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MedQA,217 | Exam | D | An investigator is studying neuronal regeneration. For microscopic visualization of the neuron, an aniline stain is applied. After staining, only the soma and dendrites of the neurons are visualized, not the axon. Presence of which of the following cellular elements best explains this staining pattern?
A. Microtubule
... |
MedQA,218 | Exam | A | A 67-year-old woman presents to a surgeon with a painless, slowly growing ulcer in the periauricular region for the last 2 months. On physical examination, there is an irregular-shaped ulcer, 2 cm x 1 cm in its dimensions, with irregular margins and crusting over the surface. The woman is a fair-skinned individual who ... |
MedQA,219 | Exam | A | A 67-year-old man presents to the physician with profuse watery diarrhea along with fever and crampy abdominal pain. He has been taking an antibiotic course of cefixime for about a week to treat a respiratory tract infection. At the doctor’s office, his pulse is 112/min, the blood pressure is 100/66 mm Hg, the respirat... |
MedQA,220 | Exam | A | A 45-year-old man presents to the emergency department with fever and easy bruising for 3 days. He has had fatigue for 2 weeks. He has no past medical history, and takes no medications. Excessive bleeding from intravenous lines was reported by the nurse. He does not smoke or drink alcohol. The temperature is 38.2°C (10... |
MedQA,221 | Exam | C | A 2-month-old is brought to the physician for a well-child examination. She was born at 39 weeks gestation via spontaneous vaginal delivery and is exclusively breastfed. She weighed 3,400 g (7 lb 8 oz) at birth. At the physician's office, she appears well. Her pulse is 136/min, the respirations are 41/min, and the bloo... |
MedQA,222 | Exam | A | A 40-year-old female comes in with several months of unintentional weight loss, epigastric pain, and a sensation of abdominal pressure. She has diabetes well-controlled on metformin but no other prior medical history. She has not previously had any surgeries. On physical exam, her doctor notices brown velvety areas of ... |
MedQA,223 | Exam | B | A 6-year-old boy is brought to the emergency room by ambulance, accompanied by his kindergarten teacher. Emergency department staff attempt to call his parents, but they cannot be reached. The boy’s medical history is unknown. According to his teacher, the boy was eating in the cafeteria with friends when he suddenly c... |
MedQA,225 | Exam | B | A 27-year-old woman presents to the emergency department with right lower quadrant abdominal pain and vaginal spotting. She denies diarrhea, constipation, or blood in the stool. The medical history is unremarkable. She does not use tobacco or drink alcohol. She is sexually active with her husband and uses an IUD for co... |
MedQA,226 | Exam | A | A 58-year-old man with a past medical history of diabetes, hypertension, and hyperlipidemia was brought into the emergency department by his wife after she observed him go without sleep for several days and recently open and max out several credit cards. She also reports that he has quit his bartending job and has been... |
MedQA,227 | Exam | D | A 42-year-old woman comes to the physician for the evaluation of a 1-month history of dull lower abdominal pain, decreased appetite, and a 5-kg (11-lb) weight loss. Physical examination shows no abnormalities. Pelvic ultrasonography shows bilateral ovarian enlargement and free fluid in the rectouterine pouch. Biopsy sp... |
MedQA,228 | Exam | A | A 71-year-old man presents to the clinic with complaints of right wrist pain for 2 days. On examination, redness and swelling were noted on the dorsal aspect of his right wrist. He had pain with extreme range of motion of the wrist. His history includes 2 hip replacements, 2 previous episodes of gout in both first met... |
MedQA,230 | Exam | D | A 39-year-old male presents to your office with nodular skin lesions that progress from his right hand to right shoulder. The patient reports that the initial lesion, currently necrotic and ulcerative, developed from an injury he received while weeding his shrubs a couple weeks earlier. The patient denies symptoms of r... |
MedQA,231 | Exam | A | A 17-year-old Latin American woman with no significant past medical history or family history presents to her pediatrician with concerns about several long-standing skin lesions. She notes that she has had a light-colored rash on her chest and abdomen that has been present for the last 2 years. The blood pressure is 11... |
MedQA,232 | Exam | D | A 45-year-old male presents to the emergency room complaining of severe diarrhea. He recently returned from a business trip to Bangladesh. Since returning, he has experienced several loose bloody stools per day that are accompanied by abdominal cramping and occasional nausea and vomiting. His temperature is 101.7°F (38... |
MedQA,233 | Exam | D | An 80-year-old woman seeks evaluation at an outpatient clinic for a firm nodular lump on the left side of her labia. The medical history is notable for hypertension, coronary artery disease status post CABG, and lichen sclerosus of the vagina that was treated with an over-the-counter steroid cream as needed. She first ... |
MedQA,235 | Exam | A | Two days following the home birth of her son, a mother brings the infant to the pediatric emergency room because of bilious vomiting. He is unable to pass meconium and his abdomen is distended. Endoscopic biopsy of the proximal colon demonstrates an absence of Meissner’s and Auerbach’s plexi in the bowel wall. Which of... |
MedQA,236 | Exam | B | A 49-year-old man comes to the physician because of a 6-month history of increasing fatigue and reduced libido. He also complains of joint pain in both of his hands. His vital signs are within normal limits. Physical examination shows tanned skin and small testes. The second and third metacarpophalangeal joints of both... |
MedQA,237 | Exam | A | A general surgery intern is paged to the bedside of a 59-year-old male who underwent a successful sigmoidectomy for treatment of recurrent diverticulitis. The patient's nurse just recorded a temperature of 38.7 C, and relates that the patient is complaining of chills. The surgery was completed 8 hours ago and was compl... |
MedQA,239 | Exam | A | An 18-year-old female returning from a trip to a developing country presents with diarrhea and pain in the abdominal region. Microscopic evaluation of the stool reveals the presence of RBC's and WBC's. The patient reports poor sewage sanitation in the region she visited. The physician suspects a bacterial infection and... |
MedQA,240 | Exam | B | A 51-year-old man with a recent diagnosis of peptic ulcer disease currently treated with an oral proton pump inhibitor twice daily presents to the urgent care center complaining of acute abdominal pain which began suddenly less than 2 hours ago. On physical exam, you find his abdomen to be mildly distended, diffusely t... |
MedQA,241 | Exam | D | A 31-year-old male presents to the emergency room following an altercation with patrons at a local grocery store. He is acting aggressively toward hospital staff and appears to be speaking to non-existent individuals. On examination he is tachycardic and diaphoretic. Horizontal and vertical nystagmus is noted. The pati... |
MedQA,242 | Exam | D | A 29-year-old female presents to her primary care provider complaining of pain and stiffness in her hands and knees. She reports that the stiffness is worse in the morning and appears to get better throughout the day. She is otherwise healthy and denies any recent illness. She does not play sports. On examination, her ... |
MedQA,243 | Exam | A | A 28-year-old man presents for severe abdominal pain and is diagnosed with appendicitis. He is taken for emergent appendectomy. During the procedure, the patient has massive and persistent bleeding requiring a blood transfusion. The preoperative laboratory studies showed a normal bleeding time, normal prothrombin time ... |
MedQA,244 | Exam | C | An 11-year-old girl is brought to the emergency department because of high-grade fever, headache, and nausea for 3 days. She avoids looking at any light source because this aggravates her headache. She has acute lymphoblastic leukemia and her last chemotherapy cycle was 2 weeks ago. She appears lethargic. Her temperatu... |
MedQA,245 | Exam | A | A 49-year-old man presents to a new primary care provider complaining of fatigue and occasional fever over the last month. These symptoms are starting to affect his job and he would like treatment. The physician runs a standard metabolic panel that shows elevated AST and ALT. The patient is then tested for hepatitis vi... |
MedQA,246 | Exam | D | A 45-year-old immigrant presents with unintentional weight loss, sleep hyperhidrosis, and a persistent cough. He says these symptoms have been present for quite some time. Upon imaging, many granulomas in the upper lobes are present. It is noted that these apical granulomas have centers of necrosis that appear cheese-l... |
MedQA,247 | Exam | B | A 27-year-old woman comes to the emergency room because of fever and severe left knee pain for the past week. She has not sustained any trauma or injury to the area, nor has she traveled or taken part in outdoor activities in the recent past. She is sexually active with one male partner, and they use condoms inconsiste... |
MedQA,248 | Exam | D | A 30-year-old man presents with restlessness and an inability to sit or lie down for the past 2 days. Past medical history is significant for schizophrenia, diagnosed 3 weeks ago and managed medically. Vital signs are a blood pressure of 140/90 mm Hg and a pulse of 96/min. On physical examination, the patient is fidget... |
MedQA,249 | Exam | A | In a previous experiment infecting hepatocytes, it was shown that viable HDV virions were only produced in the presence of a co-infection with HBV. To better understand which HBV particle was necessary for the production of viable HDV virions, the scientist encoded in separate plasmids the various antigens/proteins of ... |
MedQA,250 | Exam | B | A 61-year-old woman presents to her primary care physician for a routine check-up. Physical examination demonstrates asymmetric peripheral neuropathy in her feet. The patient has no previous relevant history and denies any symptoms of diabetes. Routine blood work shows normal results, and she is referred to a hematolog... |
MedQA,251 | Exam | A | A 71-year-old man presents to his primary care physician because he is increasingly troubled by a tremor in his hands. He says that the tremor is worse when he is resting and gets better when he reaches for objects. His wife reports that he has been slowing in his movements and also has difficulty starting to walk. His... |
MedQA,252 | Exam | B | A 52-year-old man is brought to the emergency department while on vacation with a history of sudden onset vertigo and difficulty walking. He was in normal health since starting his vacation a week ago, but today he is suffering from a loss of balance, mild headache, and has had 5–6 episodes of vomiting over the last fe... |
MedQA,253 | Exam | D | A 65-year-old man presents with painless swelling of the neck over the past week. He also has noted severe night sweats, which require a change of clothes and bed linens the next day. His medical history is significant for long-standing hypertension. He received a kidney transplant 6 years ago. His current medications ... |
MedQA,254 | Exam | B | A 56-year-old man is brought to the emergency department by his neighbor 2 hours after ingesting an unknown substance in a suicide attempt. He is confused and unable to provide further history. His temperature is 39.1°C (102.3°F), pulse is 124/min, respiratory rate is 12/min, and blood pressure is 150/92 mm Hg. His ski... |
MedQA,256 | Exam | B | A 72-year-old man presents to his primary care provider complaining of fatigue, mild headache, and discomfort with chewing for roughly 1 week. Before this, he felt well overall, but now is he is quite bothered by these symptoms. His medical history is notable for hypertension and hyperlipidemia, both controlled. On exa... |
MedQA,257 | Exam | D | A 14-month-old boy is brought to the clinic for evaluation of a rash. The rash started on the face and spread to the trunk. He also had a fever and cough for the past 2 days. His mother says that they recently immigrated from Asia and cannot provide vaccination records. The physical examination reveals a maculopapular ... |
MedQA,258 | Exam | B | A 31-year-old G1P0 woman at 26 weeks gestation presents to the clinic for evaluation of an abnormal glucose tolerance test. She denies any symptoms, but states that she was given 50 g of oral glucose 1 week earlier and demonstrated a subsequent venous plasma glucose level of 156 mg/dL 1 hour later. The vital signs are:... |
MedQA,259 | Exam | C | A newborn of a mother with poor antenatal care is found to have a larger than normal head circumference with bulging fontanelles. Physical examination reveals a predominant downward gaze with marked eyelid retraction and convergence-retraction nystagmus. Ultrasound examination showed dilated lateral ventricles and a di... |
MedQA,262 | Exam | B | A 67-year-old man comes to the physician because of a 3-day history of fever, chills, headache, and fatigue. He appears ill. His temperature is 39°C (102.2°F). Analysis of nasal secretions shows infection with an enveloped, single-stranded segmented RNA virus. In response to infection with this pathogen, certain cells ... |
MedQA,263 | Exam | B | A 58-year-old female, being treated on the medical floor for community-acquired pneumonia with levofloxacin, develops watery diarrhea. She reports at least 9 episodes of diarrhea within the last two days, with lower abdominal discomfort and cramping. Her temperature is 98.6° F (37° C), respiratory rate is 15/min, pulse... |
MedQA,264 | Exam | C | A 7-year-old girl presents to her primary care physician for a routine check-up. The physician allows the medical student to perform a physical examination. The medical student notes hearing impairment as well as the findings show in Figures A and B. Radiographs show indications of multiple old fractures of the humerus... |
MedQA,265 | Exam | D | A 47-year-old man comes to the physician because of abdominal pain and foul-smelling, watery diarrhea for several days. He has not had nausea, vomiting, or blood in the stool. He has a history of alcohol use disorder and recently completed a 7-day course of clindamycin for pneumonia. He has not traveled out of the Unit... |
MedQA,266 | Exam | C | A 6-year-old boy presents to the clinic because of monosymptomatic enuresis for the past month. Urinalysis, detailed patient history, and fluid intake, stool, and voiding diary from a previous visit all show no abnormalities. The parent and child are referred for education and behavioral therapy. Enuresis decreases but... |
MedQA,267 | Exam | B | A 32-year-old homeless woman is brought to the emergency department by ambulance 30 minutes after the police found her on the sidewalk. On arrival, she is unresponsive. Her pulse is 76/min, respirations are 6/min, and blood pressure is 110/78 mm Hg. Examination shows cool, dry skin. The pupils are pinpoint and react sl... |
MedQA,268 | Exam | B | An infectious disease investigator is evaluating the diagnostic accuracy of a new interferon-gamma-based assay for diagnosing tuberculosis in patients who have previously received a Bacillus Calmette-Guérin (BCG) vaccine. Consenting participants with a history of BCG vaccination received an interferon-gamma assay and w... |
MedQA,269 | Exam | B | Several patients at a local US hospital present with chronic secretory diarrhea. Although there are multiple potential causes of diarrhea present in these patients, which of the following is most likely the common cause of their chronic secretory diarrhea?
A. Lymphocytic colitis
B. Medications
C. Lactose intolerance
D... |
MedQA,270 | Exam | B | A 27-year-old woman with sickle cell disease and at 39-weeks' gestation is brought to the emergency department in active labor. She has had multiple episodes of acute chest syndrome and has required several transfusions in the past. She has a prolonged vaginal delivery complicated by postpartum bleeding, and she receiv... |
MedQA,272 | Exam | B | A 7-month old boy, born to immigrant parents from Greece, presents to the hospital with pallor and abdominal distention. His parents note that they recently moved into an old apartment building and have been concerned about their son's exposure to chipped paint from the walls. On physical exam, the patient is found to ... |
MedQA,273 | Exam | C | A 51-year-old woman comes to the physician because of progressively worsening lower back pain. The pain radiates down the right leg to the lateral side of the foot. She has had no trauma, urinary incontinence, or fever. An MRI of the lumbar spine shows disc degeneration and herniation at the level of L5–S1. Which of th... |
MedQA,274 | Exam | C | A 52-year-old woman comes to the physician because of a 4-month history of progressive pain and stiffness of the fingers of her right hand that is worse at the end of the day. She works as a hair dresser and has to take frequent breaks to rest her hand. She has hypertension, for which she takes hydrochlorothiazide. Two... |
MedQA,275 | Exam | C | A 51-year-old man presents to his dermatologist because of severe stomatitis and superficial skin erosions over his trunk. His condition started 2 months ago and was unresponsive to oral antibiotics and antiherpetic medications. He has no history of a similar rash. His medical history is remarkable for type 2 diabetes ... |
MedQA,277 | Exam | A | A 57-year-old man presents to the emergency department because of pain in the center of his chest that is radiating down his left arm and up the left side of his neck. The pain started suddenly 30 minutes ago while the patient was at work. The patient describes the pain as squeezing in nature, 10/10 in intensity, and i... |
MedQA,278 | Exam | D | A 29-year-old African American female presents to your office with extreme fatigue and bilateral joint pain. Serologies demonstrate the presence of rheumatoid factor along with anti-Smith and anti-dsDNA antibodies. A VDRL syphilis test is positive. You order a coagulation profile, which reveals normal bleeding time, no... |
MedQA,279 | Exam | C | A 31-year-old man comes to the physician because of a 5-day history of fever, chills, and dyspnea. His temperature is 38.9°C (102°F) and pulse is 90/min. Cardiac examination shows a murmur. In addition to other measures, cardiac catheterization is performed. A graph showing the results of the catheterization is shown. ... |
MedQA,280 | Exam | B | A 54-year-old woman comes to the physician because of a painful skin lesion on her right leg for 1 month. It initially started out as a small red spot but has rapidly increased in size during this period. She remembers an ant bite on her leg prior to the lesion occurring. She was treated for anterior uveitis 8 months a... |
MedQA,281 | Exam | B | A primary care physician is recently receiving more negative online reviews from his patients. He is increasingly feeling tired and has written 2 wrong prescriptions over the past month alone. Currently, on his panel, he has a list of 1,051 patients, half of whom are geriatric patients. He spends approx. 51 hours per w... |
MedQA,282 | Exam | C | A 42-year-old Caucasian woman is enrolled in a randomized controlled trial to study cardiac function in the setting of several different drugs. She is started on verapamil and instructed to exercise at 50% of her VO2 max while several cardiac parameters are being measured. During this experiment, which of the following... |
MedQA,283 | Exam | C | A 7-year-old boy comes to the physician because of a generalized rash for 3 days. Over the past 5 days, he has also had a high fever and a sore throat. His 16-year-old sister was treated for infectious mononucleosis 2 weeks ago. He returned from a summer camp a week ago. His immunizations are up-to-date. Three years ag... |
MedQA,284 | Exam | D | A 30-year-old woman comes to the physician because of a swelling on her neck for 5 months. It has gradually enlarged in size and is mildly painful. She has also had intermittent episodes of throbbing headache, sweating, and palpitations over the past 3 months. Menses occur at regular 28-day intervals and last for 4–5 d... |
MedQA,285 | Exam | D | A 31-year-old G3P1 woman who is at 37 weeks of gestation is brought into the emergency department by her husband after repeated twitching. According to the husband, they were watching TV when she suddenly became unresponsive and her hands and legs started shaking. The episode lasted about 5 minutes and she “seemed to b... |
MedQA,286 | Exam | C | A 65-year-old man was picked up by the security personnel for voiding urine and defecating at an inappropriate place in the community. On questioning, he was making offensive remarks and behaving inappropriately. On physical examination, the physician observed an ataxic gait and amnesia. Initial urine drug screen is ne... |
MedQA,287 | Exam | B | A 52-year-old man undergoes an exercise stress test for a 1-week history of squeezing substernal chest pain that is aggravated by exercise and relieved by rest. During the test, there is a substantial increase in the breakdown of glycogen in the muscle cells. Which of the following changes best explains this intracellu... |
MedQA,288 | Exam | A | A 35-year-old man presents to the general practitioner with a skin rash that has been present for 2 days. The rash appeared suddenly and has progressively gotten worse. It started off as an erythematous lesion on the back of his hands and also over his nose. The lesions over his hands have become bullous and tense. He ... |
MedQA,289 | Exam | C | A 32-year-old woman, gravida 2, para 1, at 38 weeks' gestation comes to the emergency department because of vaginal bleeding for the past hour. The patient reports that she felt contractions prior to the onset of the bleeding, but the contractions stopped after the bleeding started. She also has severe abdominal pain. ... |
MedQA,290 | Exam | B | A 5-year-old boy is brought to the emergency department by his parents for difficulty breathing. He was playing outside in the snow and had progressive onset of wheezing and gasping. His history is notable for eczema and nut allergies. The patient has respirations of 22/min and is leaning forward with his hands on his ... |
MedQA,291 | Exam | C | A 78-year-old male with history of coronary artery disease, status post coronary stent placement currently on aspirin and clopidogrel was found down in his bathroom by his wife. His GCS score was 3 and an accurate physical exam is limited. A stat non-contrast CT scan of his brain demonstrated a large right parietal int... |
MedQA,292 | Exam | A | A 53-year-old woman comes to the physician for a follow-up examination. One month ago, she was diagnosed with carcinoma of the left breast. She underwent a lumpectomy for a 2.1-cm mass and sentinel lymph node biopsy 2 weeks ago. The biopsy of the breast mass showed margin-free invasive ductal carcinoma; immunohistochem... |
MedQA,293 | Exam | D | Three weeks after birth, an infant girl develops episodes of apnea. She has become increasingly lethargic over the past two days, and experienced two episodes of apnea lasting 10 seconds each within the last day. She was born at 31 weeks of gestation and weighed 1600-g (3-lb 8-oz). Apgar scores were 4 and 7 at 1 and 5 ... |
MedQA,294 | Exam | B | A 45-year-old woman presents to the physician with a 6-month history of progressive shortness of breath. She now has to stop to rest three or four times whenever she climbs the stairs to her apartment on the third floor. She reports chronic, nonproductive cough and wheezing, for which she uses ipratropium inhalers. She... |
MedQA,296 | Exam | A | A 26-year-old woman presents with sudden-onset pain in her lower back. She says she was exercising in the gym several hours ago when she felt a sharp pain. The pain is radiating down the side of her leg and into her foot. On physical exam, her vital signs are as follows: HR 95, BP 120/70, T 37.2 degrees C. She has extr... |
MedQA,297 | Exam | A | A 34-year-old man with AIDS comes to the physician because of a 2-day history of decreasing vision and seeing black spots in his right eye. He has no pain and the left eye is asymptomatic. He was treated for fungal esophagitis 6 months ago with fluconazole. He was diagnosed with Kaposi's sarcoma 2 years ago. Current me... |
MedQA,298 | Exam | D | A 45-year old man comes to the physician because of a painless neck lump and a 2-month history of difficulty swallowing. He has a history of recurrent nephrolithiasis and episodic hypertension. Physical examination shows a 3 × 3-cm, nontender nodule at the level of the thyroid cartilage. A photomicrograph of a section ... |
MedQA,299 | Exam | C | A 17-year-old boy is brought to the physician because of increasing pain and swelling of his right knee for 12 days. He has had episodes of pain with urination for 3 weeks. He had a painful, swollen left ankle joint that resolved without treatment one week ago. His mother has rheumatoid arthritis. He is sexually active... |
MedQA,300 | Exam | B | A 72-year-old man presents to his primary care provider to discuss the frequency with which he wakes up at night to urinate. He avoids drinking liquids at night, but the symptoms have progressively worsened. The medical history is significant for hypertension and hyperlipidemia. He takes lisinopril, atorvastatin, and a... |
MedQA,303 | Exam | C | A 34-year-old man is brought to the emergency department 3 hours after being bitten by a rattlesnake. He was hiking in the Arizona desert when he accidentally stepped on the snake and it bit his right leg. His pulse is 135/min and blood pressure is 104/81 mm Hg. Examination shows right lower leg swelling, ecchymosis, a... |
MedQA,304 | Exam | A | A 31-year-old woman visits the clinic with chronic diarrhea on most days for the past four months. She also complains of lower abdominal discomfort and cramping, which is relieved by episodes of diarrhea. She denies any recent change in her weight. Bowel movements are preceded by a sensation of urgency, associated with... |
MedQA,305 | Exam | C | A 24-year-old man presents to his primary care physician for a persistent and low grade headache as well as trouble focusing. The patient was seen in the emergency department 3 days ago after hitting his head on a branch while biking under the influence of alcohol. His head CT at the time was normal, and the patient wa... |
MedQA,306 | Exam | D | While playing the catcher position in baseball, a 27-year-old male sustained a blow to his left testes which required surgical removal. Upon awakening from anesthesia, he jokes to his wife that he is now half the man that she once knew. Which of the following scenarios is a similar ego defense as the one above?
A. A r... |
MedQA,307 | Exam | D | A 31-year-old man comes to the physician because of severe muscle pain and fever for 4 days. He likes to go hunting and consumed bear meat 1 month ago. Examination shows periorbital edema and generalized muscle tenderness. His leukocyte count is 12,000/mm3 with 19% eosinophils. The release of major basic protein in res... |
MedQA,308 | Exam | C | A 65-year-old patient with a history of COPD and open-angle glaucoma in the left eye has had uncontrolled intraocular pressure (IOP) for the last few months. She is currently using latanoprost eye drops. Her ophthalmologist adds another eye drop to her regimen to further decrease her IOP. A week later, the patient retu... |
MedQA,309 | Exam | D | A 47-year-old man presents to the clinic with a 10-day history of a sore throat and fever. He has a past medical history significant for ulcerative colitis and chronic lower back pain. He smokes at least 1 pack of cigarettes daily for 10 years. The father of the patient died of colon cancer at the age of 50. He takes s... |
MedQA,310 | Exam | A | A patient with HCC and a long history of alcohol dependence and chronic hepatitis C has been using the mTOR inhibitor Metalimus 100 mg for cancer treatment. Her cancer has shown a partial response. She also has a history of hypertension and poorly controlled type 2 diabetes mellitus complicated by diabetic retinopathy.... |
MedQA,311 | Exam | B | A 22-year-old G4P2 at 35 weeks gestation presents to the hospital after she noticed that "her water broke." Her prenatal course is unremarkable, but her obstetric history includes postpartum hemorrhage after her third pregnancy, attributed to a retained placenta. The patient undergoes augmentation of labor with oxytoci... |
MedQA,312 | Exam | C | A 40-year-old nulliparous woman with no significant medical history presents to your office with shortness of breath and increased abdominal girth over the past month. The initial assessment demonstrates that the patient has a right-sided hydrothorax, ascites, and a large ovarian mass. Surgery is performed to remove th... |
MedQA,313 | Exam | B | A 32-year-old man comes to the physician for a follow-up examination. He has a 2-month history of increasing generalized fatigue and severe pruritus. He has hypertension and ulcerative colitis which was diagnosed via colonoscopy 5 years ago. Current medications include lisinopril and rectal mesalamine. He is sexually a... |
MedQA,314 | Exam | B | An 82-year-old woman is brought to the emergency department after losing consciousness at her nursing home. She had been watching TV for several hours and while getting up to use the bathroom, she fell and was unconscious for several seconds. She felt dizzy shortly before the fall. She does not have a headache or any o... |
MedQA,315 | Exam | B | A 38-year-old woman comes to the physician because of a 10-month history of nonbloody diarrhea and recurrent episodes of flushing and wheezing. She does not take any medications. Physical examination shows a hyperpigmented rash around the base of her neck. Cardiac examination shows a grade 4/6, holosystolic murmur in t... |
MedQA,316 | Exam | D | A 4-year-old boy is brought to the clinic by his mother with fever and a rash. The patient’s mother says his symptoms started 1 week ago with the acute onset of fever and a runny nose, which resolved over the next 3 days. Then, 4 days later, she noted a rash on his face, which, after a day, spread to his neck, torso, a... |
MedQA,317 | Exam | D | A 24-year-old woman presents to her physician’s office complaining of a worsening cough with large volumes of mucoid sputum in her phlegm every morning and thickened foul smell sputum almost every time she coughs. She says that this cough started about one month ago and has been increasing in intensity. Over the counte... |
MedQA,318 | Exam | A | A 7-month-old boy is brought to the pediatrician for a change in his behavior. The patient has been breastfeeding up until this point and has been meeting his developmental milestones. He is in the 90th percentile for weight and 89th percentile for height. This past week, the patient has been lethargic, vomiting, and h... |
MedQA,319 | Exam | C | A 21-year-old woman is admitted to the hospital for severe malnutrition with a BMI of 15 kg/m2. Past medical history is significant for chronic anorexia nervosa. During the course of her stay, she is treated with parenteral fluids and nutrition management. On the 4th day, her status changes. Her blood pressure is 110/7... |
MedQA,320 | Exam | C | A 62-year-old man comes to the physician because of a 5-day history of fatigue, fever, and chills. For the past 9 months, he has had hand pain and stiffness that has progressively worsened. He started a new medication for these symptoms 3 months ago. Medications used prior to that included ibuprofen, prednisone, and hy... |
MedQA,321 | Exam | B | Please refer to the summary above to answer this question
An ECG is most likely to show which of the following findings in this patient?"
"Patient Information
Age: 64 years
Gender: F, self-identified
Ethnicity: unspecified
Site of Care: emergency department
History
Reason for Visit/Chief Concern: “My chest hurts, espec... |
MedQA,322 | Exam | B | A 16-year-old boy is brought to the physician for a follow-up appointment. He has a seizure disorder treated with valproic acid. He has always had difficulties with his schoolwork. He was able to walk independently at the age of 2 years and was able to use a fork and spoon at the age of 3 years. Ophthalmic examination ... |
MedQA,323 | Exam | C | A 52-year-old woman presents to her primary care physician with a chief complaint of diarrhea. She states that it has been going on for the past month and started after she ate a burger cooked over a campfire. She endorses having lost 10 pounds during this time. The patient has no other complaints other than hoarseness... |
MedQA,324 | Exam | C | A 27-year-old female presents to her OB/GYN for a check-up. During her visit, a pelvic exam and Pap smear are performed. The patient does not have any past medical issues and has had routine gynecologic care with normal pap smears every 3 years since age 21. The results of the Pap smear demonstrate atypical squamous ce... |
MedQA,325 | Exam | D | A 19-year-old man comes to the physician for the evaluation of progressive difficulty climbing stairs over the last 2 years. During this period, he has also had problems with running, occasional falls, and standing from a chair. He has not had any vision problems or muscle cramping. There is no personal or family histo... |
MedQA,326 | Exam | D | An 11-year-old man presents with fever and joint pain for the last 3 days. His mother says that he had a sore throat 3 weeks ago but did not seek medical care at that time. The family immigrated from the Middle East 3 years ago. The patient has no past medical history. The current illness started with a fever and a swo... |
MedQA,327 | Exam | D | A 41-year-old woman is referred by her radiation oncologist to the medical genetics clinic. She was recently diagnosed with an infiltrating ductal carcinoma of the breast. She has a previous history of colonic polyps for which she undergoes bi-annual colonoscopy. The maternal and paternal family history is unremarkable... |
MedQA,328 | Exam | B | A 40-year-old woman presents to her primary care physician with a 5-month history of worsening bladder discomfort. Her discomfort is relieved by voiding. She voids 10–15 times per day and wakes up 2–3 times per night to void. She has not had any involuntary loss of urine. She has tried cutting down on fluids and taking... |
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