1103 USMLE QUESTIONS BANK November 16, 2022 1 Min Read 1 USMLE QUESTION BANK USMLE quiz helps us to increase our knowledge Read moreScrape Multiple-Choice Questions from the Web1 / 20 1) A 72-year-old man presents to the office for evaluation of new symptoms. He has a history of cancer and takes chemotherapeutic treatment. Now he complains of dyspnea and mild fatigue since last week. Examination reveals temperature of 98.3 F, pulse of 80/min, blood pressure of 140/86 and respiratory rate of 22/min. On chest auscultation, there are crackles on both lung bases with no wheezes. A chest x-ray shows bilateral diffuse interstitial markings. Which of the following agents is responsible for this patient’s new features? A) Bleomycin B) Cisplatin C) Cyclophosphamide D) Etoposide E) Paclitaxel Read moreCookie Policy It is the only drug of the above list that causes pulmonary fibrosis. It is age- and dose-dependent. 2 / 20 2) A 54 year old man visits his physician for evaluation of low back pain. He has a history of lung cancer and he receives a combination of radiation and chemotherapy. His back pain started 3 months ago and now he complains of numbness and tingling in his lower limbs. What is the most likely cause of this patient’s back pain? A) Paraneoplastic disease B) Metastases to the vertebral column C) Muscular spasm of paravertebral muscles D) Primary osteosarcoma Vertebral column is the most common site for metastases of lung cancer. Symptoms start when compression of spinal cord occurs. It causes neurological symptoms of the areas affected. Other choices are less likely associated with cancer lung. 3 / 20 3) A 36-year-old man visits his physician complaining of chronic gastric pain for several years. Physical examination is unremarkable. Serology studies are positive for Helicobacter Pylori. Endoscopy reveals gastritis with no ulcers or tumors. Treatment starts with omeprazole, clarithromycin and metronidazole. What is the most appropriate noninvasive test to check for H. pylori eradication? A) Rapid urease test B) Stool analysis and culture C) Examination and culture of gastric contents D) Urea breath test E) Serum test for IgG antibodies against H. Pylori Urea breath test is the most appropriate noninvasive test to check for H. Pylori eradication. It is recommended after one month of treatment. 4 / 20 4) A 69 year-old man with a long history of poorly controlled diabetes presents to his physician complaining of pain and drainage in his left ear. His vital signs are within normal limits. The pinna of his left ear is tender. The external meatus is swollen and covered with purulent drainage. What is the most likely organism responsible for his condition? A) Candida albicans B) Homophilus influenzae C) Pseudomonas aeruginosa D) Moraxella catarrhalis E) Streptococcus pneumoniae This infection is most likely malignant otitis externa and caused by pseudomonas aeruginosa. It is common in elderly people and specifically those with a history of poorly controlled diabetes. Other organisms mainly cause otitis media but they very rarely affect external ear. 5 / 20 5) A 43 year-old man presents to his physician with a complaint of progressive difficulty in swallowing solid food. He has a 10-year history of heartburn which increases with spicy food and relieves by antacids. He does not smoke or drink alcohol. His weight is the same since last visit six months ago. He is scheduled for endoscopy next week. What is the most likely initial diagnosis for this patient? A) Cancer esophagus B) Peptic esophageal stricture C) Diffuse esophageal spasm D) Achalasia E) Lower esophageal ring This patient has progressive dysphagia to solids. He also has a history of heartburn for 10 years. Heartburn that increases with spicy food and relieves by anti-acids in suggestive of GERD. The first complication of GERD is peptic esophageal stricture which is caused by acid reflux from the stomach into the lower part of esophagus. Cancer esophagus is excluded as the patient didn’t lose any weight and he doesn’t have the precipitating factors such as smoking and alcohol intake. Achalasia is characterized by dysphagia to both liquids and solids. 6 / 20 6) A concerned mother has brought her 8-year old girl to the gynecology clinic because of enlarged breasts. Her daughter has been feeling depressed as her schoolmates make fun at her for her large breasts. There has no axillary or pubic hair. There is no history of menarche. Her voice did not change. Her examination is completely normal. What is the most likely diagnosis? A) Precocious puberty B) Isolated premature thelarche C) Pituitary adenoma D) Androgen insensitivity syndrome E) Congenital adrenal hyperplasia This is a typical case of isolated premature thelarche. Precocious puberty is incorrect as it is characterized by premature menstruation and appearance of pubic and axillary hair in addition to enlarged breasts. It is a normal condition occurs in 40% of girls under the age of 8. There is no other symptoms suggesting any abnormality so, other options are all incorrect. 7 / 20 7) A 27-year-old man complains of 2-week history of watery diarrhea and 5 lb. weight loss. He had no similar episodes in the past, did not travel recently, did not eat out or take antibiotics. He quit smoking last month after 1 PPD for 5 years. His family history is significant of some relatives who are diagnosed with inflammatory bowel syndrome. His examination reveals diffuse mild abdominal tenderness and hyperactive bowel sounds. Stool analysis is negative for blood and ova. What is in the history and/or examination could support the diagnosis of ulcerative colitis rather than Crohn’s disease in this patient? A) History of diarrhea and weight loss B) Family history of inflammatory bowel syndrome C) Smoking cessation D) Negative stool analysis E) Having first attack in his twenties Incidence and severity of ulcerative colitis are related to smoking cessation. This relation does not occur in cases of Crohn’s disease. Other choices are found in both ulcerative colitis and Crohn’s disease. 8 / 20 8) Which one of the following medications can be reversed by administration of vitamin K? A) Clopidogrel B) Heparin C) Tirofiban D) Warfarin 9 / 20 9) Which of the following signs of infective endocarditis appears as small, tender nodules on the finger and toe pads? A) Janeway lesions B) Osler nodes C) Roth’s spots D) Splinter hemorrhages 10 / 20 10) Coagulation factor VIII is produced by which of the following cells? A) Endothelial cells B) Hepatic cells C) Juxtaglomerular cells D) Splenic macrophages 11 / 20 11) A patient presents with vomiting, diarrhea and abdominal cramps a few hours after a picnic. Which is the causative organism? A) Clostridium difficile B) E-coli C) Staphylococcus aureus D) Streptococcus pyogenes 12 / 20 12) Which of the following is the most serious contraindication of electroconvulsive therapy? A) History of fracture B) History of seizures C) Meningioma D) Old age Space occupying lesions are the most serious contraindication of electroconvulsive therapy. 13 / 20 13) A 23-year-old nursing student presents with confusion, fatigue and sweating. Her blood sugar is 40 mg/dL. Lab tests show a high insulin level and a very low C peptide level. Which of the following is the most likely diagnosis? A) Factitious hypoglycemia B) Insulinoma C) Reactive hypoglycemia D) Pheochromocytoma Low C peptide is the clue of exogenous insulin. This patient injected herself with insulin to fake hypoglycemia. 14 / 20 14) Which of the following should be added to premature infants of breast-feeding mothers after 2 month of age? A) Copper B) Iron C) Vitamin C D) Zink It should be added after 2 months while vitamin C can be added after 3-6 months. 15 / 20 15) A pregnant woman in her third trimester was in a motor vehicle accident presets to the ER. She is stable and no uterine bleeding or contractions. Fetal heart sounds are normal and placenta is intact. Which of the following is the best next step? A) Blood type and Rh testing B) Cesarean section C) Induction of labor D) Send her home and follow up the next scheduled visit RhoGAM should be given in cases of Rh –ve to avoid Rh isoimmunity. 16 / 20 16) Drug-to-drug interaction based on absorption, transformation, distribution and excretion is considered which one of the following types of interaction? A) Chemical interaction B) Pharmaceutical interaction C) Pharmacodynamic interaction D) Pharmacokinetic interaction Pharmacokinetics of a drug is related to the drug’s absorption, transformation, distribution and excretion while pharmacodynamics deals with receptors, cells, enzymes and organs. 17 / 20 17) A young man was stuck on his leg by a falling rack a week ago. Today, a purple bruise developed on the site of injury. Which one of the following substances is responsible for the color at the site of injury? A) Bilirubin B) Hemosiderin C) Melanin D) Thromboplastin Heme pigment of the blood is transformed into yellowish brown hemosiderin granules which are accumulated at the site of injury resulting in the purple color of the bruise. 18 / 20 18) Which one of the following is the most common cause of microcytic hypochromic anemia in a patient diagnosed with progressive renal failure? A) Blood loss B) Erythropoietin deficiency C) Frequent hematuria D) Iron deficiency anemia Kidneys produce erythropoietin which stimulates the production of RBCs. Its production is affected by renal failure. 19 / 20 19) Bronchoconstriction results from stimulation of which one of the following receptor types? A) Alpha-1- adrenergic receptors B) Beta-2- adrenergic receptors C) M2 cholinergic receptors D) M3 cholinergic receptors They cause stimulation of bronchiolar smooth muscles which leads to bronchoconstriction and pulmonary obstructive symptoms. There are no alpha adrenergic or M2 receptors in the lungs. Beta-2-adrenergic receptors’ stimulation causes bronchodilation. 20 / 20 20) A middle-aged woman presents to the clinic complaining of visual difficulty. Examination is normal except one abnormal sign. When light is shined in the right eye, both pupils constrict while if it is shined in the left eye, both pupils dilate to the normal size. Which one of the following nerves is affected in this patient? A) Left oculomotor nerve B) Left optic nerve C) Right oculomotor nerve D) Right optic nerve Consensual light reflex differentiates between optic nerve injury vs oculomotor nerve injury. It is lost in optic nerve injury while it is intact in oculomotor nerve injury. Your score is 0% Restart quiz Uncategorized Show Comments Leave a Reply Cancel reply Save my name, email, and website in this browser for the next time I comment. Hover or click the text box below Share Article:
