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 43 year-old man presents to the ER with an excruciating chest pain radiates to his jaw and left shoulder. The patient is in moderate distress. Examination reveals a small nodule in his right Achilles tendon. Family history indicates that his father died of a heart attack in the age of 45. His laboratory tests reveal elevated levels of CK-MB, troponin T and very high level of cholesterol (670 mg/dL). A diagnosis of myocardial infarction and familial hypercholesterolemia is made in this patient. The patient is admitted to the intensive care unit (ICU) for urgent treatment. The patient has improved in the following week and is discharged. A list of medications has been prescribed for this patient. Which one of these medications acts through inhibition of the enzyme HMG-CoA reductase? A) Atenolol B) Fenofibrate C) Lovastatin D) Niacin​ E) Orlistat Read moreCookie Policy Statins lower LDL through inhibition of HMG-CoA reductase, the rate limiting step in the production of cholesterol. Statins dramatically reduce mortality of patients with hypercholesterolemia. Atenolol is a beta blocker and has no role in reducing cholesterol. Fenofibrate and niacin have different mechanism of action. They mainly lower triglycerides and increase HDL. Orlistat lowers rate of absorption of fat from diet by inhibition of pancreatic lipase. 2 / 20 2) A 35-year-old man with a history of Marfan syndrome presents to the emergency room complaining of chest pain radiating to his upper back between shoulder blades. His blood pressure is 170/90 mmHg in his right arm and 90/60 in left arm. His pulse is 98/min. Cardiac examination reveals regular rhythm with diastolic murmur on the left lower sternal border. Lung examination reveals clear bilateral breath sounds. An echocardiogram shows dissection of the thoracic aorta involving the left subclavian artery. Which of these is the recommended immediate drug of choice? A) Clopidogrel B) Heparin C) Sodium nitroprusside D) Calcium gluconate E) Labetalol This is a typical presentation of aortic dissection. Labetalol is an alpha and beta adrenergic antagonist. It is the recommended drug of choice in this case. Sodium nitroprusside is contraindicated as its mechanism of action is dilation of blood vessels which could worsens the case. 3 / 20 3) An 8-month-old boy presents to the clinic with his mother. She tells you that her son had several bowel movements today and his stool was like red jelly. He vomited all food and water. He is also weak, fussy and holding his belly. He has no fever or signs of dehydration. On abdominal examination, there is a palpable abdominal mass in the right hypochondrium and emptiness in the right lower abdomen. Ultrasonography is performed to confirm the diagnosis. What is the next step of management for this patient? A) MRI of the abdomen B) Colonoscopy C) IV hydration and antibiotics D) Contrast enema E) Refer to surgery for bowel resection This is a typical presentation of intussusception of infant. The only procedure of the choices above that diagnose and treat this condition is contrast enema. 4 / 20 4) Which one of the following drugs associated with nephrotoxicity? A) Capreomycin B) Ethambutol C) Isoniazid D) Rifampin 5 / 20 5) 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 6 / 20 6) Which of the following is the diagnostic test used when ultrasound is equivocal for cholecystitis? A) Abdominal x-ray B) CT scan C) HIDA scan D) Liver function tests 7 / 20 7) Which one of the following drugs increase survival in patients with MI? A) Atenolol B) Digoxin C) Furosemide D) Verapamil 8 / 20 8) 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 9 / 20 9) Which of the following drugs is an ergosterol synthesis inhibitor? A) Acyclovir B) Ampicillin C) Ketoconazole D) Ritonavir 10 / 20 10) Which of the following is the most prominent side effect of scopolamine? A) Bradycardia B) Miosis C) Mydriasis D) Profuse sweating 11 / 20 11) Which of the following is a contraindication of use of benzodiazepines in anxiety disorder? A) Diabetes mellitus B) Seizures C) Sleep apnea D) Smoking It is dangerous to use in cases of sleep apnea but other conditions are not that risky. 12 / 20 12) Which of the following is the most common cause of congestive heart failure associated with systolic impairment in the United States? A) Alcohol B) Atherosclerosis C) Diabetes D) Rheumatic heart disease CHF with systolic impairment is mainly caused by ischemic cardiomyopathy due to coronary atherosclerosis. 13 / 20 13) A single injection of leuprolide was given to a man 2 weeks ago. Which of the following changes could be revealed today? A) Decreased testosterone production B) Increased FSH receptors C) Increased LH receptors D) Increased testosterone production No effect on receptors but it increases FSH/LH and steroid production. 14 / 20 14) Which one of the following disorders is accompanied by blue sclera? A) Duchenne muscular dystrophy B) Neurofibromatosis type 2 C) Osteogenesis imperfecta D) Systemic lupus erythematosus It is type 1 collagen defect affects bones and sclera. 15 / 20 15) A 30-year-old man tells you that when he carries a heavy lift, his muscle gives up all of a sudden. Which of the following actions is responsible for abrupt cessation of skeletal muscle contraction? A) Activation of Golgi tendon organs B) Activation of lower motor neuron C) Activation of muscle spindles D) Lower blood supply to the muscle Prolonged stretch of a skeletal muscle results in activation of Golgi organs which leads to reflex relaxation of the muscle. Ischemia leads to gradual relaxation, not abrupt. 16 / 20 16) Which of the following joint conditions is characterized by narrowing of joint space and formation of osteophytes? A) Gouty arthritis B) Osteoarthriti C) Pseudo-gout D) Rheumatoid arthritis 17 / 20 17) Which one of the following studies measures heritability and influence of environmental factors? A) Adoption study B) Case-control study C) Cohort study D) Cross-sectional study This study compares siblings raised by biological vs adoptive parents to measure heritability and influence of environmental factors. 18 / 20 18) High levels of which one of the following substances signals the initiation of gluconeogenesis? A) Acetyl CoA B) Adenosine triphosphate (ATP) C) Citrate D) Oxalate The primary control of gluconeogenesis is exerted by acetyl-CoA. The first step is controlled by pyruvate carboxylase which does not function in the absence of Acetyl-CoA. 19 / 20 19) An old patient complains of server pain in his right shoulder. He mentions that he had shingles on the same area of skin last week. Which of the following is the most appropriate treatment at this time? A) Carbamazepine B) Ibuprofen C) Morphine D) Nortriptyline This is a case of post-herpetic neuralgia (PHN) which affects nerves. Tricyclic antidepressants such as Nortriptyline are very effective in this case. Carbamazepine is more effective in trigeminal neuralgia. 20 / 20 20) A 28-year-old man is brought by his father to the emergency room with flaccid coma for 15 minutes. His father mentions that his son had seizures on a regular basis. This time, he lost his consciousness, fell to the ground and his body started jerking for about 3 minutes. While talking to his father, the patient becomes conscious, confused and complains of headache. Which of the following medications is the initial treatment for this condition? A) Ethosuximide B) Felbamate C) Phenytoin D) Topiramate Phenytoin- This is a typical case of tonic-clonic seizure (grand mal epilepsy) and phenytoin is the initial drug of choice. It prevents further attacks in the future. 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:
