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) An 82 year-old woman who underwent right knee replacement yesterday develops new symptoms. Right after surgery, she was agitated, awake all night and refused to eat or take postoperative medications. Today she is still agitated and not oriented to time and place. What is the most appropriate management at this point? A) Restrain in bed and lorazepam administration B) Restrain in bed and haloperidol administration C) Sleep enhancement protocol and family support as well as haloperidol administration D) Diphenhydramine to enhance sleeping E) Refer to psychiatry department Read moreCookie Policy This is a case of delirium. It is mild in this patient and she only needs support and normalizing sleep-wake cycle. Restrain in only recommended in cases of severe delirium to avoid hurting herself and others. Haloperidol is safe to improve agitation. Benzodiazepines enhance delirium and they are not recommended in this case. Refer to psychiatry department is premature in this mild case of delirium. 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 62-year-old woman with a history of type 2 diabetes complains of nausea and bloating for the last three months. Gastric emptying studies confirm the diagnosis of diabetic gastroparesis. What is the first line therapy for this patient? A) Clindamycin B) Metoclopramide C) Omeprazole D) Ondansetron E) Sodium bicarbonate Diabetic gastroparesis is characterized by delayed stomach emptying which leads to nausea and bloating following meals. A prokinetic (promotility) drug such as metoclopramide helps in emptying of the stomach and improving her symptoms. Other choices have no role in esophageal or gastric motility. 4 / 20 4) Which one of the following fractures is incomplete and involving the cortex of only one side of the bone? A) Greenstick fracture B) Nursemaid’s elbow C) Osgood-Schlatter disease D) Torus fracture 5 / 20 5) Which of the following is the drug of choice of anaphylactic shock? A) Adrenaline B) Diphenhydramine C) Dopamine D) Phenylephrine 6 / 20 6) Which one of the following types of cells myelinates axons of neurons of CNS? A) Astrocytes B) Microglia C) Oligodendroglia D) Schwann cells 7 / 20 7) Which of the following is not a feature of Tetralogy of Fallot? A) Atrial septal defect B) Overriding aorta C) Pulmonary stenosis D) Right ventricular hypertrophy 8 / 20 8) Which one of the following features characterizes Crohn’s disease from ulcerative colitis? A) Bloody diarrhea B) Colectomy is curative C) Continuous disease beginning at rectum and extending without skipped areas D) Perineal fissures and fistulas 9 / 20 9) Decreased production of which type of collagen may result in osteogenesis imperfecta? A) Type I B) Type II C) Type III D) Type IV 10 / 20 10) Which type of bias is reflected when individuals with severe disease are uncovered because they die first? A) Confounding bias B) Late-look bias C) Measurement bias D) Selection bias 11 / 20 11) Which of the following medications may cause acute cholestatic hepatitis? A) Acarbose B) Colchicine C) Erythromycin D) Metformin Erythromycin is the only drug on this list that can cause hepatitis while all others can cause diarrhea. 12 / 20 12) Which of the following tests is most likely used to rule out congestive heart failure in a case of cardiomegaly during pregnancy? A) Arterial blood gas B) Echocardiography C) Electrocardiogram (ECG) D) MRI of the chest It is the only test to rule out CHF. Other tests are not specific. 13 / 20 13) Which of these medications is the most appropriate treatment of malignant hyperthermia? A) Acetaminophen B) Dantrolene C) Ibuprofen D) Indomethacin It is the only approved drug out of this list that improves malignant hyperthermia 14 / 20 14) A 61-year-old male represents to the ER with severe substernal chest pain. He’s given sublingual nitroglycerin and oxygen. His vital signs are within normal limits and ECG is normal. Which of the following is the best next step? A) Aspirin B) Coronary angiography C) Echocardiography D) Thallium stress test It is life saving in cases of coronary disease. Other options may be needed later but not as urgent as aspirin. 15 / 20 15) A young female presents with areas of erythema and itching over the skin of her hands, arms and legs two hours after she ate nuts. Which of the following immunological reactions is the most likely responsible? A) Anaphylaxis B) Cell mediated hypersensitivity C) Complement activity D) Immune complex deposition This is a case of type 1 hypersensitivity which is characterized by IgE, mast cells and histamine release. It can progress to anaphylactic shock. Other immunological reactions are involved with other types of hypersensitivity. 16 / 20 16) Which one of the following enzymes is associated with Lyesh-Nyhan syndrome? A) Adenosine deaminase B) Hypoxanthine-guanine phosphoribosyl transferase C) Ribonucleotide reductase D) Xanthine oxidase This enzyme is a part of the salvage pathway for purines. A deficiency leads to inability to recycle purines which results in overproduction of uric acid. Individuals with Lesch-Nyhan syndrome are mentally retarded. 17 / 20 17) Which of the following insects is the victor responsible for transmission of Rocky Mountain spotted fever? A) Flea B) Louse C) Mite D) Tick 18 / 20 18) Which of the following is the most common cause of sudden death in patients with diabetes mellitus? A) Cerebral hemorrhage B) Gangrene C) Hyperosmolar coma D) Myocardial infarction Atherosclerosis that leads to myocardial infarction is the leading cause of death in patients with diabetes mellitus. 19 / 20 19) A young man is involved in a car accident which results in laceration to some great vessels and is admitted for surgery. Which of the following organs is the LEAST affected by loss of blood for a an extended period of time? A) Brain B) Liver C) Retina D) Skeletal muscles E) Small intestine Anaerobic glycolysis saves sometime for skeletal muscles to survive. Other organs need more oxygen to survive. 20 / 20 20) A 45-year-old man is rushed to the emergency room having severe headaches and recurrent fever started 1 week ago, a week after he came back from a trip to Africa. Physical examination reveals high fever and splenomegaly. Brain imaging reveals signs of cerebral involvement. Which of these following parasites is likely causing the patient’s symptoms? A) Babesia microti B) Plasmodium falciparum C) Plasmodium malariae D) Plasmodium vivax Plasmodium falciparum causes malaria. Spread by the Anopheles mosquito, P. falciparum infection is detected by a blood smear. The patient is suffering from cerebral malaria and the only species of Plasmodium that causes cerebral malaria is P. falciparum. 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:
