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 scientific researcher is classifying some drugs according to their actions on different receptors. One of these drugs binds to its receptor without producing any action. A) is drug should be classified as what? B) Agonist C) Antagonist D) Partial agonist E) Inverse agonist Read moreCookie Policy When a drug binds to its receptor, it competes with other substances which normally affect this receptor causing them to be ineffective. This class of drugs is considered antagonists because they block the action of natural and synthetic agonists. Agonists and partial agonists enhance the action of their receptors either totally or partially. Inverse agonists also activate the receptors but they produce an effect opposite to the action of agonists. 2 / 20 2) A 56-year-old man with a history of type 2 diabetes presents to his physician for a follow up. He complains of recurrent hypoglycemic reactions to his medications. Which of these medications is most likely responsible for this patient’s hypoglycemic reactions? A) Glyburide B) Glucagon C) Metformin D) Acarbose E) Rosiglitazone The only medication of the listed ones that its mechanism is to release insulin from the pancreas is glyburide. Release of insulin in type 2 diabetes causes hypoglycemic reactions. Other drugs lowers blood glucose through other mechanisms i.e. euglycemic as metformin or preventing postprandial hypoglycemia as acarbose. 3 / 20 3) 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 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. 4 / 20 4) A 57 year-old man presents to the ER complaining of sudden dizziness and heart racing for 2 hours. He is a CEO of a big corporation and those symptoms started during a stressful meeting. At first, he felt irregular heartbeats and ignored it but he felt dizzy soon after and his staff drove him to the ER. There is no chest pain, shortness of breath or loss of consciousness. His vital signs are temp 97.8 F, Pulse 138/min and irregular, blood pressure 107/60 and oxygen saturation is 96% on room air. His ECG shows irregular irregularity with absence of P waves. What is the appropriate treatment to improve his symptoms in this current situation? A) Metoprolol B) Aspirin C) Heparin D) Cardioversion E) Refer to cardiologist This is most probably a case of atrial fibrillation. The next appropriate step of action is to improve the rate in order to improve the symptoms as the question specifies it. The drug of choice to improve the rate is metoprolol. The patient may need cardioversion later in the process but it is not the appropriate first step and the patient condition needs to be stable before taking any further action. 5 / 20 5) A 23-year-old man visits his physician for routine examination. He has a history of HIV infection for 3 months and he is compliant with his medications. He is concerned about developing AIDS. Which of the following is the most useful test to address his concern? A) HIV antibody test B) HIV RT PCR C) HIV p24 antigen D) CD4 lymphocyte count The most recent and accurate test to determine the progress of HIV patient to develop AIDS is HIV RT PCR. Viral load of 30,000 increases the chance to develop AIDS by 18.5 times than those with insignificant viral load. The higher the viral load, the more chance to die from Aids. HIV antibody test and HIV p24 antigen are important tests to diagnose HIV infection but they have no major rule in prognosis. CD4 lymphocyte count is the most common WRONG answer. It is used to check if the patient already developed AIDS and to evaluate the most possible complications. CD4 lymphocyte count is also important to determine prophylactic treatment for susceptible opportunistic infections. 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) Which one of the following procoagulant factors is produced by the epithelial cells? A) Fibrinogen B) Prostacyclin C) Thromboxane A2 D) von Willebrand’s factor (vWF) 8 / 20 8) Which one of the following cells secretes glycosaminoglycans and found in the in the terminal and respiratory bronchioles? A) Clara cells B) K cells C) Macrophages D) Pneumocytes type I E) Pneumocytes type II 9 / 20 9) Which one of the following cells is derived from monocytes and lying within the alveoli? A) Clara cells B) K cells C) Macrophages D) Pneumocytes type I E) Pneumocytes type II 10 / 20 10) Which of the following are the characteristics of Dressler’s syndrome? A) Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) B) Hypotension, distant heart sounds and jugular vein distention (JVD) C) Stasis, hypercoagulability and endothelial damage 11 / 20 11) 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 12 / 20 12) Which of the following is characteristic of Alzheimer’s disease? A) Lewy bodies B) Negri bodies C) Neurofibrillary tangles D) Nuclear atypia 13 / 20 13) A middle aged woman is evaluated for gait problems. On examination, her ability to touch her nose while her eyes closed fails and so, touching the heel of one toe to the toe of the other. Which of the following locations is the most likely affected? A) Cerebellum B) Frontal lobe C) Parietal lobe D) Ankle and elbow joints 14 / 20 14) An empty scrotal sac is found upon examination of a newborn male. Which of the following is the most likely abnormality? A) Agenesis B) Hypogonadism C) Undescended testis D) Venous atresia Incomplete descent is the most common male gonadal abnormality. Other options occur sometimes but UT is the most common condition. 15 / 20 15) The gland responsible for secretion of prolactin is derived from which of the following structures? A) Infundibulum B) Neurohypophysis C) Primordial follicle D) Rathke’s pouch Anterior pituitary is originated from this structure while posterior pituitary is originated from neurohypophysis. 16 / 20 16) Which one of the following medications inhibits cell wall synthesis of bacteria? A) Aminoglycoside. B) Carbapenem C) Clindamycin D) Erythromycin E) otein Synthesis Inhibitors: Aminoglycosides, Tetracyclines, Spectinomycin, Erythromycin, Lincomycin, Clindamycin and Chloramphenicol. Cell Wall Synthesis Inhibitors: Penicillins, Cephalosporins, Carbapenems, Monobactams, Vancomycin, Bacitracin and Cycloserine. 17 / 20 17) Which one of the following gastrointestinal conditions is NOT associated with blood in stools? A) Cancer colon B) Diverticulosis C) Irritable bowel syndrome D) Ulcerative colitis 18 / 20 18) A 90-year-old man is hospitalized from falling and breaking his hip. He has been already in the hospital for 6 days when he developed a burning sensation upon urinating. An analysis of his urine shows plenty of gram positive cocci and leukocytosis. The attendant physician treats him with trimethoprim-sulfamethoxazole. However, the fever still persists. After 2 more days, the patient develops a diastolic murmur radiating to the axilla and a low-grade fever is still persisting. Out of the following, which would be the first line treatment for the cause of the possible infection? A) Ampicillin B) Gentamicin C) Piperacillin D) Vancomycin Enterococcus is one of the most common causes of nosocomial urinary tract infection, along with subacute endocarditis. Ampicillin is known to be the standard prescribed medication for treating enterococcus infections. 19 / 20 19) A 75-year-old man presents to his physician for a routine examination. He has a history of hypertension, hypercholesterolemia and osteoarthritis. He takes atenolol, simvastatin and ibuprofen as needed. His pulse is 76/min and irregular. Blood pressure is 130/74. Physical examination and imaging studies are normal except for asymptomatic atrial fibrillation. What is the most appropriate next step in management of this patient? A) Assurance and follow up in 3 months B) Start aspirin C) Start heparin D) Start warfarin E) Start low molecular weight heparin and warfarin According to the most recent studies, warfarin 5 mg/day is the drug of choice for asymptomatic atrial fibrillation. Aspirin alone can be used as prophylactic if there is no AFib. Initial therapy with heparin is unnecessary because it has the same effect as warfarin alone. 20 / 20 20) Which of the following is the most common etiology of type II diabetes? A) Altered hormone-receptor complex B) Increased hepatic glycogen breakdown C) Insulin receptor deficiency D) Low insulin production Low insulin production is the etiology of type 1. 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:
