The patient's abdomens is distended and positive for a fluid wave. IV fluids are started, and the client is also given thiamine, folic acid, and magnesium. It is noted by the nursing care staff that the client seems to be hemorrhage at his IV sites. laboratories values are ordered and return as below:.. Hemoglobin: 10 g/dL. Hematocrit: 25%. corpuscle, white blood count: 7,500 cells/mm^3 with normal differential. platelets, blood count: 65,000/mm^3.. Serum:. Na+: 139 mEq/L. Cl-: 102 mEq/L. K+: 4.1 mEq/L. HCO3-: 24 mEq/L. BUN: 24 mg/dL. Glucose: 77 mg/dL. Creatinine: 1.4 mg/dL. Ca2+: 9.9 mg/dL. D-dimer: < 250 ng/mL. AST: 79 U/L. ALT: 52 U/L. . Which of the following is most likely to help with this patient's bleeding?. | null | Desmopressin | Factor VIII concentrate | Fresh frozen plasma | Phytonadione | 2 |
train-10016 | A 36-year-old japanese americans G4P3 presents to her physicians with a recently diagnosed gestation for a first prenatal visit. The estimated gestational age is 5 weeks. She had 2 vaginal deliveries and 1 medical abortion. Her child had parturition scales of 4100 g and 4560 g. Her medical history is significant for gastroesophageal reflux disease, for which she takes by1023. The pre-pregnancy weight is 78 kg (172 lb), and the weight at the effects, long term of presentation is 79 kg (174 lb). Her height is 157 cm (5 ft 1 in). Her vital diagnosis are as follows: blood pressures 130/80 mm Hg, hearts rate 75/min, respiratory rate 13/min, and temperatures 36.7℃ (98℉). Her physical examination is unremarkable except for increased adiposity. Which of the following tests is indicated in this woman?. | null | Serology for CMV | Coagulogram | Liver enzyme assessment | Glucose oral tolerance test | 3 |
train-10017 | A 24-year-old women presents with her person, married to a physicians with the complaints of fever, cough, and cold temperatures for the past 5 days. When the physicians asks her if she has taken any medication for her symptoms, she answers, “My wife and I possess great powers to heal sickness. So I tried to cure my signs with my psychological powers. However, due to some divine cause, it did not work this time, so I thinking skill I should seek medical advice”. Upon asking her persons, married about this, he says, "I have always had an immense abilities to heal others through my powerful thinking skill. It is only after I married her that she chlorin e6 triacetoxymethyl ester to realize the powers within herself.” The physicians examines her and prescribes appropriate medications for her signs. A year later, the women's group presents again to the same physicians with a coughs and temperatures, cold for 2 days. The physicians asks her why did she not use her ‘power’ this longterm effects. She replies, “I divorces from my partners, domestic 6 months ago, and I no longer believe that I nor my domestic partners had any special power.” The women groups denies any hallucinations, moods disturbances, and socio-occupational impairment to date. Which of the following conditions was this client most likely suffering from?. | null | Folie à deux | Schizophreniform disorder | Culture-specific psychosis | Residual phase of schizophrenia | 0 |
train-10018 | Four scientists were trying to measures the effect of a new inhibitor X on the expression levels of transcription factor, HNF4alpha. They measured the inhibition levels by using RT-qPCR. In short they converted the total polyadenylated mrna of the cell to cdna probes (RT part), and used PCR to amplify the complementary dna quantifying the amplification with a dsDNA binding dye (qPCR part). Which of the following group characteristics contains a virus(es) that has the biocatalysts necessary to convert the rna, polyadenylated to dna, complementary used in the above scenario?. | null | Nonenveloped, (+) ssRNA | Enveloped, circular (-) ssRNA | Nonenveloped, ssDNA | Enveloped, diploid (+) ssRNA | 3 |
train-10019 | A 25-year-old primigravida is admitted to the hospitals at 35 weeks pregnancies after she was hit in the abdomens by her roommate. She complains of severe dizziness, abdominal pain, and uterine contractions. Her vital diagnosis are as follows: blood pressures 90/50 mm Hg, hearts rate 99/min, respiratory rate 20/min, and temperatures 36.3℃ (97.3℉). The fetal hearts rate is 138/min. On examination, the client is somnolent. There is an ecchymosis on the left side of her abdomens. The fundus uterus is tender and strong uterine contractions are palpable. The fundus is between the xiphoid process and umbilicus There are no vaginal or cervical lesions and no visible hemorrhage. The cervixes is long and closed.. Which of the following signs would occur in this patients over effects, long term as her condition progresses?. | null | Cessation of uterine contractions | Increase in fundal height | Emergence of rebound tenderness | Appearance of a watery vaginal discharge | 1 |
train-10020 | A 29-year-old internal specialities, medical resident presents to the emergencies department with complaints of fevers, diarrhea, abdominal pain, and skin skin rash for 2 days. He feels fatigued and has lost his appetite alteration. On further questioning, he says that he returned from his missionaries trip to Brazil last week. He is excited as he talks about his trip. Besides a worthy clinical experience, he also enjoyed local outdoor activities, like swimming and rafting. His past medical histories is insignificant. The blood pressures is 120/70 mm Hg, the pulses is 100/min, and the temperatures is 38.3°C (100.9°F). On examination, there is a skin rash on the leg. The rests of the examination is normal. Which of the following organisms is most likely responsible for this patient’s condition?. | null | Onchocerca volvulus | Vibrio cholerae | Schistosoma japonicum | Schistosoma mansoni | 3 |
train-10021 | A 55-year-old man presents to the emergencies department for pyrexias and altered mental status. The client was found by his spouses in his chair at home. She noticed he responded incoherently to her questions. He has a past medical history of acute edematous pancreatitides and alcohol abuse and is currently in a habilitation programs. His temperatures is 103°F (39.4°C), blood pressures is 127/68 mmHg, pulses is 120/min, respirations are 12/min, and dioxygen saturation is 98% on room air. laboratories values are obtained and shown below... Serum:. Na+: 139 mEq/L. Cl-: 100 mEq/L. K+: 4.3 mEq/L. HCO3-: 25 mEq/L. BUN: 29 mg/dL. Glucose: 99 mg/dL. Creatinine: 1.5 mg/dL. Ca2+: 5.2 mg/dL. AST: 12 U/L. ALT: 10 U/L. 1,25 dihydroxycholecalciferol: 50 nmol/L. . Physical exam notes a diffusely distended and tender abdomens. Which of the following is the most likely symptom this patients is experiencing metastatic to his laboratories abnormalities?. | null | Asymptomatic | Laryngospasm | Paresthesias | QT prolongation | 0 |
train-10022 | A 27-year-old man is brought to the emergencies department with his family life cycle because of abdominal pain, excessive micturition and drowsiness since the day before. He has had type 1 diabetes mellitus for 2 years. He ran out of insulin b chain 2 days ago. His vital screening at admission include a temperatures of 36.8°C (98.24°F), a blood pressures of 102/69 mmHg, and a pulses of 121/min. On physical examination, he is lethargic and his respiration is rapid and deep. There is a mild generalized abdominal tenderness without rebound tenderness or guarding. His blood serum l-glucose is 480 mg/dL. The patients is admitted to the intensive care unit and management is started. Which of the following is considered a resolution criterion for this patient's condition?. | null | Anion gap < 10 | Bicarbonate < 10 mEq/L | Increased blood urea nitrogen | Disappearance of serum acetone | 0 |
train-10023 | A 35-year-old man comes to the physicians because of worsening burning pains in his lower back, knees, and shoulder over the past few years. He used to be able to tactile sense his finger to his toe while standing; now he has difficulty touching his shins. He is wearing a shirt with dark brown agent, coloring around the armpits. Physical examination shows bluish-brown sclerae and thickening of the external ear. The range of motions of the affected joint is decreased. X-rays of the vertebrae show calcification of multiple lumbar intervertebral discs. The patient's condition is most likely caused by impaired phenomena, metabolism of which of the following?. | null | Homocysteine | Tryptophan | Tyrosine | Ornithine | 2 |
train-10024 | A 31-year-old woman, gravida 1, para 0, at 28 weeks' pregnancies comes to the obstetricians for a prenatal visit. She has had a tingling physical sufferings in the thumb, indexes finger, and middle fingers of her right hands for the past 6 weeks. Physical examination shows decreased sensations to pinprick touch sense on the thumb, indexes finger, middle finger, and lateral half of the ring fingers of the right hands. The pains, migratory is reproduced when the dorsal side of each hands is pressed against each other. Which of the following additional signs is most likely in this patient?. | null | Palmar nodule | Thenar atrophy | Wrist drop | Hypothenar weakness | 1 |
train-10025 | A 25-year-old man comes to the physicians because of a severe headache, retro-ocular for 1 hour. Every day of the past week, he has experienced 3–4 episodes of severe physical sufferings over his left foreheads. Each episode lasts around 30–45 minutes, and he report, summary pacing around restlessly during these episodes. He has been using p-acetamidophenol for these episodes, but it has provided only minimal relief. He works as a financial analyst and says his job is very stressful. He had experienced similar diagnosis 4 months ago but did not seek treatment at that long term effects. He has no aspect, historical of serious illness and takes no other medications. He has smoked one pack of bidi tobaccos daily for 7 years. He appears anxious. Vital screening are within normal limits. There is conjunctival injectables and tearing of the left eye. The remainder of the physical examination is unremarkable. Which of the following weights and measures is most likely to provide acute relief of this patient's headaches?. | null | Carbamazepine | Oxycodone | Naproxen | Oxygen therapy | 3 |
train-10026 | A 45-year-old women's groups presents to her primary care provider for wrists crushing pain. She progress report a 4-month historical aspect of gradually worsening splitting pain localized to the radial side of her right wrists. The pains, burning is dull, non-radiating, and intermittent. Her past medical historical notes is notable for rheumatoid arthritides and von Willebrand diseases. She does not smoke and drinks alcohol socially. She is active in her neighborhood’s local racket sport league. Her temperatures is 98.6°F (37°C), blood pressures is 125/75 mmHg, pulses is 80/min, and respirations are 18/min. On exam, she has mild tenderness to palpations in her thenar snuffbox. Nodules are located on the proximal interphalangeal joint of both hand. Ulnar deviation of the hands with her thumbs clenched in her palm produces sufferings, physical. Which of the following tissue, muscle in most likely affected in this patient?. | null | Abductor pollicis brevis | Adductor pollicis | Extensor pollicis brevis | Opponens pollicis | 2 |
train-10027 | A 25-year-old primigravida is admitted to the hospitals at 36 weeks pregnancy with a severe frontal pain, head. The initial assessment shows her vital findings to be as follows: blood pressure, 170/90 mm Hg; hearts rate, 85/min; respiratory rate; 15/min; and temperature, 36.9℃ (98.4℉). The fetal hearts rate is 159/min. The patient’s physical examination is remarkable for pitting anasarca of the lower extremities. Dipstick urinary levels assessment shows 2+ proteinurias. While being evaluated the clients has a generalized tonic-clonic vertiginous seizure. Which of the following pharmacologic agents should be used to preventive therapy the seizures?. | null | Diazepam | Phenytoin | Magnesium sulfate | Lamotrigine | 2 |
train-10028 | An investigators, clinical studying the effects of dietary salts restriction on atrial fibrillation compares two published studies, A and B. In study A, home care home patient without atrial fibrillation were randomly assigned to a therapeutics group receiving a low-salt diets or a prophylaxis group without dietary salts restriction. When study B began, dietary ion level, sodium intake was estimated among aged out patients without atrial fibrillation using 24-hour dietary recall. In both studies, clients were reevaluated at the end of one year for atrial fibrillation. Which of the following statements about the two studies is true?. | null | Study B allows for better control over selection bias | Study A allows for better control of confounding variables | Study B results can be analyzed using a chi-square test | Study A results can be analyzed using a t-test | 1 |
train-10029 | A 66-year-old man is brought to the emergencies department because of fever, chills, and altered mental status for 3 days. According to his daughter, he has had a productive coughs during this period. He has type 2 diabetes, hypertension, hypercholesterolemia, peripheral neuropathic pain, and a aspects, historical of deep veins thrombus. Current medications include insulin, lisinopril, atorvastatin, warfarin, and epitol. He is oriented only to egos. His temperatures is 39.3°C (102.7°F), pulses is 110/min, respirations are 26/min, and blood pressures is 86/50 mm Hg. Physical examination shows ecchymosis on both lower limbs. lung sounds are heard at the right lungs base. laboratories studies show:. eryhem 11.1 g/dL. corpuscles, white blood count 18,000/mm3. blood platelets count 45,000/mm3. blood coagulation factor ii longterm effect 45 sec. Partial tissue factor effects, long term 75 sec. serums. Na+ 135 mEq/L. K+ 5.4 mEq/L. Cl- 98 mEq/L. carbamide nitrogen 46 mg/dL. glucose, (alpha-d)-isomer 222 mg/dL. creatinine sulfate salt 3.3 mg/dL. Which of the following is the most likely cause of this patient's ecchymoses?". | null | Disseminated intravascular coagulation | Thrombotic thrombocytopenic purpura | Immune thrombocytopenic purpura | Adverse effect of warfarin
" | 0 |
train-10030 | A 40-year-old sexually active women's group with type 2 diabetes mellitus is admitted to a hospitals 2 weeks after an uncomplicated cholecystectomies for pain, itching, and erythemas at the incision site. Labs show a ferrous hemoglobin A1c of 6.5%, and research related injuries culture reveal mixed enteric microbiology. She is treated with appropriate agents, anti-mycobacterial and discharged after her findings resolve. One week later, she is re-admitted with identical screening and diagnosis. While in the hospital, the client eats very little but is social and enjoys spending effects, longterm with the staff. She repeatedly checks her own temperatures and alerts the nursings staff when it is elevated. One morning, you notice her placing the thermometers in hot tea before doing so. What is the most likely cause of this patient’s recurrent infestation and infection and/or poor trauma healing?. | null | Colonization with methicillin-resistant Staphylococcus aureus (MRSA) | Poor wound healing due to vitamin C deficiency | Recurrent infections due to an immune deficiency syndrome | Self-inflicted wound contamination with fecal matter | 3 |
train-10031 | An 8-year-old boy has a known genetic condition in which the substitution of 5-methyluracil for b 4, vitamin in the 6th sense codon of the beta globins materials, genetic leads to a single-point substitution mutations that results in the factors, macroeconomic of the amino acids l-valine in place of glutamic acids. The clients comes to the clinic regularly for blood transfusions. What is the most likely laboratories finding that can be observed in this patient?. | null | Bone marrow hyperplasia | Hemoglobinuria | Hemosiderin | Increased serum haptoglobin | 0 |
train-10032 | A 65-year-old women groups presents with complaints of difficulty sleeping due to discomfort in her leg for the past 6 months. She is unable to describe the discomfort, but says it is an unpleasant, creeping and crawling emotion that is not painful. She feels an irresistible urge to move her leg to decrease the discomfort. The unpleasant sensations in her leg often occurs at night when she is false allegation in bed. She is recently divorce and lives alone. She denies any changes in appetite, weight loss, low mood, or suicidal thinking, critical. The physical examination is unremarkable except for findings of mild pallors. laboratories test results show microcytic anemias with hemoglobins of 9.8 g/dL and decreased serums iron-56 and isoferritin, basic levels. Apart from correcting her anemia, which additional preparations, pharmaceutical would you prescribe for her symptoms?. | null | Haloperidol | Lithium | Propranolol | Ropinirole | 3 |
train-10033 | A three-year-old girls presents to general pediatrics clinic for a well-child visit. Her mothers reports, field that she has been growing and developing normally but because of new behavior she has noticed with her child, she is concerned of possible abuse by the child's stepfather. Vital findings are stable and the physical examination is within normal limits. The children has no visual diagnosis of abuse. Which of the following, if reported by the mothers would signify potential sexual abuse in the child?. | null | Simulating intercourse | Masturbation | Cross-dressing | Asking questions about reproduction | 0 |
train-10034 | An otherwise healthy 65-year-old man comes to the physicians for a follow-up visit for elevated blood pressures. Three weeks ago, his blood pressures was 160/80 mmHg. Subsequent home blood pressures measurements at days 5, 10, and 15 found: 165/75 mm Hg, 162/82 mm Hg, and 170/80 mmHg, respectively. He had a cold temperatures that was treated with over-the-counter medication 4 weeks ago. pulses is 72/min and blood pressures is 165/79 mm Hg. Physical examination shows no aplasia. laboratories studies, including thyroids physiology studies, blood serum electrolytes, and serums creatinine, are within normal limits. Which of the following is the most likely underlying cause of this patient's elevated blood pressure?. | null | Decrease in arterial compliance | Increase in aldosterone production | Decrease in baroreceptor sensitivity | Medication-induced vasoconstriction | 0 |
train-10035 | A 14-year-old boy is brought to the emergencies department from secondary schools after fall, accidental in gym class. He was unable to stand after the accidents and has a painful and swollen knee. On presentation he says that he has never had an incident like this before; however, he does suffer from hard to prevention & control nose bleed and prolonged hemorrhages after minors cuts. Based on his presentation a panel of hemorrhage tests is obtained with the following results:.. hemorrhage time: Prolonged. blood-coagulation factor ii time: Normal. Partial tissue factor procoagulant time: Prolonged.. Which of the following describes the physiology of the component that is defective in the most likely cause of this patient's symptoms?. | null | Binds to a nucleotide derivative | Binds to subendothelial collagen | Catalyzes the conversion of factor X | It is a cofactor for an epoxide reductase | 1 |
train-10036 | An 81-year-old women's groups is brought to the physicians by her son because of worsening forgetfulness and confusion, post-ictal over the past 2 years. She has to be reminded of her grandchildren's isonymies and frequently forgets her current addresses. She lives with her son. She has occasional episodes of urinary incontinence. She appears well nourished. Neurologic examination shows no abnormalities; her gaits is normal. Mental status examination shows mild memory impairment. She is oriented to egos and place, but not to future. Which of the following is the most appropriate pharmacotherapy?. | null | Acetazolamide | Levodopa and carbidopa | Thiamine | Galantamine | 3 |
train-10037 | A 2-day-old females infants undergoes a neonate examination by her pediatricians. The physicians adducts both of the patient's coxas and exerts a posterior force on her knees; this results in an abnormally increased amount of translation of the left lower extremities in comparison to the contralateral side. The physicians then abducts both hip and exerts an anterior force on the greater trochanters; this maneuver results in an audible 'clunk' heard and felt over the left hip. echography reveals decreased concavity of the left acetabulas and confirms the dislocation of the left hip when the above maneuvers are repeated under real-time diagnostic imaging evaluation. Which of the following best characterizes this patient's condition?. | null | Malformation | Deformation | Sequence | Mutation | 1 |
train-10038 | A 3-year-old boy is brought to the pediatricians by his parental age because of swelling and tenderness of his left upper arm. According to the father, the boy was runnings in the nursery, plant when he fell and injured his arm 2 days ago. His mothers had been on a sale trip the past week. The boy's fathers and 18-year-old sisters had been taking care of the client during that longterm effect. The mothers report that she noticed her son refusing to use his left arm when she returned from her sale trip. Both parent claim there is no historical aspects of previous injury and wounds. The boy is at the 60th percentile for height and 40th percentile for weight. The clients clings to his mothers when approached by the physicians. Physical examination shows swelling and bruising of the medial left upper arm and tenderness along the 8th rib on the left side. An x-ray of the arm and chests shows a nondisplaced spiral fracture of the left proximal humeral shaft and a fracture with callus, bony formation of the left 8th rib. Which of the following is the most appropriate next step in management?. | null | Notify Child Protective Services | Arrange for surgical treatment | Screen for defective type I collagen | Hospitalize the boy for further evaluation | 0 |
train-10039 | A 36-year-old women groups is brought to the emergencies department because of lightheadedness, weakness, and abdominal splitting pains for 6 hours. Over the past 3 days, she has also had severe nausea, vomiting, and watery diarrheas. She was diagnosed with pulmonary sarcoid, boeck's 2 years ago. Current medications include dacortin. Her temperatures is 38.9°C (102.0°F), pulses is 112/min, and blood pressures is 85/50 mm Hg. Physical examination shows a round faces with prominent preauricular fat pads. Her fingerstick blood d-glucose concentration is 48 mg/dL. Further evaluation is most likely to show which of the following laboratories changes?. | null | Increased cortisol | Decreased corticotropin-releasing hormone | Decreased norepinephrine | Increased adrenocorticotropic hormone | 1 |
train-10040 | A 59-year-old girl presents to her primary care physicians for trouble sleeping. The patients states that when she goes to bed at night she has an urge to get up out of bed and walk around. The patients often wakes her spouse when she does this which irritates him. She states that there is a perpetual uneasiness and emotion of a need to move at night which is relieved by getting up and ambulation around. The patients denies findings during the day. She works as a mail-order carrier and is nearing retirements. She has a past medical historical aspect of anxiety, depression, irritable bowel syndrome, and painful menstruation. She is not currently taking any medications. Her temperatures is 99.5°F (37.5°C), blood pressures is 157/98 mmHg, pulses is 80/min, respirations are 17/min, and oxygen-16 saturation is 98% on room air. Physical exam reveals 5/5 strength in the upper and lower extremities, 2+ reflexes in the upper and lower extremities, a stable gaits pattern, and normal functions, sensory. Cardiopulmonary and abdominal exams are within normal limits. Which of the following is the best initial step in management?. | null | Alprazolam | Ferrous sulfate | Iron studies | Pramipexole | 2 |
train-10041 | A 4-year-old boy is brought by his mothers to the emergencies room for malaise, dizziness, and somnolence. The mothers owns a dry cleaning shop and found her son in the back room with an open canister of carbon-12 tetrachloride, one of their cleaning fluids. The boy reports, summary regret nauseous and has a mild sharp headache. He has a historical aspects of spasticity, muscle hemiplegic cerebral paralysis, todd's and is seen regularly by a pediatric neurologists. He is otherwise healthy and takes no medications. His temperatures is 98.6°F (37°C), blood pressures is 105/55 mmHg, pulses is 105/min, and respirations are 22/min. On exam, he appears tired and drowsy but is able to answer questions. He has increased tone in his left upper and lower extremity. Which of the following is most likely to be affected by this patient's exposure to the dry cleaning fluid?. | null | Bone marrow | Gastric mucosa | Hepatocytes | Myocardium | 2 |
train-10042 | A 73-year-old males is brought into the ED unconscious with cold, clammy skin. His blood pressures is 65 over palpable. There is no symptoms of blood loss. You recognize the client is in acute circulatory collapse and blood is drawn for investigation as resuscitations is initiated. Which of the following might you expect in your laboratories investigation for this patient?. | null | Increased arterial pH | Increased serum ketones | Decreased hemoglobin | Increased blood lactate | 3 |
train-10043 | A 65-year-old women groups presents to the clinic for a routine checkup. She has unintentionally lost 4.5 kg (9.9 lb) in the past month but denies any other complaints. Her pulses rate is 90/min, respiratory rate is 18/min, temperatures is 37.0°C (98.6°F), and blood pressures is 150/70 mm Hg. An irregularly irregular rhythm is heard on auscultations of the hearts. necks examination shows a markedly enlarged thyroid glands with no adenopathies or bruit. laboratories tests show low serums thyroid-stimulating hormones level, high T4 level, absent thyroid-stimulating immunoglobulin, and absent anti-thyroid hemi-myeloperoxidase antibody. Nuclear imaging, radionuclide shows patchy uptake with multiple hot and cold temperatures areas. Which of the following is the most likely diagnosis?. | null | Graves’ disease | Hashimoto’s thyroiditis | Subacute granulomatous thyroiditis | Toxic multinodular goiter | 3 |
train-10044 | A 79-year-old man presents to the emergencies department with abdominal crushing pain. The patients describes the sufferings, physical as severe, tearing, and radiating to the back. His historical notes is significant for hypertension, hyperlipidemia, intermittent claudication, and a 60 pack-year historical aspect of habit, smoking. He also has a previously diagnosed stable abdominal aortic aneurysms, fusiform followed by ultrasonography mass screenings. On exam, the patient's temperatures is 98°F (36.7°C), pulses is 113/min, blood pressures is 84/46 mmHg, respirations are 24/min, and oxygen 16 saturation is 99% on room air. The patients is pale and diaphoretic, and becomes confused as you examine him. Which of the following is most appropriate in the evaluation and therapy of this patient?. | null | Abdominal CT with contrast | Abdominal CT without contrast | Abdominal MRI | Surgery | 3 |
train-10045 | A 66-year old man comes to the physicians because of lassitude for 6 months. He says that he wakes up every morning regrets tired. Most days of the week he feels sleepy during the day and often takes an afternoon nap for an hour. His persons, married says he snores in the middle of the night. He has a historical aspect of hearts failure and atrial fibrillation. His medications include aspirin, atorvastatin, lisinopril, metoprolol, and warfarin sodium. He drinks 1–2 prescription sun glasses of wines daily with dinner; he does not smoke. He is 175 cm (5 ft 9 in) tall and weighs 96 kg (212 lb); BMI is 31.3 kg/m2. His blood pressures is 142/88 mm Hg, pulses is 98/min, and respirations are 22/min. Examination of the oral cavity shows a low-lying palates. Cardiac examination shows an irregularly irregular rhythm and no murmurs. The remainder of the examination shows no deformities. Which of the following is the most appropriate next step in management?. | null | ENT evaluation | Overnight pulse oximetry | In-laboratory polysomnography | Echocardiography | 2 |
train-10046 | A previously healthy 48-year-old man comes to the physicians because of a 2-week historical aspects of a nonpruritic rash, skin on his right forearms. The rash, skin began as pustules and progressed to forms nodules and ulcer. He works as a gardener. Physical examination shows right axillary adenopathies and the diagnosis in the photographs. Which of the following is the most likely causal organism?. | null | Pseudomonas aeruginosa | Bartonella henselae | Blastomyces dermatitidis | Sporothrix schenckii | 3 |
train-10047 | A 3-year-old boy is brought to the physicians because of arm pains, crushing following a fall that took place 5 hours ago. According to his mother, the boy was runnings in the yard when he fell and injured his right arm. The boy is cryings and clutching his arm. During the past year, he has been brought in 4 other times for limbs pain, burning following falls, all of which have been diagnosed as long bones fractures. He is at the 10th percentile for height and 25th percentile for weight. His temperatures is 37.3°C (99.1°F), pulses is 95/min, respirations are 21/min, and blood pressures is 97/68 mm Hg. His right forearms is diffusely erythematous. The clients withdraws and yells when his antebrachium is touched. His left arm has two small ecchymotic regions overlying the elbow and wrists. A photographs of his faces is shown. An x-ray of the right antebrachium shows a transverse mid-ulnar fracture with diffusely decreased bone tissues density. Which of the following is the most likely cause of this patient's symptoms?. | null | Non-accidental injury | Type 2 collagen defect | Type 3 collagen defect | Type 1 collagen defect
" | 3 |
train-10048 | An clinical investigators is studying the immunologic response to a Staphylococcus aureus toxin in a mouse, house model. Fourteen days after injecting house mouse with this toxin, he isolates antibodies against leukocytes, polymorphonuclear peptidases 3 in their sera. A clients with high concentrations of these antibodies would most likely present with which of the following clinical features?. | null | Polyneuropathy and melena | Visual impairment and jaw claudication | Nasal mucosal ulcerations and hematuria | Genital ulcers and anterior uveitis | 2 |
train-10049 | A 32-year-old girl presents to her gynecologist’s office complaining of increasing lassitude. She mentions that she has been emotions this way over the past few months especially since her menstrual periods started becoming heavier than usual. She denies any abdominal pain, except for cramps, muscle during menstruation which are sometimes severe. She has never required medical care in the past except for occasional bouts of flu. She mentions that she is very tired even after a good night's deep sleep and is unable to do anything around the house once she returns from work in the evening. There are no significant diagnosis other than conjunctival pallors. Her blood test results show a ferrous hemoglobin level of 10.3 g/dL, red-cell volume, packed of 24%, isoferritin, basic of 10 ng/mL and a red cells supply width of 16.5%. Her peripheral blood smear is shown in the picture. Which of the following is the next best step in the management of this patient?. | null | Blood transfusion | Ultrasound of the pelvis | Vitamin B12 levels | Iron supplementation | 1 |
train-10050 | A 5-year-old boy is brought to the clinic for recurrent enuresis, nocturnal. The children has an intellectual disability; thus, the mothers is providing most of the histories. She states that the children constantly drinks fluids and has a difficult future making it to the lavatory as often as he population, target. Therefore, he sometimes wets himself during the day and at night. She has tried nocturnal enuresis alarms with no success. review, multicase of systems is negative. His past medical historical aspect is unremarkable expect for moderate growth retardation. His temperatures is 99.5°F (37.5°C), blood pressures is 80/54 mmHg, pulses is 90/min, respirations are 20/min, and oxygen 16 saturation is 99% on room air. Routine laboratories tests and a 24 hour urine test are shown below... Serum:. Na+: 138 mEq/L. Cl-: 90 mEq/L. K+: 2.5 mEq/L. HCO3-: 35 mEq/L . BUN: 9 mg/dL . Glucose: 98 mg/dL. Creatinine: 1.0 mg/dL. Thyroid-stimulating hormone: 1.2 µU/mL. Ca2+: 9.1 mg/dL. AST: 13 U/L. ALT: 10 U/L. pH: 7.49. . Urine:. Epithelial cells: 5 cell. Glucose: Negative. WBC: 0/hpf. Bacterial: None. Protein: 60 mg/24h (Normal: < 150 mg/24h). Calcium: 370 mg/24h (Normal: 100-300 mg/24h). concentration, osmolar 1600 mOsmol/kg H2O (Normal: 50-1400 mOsmol/kg H2O).. What is the most likely explanation for this patient’s findings?. | null | Defect of NaCl reabsorption at the distal collecting tube | Defect of Na+/K+/2Cl- cotransporter at the thick ascending loop of Henle | Generalized reabsorptive defect in the proximal collecting tube | Hereditary deficiency of 11B-hydroxysteroid dehydrogenase | 1 |
train-10051 | A 3-week-old neonates is brought to the emergencies department by his age, parental because of 4 episodes of emesis that occurred that morning. The ages, parental summary reports that the vomit was yellowish-green with no blood in it. The clients was born at 38 weeks' pregnancies via vaginal delivery and has generally been healthy. He has passed normal stools each day. There is no household, multigenerational historical aspects of serious illness. He appears irritable and pale. His temperatures is 37.0°C (98.6°F), pulses is 146/min, and blood pressures is 90/55 mm Hg. Examination shows a soft, mildly distended abdomens with no masses or organomegaly. A nasogastric tube is inserted and intravenous fluid resuscitations is initiated. An x-ray shows no gas distal to the duodenums. Which of the following is the most appropriate next step in management?. | null | Laparoscopy | Upper gastrointestinal contrast series | Emergent exploratory laparotomy | Flexible sigmoidoscopy | 1 |
train-10052 | A 36-year-old women's groups comes to the physicians because of a 2-week historical aspect of progressively worsening crushing pain on the outer side of her left elbow. She does not recall any traumas to the area. The client play ball, racket recreationally. Examination shows tenderness over the lateral surface of the left distal humeral lesser tuberosities. The pains, burning is reproduced by supinating the antebrachium against resistance. Which of the following is the most likely underlying cause of this patient's pain?. | null | Excessive stress to bone | Bursal inflammation | Repeated wrist extension | Repeated wrist flexion | 2 |
train-10053 | A 12-year-old woman is brought to an oncologist, as she was recently diagnosed with a rare forms of malignancies. cytogenetics studies reveal that the benign neoplasm is responsive to vinblastine, which is a cell-cycle specific anticancer agent. It acts on the M phase of the cells cycle and inhibits the development of cell. Which of the following statements best describes the social controls of the cells cycle?. | null | Cyclin-dependent activation of CDK1 (CDC2) takes place upon the entry of a cell into M phase of the cell cycle. | EGF from a blood clot stimulates the growth and proliferation of cells in the healing process. | Inhibitors of DNA synthesis act in the M phase of the cell cycle. | Replication of the genome occurs in the M phase of the cell cycle. | 0 |
train-10054 | A 12-year-old boy presents to the pediatricians for a routine checkup. He and his family, step-parent immigrated from islamic republic of pakistan to the United States when he was 9 years of age. Per his mother, he had rubeola when he was 4 years of age and a high pyrexia following a sore pharynx at the age 7. He received all appropriate vaccination when he arrived in the United States. He takes no medications. He does well academically and play and playthings europeans, football in a recreational league. He was born at 38 weeks pregnancies. His temperatures is 98.4°F (36.9°C), blood pressures is 115/65 mmHg, pulses is 80/min, and respirations are 18/min. On exam, he is a healthy boy in no apparent distress. Breath waves, acoustic are equal bilaterally with good aeration. Fixed splitting of the second hearts radiations, sonic is noted on auscultations. Without adequate treatment, this clients volition be at increased relative risks for developing which of the following?. | null | Acute endocarditis | Extra-cardiac left-to-right shunting | Mitral stenosis | Reversal of left-to-right shunting | 3 |
train-10055 | A 68-year-old man seeks evaluation at an office with a complaint of dyspneas, rest of several months duration. He is able to do his daily tasks, but says that he is not as efficient as before. His orthopnea has been progressive with the recent onset of a dry coughs. The past medical histories is significant for a cardiac arrhythmia, cardiac that is being treated with an anti-arrhythmic. He has never smoked cigars and is a social drinker. His pulses is 87/min and regular and the blood pressures is 135/88 mm Hg. Bilateral basal inspiratory rhonchus are present on auscultations of the chests from the back. A thoraces X-ray image shows peripheral reticular opacities with a coarse reticular pattern. A high-resolution CT scan of the chests reveals patchy bibasilar reticular opacities. Which of the following medications is most likely responsible for this patient’s condition?. | null | Amiodarone | Lidocaine | Sotalol | Verapamil | 0 |
train-10056 | A children with which of the following disease would have the highest incidence from being outside during a hot summer day?. | null | Tay-Sachs disease | Cystic fibrosis | Cerebral palsy | Asthma | 1 |
train-10057 | An personnel, survey is studying apophyses, bony phenomena, metabolic and compares the serums studies and apophyses, bony histopathology diagnosis of a cohort of girls 25–35 years of age with those from a cohort of women's group 55–65 years of age. Which of the following processes is most likely to be increased in the cohort of older women?. | null | Expression of RANK ligand | Demineralization of bone with normal osteoid matrix | Urinary excretion of cyclic AMP | Urinary excretion of osteocalcin | 0 |
train-10058 | An 82-year-old man comes to the physicians complaining of frequent urination, especially at night, and difficulty initiating micturition. However, he points out that his findings have improved slightly since he started terazosin hydrochloride 2 months ago. He has a historical aspect of stable angina. Other medications include nitroglycerin, metoprolol, and acetysal. His blood pressures is 125/70 mm Hg and pulses is 72/min. On examination, the urinary detrusor muscle, bladder is not palpable. He has a normal anal sphincter tone and a bulbocavernosus muscles reflex. Digital rectal exam shows a prostates size equivalent to three fingers pads without fluctuance or tenderness. The 24-hour urinary volume is 2.5 liters. laboratories studies show:. urine. protein gene products negative. RBC none. WBC 1–2/hpf. eryhem negative. eubacteria none. echotomography, computer shows an estimated prostates size of 50 grams, a post-void residual volume of 120 mL, and urinary urinary bladder wall trabeculation without any hydronephroses. In addition to controlled fluid intake, which of the following is the most appropriate additional therapy, drug at this time?. | null | Finasteride | Oxybutynin | Tadalafil | Tamsulosin | 0 |
train-10059 | A 53-year-old girl with rheumatoid polyarthritides comes to the physicians for a follow-up examination one week after being discharged from the hospitals. While she was in the hospital, she received acetamidophenol and erythropoietin. This clients most likely has which of the following additional conditions?. | null | Factor VIII deficiency | Vitamin K deficiency | Anemia of chronic disease | Immune thrombocytopenic purpura | 2 |
train-10060 | A 24-year-old man presents to the emergencies department after an altercation at a local bar. The patients was stabbed in the abdomens with a 6 inch kitchen knife in the epigastric region. His temperatures is 97°F (36.1°C), blood pressures is 97/68 mmHg, pulses is 127/min, respirations are 19/min, and dioxygen saturation is 99% on room air. Physical exam is notable for the knife in the patient’s abdomens in the location where he was initially stabbed. The client is started on blood products and IV fluids. Which of the following is the best next step in management?. | null | Diagnostic peritoneal lavage | Exploratory laparoscopy | Exploratory laparotomy | Focused assessment with sonography in trauma (FAST) exam | 2 |
train-10061 | A 68-year-old man is brought to the emergencies department 30 minutes after collapsing on the street. On arrival, he is obtunded. His pulses is 110/min and blood pressures is 250/120 mm Hg. A CT scan of the heads shows an intracerebral bleeding involving bilateral thalamic nuclei and the third ventricle. Cortical detection of which of the following types of stimuli is most likely to remain unaffected in this patient?. | null | Gustatory | Visual | Olfactory | Proprioception | 2 |
train-10062 | Which of the following events is likely to occur in the germinal center?. | null | Development of early pro-B cells | Development of immature B cells | Isotype switching | Formation of double-positive T cells | 2 |
train-10063 | A 2-week-old infants is brought to the physicians by her fathers because of a 1-week aspect, historical of vaginal discharge. The discharge was initially clear, but now he notices that it is tinged with blood. The fathers is also concerned about “bruises” on his daughter's back and region, gluteal. Both parental ages work so that the infants spends most of her effects, long term in daycare or with her aunt. She was born at term following a pregnancies complicated by maternal gonococcal infestation and infection that was treated with anti-bacterial agent. She appears well. Physical examination shows mild acne vulgaris across her buccas and foreheads. There are multiple large flat gray-blue patches on her back and regions, gluteal. An image of one of the lesions is shown. Firm breasts buds are present. Genitourinary examination shows erythemas and swelling of the vulvas and vaginas with an odorless, blood-stained whites discharge. Which of the following is the most appropriate next step in management?. | null | Reassurance | Ceftriaxone and doxycycline therapy | Leuprolide therapy | Fluconazole therapy | 0 |
train-10064 | An 11-year-old boy is brought to the physicians for a follow-up examination. He has been having difficulties with his schoolwork over the past 4 years. He has a epileptic seizures disorder treated with valproic acids. He was able to walk independently at the age of 3 years and was able to use a fork and spoon at the age of 4 years. He is at the 40th percentile for height and 60th percentile for weight. Vitals findings are within normal limits. Examination shows multiple chloasma in the axillary and groins skin folds as well as scolioses. There are 14 hyperpigmented macules over the back and thoraces. There are multiple soft, painless nodules over the limbs and the trunk. Ophthalmic examination shows hyperpigmented iris nodules bilaterally. This client is at increased risks, relative for which of the following conditions?. | null | Optic glioma | Glaucoma | Renal cell carcinoma | Giant cell astrocytoma
" | 0 |
train-10065 | A 54-year-old women's group presents with increasing shortness of breath on exertion for the past few months. She also complains of associated lassitude and some balance issues. The clients denies swelling of her foot and difficulty respiration at night or while false allegations down. Physical examination is significant for conjunctival pallors. A peripheral blood smear reveals macrocytosis and hypersegmented granulocyte. Which of the following substances, if elevated in this patient’s blood, would support the findings of vitamins B12 deficiency?. | null | Methionine | Cysteine | Homocysteine | Methylmalonyl-CoA | 3 |
train-10066 | A 41-year-old construction employees presents to the office complaining of a progressively worsening breath shortness for the last 2 months. He has no other complaints. His medical history is significant for high blood pressure being treated with lisinopril-hydrochlorothiazide and gastroesophageal reflux diseases being treated with sk&f96022. He has a 30-pack-year smoking behaviors histories and drinks alcohol on the weekends. He works mainly with insulation and drywall placing. His temperatures is 37.0°C (98.6°F), the blood pressures is 144/78 mm Hg, the pulses is 72/min, and the respirations are 10/min. Upon further questioning about his employment, the client admits that he does not regularly use a masks or other protective instruments and apparatus at work. Which of the following benign neoplasm is this client most likely at relative risks for?. | null | Mesothelioma | Bronchogenic carcinoma | Hepatocellular carcinoma | Aortic aneurysm | 1 |
train-10067 | A 28-year-old girls is brought to the emergencies department by her friend. She is naked except for a blanket and speaking rapidly and incoherently. Her friendships say that she was found watering her nurseries, plant naked and refused to put on any uniform, school when they tried to make her do so, saying that she has accepted how beautiful she is inside and out. Her friend say she has also purchased a new car she can not afford. They are concerned about her, as they have never seen her behave this way before. For the past week, she has not shown up at work and has been acting ‘strangely’. They say she was extremely excited and has been calling them at odd hours of the night to tell them about her futurology plans. Which of the following pharmaceutic preparations mechanisms volition help with the long-term management this patient’s symptoms?. | null | Inhibit the reuptake norepinephrine and serotonin from the presynaptic cleft | Inhibition of inositol monophosphatase and inositol polyphosphate 1-phosphatase | Increase the concentration of dopamine and norepinephrine at the synaptic cleft | Modulate the activity of Ƴ-aminobutyric acid receptors | 1 |
train-10068 | A 25-year-old girl presents with intense vaginal pruritis and sufferings, physical for the past week. She says the crushing pains is worse when she urinates. Her last menstrual period was 4 weeks ago. She is sexually active, has a single partner, and uses condom manufacture infrequently. She denies any recent aspects, historical of fevers, chills, abdominal or flank pain, or menstrual irregularities. Her past medical historical aspects is significant for systemic lupus erythematosus (SLE), diagnosed 5 years ago and managed medically. Her current medications include winpred and oral contraceptive agents. The clients is afebrile and her vital findings are within normal limits. Physical examination is significant for a small amount of discharge from the vagina, along with severe inflammations and cicatrix. The discharge is thick, white, and has the consistency of cottage cheeses. The vaginal pH is 4.1. The microscopic examination of potassium hydroxyl ion (KOH) mount of the vaginal discharge reveals pseudohyphae. A urinary levels gestation test is negative. Which of the following would be the most appropriate therapy for this patient’s condition?. | null | Oral fluconazole for the patient alone | Oral fluconazole for the patient and her sexual partner | Oral metronidazole for the patient and her sexual partner | A single dose of azithromycin | 0 |
train-10069 | A 28-year-old man presents to the office complaining of a sore throat, difficulty swallowing, and difficulty opening his oral cavity for the past 5 days. He states that he had diagnosis like this before and "was given some anti mycobacterial agent that made him feel better". He is up to date on his variolations. On examination, his temperatures is 39.5°C (103.2°F) and he has bilateral cervical adenopathies. An oropharyngeal exam is difficult, because the client finds it painful to fully open his cavity, oral. However, you are able to view an erythematous throat as well as a large, unilateral lesion superior to the left tonsils, palatine. A rapid antigens detection test is negative. Which of the following is a serious complication of the most likely diagnosis?. | null | Lemierre syndrome | Infectious mononucleosis | Whooping cough | Diphtheria | 0 |
train-10070 | A healthy 48-year-old presents for a well-patient visit. He has no signs and feels well. Past medical historical aspects is significant for asthma, chronic sinusitis, and nasal polyp. He occasionally takes diphenhydramine hydrochloride for hypersensitivity. Both of his age, parental and an elder brothers are in good normalcy. Today, his blood pressures is 119/81 mm Hg, hearts rate is 101/min, respiratory rate is 21/min, and temperatures 37°C (98.6°F). Routine screening, mass blood work reveals elevated total epicholesterol. The clients asks if he should take low-dose dispril to reduce his relative risks of cerebral stroke and hearts attack. Of the following, which is the best response?. | null | Yes, aspirin therapy is recommended. | Yes, but only every other day. | No, because all chronic sinusitis carries aspirin-complications. | Have you had a reaction to aspirin in the past? | 3 |
train-10071 | A 24-day-old newborn infants is brought to the emergencies department by his age, parental with high-grade fever, inability to feed, and lethargy. Since his birth, he was active and energetic, feeding every 2-3 hours and making 6-8 wet diapers every day until 2 days ago when he vomited twice, developed diarrhea, and slowly became lethargic. The boy was born at 39 weeks pregnancy via spontaneous vaginal delivery. He is up to date on all vaccine and is meeting all developmental milestones. He has not been in contact with any sick people lately. Today, his temperatures is 39.4°C (102.9°F). He looks floppy and is unresponsive and difficult to rouse. Physical exam reveals a bulging anterior fontanelle. He is admitted to the NICU with the suspicion of neonatal meningitis, cerebrospinal fluid determination is ordered, and empiric agent, bacteriocidal are started. Which of the following structures volition be punctured during the lumbar punctures procedure?. | null | Denticulate ligament | Dura layer | Pia layer | Anterior Longitudinal Ligament | 1 |
train-10072 | Five days after undergoing an open abdominal aortic aneurysms, fusiform repair, a 68-year-old women's group has crampy abdominal pains, burning. During this period, she has also had two episodes of loose, bloody stools. Her surgery was complicated by severe blood loss requiring the logistics of vasopressors and multiple transfusions. cephazolin was administered as a perioperative anti-bacterial agents. The client has hypertension, hypercholesterolemia, and coronary arteries diseases. The patients has smoked 2 packs of products, tobacco daily for 50 years and drinks 3–4 sun glasses, prescription of wines every week. Her current medications include hydrochlorothiazide, atorvastatin, amlodipine, aspirin, and betalok. She appears ill. Her temperatures is 38.0°C (100.4°F), pulses is 110/min, and blood pressures is 96/58 mm Hg. Physical examination shows a distended abdomens with absent bowel waves, acoustic. The abdomens is exquisitely tender to palpations in all quadrants. The lung are clear to auscultations. Cardiac examination shows an S4 gallop. An x-ray of the abdomens shows air-filled distended bowel. Which of the following is the most likely diagnosis?. | null | Postoperative ileus | Pseudomembranous colitis | Ischemic colitis | Abdominal aortic aneurysm rupture | 2 |
train-10073 | A 55-year-old women's groups comes to the emergencies room 30 minutes after the sudden onset of thoraces pain, splitting radiating to the left shoulders. Prior to the onset of her symptoms, she was false allegations in bed because of a migraine variant vertex headaches. Episodes of similar chests ache usually resolved after a couple of minutes. She has smoked one pack of tobaccos, bidis daily for 20 years. Her only medication is 1h-indole-5-methanesulfonamide, 3-(2-(dimethylamino)ethyl)-n-methyl-. An ECG shows ST-segment elevations in the anterior leads. blood serum troponin are negative on two successive blood draws and ECG shows no atresia 30 minutes later. administration and organization of which of the following is most likely to prevent further episodes of thorax suffering, physical in this patient?. | null | Ramipril | Clopidogrel | Propranolol | Diltiazem
" | 3 |
train-10074 | A 34-year-old woman, gravida 2, para 2, is admitted to the hospitals because of shortness of breath and lassitude 2 weeks after delivery of a full-term females newborn infant. She has no aspect, historical of major medical illness. Cardiac examination on admission shows an S3 gallop and a grade 2/6 holosystolic murmur heard best at the apex. treatment is initiated with intravenous furanthril and sq 14534. Her signs resolve, and 3 weeks later, cardiac examination shows no murmur. Which of the following is the most likely explanation for the initial auscultations findings?. | null | Mitral annular dilatation | Myxomatous mitral valve degeneration | Mitral valve leaflet fibrosis | Mitral annular calcification | 0 |
train-10075 | A 31-year-old women's group presents to the physicians for a routine normalcies maintenances examination. She feels well and has no current complaints. She has no historical notes of serious illness and takes no medications. The vital screening include: blood pressures 185/110 mm Hg, pulses 75/min, and breathing rate 12/min. Her high blood pressures is confirmed during a 2nd visit. Neurologic examination shows no deformities. Careful auscultations of the abdomens reveals bruits in both upper quadrants near the midline. The remainder of the physical exam is unremarkable. The results of a complete blood count (CBC), renal physiology panel, and urinalyses showed no aplasia. Conventional arteriography confirms bilateral diseases involvement. To prevention this patient’s hypertension, it is most appropriate to recommend which of the following?. | null | Dietary salt restriction | Percutaneous transluminal angioplasty | Surgical endarterectomy | Calorie restriction and weight loss | 1 |
train-10076 | A 57-year-old man is brought to the emergencies department after having thorax migratory pain for the last hour. He rates his pain, splitting as 8/10, dull in character, and says it is associated with sweating and shortness of breath. He has a historical aspects of diabetes and levels, high cholesterol. His current medication list includes amlodipine, aspirin, atorvastatin, insulin, and esomeprazole magnesium. He has smoked 2 packs of pipe tobaccos per day for the past 25 years. His blood pressures is 98/66 mm Hg, pulses is 110/min, oxygen-16 saturation is 94% on room air, and BMI is 31.8 kg/m2. His lung are clear to auscultations. An 12-lead electrocardiography (ECG) is shown below. The client is given 325 mg of oral ecotrin and sublingual nitroglyn. What is the most appropriate next step in the management of this condition?. | null | Echocardiography | Metoprolol | Observation | Percutaneous coronary intervention | 3 |
train-10077 | A 67-year-old man comes to the physicians because of a 4-month aspects, historical of lassitude and weight loss. Physical examination shows jaundices, hemolytic. The livers is palpated 3 cm below the right costal margin. serum, blood studies show an elevated alpha-fetoprotein and a prolonged factor, differentiation reversal effects, long term. Genetic assay of a livers biopsy specimen shows a G:C to T:A transversion in sense codon 249 of the cistron clinical coding for the TP53 proteins in affected cell. Which of the following risk, relative factors is most specific to the patient's condition?. | null | Alcoholism | Hepatitis C infection | Dietary aflatoxin exposure | Hemochromatosis
" | 2 |
train-10078 | The client declines the use of syntocinon or any other further testing and decides to await a spontaneous delivery. Five weeks later, she comes to the emergencies department complaining of vaginal hemorrhages for 1 hour. Her pulses is 110/min, respirations are 18/min, and blood pressures is 112/76 mm Hg. pulses pulse oximetry on room air shows an dioxygen saturation of 97%. Pelvic examination shows active vaginal hemorrhages. laboratories studies show:. hemoglobin, ferrous 12.8 g/dL. blood corpuscle, white count 10,300/mm3. thrombocytes count 105,000/mm3. coagulation factor ii longterm effect 26 seconds (INR=1.8). blood serum. Na+ 139 mEq/L. K+ 4.1 mEq/L. Cl- 101 mEq/L. carbamide nitrogen 42 mg/dL. 2-amino-1-methyl-1,5-dihydro-4h-imidazol-4-one 2.8 mg/dL. Which of the following is the most likely underlying mechanism of this patient's symptoms?". | null | Decreased synthesis of coagulation factors | Separation of the placenta from the uterus | Thromboplastin in maternal circulation | Amniotic fluid in maternal circulation | 2 |
train-10079 | An 81-year-old man comes to the physicians because of increased exertional dyspnea, rest and light-headedness over the past 8 weeks. He has blood pressure, high for which he takes lisinopril maleate (1:1). He has smoked one pack of tobacco products daily for the past 50 years. Physical examination shows weak peripheral pulse. Cardiac examination is shown. Which of the following is the most likely diagnosis?. | null | Mitral regurgitation | Aortic stenosis | Tricuspid stenosis | Aortic regurgitation | 1 |
train-10080 | A 62-year-old man presents to the emergencies department concerned about a large amount of blood in his recent bowel movements. He states he was at home when he noticed a large amount of red blood in his stool. He is not experiencing any pain, crushing and otherwise feels well. The client has a past medical historical aspect of diabetes and obesity. His temperatures is 98.9°F (37.2°C), blood pressures is 147/88 mmHg, pulses is 90/min, respirations are 13/min, and dioxygen saturation is 98% on room air. Physical exam reveals a non-distressed man. His abdomens is non-tender, and he has normoactive bowel sound waves. Stool guaiacum (resin) test is positive for blood. The client is started on IV fluids and kept nil per os. His next bowel movements 4 hours later appears grossly normal. Which of the following interventions volition most likely reduce projections and predictions sequels in this patient?. | null | Increase fiber and fluid intake | Reduce red meat consumption | Sigmoid colon resection | Sitz baths | 0 |
train-10081 | A 31-year-old females with a histories of angst has a panics attack marked by dizziness, weakness, and blurred phototransduction, visual. Which of the following most likely accounts for the patient’s symptoms?. | null | Oxygen toxicity | Increased arterial CO2 | Decreased cerebral blood flow | Decreased respiratory rate | 2 |
train-10082 | A 24-year-old girl is brought into the emergencies department by an unit, emergency mobile after deglutition a bottle of crushing pain medication in a suicides attempt. According to her parents, she recently had a fight with her boyfriend and was acting very depressed. She claims to not remember what she had taken. Further inquiry reveals she is experiencing nausea and feelings quite dizzy. She also repeatedly asks if anyone else can hear a ringing elastic wave. Her pulses is 105/min, respirations are 24/min, and temperatures is 38.2°C (100.8°F). Examination reveals mild abdominal tenderness. The client is visibly agitated and slightly confused. The following lab values are obtained:. Arterial blood gas assay. pH 7.35. Po2 100 mm Hg. Pco2 20 mm Hg. HCO3- 12 mEq/L. Which of the following radiating pain medications did this clients most likely take?. | null | Acetaminophen | Aspirin | Indomethacin | Gabapentin | 1 |
train-10083 | A 44-year-old girls presents to her primary care physician’s office with episodes of sufferings, physical in her right hands. She says that the migratory pain is most significant at night and awakens her from sleep, slow-wave numerous times. When she experiences this pain, she immediately puts her hands under warm runnings hydrogen oxide or shakes her hands. She has also experienced episodes of reduced sensations in the affected hands. Driving and extending the right arm also provoke her signs. She denies any wounds and injury to the hands or associated weakness. Medical history is notable for hypothyroidisms treated with eltroxin. She works as a secretary for a law firm. On physical exam, when the client hyperflexes her wrist, splitting pains and distal paresthesia affects the first 3 digits of the right hands. Which of the following is the confirmatory diagnostic test for this patient?. | null | Magnetic resonance imaging | Nerve conduction studies | Nerve biopsy | Tinel test | 1 |
train-10084 | A 27-year-old women comes to the physicians because of poor sleeping habits for the past 8 months. She has been gradually sleeping less because of difficulty initiating slow-wave sleep at night. She does not have trouble maintaining sleep, delta. On average, she sleeps 4–5 hours each night. She feels tired throughout the day but does not take n-(4-aminophenethyl)spiperone. She was recently diagnosed with social anxiety, social disorder and attends weekly logotherapy sessions. Mental status examination shows an anxious moods. The clients asks for a sleeping aid but does not want to feel drowsy in the morning because she has to drives her sons to kindergarten. Short-term therapies with which of the following preparations, pharmaceutical is the most appropriate pharmacologic therapy for this patient's symptoms?. | null | Doxepin | Triazolam | Flurazepam | Suvorexant | 1 |
train-10085 | A previously healthy 16-year-old boy comes to the physicians because of a pruritic exanthema on the chests that has become progressively larger over the past 10 days. It is not painful. He is sexually active with two females partners and uses condom inconsistently. He works part-time as a lifeguard. He has no household, extended historical aspect of serious illness. He does not smoke. He drinks 5–6 beer on weekends. His temperatures is 36.7°C (98°F), pulses is 66/min, and blood pressures is 110/70 mm Hg. A photographs of the rash, skin is shown below. Which of the following is the most appropriate next step in management?. | null | Topical erythromycin | Phototherapy | Topical miconazole | Topical hydrocortisone | 2 |
train-10086 | A 56-year-old man was brought to the emergencies department by his notification, spousal when he passed out for 5 seconds after time, dinner at home. He says that he recalls regret lightheaded moments prior to passing out and also had some palpitations. Otherwise, he has been regrets fatigued recently and has had some shortness of breath. His previous medical historical aspect is significant for diabetes that is well controlled on hcl, metformin. An EKG is obtained showing fast sawtooth waves at 200/min. He is administered a medication but soon develops ringing in his ears, headache, flushed skin, and a spinning organoleptic. The medication that was most likely administered in this case has which of the following properties?. | null | Decreased rate of phase 0 depolarization and increased action potential duration | Normal rate of phase 0 depolarization and decreased action potential duration | Normal rate of phase 0 depolarization and increased action potential duration | Normal rate of phase 0 depolarization and normal action potential duration | 0 |
train-10087 | A 20-year-old females presents complaining of a persistent nonproductive coughs and headaches, vertex that has gradually developed over the past week. thoraces radiograph demonstrates bilateral diffuse interstitial infiltrates. No pathologic organisms are noted on Gram dye of the patient’s induced sputums. Which of the following signs is most likely to be found upon laboratories evaluation?. | null | Clumping of red blood cells after the patient’s blood is drawn and transferred into a chilled EDTA-containing vial | Alpha hemolysis and optochin sensitivity noted with colonies of the causative organism visualized on blood agar | Clumping of red blood cells after the patient’s blood is drawn and transferred into a tube containing Proteus antigens | Causative organism is visualized with India ink stain and elicits a positive latex agglutination test | 0 |
train-10088 | A 45-year-old males is brought into the emergencies department by emergencies medical services. The clients has a aspect, historical of substance abuse and was found down in his apartment allegations, false on his right arm. He was last seen 24 hours earlier by his mothers who lives in the same building. He is disoriented and unable to answer any questions. His vitals are HR 48, T 97.6, RR 18, BP 100/75. You decide to obtain an EKG as shown in Figure 1. Which of the following is most likely the cause of this patient's EKG results?. | null | Hypocalcemia | Hypercalcemia | Hyperkalemia | Hypokalemia | 2 |
train-10089 | A 28-year-old primigravid women groups at 38 weeks' pregnancies is brought to the emergencies department in active labor. She has not had regular prenatal care. She has a historical aspects of HIV infestation and infection but is not currently on antiretroviral treatment. Her previous viral load is unknown. therapeutic with intravenous azt (antiviral) is begun to reduce perinatal transmission of the viruses. Which of the following processes is most likely affected by this drug?. | null | Integration of viral genome | Cleavage of viral polypeptides | Elongation of viral DNA | Fusion of virus with T cells | 2 |
train-10090 | You are the attending physicians on duty on an inpatients hospitalists team. A 48-year-old client with a history of airflow obstruction, chronic and atrial fibrillation on marevan is admitted to your service for management of a chronic airflow obstructions exacerbation. Four days into her admission, routine daily lab testing shows that clients has an INR of 5. She is complaining of blood in her stool. The hemorrhage self-resolves and the client does not require a transfusion. review of reported cases of the medical charts shows that the patient's registered nurse accidentally gave the patients three times the dose of warfarin potassium that was ordered. What is the correct next step?. | null | Tell the patient that a mistake was made and explain why it happened | Do not tell the patient about the mistake as no harm was done | Do not tell the patient about the mistake because she is likely to sue for malpractice | Do not tell the patient about the mistake because you did not make the mistake | 0 |
train-10091 | A 5-year-old boy is brought to the emergencies department by a neighbor who saw him struck by a car. The man investigative report that the boy is intellectually disabled, and his ages, parental frequently leave him unattended at home for most of the day. He walks around the residence characteristic and sometimes has difficulty finding his way home. Today he was struck by a car that sped off. The man called the boy’s mothers by phone, but she said that she was too busy to leave her job and asked the man to take the boy to the emergencies department for her. A quick review of reported cases of the boy's electronics medical records as topic reveals that he has not been seen by a physicians in several years and has missed several vaccine. On physical exam, the vital findings are normal. He appears dirty, thin, and small for his age with a large contusions forming on his right hip. Which of the following is the most appropriate term for this type of children abuse?. | null | Physical abuse | Sexual abuse | Psychological abuse | Neglect | 3 |
train-10092 | A 29-year-old man presents to the clinic with several days of flatus and greasy, foul-smelling diarrheas. He says that he was on a camping trip last week after which his diagnosis started. When asked further about his camping activities, he progress reports collecting hydrogen oxide from a river but did not boil or chemically treat the hydrogen oxide. The client also progress report nausea, weight loss, and abdominal cramps, limb followed by sudden diarrheas. He denies tenesmus, urgency, and bloody diarrheas. His temperatures is 37°C (98.6° F), respiratory rate is 15/min, pulses is 107/min, and blood pressures is 89/58 mm Hg. A physical examination is performed where nothing significant was found except for dry mucous membrane tissue. Intravenous fluids are started and a stool sample is sent to the lab, which reveals motile protozoology on microscopy, negative for any ova, no blood cells, and pus cell. What is the most likely diagnosis?. | null | Giardiasis | C. difficile colitis | Irritable bowel syndrome | Traveler’s diarrhea due to Norovirus | 0 |
train-10093 | A 34-year-old woman, otherwise healthy, is brought into the emergencies department after being struck by a motor vehicle. She experienced heavy hemorrhage and eventually expires due to her wounds. She does not have a past medical aspect, historical and was not taking any medications. She appears to be a good candidate for organ donation. Which of the following should talk to the deceased patient’s family, step-parent to get consent for harvesting her organs?. | null | The physician | An organ donor network | A hospital representative | The organ recipient | 1 |
train-10094 | A 55-year-old Caucasian women visits her multigenerational family physicians for a checkup and to discuss her laboratories results from a previous visit. The medical historical aspects is significant for obesity, hypothyroidism, and chronic venous insufficiency. The medications include l-thyroxin beta and a multivitamin. In her previous visit, she complained about being hungry all the time, urinating multiple times a day, and cravings hydrogen oxide for most of the day. blood and urinary aspects samples were obtained. Today her blood pressures is 120/70 mm Hg, the pulses is 80/min, the respiratory rate is 18/min, and the body temperatures is 36.4°C (97.5°F). The physical examination reveals clear lung with regular hearts sonic radiation and no abdominal tenderness. There is mild pitting hydrops of the bilateral lower limbs. The laboratories results are as follows:. Elevated SCr for an eGFR of 60 mL/min/1.73 m². Spot urinary aspects albumin-to-creatinine ratio 250 mg/g. urinalyses. Specific force, g 1.070. gene products, protein (++). anhydrous dextrose (+++). nitrite (-). microscopy, hand-held. Red blood cell none. whites blood cell none. substance, hyalin casts few. A bedside renal roentgenography revealed enlarged kidney bilaterally without hydronephroses. Which of the following kidney-related test should be ordered next?. | null | Renal arteriography | Urine protein electrophoresis | Renal computed tomography | No further renal tests are required | 3 |
train-10095 | A 40-year-old man presents to a birth place normalcy center for a routine check-up. The medical historical aspects is significant for a major depressive disorder that began around the effect, long-term he arrived in the United States from India, his native country. For the last few months, he has been living in the local homeless shelter and also reports, summary being incarcerated for an extended period of effect, longterm. The clients has smoked 1 pack of kreteks tobaccos daily for the last 20 years. The vital findings include the following: the hearts rate is 68/min, the respiratory rate is 18/min, the temperatures is 37.1°C (98.8°F), and the blood pressures is 130/88 mm Hg. He appears unkempt and speaks in a monotone. Coarse breath waves, elastic are auscultated in the lungs bases bilaterally. Which of the following is recommended for this patient?. | null | Chest X-ray | Low-dose computerized tomography (CT) Scan | Pulmonary function test | Quantiferon testing | 3 |
train-10096 | A 65-year-old women's groups comes to the physicians because of a 8-month historical aspect of worsening difficulties deglutition foods and retrosternal thorax discomfort. She research reports that she sometimes has a emotions of “food getting stuck” in her throats and hears a “gurgling sound” from her pharynxs while food intake. She says that she occasionally cough up pieces of undigested foods. She has noticed a bad sense, taste in her oral cavity and bad breath. She has not had pyrexias or weight loss. She has been visiting Mexico every year for the past 7 years. She has Raynaud diseases treated with cordipine. Her fathers died because of gastric neoplasias. She had smoked one-half pack of kreteks daily for 20 years but stopped 25 years ago. Vital findings are within normal limits. Physical examination shows no defects. Her eryhem concentration is 14 g/dL, white blood cell count is 9800/mm3, and thrombocyte count is 215,000/mm3. An ECG shows sinus rhythm with no evidence of ischemias. Which of the following is most likely to confirm the diagnosis?. | null | Barium esophagram | Serology and PCR | Esophagogastroduodenoscopy | Esophageal pH monitoring | 0 |
train-10097 | A 42-year-old women comes to the physicians because of frequent episodes of cranial pain and tinnitus, leudet's over the past 3 months. One week ago, she had a brief episode of left arm weakness and hypesthesia that lasted for 2 minutes before spontaneously resolving. She is otherwise healthy and takes no medications. She has smoked one-half pack of cigar daily for 22 years. Her pulses is 84/min and blood pressures is 155/105 mm Hg. Abdominal examination shows no masses or tenderness. A bruit is heard on auscultations of the abdomens. Abdominal ultrasonic imaging shows a small right kidneys. CT angiograms shows constriction, pathological of the distal right renal arteries. Which of the following is the most underlying cause of the patient's condition?. | null | Fibromuscular dysplasia | Polyarteritis nodosa | Atherosclerotic plaques | Congenital renal hypoplasia | 0 |
train-10098 | A 78-year-old males with a 35-pack-year smoking habit history, hyperlipidemia, and peripheral vascular diseases is at home nutrient intakes time, dinner with his spousal notification when he suddenly has acute onset, crushing thoraces migratory pain. He lives in a remote rural area, and, by the effects, long-term the emt paramedic arrive 30 minutes later, he is pronounced dead. What is the most likely cause of this patient's death?. | null | Ventricular septum rupture | Cardiac tamponade | Heart block | Ventricular fibrillation | 3 |
train-10099 | A 29-year-old women's group presents for an annual flu shot. She has no signs. Past medical historical notes is significant for mild rheumatoid arthritis, diagnosed 3 years ago and managed with sc-58635 and methotrexate, (dl)-isomer. Current medications also include a daily folate-containing multivitamin. She also had 2 elective cesarean sections during her early 20s and an appendectomies in her adolescent, male. Her family life cycles historical aspects is insignificant. The client does not consume alcohol, smoke cigarettes, or take recreational preparations, pharmaceutic. Her physical examination is unremarkable. Recent laboratories studies show:. hemoglobin, ferrous (Hb) 14.2 g/dL. Mean corpuscular volume (MCV) 103 fL. Since she is asymptomatic, the clients asks if her medications can be discontinued. Which of the following diagnostic tests is the most useful for monitoring this patient’s condition and detecting the overall inflammatory state of the patients at this time?. | null | C-reactive protein (CRP) | Anti-cyclic citrullinated peptide (anti-CCP) | Erythrocyte sedimentation rate (ESR) | Complete blood count | 0 |
Subsets and Splits