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) 37-year-old previously healthy man is brought to the emergency room for dizziness, chest pain and A palpitations. Cardiac chemistry panel is normal. ECG shows a sloping upstroke of the QRS complex. What is the treatment of choice of this condition? A) Atropine B) Digoxin C) Metoprolol D) Procainamide E) Verapamil Read moreCookie Policy According to ECG findings, this is a case of Wolf-Parkinson-White syndrome. The treatment of choice of this case is procainamide. 2 / 20 2) Your 8-year-old daughter wakes you up in the middle of the night complaining of severe coughing. You bring the child to the doctor the next day and upon examination, the following is revealed: noisy breathing on inspiration, flaring of the nostrils, marked retractions of the chest wall, and a severe barking cough. She has also developed an upper respiratory tract infection. What would be the best diagnosis for the patient? A) Asthma B) Bronchiolitis C) Foreign body stuck in the main bronchus D) Viral croup The child is suffering from a viral croup. A barking cough is the most common symptom of a viral croup. A viral croup is also an infection of the upper respiratory tract, thus best-fitting the symptoms the child is having. 3 / 20 3) A 45-year old man presents to the emergency room complaining of breathing difficulty, palpitations, dizziness and chest pain for 15 minutes. He is a new employee at the hospital. He was waiting for a meeting when he experienced these symptoms. He had 3 similar episodes during the past 3 months but they resolved spontaneously. His medical and surgical histories are unremarkable. He has no family history of cardiac disease or sudden death. On examination, he is anxious, vital signs are within normal limits and heart and chest examinations are normal. What is the next step of management for this patient? A) Assurance and send him home for the rest of the day B) 12-Lead ECG, random blood glucose and thyroid panel C) Psychotherapy and alprazolam D) Call cardiology department and prepare for PCI Any case of chest pain in middle aged or old male patients is considered heart attack until proved otherwise. ECG is the next step and glucose and thyroid panel to exclude other causes of dizziness. 4 / 20 4) A 20-year-old exchange male student from Greece presents to the office for evaluation. Two days ago, he noticed yellow discoloration of his conjunctiva. His family history is significant for hemolytic anemia due to glucose-6-phosphate dehydrogenase deficiency. Which one of these findings is most likely revealed in this patient’s workup? A) Increased plasma unconjugated bilirubin B) Increased bilirubin in urine C) Increased urobilinogen in urine D) Clay colored stool E) Dark brown urine Hemolysis of RBCs results in a large amount of bilirubin delivered to the liver. The ability of the liver to conjugate all the bilirubin to glucuronic acid fails and unconjugated bilirubin increases in the plasma causing jaundice. Unconjugated bilirubin is unlikely to pass into the urine because it is bound to albumin and has low solubility in plasma. Clay colored stool occurs due to absence of bile pigments in the colon, which is not associated with hemolytic anemia. 5 / 20 5) A week old female presents for her first checkup. Examination reveals jaundice and splenomegaly. Laboratory investigations show: Total bilirubin level: 27 mg/dL Direct bilirubin: 0.6 mg/dL Hgb: 10.1 g/dL Reticulocytes: 6% A blood smear shows burr cells and spherocytosis. Which of these tests will be positive in this patient? A) Acid hemolysis test B) Coomb’s test C) Osmotic fragility test D) Metabisulfite test E) Schilling test This is a case of hereditary spherocytosis. Osmotic fragility test is diagnostic in this patient. Spherocytes lyse at a higher concentration of salt than normal red blood cells which causes an increased osmotic fragility. Acid hemolysis test is used to diagnose cases of paroxysmal nocturnal hemoglobinuria while Coomb’s test is used in diagnosis of autoimmune hemolytic anemia. Metabisulfite test is used in sickle cell anemia and Schilling test is used in cases of pernicious anemia. 6 / 20 6) Which one of these apoproteins is associated with chylomicrons? A) Apo A B) Apo B-48 C) Apo C-II D) Apo D E) Apo E 7 / 20 7) Which one of the following antihypertensive medications is appropriate to use for an asthmatic patient? A) Labetalol B) Metoprolol C) Propranolol D) Timolol 8 / 20 8) Which of the following tests is the most accurate for diagnosis of herpes encephalitis? A) MRI of the brain B) PCR of CSF C) Serological studies for herpes D) Viral culture of CSF 9 / 20 9) Ingestion of which of the following products may cause hypertensive crisis in patients taking MAO inhibitors? A) Carbohydrates such as starch B) Gluten-rich food C) Tyramine-rich food D) Vitamin D and calcium 10 / 20 10) Epinephrine acts to dilate bronchial smooth muscle through which one of the following receptors? A) Alpha-1-adrenoreceptors B) Alpha-2-adrenoreceptors C) Beta-1-adrenoreceptors D) Beta-2-adrenoreceptors 11 / 20 11) The anterior pituitary is derived from which of the following structures? A) Infundibulum B) Neurohypophysis C) Rathke’s pouch D) Third pharyngeal arch Posterior pituitary is derived from neurohypophysis. 12 / 20 12) A patient presents with persistent dry cough and high potassium. Which of the following medications is associated with these side effects? A) Albuterol B) Captopril C) Digoxin D) Furosemide ACE inhibitors are associated with dry cough after prolonged use. 13 / 20 13) Which of the following medications should be given to a patient that exhibits severe adverse reactions after administration of IV midazolam? A) Flumazenil B) Glucagon C) Naloxone D) Protamine It is used to treat toxicity of benzodiazepines such as midazolam. B-is used in beta blocker overdose, C in opioid toxicity and D in heparin overdose. 14 / 20 14) A 12-year-old female is evaluated for enlarged phallus at puberty. Examination reveals no breast development, a blind vaginal pouch and no uterus. Laboratory tests show normal levels of testosterone and estrogen and very low levels of dihydrotestosterone (DHT). What is the most likely diagnosis? A) Female pseudohermaphrodite B) Male pseudohermaphrodite C) True hermaphrodite D) Turner’s syndrome This condition is due to deficiency of the enzyme responsible for conversion of testosterone into dihydrotestosterone which is essential in the fetus for development of the prostate and external genitalia. True hermaphrodite would reveal the presence of both male and female genital organs. 15 / 20 15) Which one of the following cranial openings is located at the greater wing of sphenoid and contains the middle meningeal artery? A) Foramen lacerum B) Foramen ovale C) Foramen rotundum D) Foramen spinosum The only structure passes through this opening is the middle meningeal artery. A- Contains internal carotid artery, greater petrosal nerve and deep petrosal nerve. B- Contains mandibular division of trigeminal nerve and accessory meningeal artery. C- Contains maxillary division of trigeminal nerve. 16 / 20 16) An autopsy of an adult shows enormous cardiomyopathy, high level of cardiac deposition of glycosphingolipids and restricted cardiocytes. Which of the following lipid storage disease is most likely the correct diagnosis? A) Fabry’s disease B) Gaucher’s disease C) Niemann-Pick disease D) Tay-Sachs disease It is an X-linked disorder caused by deficiency of alpha-galactosidase A. It leads to deposition of glycosphingolipids in different organs most commonly heart, kidneys and eyes. 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 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) Which one of the following local anesthetics that causes local vasoconstriction and may leads to hypertension? A) Cocaine B) Etidocaine C) Lidocaine D) Tetracaine It acts by inhibiting reuptake of norepinephrine through sympathetic nerve endings. Other local anesthetics on the list cause vasodilation. 20 / 20 20) A 56 year old man is taken to the emergency room after having grand mal seizure during a staff meeting. He has no history of seizure but he complains lately of recurrent headaches on the morning and decrease in intensity later in the day. Laboratory investigations and imaging studies are performed. Which of these tests will confirm the diagnosis of glioblastoma multiform? A) Brain biopsy B) CSF analysis C) Head CT scan D) MRI of the brain All tests would suggest the presence of occupying lesion in the brain but the only confirmatory test is the brain biopsy taken during operating on the tumor. It is a common question in the USMLE and it is a tricky one. You should read the question carefully and know the difference between regular primary test and confirmatory test. In this case the next test would be head CT scan but it is not confirmatory and eventually it is not the correct answer. 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:
