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 48-year-old woman is taken for autopsy after she is pronounced dead. Her family found her unresponsive and the ER team performed CPR but she didn’t respond. The autopsy reveals the cause of death as internal hemorrhage from an artery close to the posterior wall of the body of the stomach due to erosion of a gastric ulcer. Which of these arteries is most likely involved in this case? A) Celiac trunk B) Left gastric artery C) Right gastric artery D) Splenic artery E) Superior mesenteric artery Read moreCookie Policy Celiac trunk, left gastric and right gastric artery are located close to the anterior wall of the body of the stomach while the superior mesenteric artery is located close to the duodenum. Splenic artery runs close to the posterior wall of the body of the stomach. It arises from the celiac artery and passes around the stomach to supply the spleen. 2 / 20 2) A 55-year-old woman presents to the emergency room for a cut wound on her hand. While she was cutting a piece of meat, she lost control of the knife resulting in a longitudinal wound in her hand. Bleeding stopped after a few minutes. Now she is concerned about tetanus vaccination. Records show that she received all the doses of tetanus-diphtheria (Td) and the last one was 4 years ago. What is the appropriate therapy for prophylaxis of tetanus in this patient? A) No further therapy B) Tetanus toxoid C) Tetanus immunoglobulin D) Tetanus toxoid and tetanus immunoglobulin E) Tetanus toxoid followed by tetanus immunoglobulin after 5 days No further therapy. This patient already had 3 doses of Td and the last one was less than 5 years ago. Tetanus toxoid is given if the patient has a clean wound and the last dose of tetanus was more than 10 years ago or dirty wound and the last dose was more than 5 years ago. Tetanus immunoglobulin is added to tetanus toxoid in cases of dirty wounds if the last dose was given more than 5 years ago. 3 / 20 3) While you were conducting the morning round in internal medicine department, one of the patients told you that the nurses are insensitive and irresponsible. You asked him for the reason. He said: “they are not good as doctorsâ€. All doctors I’d seen here are sensitive and responsible. Which of these is the most likely defense mechanism involved in this case? A) Projection B) Reaction formation C) Regression D) Repression E) Splitting This defense mechanism is characterized by dividing 2 groups of people into two opposite characters. Doctors are sensitive and responsible while nurses are insensitive and irresponsible. In other words, splitting them . Other choices have different definitions. 4 / 20 4) A 17-year-old male student presents to the clinic with episodes of starring with lip smacking. He reports that he became unresponsive when he has these episodes. These episodes last for 1-2 minutes and he feels confused when he retains his consciousness. General, neurological examinations and EEG are normal. What is the most likely diagnosis? A) Absence seizure B) Simple focal seizure C) Complex focal seizure D) Myoclonic seizure E) Tonic-clonic seizure The is a case of complex focal seizure which is characterized by loss of consciousness accompanied by doing things such as gag, laugh, cry or smack patient’s lips. It takes a few minutes to awake. It is different from simple focal seizure and absence seizures in loss of consciousness and longer time. Myoclonic and tonic-clonic seizure are causing jerky movements. 5 / 20 5) A 49-year-old man who is recently diagnosed with hypertension and has a history of bronchial asthma and Raynaud syndrome visits his physician for initiation of his treatment plan. In selecting the appropriate antihypertensive drug, which of the following is the best treatment for this patient? A) Atenolol B) Captopril C) Diltiazem D) Metoprolol E) Verapamil A calcium channel blocker is recommended in cases of hypertension accompanied by peripheral vascular disease such as Raynaud’s syndrome. Diltiazem and verapamil are the only calcium channel blockers in the above choices. Verapamil is preferred to diltiazem as the latter is associated with a long list of side effects including myocardial infarction (MI). Beta blockers such as atenolol and metoprolol are not recommended in patients with a history of bronchial asthma or any chronic pulmonary disease because of their bronchospasm effect. ACE Inhibitors as captopril are recommended for hypertensive patients with diabetes. They provide renal protection and delay the progress to diabetic nephropathy. 6 / 20 6) A 28-year-old man presents to the emergency room after a bar fight in which he was shot. He is mildly distressed but oriented to place and time. Neurological examination reveals weakness of the right extremities with loss of touch, position and vibratory sensations on the same side accompanied by loss of pain and temperature on the left side. What is the most likely diagnosis? A) Anterior cord syndrome B) Brown-Sequard syndrome C) Central cord syndrome D) Conus medullaris syndrome E) Transverse myopathy This is a typical case of unilateral spinal cord lesion known as Brown-Sequard syndrome. It is caused by trauma or tumor affecting one half of the spinal cord. It causes ipsilateral paresis or paralysis, ipsilateral loss of touch, position and vibratory sensations and contralateral loss of pain and temperature sensations. 7 / 20 7) Which one of the following drugs is a beta blocker (Class II)? A) Amiodarone B) Carvedilol C) Procainamide D) Verapamil 8 / 20 8) Which one of these drugs is more beneficial to treat hypertension in diabetic patients? A) Amlodipine B) Enalapril C) Furosemide D) Verapamil 9 / 20 9) 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 10 / 20 10) Megaloblastic anemia is caused by folic acid or Vitamin B12 deficiency. Which of these reactions is directly affected by vitamin B12 deficiency? A) Malonyl CoA >> palmitate B) Methylmalonyl CoA >> succinyl CoA C) Propionyl CoA >> methylmalonyl CoA D) Succinyl CoA >> fumarate 11 / 20 11) Which of the following organisms is responsible for antibiotic-associated colitis? A) Clostridium difficile B) Clostridium botulinum C) Clostridium perfringens D) Clostridium tetani 12 / 20 12) A 23-year-old nursing student presents with confusion, fatigue and sweating. Her blood sugar is 40 mg/dL. Lab tests show a high insulin level and a very low C peptide level. Which of the following is the most likely diagnosis? A) Factitious hypoglycemia B) Insulinoma C) Reactive hypoglycemia D) Pheochromocytoma Low C peptide is the clue of exogenous insulin. This patient injected herself with insulin to fake hypoglycemia. 13 / 20 13) Measurement of the content of which one of the following could help to compare the collagen content of several tissues? A) Cysteine B) Glycine C) Hydroxyproline D) Proline Although collagen is rich in glycine, several tissues also contain significant amounts of glycine. Hydroxyproline is found uniquely in collagen. 14 / 20 14) A young man complains of little finger numbness and difficulty gripping things. Which of the following is the affected nerve root? A) Cervical 5 B) Cervical 6 C) Cervical 7 D) Cervical 8 sensation of the little finger and hand grip are attributed to Cervical 8 nerve root. 15 / 20 15) Consumption of which of the following products most likely reduces the risk for coronary heart disease in susceptible patients? A) Beef products B) Fish oils C) Saturated fat D) Sugar-free snacks They reduce platelet aggregation and arachidonic acid metabolites. Sugar-free snacks are healthy but don’t have direct effect as fish oils increase the level of HDL. 16 / 20 16) Which of the following explains the reason for the formation of atheroma at the bifurcations of arteries such as aorta and carotid? A) Cholesterol breakdown B) Endothelial dysfunction C) Hypoxemia D) Regular blood flow Blood flow is turbulent at these areas which allows initiating of atherogenesis through endothelial dysfunction and insudation of lipids. 17 / 20 17) Paraneoplastic hypercalcemia is most likely caused by tumor cells secreting which one of the following substances? A) Calcitonin B) Calcitonin-related peptide C) Parathyroid hormone D) Parathyroid hormone-related peptide The tumors associated with this condition include squamous cell carcinoma of the lung, endometrial carcinoma and transitional carcinoma of the urinary bladder. PTHrP is recognized by the receptors for PTH which leads to hypercalcemia. 18 / 20 18) Administration of which one of the following medications can lead to the development of hemolytic anemia? A) Hydralazine B) Propranolol C) Quinidine D) Verapamil It is the only one on the list can cause hemolytic anemia through the formation of an immune complex and destruction of RBCs. Hydralazine may lead to lupus-like syndrome but not hemolytic anemia. 19 / 20 19) 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. 20 / 20 20) Which of the following drugs should NOT be initiated in case of acute decompensated heart failure? A) Digoxin B) Lisinopril C) Metoprolol D) Potassium supplements Beta blockers are successfully used later when heart failure is compensated and stroke volume improves. They can worsen decompensated cases by their inotropic effects. 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:
