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 54 year-old man with a history of chronic obstructive pulmonary disease (COPD) presents by his son to the emergency room semi-unconscious with shortness of breath. He has nausea, diarrhea and restlessness for the last four hours. His arterial oxygen saturation is 88% with room air. His ECG shows normal sinus rhythm with non-specific changes in lateral leads. The patient uses albuterol inhalation, ipratropium bromide, theophylline and Lisinopril. Three days ago, he had an exacerbation of his COPD and was prescribed ciprofloxacin and supplemental oxygen at night and during ambulation. What is the most likely cause of this patient presentation to the ER? A) Interaction of ciprofloxacin to albuterol B) Interaction of ciprofloxacin to ipratropium bromide C) Interaction of ciprofloxacin to theophylline D) Interaction of ciprofloxacin to Lisinopril E) Interaction of ciprofloxacin to oxygen Read moreCookie Policy Ciprofloxacin administration leads to increase in the level or effect of oral theophylline by altering the drug metabolism. Combination may lead to theophylline toxicity and life-threatening interaction. Other drugs mentioned above do not have any undesirable interaction with ciprofloxacin. 2 / 20 2) A 62 year-old man complains of fever and diminished consciousness for 2 days. He has been healthy all his life and he doesn’t take any medications. On examination, he responds inconsistently to commands. His temperature is 103 F, pulse 110/min and blood pressure is 80/56 mmHg. His physical examination is otherwise normal. There is no bleeding. Laboratory test are as follows: Hemoglobin: 12 g/dl A) ukocyte count: 25,000 – 80% neutrophils Platelet count: 20,000 B) Hemophilia a C) at is the most likely diagnosis? D) Idiopathic thrombocytopenic purpura E) Thrombotic thrombocytopenic purpura F) Disseminated intravascular coagulation G) Hemophilia b This patient most likely has sepsis leading to disseminated intravascular coagulation. It is confirmed by increased D-dimer and low level of fibrinogen. He has been healthy all his life so, acute infection leading to sepsis is the most likely etiology while major conditions that usually show up in younger age as purpura and hemophilia are not likely associated with this man’s condition. 3 / 20 3) A 25-year-old woman presents to the clinic complaining of general aches for two years. Pain is getting worse over the past 3 months. Every morning, she has stiffness all over her body, which is usually relieved in about 5-10 min. She has no history of trauma or any medical condition. Her BMI is 21 and she has no rash or joint swelling. She has multiple tender points. All laboratory investigations are within normal limits. What is the most appropriate management of this patient? A) Perform electromyogram (EMG) B) Perform nerve conduction studies C) Start duloxetine D) Start hydrocodone E) Start prednisone This patient most likely has fibromyalgia. It is diagnosed clinically depending on the presence of multiple tender points with the absence of any rash or joint swelling. The treatment of choice of fibromyalgia is duloxetine as it is approved to have positive results in many cases. In case of failure of medical treatment, investigations as EMG and nerve conduction studies can be done to exclude other conditions. 4 / 20 4) A 55-year-old woman visits her physician to consult about hormone replacement therapy (HRT).Her physician discuss with her the pros and cons of using HRT. Which one of these benefits is gained by the use of HRT? A) HRT decrease the risk of breast cancer B) HRT decrease the risk of stroke C) HRT decrease the risk of coronary artery disease D) HRT decrease the risk of deep venous thrombosis E) HRT decrease the risk of hot flashes and vaginal dryness HRT is associated with increased risk of breast cancer, stroke, coronary artery disease and deep venous thrombosis. Meanwhile, HRT improves vasomotor symptoms such as hot flashes, vaginal dryness and postmenopausal mood swings. 5 / 20 5) A 60-year-old man visits the clinic due to profuse watery diarrhea and left lower abdominal colicky pain for the last 6 hours. Upon taking history, the patient claims that he is taking broad spectrum antibiotics for acute bronchitis. Which is the most likely causative organism for the patient’s new symptoms? A) Clostridium botulinum B) Clostridium butyricum C) Clostridium difficile D) Clostridium histolyticum E) Clostridium Septicum Antibiotic-associated diarrhea is most likely caused by clostridium difficile. The relation of this organism to the use of certain antibiotics is not fully understood yet. Treatment of this condition is oral vancomycin. Other types of clostridia mentioned in the choices cause different pathological conditions i.e. botulism, general sepsis, etc. 6 / 20 6) A 66-year-old man complains of difficult micturition and drippling at the end of urination. Laboratory investigations and imaging studies confirm the diagnosis of senile enlarged prostate and exclude prostate cancer. Which these drugs is the most appropriate for this patient? A) Abiraterone B) Finasteride C) Flutamide D) Pergolide E) Tadalafil All drugs mentioned above are used in the treatment of cancer prostate except finasteride which is a dihydrotestosterone (DHT) inhibitor which is also known as 5α-Reductase inhibitors. This enzyme is essential for the growth and development of prostate gland. 7 / 20 7) What is the congenital heart disease most likely associated with Turner’s syndrome? A) Atrial Septal defect B) Coarctation of the aorta C) Transposition of the great vessels D) Ventricular septal defect 8 / 20 8) What are the 5 Ps of ischemia due to peripheral vascular disease? A) Pain-Pallor-Paralysis-Polycythemia-Proteinuria B) Pain-Pallor-Paralysis-Paresthesia-Poikilothermia C) Pain-Pallor-Paresthesia-Proteinuria-Poikilothermia D) Pain-Pallor-Proteinuria-Paresthesia-Paralysis 9 / 20 9) Which of the following is the most accurate test for multiple myeloma? A) 24-hour urine calculation B) Bone marrow biopsy C) Brain MRI D) Urine electrophoresis 10 / 20 10) Which of the following explains the benefit of lactulose in hepatic encephalopathy? A) Lactulose antagonize the action of ammonia on hepatic cells B) Lactulose converts to lactic acid by intestinal bacteria which decreases ammonia C) Lactulose decreases stress of the liver to produce glucose D) Lactulose removes circulating toxins from the blood 11 / 20 11) Which one of the following substances is used to acidify the urine? A) Acetazolamide B) Ammonium chloride C) Sodium bicarbonate 12 / 20 12) Which one of the following tests is diagnostic for acromegaly? A) Fasting blood glucose level B) Serum cortisol level C) Serum growth hormone level D) Serum insulin-like growth factor-1 (IGF-1) 13 / 20 13) Which of the following is a characteristic finding in isopropanol poisoning? A) Blindness due to ocular accumulation B) Elevated anion gap C) Elevated serum BUN and creatinine D) Ketosis without acidosis 14 / 20 14) Naloxone is the treatment of choice of which one of the following toxicities? A) Amitriptyline toxicity B) Citalopram overdose C) Hydrocodone toxicity D) Methylphenidate overdose 15 / 20 15) Which of the following organisms is responsible for the development of oral hairy leukoplakia in HIV patients? A) Bartonella henselae B) Candida albicans C) Epstein-Barr virus D) Human papilloma virus Candida can cause oral thrush while EBV causes leukoplakia on lateral tongue. 16 / 20 16) Which of the following is the main role of colchicine in treating acute attack of gout? A) Decreased uric acid absorption B) Increased uric acid excretion C) Inhibition of xanthine oxidase D) Reduction of gout symptoms and pain 17 / 20 17) A 48-year-old man complains of acute pain in his right big toe. He has a history of gout and takes treatment for it. Recently, he was diagnosed with hypertension and started treatment 2 weeks ago. Which one of these drugs is most likely responsible for his recent complaint? A) Captopril B) Hydrochlorothiazide C) Metoprolol D) Verapamil Side effects of thiazide diuretics are hyperglycemia, hyperuricemia and hypercalcemia. Acute exacerbation of gout is triggered by hyperuricemia. 18 / 20 18) Which of the following findings distinguishes chronic renal failure from acute renal failure? A) High serum calcium B) High serum sodium C) History of elevated BUN D) History of elevated serum creatinine A, B and C may occur in both acute and chronic renal failure but creatinine is specific for chronic renal failure 19 / 20 19) A young woman presents with chronic diarrhea found to have rectovaginal fistula. Which of the following is most likely her diagnosis? A) Celiac disease B) Crohn’s disease C) Ischemic colitis D) Ulcerative colitis 20 / 20 20) A female patient presents to the emergency room with a suspicious ruptured abdominal aortic aneurysm. Which of the following is the appropriate test needed at this situation? A) Abdominal CT scan B) Abdominal MRI C) Abdominal ultrasonography D) Abdominal X-ray This patient is most likely hemodynamically unstable. She needs an urgent bedside test to confirm her diagnosis. All other tests are not appropriate at this situation. 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:
