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Question 1 of 20
1. Question
A 36-year-old man presents to the clinic with complaints of a genital sore. The patient is sexually active, heterosexual involved with 3 partners and practices unprotected intercourse. Four days ago he noted, a painless sore on his penis. He is afebrile with a HR of 80bpm, BP of 120/80 mmHg. PE reveals a solitary ulcerated lesion located on the lateral aspect of his penis. The lesion is non tender and is associated with bilateral inguinal lymphadenopathy. PE is otherwise normal. If left untreated, this man is at increased risk for which of the following?
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Question 2 of 20
2. Question
A 65-year-old woman presents to the ER department complaining of dizziness. She is disoriented to the date and her location and it is difficult to gather an accurate history. Her pulse is 48 bpm, BP of 80/60 mmHg, and RR of 12 cpm. On examination, her extremities are cool and clammy. Her capillary refill time is 5 seconds. What is the most appropriate therapy?
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Question 3 of 20
3. Question
A 25-year-old man is recovering in the hospital from- an open repair of his broken femur, which he suffered during an automobile accident. On postoperative day 3, he develops sudden onset of shortness of breath and vague chest pain. His temperature is 37.6 C and HR of 108 bpm, BP of 90/60 mmHg, RR of 42 cpm and O2 sat of is 89 % on room air. PE is significant for jugular venous distention to 9 cm and an accentuated pulmonic component of S2.
Which of the following is most likely DECREASED?
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Question 4 of 20
4. Question
A 48-year-old man is brought to the emergency department confused and disoriented. He is a diagnosed case of DM type 1. He reports recent onset of nausea and has had several episodes of emesis in the past 4 days. On further questioning, he also notes a metallic taste in his mouth, frequent hiccups, and pruritus. On PE there is rough, Velcro-like sound heard across his precordium.
Which of the following is the most likely diagnosis?
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Question 5 of 20
5. Question
A 43-year-old man develops fever, headache, and altered mental status. His past medical history is notable only for a motor vehicle accident 2 years ago, during which he sustained a splenic laceration requiring splenectomy. Which of the following is the most likely causing this patient’s syndrome?
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Question 6 of 20
6. Question
A 34-year-old man presents with fever and night sweats for 3 weeks and productive cough. A recent HIV test was negative. A PPD test performed on admission shows 15 mm induration. His ESR is 97 mm/hr. Past medical history is significant for relapse of alcoholism. Review of systems reveal generalized fatigue over the past month and a 3.2 kg weight loss. His temperature is 39.6 C, RR is 25 cpm, and O2 sat is 86 % on room air. Bilateral pulmonary rales are noted on P.E and moderate sternal retractions are present. X ray of the chest reveals reticulonodular infiltrates spread evenly throughout both lung fields. Which of the following is the most likely diagnosis?
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Question 7 of 20
7. Question
A 54-year-old man presents to his physician complaining of difficulty urinating. He urinates more often during the day and often wakes at night to urinate. He also has difficulty starting and maintaining a stream of urine. DRE reveals a fusely, large, rubbery prostate. Urinalysis and urine culture reveal no hematuria or signs of infection. What is the BEST next step in the diagnosis?
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Question 8 of 20
8. Question
A 29-year-old type 1 diabetic presented to the ER with clouded sensorium. He is febrile and tachypneic, sweating profusely and pale. His BP is 90/60 mmHg, CR of 116 bpm and CBG of 300 mg/dL. Relatives reported that he has cough and yellow sputum for about a week now and has not sought consult nor took antibiotics. he has decreased appetite for the last 3 days. His breath has a characteristic fruity odor. These statements are TRUE regarding the pathophysiology of the case EXCEPT:
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Question 9 of 20
9. Question
The MOST useful physiologic marker of thyroid hormone synthesis is:
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Question 10 of 20
10. Question
The gold standard in the diagnosis of gastroesophageal reflux disease:
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Question 11 of 20
11. Question
A 37-year-old seaman came to your clinic for a second opinion. In his pre-employment medical examination, he turned (+) for HBs Ag. His industrial physician requested for a complete hepatitis serology. The following are the results: anti-HBs (-), anti -HBc (-), HBeAg (+), anti-HBe (-), anti-HAV IgG (+), anti-HCV (-). The CORRECT interpretation of the results is:
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Question 12 of 20
12. Question
A 42-year-old female came in due to diarrhea for 6 months. She has stopped all dairy and milk products for the past few months as advised by a physician who told her that her symptoms were caused by lactase deficiency. The diarrhea occurs throughout the day and she has not noticed blood or pus in the stools. Past medical history revealed PUD for many years that has been relatively resistant to medical treatment. She takes maximum doses of omeprazole and famotidine and still has symptoms. Her PE is unrevealing. her lab results are normal except for mild hypercalcemia. What is the most likely diagnosis?
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Question 13 of 20
13. Question
What is the cornerstone of the treatment for NON- ALCOHOLIC fatty liver disease?
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Question 14 of 20
14. Question
A 24-year-old man is brought to the ER department after suffering blunt trauma to his chest in a motor vehicle accident. His RR is 32 cpm, CR of 125 bpm, and BP is 80/40 mmHg, with a decrease to 60/40 mmHg on inspiration. PE reveals decreased heart sounds and a pericardial friction rub. Which other symptom would the physician expect to see as part of the patient’s presentation?
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Question 15 of 20
15. Question
A 47-year-old man with hypertension is prescribed with hydrochlorothiazide by his primary care physician. Which of the following is a potential effect of this medication?
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Question 16 of 20
16. Question
An 85-year-old man with hypertension and cerebrovascular disease presents to his physician’s office for a routine check up. Review of systems is positive only for “periodic ringing in the ears”. PE reveals left facial paralysis and poof hearing on the left side. A stroke in which vascular territory is MOST likely?
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Question 17 of 20
17. Question
Which of the following is associated with development of primary central nervous system lymphoma in patients with HIV?
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Question 18 of 20
18. Question
What is the best treatment for anemia in patients with chronic kidney disease?
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Question 19 of 20
19. Question
What is the gold standard in the diagnosis of pulmonary embolism?
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Question 20 of 20
20. Question
A 69-year-old male was diagnosed to have COPD. What is/are the only intervention/s proven to improve survival in severe COPD patients?
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