id stringlengths 36 36 | question stringlengths 150 2.58k | choices listlengths 4 4 | correct_answer stringlengths 3 136 | correct_option stringclasses 4
values |
|---|---|---|---|---|
4fbcf9ce-730c-4293-a69d-af8e89dc3ee2 | A 32-year-old woman comes to the physician because of fatigue and joint pain for the past 4 months. Examination shows erythema with scaling on both cheeks that spares the nasolabial folds and two 1-cm ulcers in the oral cavity. Further evaluation of this patient is most likely to show which of the following findings? | [
"Decreased lymphocyte count",
"Increased platelet count",
"Increased prothrombin time",
"Decreased gamma globulin"
] | Decreased lymphocyte count | A |
933d6f66-a1b8-4d5b-91e9-cfa388591e70 | A 38-year-old woman presents to the office for a routine examination. She has no complaints and offers very little information voluntarily. She answers each question with soft, short sentences and avoids eye contact. She appears timid, anxious and admits that this is one of the very few times she has left the house in ... | [
"Schizoid personality disorder",
"Avoidant personality disorder",
"Antisocial personality disorder",
"Agoraphobia"
] | Avoidant personality disorder | B |
62ad61f1-57a8-4a1b-8bba-8e5bdbd903ee | A 65-year-old man with a history of hypertension, obesity, and alcoholic cirrhosis is seen in clinic for follow-up. He feels well and currently drinks 5 glasses of wine each night. Medications include atenolol and lisinopril. On physical exam, temperature is 98.1 deg F (36.7 deg C), blood pressure is 151/82 mmHg, pulse... | [
"Proceed with liver biopsy",
"Refer for surgical resection",
"Refer for radiofrequency ablation",
"Observe and get follow-up imaging in 3 months"
] | Proceed with liver biopsy | A |
e29d5eb5-e799-4065-b9c5-a7ab87bb9786 | A 65-year-old male presents to his primary care physician for stiffness in his arm. He states that he has been having trouble combing his hair and reaching objects that are high on the shelf. The patient has a past medical history of diabetes mellitus type II, obesity, and hypertension. His current medications include ... | [
"Rotator cuff impingement",
"Adhesive capsulitis",
"Glenohumeral osteoarthritis",
"Subacromial bursitis"
] | Adhesive capsulitis | B |
95eedc6d-7f88-49a7-9a36-92b9799ef45a | A 65-year-old man presents with pain in his left thigh for a week. He describes the pain as dull and constant, boring in nature, and localized deep below the thigh muscle. He says it is worse at night. Physical examination is significant for tenderness and warmth over the anterior aspect of the left thigh. A plain radi... | [
"Ewing's sarcoma",
"Osteitis deformans",
"Osteochondritis dissecans",
"Osteitis fibrosa cystica"
] | Osteitis deformans | B |
d99e31e2-d07e-4934-b551-508fd6a67e7c | A medical researcher is studying the physiology of the immune system in order to better understand the effects of HIV on patients. He isolates a group of cells that are shown by flow cytometry to be positive for the cell surface marker CD8. He then mixes this cell population with a group of infected cells, crosslinks e... | [
"Binds complement proteins on the cell surface",
"Binds endogenous peptides that are present in the endosome",
"Binds endogenous peptides that have been transported by the TAP channel",
"Binds exogenous peptides that are present in the endosome"
] | Binds endogenous peptides that have been transported by the TAP channel | C |
b742ade9-720d-4d7e-83a3-d2e4468f82aa | A 64-year-old male with a past medical history of two myocardial infarctions presents to the emergency room with shortness of breath. He notes that he stopped taking his furosemide two weeks prior, because he ran out of pills. On exam, his oxygen saturation is 78%, his lungs have crackles throughout, and jugular venous... | [
"Decreased Aa gradient, decreased surface area for diffusion, normal diffusion distance",
"Decreased Aa gradient, increased surface area for diffusion, decreased diffusion distance",
"Increased Aa gradient, normal surface area for diffusion, increased diffusion distance",
"Increased Aa gradient, decreased sur... | Increased Aa gradient, decreased surface area for diffusion, increased diffusion distance | D |
9a7ed7a5-3bf4-4e43-b2fc-f56949df7656 | A 55-year-old man presents with complaints of exertional dyspnea and dry cough. He reports using extra pillows at night to sleep and two nighttime awakenings to catch his breath in the last month. The patient lives in a homeless shelter and has not seen a doctor in the last 20 years. He has been drinking 5-8 drinks of ... | [
"Decreased glomerular filtration rate (GFR)",
"Decreased extracellular fluid (ECF) volume",
"Increased renal blood flow",
"Increased renal tubular sodium reabsorption"
] | Increased renal tubular sodium reabsorption | D |
0a0a58bc-a30b-45b0-a3f8-8ad5e9c8e787 | An investigator is studying the pattern of glutamate release from presynaptic nerve terminals in human volunteers with Alzheimer disease. The concentration of glutamate in the CA1 region of the hippocampus is measured using magnetic resonance spectroscopy after Schaffer collateral fibers are electrically stimulated. Wh... | [
"Activation of G protein-coupled receptors",
"Accumulation of cAMP",
"Opening of ligand-gated ion channels",
"Influx of calcium"
] | Influx of calcium | D |
de5141e5-4d08-4b2a-b67d-c82e9f22a159 | A group of researchers decided to explore whether the estimates of incidence and prevalence rates of systemic lupus erythematosus (SLE) were influenced by the number of years it took to examine administrative data. These estimates were not only based on hospital discharges, but also on physician billing codes. For stud... | [
"Incidence rates will be higher during shorter time periods than longer periods.",
"The prevalence of SLE during consecutively shorter time windows will be overestimated.",
"The inclusion of attack rates would increase incidence estimates in longer time periods.",
"The inclusion of attack rates would decrease... | Incidence rates will be higher during shorter time periods than longer periods. | A |
612b4d69-d8a2-4d0c-8447-ec63a8381e24 | A 25-year-old woman comes to the office complaining of pelvic pain and feeling “off” for the past few weeks. She has not had any changes in diet or lifestyle but reports weight loss despite an increase in appetite. In addition, she has been experiencing chest palpitations, increased frequency of diarrhea, and heat into... | [
"Meigs syndrome",
"Jod-Basedow phenomenon",
"Dermoid cyst",
"Struma ovarii"
] | Struma ovarii | D |
df6620c1-0e5c-4458-a7af-014d1ffe27b2 | A 32-year-old pregnant woman presents to her physician with flu-like symptoms for the past 3 days. She has a runny nose, mild headache, and feels achy. She has a mild fever and diffuse rash over her body. She is concerned about the health of her baby and wants to know if there are any medications that will make her fee... | [
"Single S2",
"Wide pulse pressure",
"Brachial-femoral delay",
"Tricuspid valve regurgitation"
] | Wide pulse pressure | B |
2c188fb9-0176-45ff-b542-fabd1be505ab | A 47-year-old woman presents to her primary care physician for evaluation of her right hand. Specifically, she says that she was gardening 8 hours prior to presentation when she sustained a laceration over her distal interphalangeal (DIP) joints. Since then, they have become red and swollen. She has also had pain in he... | [
"DIP has fewer neutrophils and more monocytes than PIP",
"DIP has more neutrophils and fewer monocytes than PIP",
"DIP has more neutrophils and more monocytes than PIP",
"DIP and PIP have similar numbers of neutrophils and monocytes"
] | DIP has more neutrophils and fewer monocytes than PIP | B |
9dde47b9-d3ab-453b-b630-296802ac0df8 | The menses are 4 weeks overdue in a 23-year-old sexually active woman, thus she is scheduled for an ultrasound examination. The result is shown in the exhibit. What is the function of the structure marked with the green arrow? | [
"Removal of nitrogenous waste",
"Embryonic hematopoiesis",
"Production of amniotic fluid",
"Gas exchange"
] | Embryonic hematopoiesis | B |
f521cf90-7c51-4052-985c-c2407144b6ab | A 48-year-old female presents with an enlargement of her anterior neck which made swallowing very difficult for 2 weeks now. She has had constipation for the past 6 weeks and overall fatigue. She also had heavy menstrual bleeding; and often feels extremely cold at home. On the other hand, she has well-controlled asthma... | [
"Anaplastic carcinoma",
"Medullary carcinoma",
"Reidel thyroiditis",
"Silent thyroiditis"
] | Reidel thyroiditis | C |
640c81dc-a749-4564-a0b1-3b2499514488 | A 13-month-old boy is brought to the physician for a well-child examination. Physical examination shows hepatosplenomegaly. A venous blood sample obtained for routine screening tests is milky. After refrigeration, a creamy supernatant layer appears on top of the sample. Genetic analysis shows a mutation in the apolipop... | [
"Acute pancreatitis",
"Myocardial infarction",
"Corneal arci",
"Cerebrovascular accident"
] | Acute pancreatitis | A |
23dd9add-caa4-4372-8168-5ac18929bed4 | A 29-year-old woman presents to her primary care doctor with a lesion on her left labia. She first noticed the lesion 3 days ago. The patient describes the lesion as painful and swollen. She denies vaginal discharge. Her past medical history is notable for mild intermittent asthma, gout, and obesity. She uses an albute... | [
"Klebsiella granulomatis",
"Herpes simplex virus type 2",
"Haemophilus ducreyi",
"Treponema pallidum"
] | Haemophilus ducreyi | C |
9d98c23a-c6aa-43a0-a651-0e5dcc394e77 | A 43-year-old woman comes to the physician because of a 1-day history of rash on the trunk and lower extremities. Three days ago, she visited a spa resort with multiple swimming pools and whirlpools. A friend of hers who also visited the spa has developed a similar rash. She does not smoke or drink alcohol and takes no... | [
"Superfical epidermis",
"Hair follicles",
"Papillary dermis",
"Eccrine sweat glands"
] | Hair follicles | B |
c9deb4c1-c8d8-4cff-8316-d1ff692ac2d0 | A 2-day-old male newborn is brought to the physician because of yellowing of the skin and sclerae for 16 hours. He had previously been well. He was born at 38 weeks' gestation via uncomplicated vaginal delivery and weighed 3.1 kg (6 lb 13 oz). The mother has no medical insurance and did not receive prenatal care. The n... | [
"RBC sickling",
"Anti-D antibodies",
"Biliary duct malformation",
"Anti-B antibodies"
] | Anti-B antibodies | D |
2e1647d9-9dfb-49a7-88ec-11ba2ab8d98b | A 48-year-old homeless male is brought to the emergency department, by the police, for altered mental status. Past medical records are unavailable. A physical exam on admission reveals scleral icterus and a flapping tremor of the wrists during extension. The patient is admitted to the hospital and his treatment is star... | [
"Thiamine",
"Lactulose",
"Naloxone",
"Rifaximin"
] | Lactulose | B |
9af41749-5a32-4f2f-9e52-0e209e8e0bce | A 10-year-old boy is brought to the physician because of a generalized, non-itchy rash for 2 days. He has also had a fever and sore throat for 4 days. He has not received any routine childhood vaccinations. Examination shows a flushed face except around his mouth. A diffuse, papular, erythematous rash that blanches wit... | [
"Coronary artery aneurysms",
"Encephalitis",
"Mitral valve regurgitation",
"Minimal change disease"
] | Mitral valve regurgitation | C |
26d298f8-9d83-4148-8654-f99660d02447 | Three days after induction chemotherapy, a 9-year-old boy is admitted to the hospital for fever and neutropenia. He was initially diagnosed with t(9;22)-positive acute T cell lymphoblastic leukemia following workup for fatigue and pancytopenia. He is fully conscious. His blood pressure is 110/65 mm Hg, temperature is 3... | [
"Age",
"Cytogenetics",
"Fever and neutropenia",
"Initial presentation"
] | Cytogenetics | B |
1c84ea05-c043-4e5a-b6f3-2a89249e6902 | A 24-year-old pregnant woman at 28 weeks gestation presents to the emergency department with complaints of fever with chills and pain in her knee and ankle joints for the past 2 days. She also complains of headaches and difficulty moving her neck. Further questioning reveals that she had a tick bite on her arm while ga... | [
"Ibuprofen",
"Tetracycline",
"Amoxicilin",
"Gentamicin"
] | Amoxicilin | C |
6b93873f-c976-4541-8dd8-7d20129d65aa | A 62-year-old patient with a history of deep venous thrombosis is enrolled in a clinical trial for a new oral anticoagulant. This novel drug has the property where its clearance is relatively predictable based on patient demographics and can easily be extrapolated from other data. Its metabolism and volume of distribut... | [
"150 milligrams",
"430 milligrams",
"1200 milligrams",
"3600 milligrams"
] | 1200 milligrams | C |
c711f97b-4179-41da-bc56-973e58e045c9 | A 62-year-old man comes to the physician because of worsening involuntary movements of both arms for the past 7 months. He reports that certain daily activities have become more difficult to perform. His father had a similar condition that was treated with medications. The patient appears anxious. Vital signs are withi... | [
"Deep brain stimulation",
"Thalamotomy",
"Levodopa and carbidopa therapy",
"Propranolol therapy"
] | Propranolol therapy | D |
bc141afa-b879-45f8-aae4-d05761f9efc4 | A 16-year-old male presents to his pediatrician with complaints of malaise, fatigue, sore throat, and fever over the last several days. His vital signs are as follows: T 39.1 C, HR 82, BP 122/76, RR 14, and SpO2 99%. Physical examination is significant for splenomegaly, tonsillar exudate, and posterior auricular lympha... | [
"Bed rest and activity limitation",
"Ganciclovir",
"Amoxicillin",
"Prednisone"
] | Bed rest and activity limitation | A |
11b768c9-cbae-4cd5-9162-70985262ab79 | A 65-year-old woman schedules an appointment with her physician for evaluation of weight loss and weakness. The weakness is more noticeable when climbing stairs and combing hair. The weakness improves after brief exercise. She also has bladder incontinence for the past 4 weeks and was given an anticholinesterase agent ... | [
"Duchenne muscular dystrophy",
"Hypothyroidism",
"Myasthenia gravis",
"Paraneoplastic syndrome from small cell carcinoma of the lung"
] | Paraneoplastic syndrome from small cell carcinoma of the lung | D |
397c13bf-f730-4d38-b8b2-d7a82683767a | A 63-year-old woman comes to the physician because of a 6-month history of fatigue and shortness of breath on exertion in addition to a 1-month history of ankle swelling. She has a history of sleep apnea. Examination of the lower extremities shows bilateral pitting pedal and ankle edema. Cardiac examination shows a wid... | [
"Localized lymphatic obstruction",
"Thrombus formation in a deep vein",
"Increased capillary hydrostatic pressure",
"Decreased plasma oncotic pressure\n\""
] | Increased capillary hydrostatic pressure | C |
8ff21f9e-8dfa-4144-8fbe-882b5ba564af | A 75-year-old woman is brought to the emergency department by her son because of a 2-day history of fever, headache, malaise, and dry cough. The patient lives with her son and his family and her son reports that other members of the family have had similar symptoms during the past week but that he has not had any sympt... | [
"Serum antibodies against hemagglutinin",
"Downregulation of ICAM-1 expression",
"Protease-resistant antibodies in nasal secretions",
"Homozygous mutation in the CCR5 gene"
] | Serum antibodies against hemagglutinin | A |
4900840a-fa04-4416-9a09-99c13ba31b52 | An 18-year-old patient is visiting the pediatrician with her mother for her annual exam before college starts. Her height and weight are appropriate for her age, and she is up to date on all her vaccinations and has no medical complaints. She is doing well in school and has a part-time job stocking shelves at a clothin... | [
"Schizotypal personality disorder",
"Generalized anxiety disorder",
"Avoidant personality disorder",
"Dependent personality disorder"
] | Avoidant personality disorder | C |
619e23af-fafd-4e42-bc3d-8f08c26380b4 | A 35-year-old woman comes to the physician because of intermittent episodes of heart palpitations for 3 weeks. The palpitations are accompanied by chest pain that is sharp and localized to the left 3rd intercostal space. The patient does not smoke. She drinks one to two glasses of wine on the weekends. She appears nerv... | [
"Propranolol",
"Digoxin",
"Amiodarone",
"Warfarin"
] | Propranolol | A |
ef5cb7e7-f7c8-4fcf-980c-b8cb6447b1d0 | Three patients present to the pediatrician for routine well-child visits. The first child’s mother reports that he seems to be breastfeeding well and voids at least eight times per day. His stools are a yellow color, and he does not seem to be straining. In the office, he can lift his head and chest when in the prone p... | [
"Ages 1 month, 4 months, and 9 months",
"Ages 2 months, 4 months, and 12 months",
"Ages 2 months, 6 months, and 9 months",
"Ages 2 months, 6 months, and 12 months"
] | Ages 2 months, 6 months, and 12 months | D |
be3e50b6-34b0-4bfb-9ade-18263b732557 | A 25-year-old African American man presents to his primary care provider for routine blood work. He is a well-known case of sickle cell disease treated with hydroxyurea and tramadol as needed for pain. He does not smoke or drink alcohol. The patient asks if his disease can adversely affect his kidneys because his frien... | [
"Membranous glomerulonephritis",
"Proximal renal tubular acidosis",
"Impaired urine diluting ability",
"Impaired urine concentration ability"
] | Impaired urine concentration ability | D |
f046c1c7-50b6-4383-ad6e-bed77b79fa0f | A 55-year-old man is brought to the emergency room by his wife for severe abdominal pain for the past 1 hour. He is unable to give more information about the nature of his pain. His wife says that he has peptic ulcer disease and is being treated with antacids without a good response. She adds that he vomited repeatedly... | [
"Duodenal peptic ulcer",
"Gastric peptic ulcer",
"Pancreatitis",
"Perforated gastric peptic ulcer"
] | Perforated gastric peptic ulcer | D |
c7a9f98f-dfa4-4040-9aea-bb99053785b4 | A 24-year-old female presents to the emergency department with a chief complaint of an inability to urinate. She states that this has been one of many symptoms she has experienced lately. At times she has had trouble speaking and has noticed changes in her vision however these episodes occurred over a month ago and hav... | [
"Head CT",
"Head MRI",
"Lumbar puncture",
"Domestic abuse screening and exploring patient's life stressors"
] | Head MRI | B |
b434ab41-7ca0-4321-893d-4e4a3b0da552 | A 15-year-old female presents to her pediatrician’s office for severe menstrual cramping. The patient underwent menarche at age 11, and her periods were irregular every 2-3 months for two years. After that, her cycles became roughly regular every 28-35 days, but she has had extremely painful cramps and often has to mis... | [
"Pelvic ultrasound",
"MRI of the pelvis",
"NSAIDs",
"Increased exercise"
] | NSAIDs | C |
a7666edc-6379-4d6a-b6da-0933a6d8ae1e | A 3-day-old boy is admitted to the neonatal intensive care unit for seizures. He was born to a 33-year-old woman at 31 weeks gestation via cesarean section. His birth weight was 1400 grams. Vital signs are significant for systemic hypotension, bradycardia, and hypoventilation. On physical exam, the patient has an alter... | [
"Complete blood count",
"Cranial ultrasonography",
"Head CT",
"MRI of the head"
] | Cranial ultrasonography | B |
5998c4de-1d9b-4f45-8c34-a62536e9fe4b | A 24-year-old G2P1 woman at 39 weeks’ gestation presents to the emergency department complaining of painful contractions occurring every 10 minutes for the past 2 hours, consistent with latent labor. She says she has not experienced vaginal discharge, bleeding, or fluid leakage, and is currently taking no medications. ... | [
"It is a Southwestern blot, identifying the presence of DNA-binding proteins",
"It is a Northern blot, identifying the presence of RNA",
"It is a Northern blot, identifying the presence of DNA",
"It is an HIV-1/HIV2 antibody differentiation immunoassay"
] | It is an HIV-1/HIV2 antibody differentiation immunoassay | D |
fde37b0a-5098-4808-9edc-29866c5f200c | A group of researchers from Italy conducted a case register study that included all patients from a city who had an International Classification of Diseases diagnosis and contacts with specialist psychiatric services over a 10-year period. Mortality was studied in relation to age, sex, diagnosis, care pattern, and regi... | [
"The total number of deaths divided by the mid-year population",
"The number of deaths in a specific age group divided by a mid-year population in that age group",
"The observed number of deaths divided by the expected number of deaths",
"The number of deaths from a certain disease in 1 year divided by the to... | The observed number of deaths divided by the expected number of deaths | C |
be3d4ce6-0bbd-4b8e-a82d-64eea5e34c2b | A 74-year-old man has been treated for prostate cancer for the past 6 months. He is on an experimental drug (drug X) that is used to reduce the action of testosterone by blocking the androgen receptor. Since the initiation of therapy, the growth of the cancerous tissue has slowed. This medication is known to be excrete... | [
"Leuprolide",
"Finasteride",
"Flutamide",
"Anastrozole"
] | Flutamide | C |
10e579d0-6e69-45cd-9348-8a7dad69166b | An 18-year-old college student presents to the student health clinic complaining of excessive sleepiness. He first noticed the daytime sleepiness about a year ago but reports that it significantly worsened once he started college. He reports that he goes to bed around 9 p.m. and wakes up for class at 8 a.m.. He naps be... | [
"Clomipramine",
"Dextroamphetamine",
"Modafinil",
"Sleep deprivation"
] | Modafinil | C |
1c3b4c33-d5fe-41f1-a40b-75ad99809ba8 | A 15-year-old girl comes to the physician because of episodic pelvic pain radiating to her back and thighs for 4 months. The pain occurs a few hours before her menstrual period and lasts for 2 days. She has been taking ibuprofen, which has provided some relief. Menses have occurred at regular 28-day intervals since men... | [
"Endometrial sloughing and uterine contractions mediated by prostaglandin",
"Ascending infection of the uterus, fallopian tubes, ovaries, or surrounding tissue",
"Fluid-filled sac within the ovary",
"Hormone-sensitive smooth muscle tumor of the myometrium"
] | Endometrial sloughing and uterine contractions mediated by prostaglandin | A |
fe9c5266-09f6-48ba-a6da-32ab407aa860 | Background: There is a lack of consensus about whether the initial imaging method for patients with suspected nephrolithiasis should be computed tomography (CT) or ultrasonography.
Methods: In this multicenter, pragmatic, comparative effectiveness trial, we randomly assigned patients 18 to 76 years of age who presented... | [
"Measurement bias",
"Recall bias",
"Lead-time bias",
"Selection bias"
] | Measurement bias | A |
661fb38c-f73d-4704-b799-f43c20229ac0 | A 71-year-old woman comes to the physician for evaluation of a pigmented lesion on her left foot. She has had decreased appetite and a 6-kg (13-lb) weight loss in the past 2 months. Physical examination shows that on the left medial ankle there is a 2-cm reddish-black nodule with a verrucous surface. A full-thickness e... | [
"Stimulating release of acute-phase reactants",
"Stimulating antigen-processing cells",
"Activating natural killer cells and cytotoxic T cells",
"Supporting growth of bone marrow stem cells"
] | Activating natural killer cells and cytotoxic T cells | C |
c95a7223-d407-4b86-b2ee-4ee7b5e95ca3 | An 8-week-old male presents with his mother to the pediatrician for a well visit. The patient has been breastfed since birth, and usually feeds for 30 minutes every 2-3 hours. The patient’s mother is concerned that her milk production is not keeping up with the patient’s nutritional requirements. She reports that about... | [
"Initiate proton pump inhibitor",
"Obtain abdominal ultrasound",
"Reassurance and counseling on positioning",
"Recommend modification of mother’s diet"
] | Reassurance and counseling on positioning | C |
5a84eedc-679c-459c-8a10-6373aaea7112 | A 40-year-old man presents to the emergency department with altered mental status. He has a history of cirrhosis of the liver secondary to alcoholism. He started becoming more confused a few days ago and it has been getting gradually worse. His temperature is 98.8°F (37.1°C), blood pressure is 134/90 mmHg, pulse is 83/... | [
"Dextrose",
"Lactulose",
"Potassium",
"Rifaximin"
] | Potassium | C |
1cf5f6ab-22b5-49dd-8aae-a9c23f2db8f0 | A 3-year-old boy is brought to his pediatrician for evaluation because his parents have been concerned by a number of troubling signs. Specifically, they have noticed that he has been exhibiting aggressive behavior as well as hyperactivity. In addition, he has had intellectual disability and is slow to hit developmenta... | [
"Cerebroside sulfate",
"Galactocerebroside",
"Heparan sulfate",
"Sphingomyelin"
] | Heparan sulfate | C |
a7cc0ddf-e9d7-4197-984c-6a5332bd28cd | A 16-year-old boy presents to the emergency department with shortness of breath after prolonged exposure to cold air during a recent hike with his friends. He informs the physician that he is asthmatic, but does not use inhalers regularly because he does not like using medications. He is a non-smoker and occasionally d... | [
"Cyclic guanosine monophosphate (cGMP) system",
"Arachidonic acid system",
"Phosphoinositol system",
"Tyrosine kinase system"
] | Phosphoinositol system | C |
ac8c5e66-18e9-4206-8775-37babf026684 | A 4-month-old infant is brought to the office by his parents due to sudden nose bleeding without trauma of any kind. He has a 1-month history of multiple bruising that measures 1 cm in diameter each in the hands and feet, and tiny red spots that appeared in the upper and lower extremities without any trauma either. He ... | [
"Von Willebrand disease",
"Glanzmann’s thrombasthenia",
"Bernard-Soulier disease",
"Scurvy"
] | Glanzmann’s thrombasthenia | B |
865544bd-66a8-4836-8247-1802bcd5f03e | A 40-year-old female with a past medical history of high cholesterol, high blood pressure, hyperthyroidism, and asthma presents to the primary care clinic today. She has tried several different statins, all of which have resulted in bothersome side effects. Her current medications include hydrochlorothiazide, levothyro... | [
"Colesevelam can cause cognitive impairment.",
"Colesevelam can increase the risk of cholelithiasis.",
"Timing of the dosing of colesevelam should be separated from this patient’s other medications.",
"Colesevelam can significantly decrease your HDL."
] | Timing of the dosing of colesevelam should be separated from this patient’s other medications. | C |
1917044a-bd75-4521-9dad-b57057c7bce5 | A 16-year-old boy is brought to the emergency department by ambulance from a soccer game. During the game, he was about to kick the ball when another player collided with his leg from the front. He was unable to stand up after this collision and reported severe knee pain. On presentation, he was found to have a mild kn... | [
"Runs anteriorly from the medial femoral condyle",
"Runs medially from the lateral femoral condyle",
"Runs posteriorly from the lateral femoral condyle",
"Runs posteriorly from the medial femoral condyle"
] | Runs posteriorly from the medial femoral condyle | D |
47966f90-1093-4b24-a5a6-14828cea692d | A 46-year-old woman presents with difficulty initiating sleep, as well as frequent nighttime awakenings. She reports making multiple mistakes at her office job, has an inability to concentrate, and feels sleepy throughout the day. She is worried that her sleeping troubles will cause her to get fired. Which of the follo... | [
"Chlordiazepoxide",
"Triazolam",
"Diazepam",
"Modafinil"
] | Triazolam | B |
124d9ceb-3f62-46af-a6c1-65c0f8ad6c0c | A 45-year-old male with a history of diabetes and poorly controlled hypertension presents to his primary care physician for an annual check-up. He reports that he feels well and has no complaints. He takes enalapril and metformin. His temperature is 98.8°F (37.1°C), blood pressure is 155/90 mmHg, pulse is 80/min, and r... | [
"Metoprolol",
"Verapamil",
"Nifedipine",
"Hydrochlorthiazide"
] | Nifedipine | C |
3020757a-da99-4b77-acd8-ae369bfe560e | A 47-year-old man presents with hemoptysis, diffuse muscle pain, and shortness of breath. He has had these symptoms before but did not seek treatment. His past medical history is not known as he is not typically followed by a doctor and is homeless. His temperature is 99.0°F (37.2°C), blood pressure is 154/94 mmHg, pul... | [
"Methylprednisolone",
"Methylprednisolone and cyclophosphamide",
"Methylprednisolone, plasmapheresis, and cyclophosphamide",
"Plasmapheresis and cyclophosphamide"
] | Methylprednisolone, plasmapheresis, and cyclophosphamide | C |
d2ef850d-7894-424c-95a2-6a13d8da5a92 | A 23-year-old woman visits her obstetrician for an antenatal appointment. She is at the 24th week of gestation. She has had type 1 diabetes mellitus for 5 years and is on insulin. She also has mitral stenosis, for which she has been advised to undergo a balloon valvotomy. Her temperature is 37.1°C (98.7°F), blood press... | [
"Hypertrophic obstructive cardiomyopathy",
"Transient hypertrophic cardiomyopathy",
"Tetralogy of Fallot",
"Mitral valve prolapse"
] | Transient hypertrophic cardiomyopathy | B |
0a46113e-2765-413c-88de-46ea33ce907a | A 70-year-old obese male presents to the emergency department with shortness of breath and cough of sudden onset. The patient states that his symptoms came on while he was sleeping. The patient has a past medical history of type II diabetes and is currently taking lisinopril, metformin, insulin, and fish oil. On physic... | [
"Furosemide",
"Hydrochlorothiazide",
"Renal tubular acidosis type II",
"Renal tubular acidosis type IV"
] | Hydrochlorothiazide | B |
55f1f193-de7b-44e2-8235-39b71a378ca6 | A 59-year-old man complains of chest pain that has been present for 4 hours on the 5th day of hospitalization for acute myocardial infarction. 5 days ago, he had a burning sensation in his chest and discomfort in his left shoulder. Upon initial presentation to the hospital’s emergency department, he was diagnosed with ... | [
"Alkaline phosphatase",
"Creatine kinase (CK-MB)",
"Lactate dehydrogenase",
"Troponin T"
] | Creatine kinase (CK-MB) | B |
c14a62a4-9605-45f8-ac3d-f80bf210e529 | A 60-year-old man is referred to a dermatologist by his family physician for management of a rare case of dermatitis that has not responded to standard therapy with corticosteroids. The patient’s medical history is unremarkable, and he is currently working reduced hours at his job as an accountant. Physical examination... | [
"Vascular tumor containing spindle cells",
"Tumor arising from the folliculosebaceous–apocrine germ",
"Tumor arising from cutaneous T cells",
"Tumor arising from epidermal keratinocytes"
] | Tumor arising from cutaneous T cells | C |
c6881af4-537f-4580-88c8-a2017c591d1b | A 35-year-old male presents to the emergency department for evaluation of hemoptysis. A chest X-ray reveals bilateral focal pulmonary consolidation. On further questioning, he admits having hematuria. Urinalysis shows RBC casts and 400 mL of urine is excreted in 24 hours. What is the most likely cause of hemoptysis and... | [
"Anti-Smith antibodies",
"Anti-neutrophil antibodies",
"Anti-mitochondrial antibodies",
"Anti-glomerular basement membrane antibodies"
] | Anti-glomerular basement membrane antibodies | D |
cc7b28e5-04d1-4a9b-b2cf-35fdd15e9c1e | A 22-year-old woman with a history of asthma visits her physician for worsening shortness of breath. She states that she feels as though her “lungs are falling apart,” noting that her lung function has been steadily deteriorating. She further states that she has visited a number of other physicians who prescribed sever... | [
"Isoniazid",
"Fluconazole",
"Caspofungin",
"Prednisone"
] | Prednisone | D |
8f809dfd-8206-4f2f-934e-e70c84e1619d | A 27-year-old woman was referred to a dermatology clinic due to a changing discoloration of her fingers from white to red to blue. Although she has not had any recent changes in her daily routines, she also complains of increasing fatigue, muscle weakness, and weight loss. She has a blood pressure of 126/77 mm Hg, resp... | [
"Mixed connective tissue disease",
"Polymyositis",
"Systemic sclerosis",
"Rheumatoid arthritis"
] | Mixed connective tissue disease | A |
3b2c0115-8810-4ea4-b7cc-2f8f69fde94a | A 47-year-old female undergoes a thyroidectomy for treatment of Graves' disease. Post-operatively, she reports a hoarse voice and difficulty speaking. You suspect that this is likely a complication of her recent surgery. What is the embryologic origin of the damaged nerve that is most likely causing this patient's hoar... | [
"1st pharyngeal arch",
"2nd pharyngeal arch",
"3rd pharyngeal arch",
"6th pharyngeal arch"
] | 6th pharyngeal arch | D |
23022029-7ade-4130-8436-43e0dba52cea | A 39-year-old man is brought to the physician by his wife because of personality changes over the past year. He has become increasingly irritable, loud, aggressive, and impulsive. His wife also reports jerky movements of his limbs and trunk for the past few months. His father had dementia in his mid-40s, but the detail... | [
"Reduced hippocampal volume",
"Multiple cortical and subcortical infarctions",
"Degeneration of the frontal and temporal lobes",
"Atrophy of the striatum"
] | Atrophy of the striatum | D |
a71d9f38-5e85-4a71-a297-f22202c5ce5b | A 48-year-old woman comes to the emergency department because of a 1-day history of fever, vomiting, and abdominal pain. Two weeks ago, while visiting Guatemala, she had an emergency appendectomy under general inhalational anesthesia. During the surgery, she received a transfusion of 1 unit of packed red blood cells. H... | [
"Acalculous inflammation of the gallbladder",
"Virus-mediated hepatocellular injury",
"Adverse effect of anesthetic",
"Gram-negative bacteria in the bloodstream"
] | Adverse effect of anesthetic | C |
0adc156e-461e-4085-9249-122afe372156 | A researcher is studying risk factors for open-angle glaucoma in a group of elderly patients at a primary care clinic. He is curious if patients with diabetes (defined as fasting serum glucose ≥126 mg/dL on two separate readings) are at increased risk of developing open-angle glaucoma over time. Which of the following ... | [
"The future risk of open-angle glaucoma is the same in patients with and those without diabetes",
"Having diabetes will not cause changes in risk of future open-angle glaucoma",
"Diabetes is not associated with an increased prevalence of open-angle glaucoma",
"Improved adherence to antidiabetics will not be e... | The future risk of open-angle glaucoma is the same in patients with and those without diabetes | A |
e66ad242-3d1b-47e7-933f-4c8987a070ac | A 56-year-old man with a history of hypertension presents to his physician with progressive fatigue and new onset muscle cramps. He has had no recent changes to his medication regimen, which includes hydrochlorothiazide, lisinopril, and amlodipine. His temperature is 98.0°F (36.7°C), blood pressure is 174/111 mmHg, pul... | [
"Aldosterone excess",
"Catecholamine-secreting mass",
"Cortisol excess",
"Impaired kidney perfusion"
] | Aldosterone excess | A |
b3e0b7bb-bf86-4127-825d-e45c897eb542 | A 16-year-old female presents to her physician’s office after noticing a round lump in her left breast 2 months ago. She reports that the lump seemed to enlarge and became tender just preceding her last 2 menses. It is otherwise painless, and the patient denies any discharge or skin changes. She has no past medical his... | [
"This mass will decrease in size if the patient starts oral contraceptives",
"This mass slightly increases this patient’s risk of breast cancer in the future",
"This mass will most likely decrease in size or disappear over time",
"If this mass grows rapidly to greater than 5 cm, radiation and chemotherapy are... | This mass will most likely decrease in size or disappear over time | C |
e60e7a64-03b4-49d7-992f-f25c0fba4227 | A 35-year-old man presents to the emergency room due to shortness of breath that started an hour ago while playing football with some friends. He has had similar episodes in the past when he also had to be rushed to the hospital. Physical examination shows body temperature is 37.2°C (98.9°F), pulse rate is 100/min, res... | [
"Asthma attack",
"Carbon monoxide (CO) poisoning",
"Neuromuscular disease",
"Acute respiratory distress syndrome (ARDS)"
] | Asthma attack | A |
8b0bfedf-7295-405e-bc71-9bae4872a750 | A 59-year-old man is brought to the emergency department with a history of black, tarry stools but denies vomiting of blood or abdominal pain. His family has noticed progressive confusion. History is significant for liver cirrhosis and alcoholism. His heart rate is 112/min, temperature is 37.1°C (98.7°F), and blood pre... | [
"Ammonia level is the best initial test to confirm the diagnosis",
"It is a diagnosis of exclusion",
"It only occurs in patients with cirrhosis",
"Electroencephalography (EEG) usually shows focal localising abnormality"
] | It is a diagnosis of exclusion | B |
34e302c5-20cd-472c-a63c-cff98a74e126 | A 4-year-old boy presents for a routine checkup. The patient’s parents say he was doing well until a few weeks ago at which time he started to complain of daily abdominal cramps and occasional muscle pains. His mother also noticed that he has been less active than usual. The parents deny any complaints of headaches or ... | [
"Trientine",
"Calcium disodium edetate (EDTA)",
"Penicillamine",
"Dimercaptosuccinic acid (DMSA), also known as succimer"
] | Dimercaptosuccinic acid (DMSA), also known as succimer | D |
39bc0a99-c608-4a7d-9ca6-5a67a1b420fb | A 4-year-old boy is brought to the emergency department because of severe abdominal pain and bilious vomiting for 6 hours. He has not had bowel movements in the past 24 hours. He appears ill. His temperature is 37.8°C (100°F) and pulse is 122/min. Examination shows a distended abdomen. There is tenderness to palpation ... | [
"Get consent from the patient's brother",
"Get consent from the patient",
"Perform emergency laparotomy",
"Delay surgery until parental consent"
] | Perform emergency laparotomy | C |
1b9ad986-e40f-4583-9752-01ce2a671dd4 | A 65-year-old woman presented to the emergency room due to progressive dyspnea. She is a known hypertensive but is poorly compliant with medications. The patient claims to have orthopnea, paroxysmal nocturnal dyspnea, and easy fatigability. On physical examination, the blood pressure is 80/50 mm Hg. There is prominent ... | [
"Furosemide",
"Nesiritide",
"Metoprolol",
"Digoxin"
] | Metoprolol | C |
50a43211-dc6e-4072-8ca0-9e08ac96c1bf | A 3-month-old infant is brought to her pediatrician because she coughs and seems to have difficulty breathing while feeding. In addition, she seems to have less energy compared to other babies and appears listless throughout the day. She was born by cesarean section to a G1P1 woman with no prior medical history and had... | [
"22q11 deletion",
"Deletion of genes on chromosome 7",
"Lithium exposure in utero",
"Maternal alcohol consumption"
] | 22q11 deletion | A |
8f3daac5-53c1-4ba9-969e-bca6839874c4 | A 63-year-old man comes to the emergency department because of retrosternal chest pain. He describes it as 7 out of 10 in intensity. He has coronary artery disease, hypertension, and type 2 diabetes mellitus. His current medications are aspirin, simvastatin, metformin, and enalapril. He has smoked one pack of cigarette... | [
"Coronary angiogram",
"Intravenous esmolol",
"Intravenous amiodarone",
"Synchronized cardioversion"
] | Synchronized cardioversion | D |
6714b09d-572a-454c-bcf1-b997bd272b16 | A 20-year-old woman presents with vaginal discharge, pruritus, and painful micturition for the past 5 days. She is sexually active with multiple partners and admits to using barrier protection inconsistently. Her last menstrual period was 2 weeks ago. The patient denies any fever, chills, abdominal pain, menorrhagia, o... | [
"Urinary tract infection",
"Bacterial vaginosis",
"Trichomonal vaginitis",
"Chlamydia infection"
] | Trichomonal vaginitis | C |
43880a0d-79b1-4269-b340-0a32673035f8 | A 69-year-old right-handed man comes to the physician for a routine health maintenance examination. On questioning, he has had some difficulty speaking for 3 months. During a conversation, he often has difficulty repeating what his interlocutor has said. He has hypertension and takes hydrochlorothiazide. His vital sign... | [
"Left middle cerebral",
"Right vertebral",
"Left posterior inferior cerebellar",
"Left penetrating"
] | Left middle cerebral | A |
145b1bc4-e74b-4e5a-94a5-47d5832c7754 | A 24-year-old man with chronic back pain comes to the physician to establish care after moving to Florida. He complains of anxiety, nausea, abdominal cramping, vomiting, and diarrhea for three days. He denies smoking, drinking alcohol, and using illicit drugs. He appears restless. His temperature is 37°C (98.6°F), puls... | [
"Lorazepam",
"Naltrexone",
"Methadone",
"Naloxone\n\""
] | Methadone | C |
ff75f366-4f43-4b11-b219-83ed9e00f309 | A 5-year-old female suffers from recurrent infections by Aspergillus species, Pseudomonas species, and Staphylococcus aureus. The patient's neutrophils are examined in the laboratory and they fail to react during the nitroblue tetrazolium test. Which of the following is most likely dysfunctional in this patient? | [
"Immunoglobulin class switching",
"Superoxide dismutase",
"Myeloperoxidase",
"Respiratory burst"
] | Respiratory burst | D |
11798523-ae15-4a7d-8e75-5281282aeadf | A junior orthopaedic surgery resident is completing a carpal tunnel repair with the department chairman as the attending physician. During the case, the resident inadvertently cuts a flexor tendon. The tendon is repaired without complication. The attending tells the resident that the patient will do fine, and there is ... | [
"Disclose the error to the patient and put it in the operative report",
"Tell the attending that he cannot fail to disclose this mistake",
"Report the physician to the ethics committee",
"Refuse to dictate the operative report"
] | Tell the attending that he cannot fail to disclose this mistake | B |
6199268b-f338-4809-90c5-1c413a3c0d69 | A 12-year-old girl is brought to the emergency department 3 hours after the sudden onset of colicky abdominal pain and vomiting. The patient also manifests symptoms of redness and swelling of the face and lips without pruritus. Her symptoms began following a tooth extraction earlier in the morning. She had a similar ep... | [
"Autoantibody-mediated tissue damage",
"Complement inhibitor deficiency",
"Drug-induced bradykinin excess",
"Mast-cell activation"
] | Complement inhibitor deficiency | B |
338b0c1e-e272-43a7-91ba-27f15d2aa3e7 | A 78-year-old man is brought to the physician by his daughter because of increasing forgetfulness over the past 5 weeks. He had been living independently but came to live with his daughter temporarily after he complained that he was unable to perform some of his daily activities. He has left the front door wide open an... | [
"Fluoxetine",
"Aspirin",
"Ventriculoperitoneal shunt",
"Memantine"
] | Fluoxetine | A |
867cd933-5831-466a-80df-403ffeae565e | A 3-year-old male is brought by his mother to the pediatrician's office. The mother and child are refugees from Somalia and arrived in the United States one week ago. They were recently placed in temporary housing. The mother reports that the child has been chronically tired and subdued since before their arrival in th... | [
"Total caloric intake",
"Relative protein intake",
"Relative carbohydrate intake",
"Relative fat intake"
] | Relative protein intake | B |
aa92e2ff-006c-45c7-be69-172a27a116b9 | A microbiologist is studying the emergence of a virulent strain of the virus. After a detailed study of the virus and its life cycle, he proposes a theory: Initially, a host cell is co-infected with 2 viruses from the same virus family. Within the host cell, concomitant production of various genome segments from both v... | [
"Epstein-Barr virus",
"Human immunodeficiency virus",
"Rotavirus",
"Vaccinia virus"
] | Rotavirus | C |
2cb7033d-bf69-40ed-abd2-cf075f316ce9 | A patient with a1-antitrypsin deficiency is warned by his physician that his increasing dyspnea may be worsened by his continued cigarette smoking. Which of the following factors, released by both neutrophils and alveolar macrophages, is responsible for the patient's condition? | [
"Major Basic Protein",
"Mucus",
"Surfactant",
"Elastase"
] | Elastase | D |
b86bdc05-e98d-4792-9848-e0014241e442 | Twelve hours after undergoing an exploratory laparotomy for a perforated duodenal ulcer, a 36-year-old man has shortness of breath. He has asthma well controlled with an albuterol inhaler. His father died of lung cancer at 62 years of age. He has smoked one pack of cigarettes daily for 14 years. He does not drink alcoh... | [
"Asthma exacerbation",
"Pneumonitis",
"Pulmonary embolism",
"Atelectasis"
] | Atelectasis | D |
cc7eaca7-57b2-46f0-9d65-aeda78676896 | A 58-year-old man comes to the physician because he is unable to achieve erections during sexual intercourse. He first noticed the problem 8 months ago, when he became sexually active with a new girlfriend. He states that his relationship with his girlfriend is good, but his inability to engage in sexual intercourse ha... | [
"Psychotherapy",
"Penile prosthesis insertion",
"Nocturnal penile tumescence testing",
"Switch citalopram to bupropion"
] | Nocturnal penile tumescence testing | C |
1ac4d8fb-ae45-43e7-9eb9-af53821a3cf4 | A 49-year-old woman comes to the physician for a scheduled colposcopy. Two weeks ago, she had a routine Pap smear that showed atypical squamous cells. Colposcopy shows an area of white discoloration of the cervix with application of acetic acid solution. Biopsy of this area shows carcinoma-in-situ. Activation of which ... | [
"JAK2 tyrosine kinase",
"E2F transcription factors",
"Phosphoprotein p53",
"Cyclin-dependent kinase inhibitors"
] | E2F transcription factors | B |
ed616283-ec9d-426e-b366-b30c9722753e | An unresponsive 92-year-old man is brought to the emergency department by ambulance and is quickly followed by his grand-daughter. Approx. 1 month ago, he had a radical prostatectomy, pelvic radiation, and several rounds of chemotherapy for aggressive prostate cancer in Nicaragua and was discharged from the hospital wi... | [
"Renal biopsy",
"Ultrasound",
"Abdominal-pelvic CT scan",
"Blood analysis"
] | Ultrasound | B |
cd83d8c1-54f5-4dfc-a41d-886ef0b7f006 | An 81-year-old man patient recently moved into an assisted living facility and presents today with itchy blisters in his axilla. He attributes these to a poor diet. He also complains that the nurse practitioner at the facility started him on 4 new medications, in addition to his existing prescriptions. On physical exam... | [
"Staphylococcal scalded skin syndrome",
"Bullous pemphigoid",
"Pemphigus vulgaris",
"Cicatricial pemphigoid"
] | Bullous pemphigoid | B |
d9bafe58-43b2-486a-8e9a-1ccd2e60dcd6 | Two weeks after starting chemotherapy with etoposide, a 66-year-old man with small cell lung cancer comes to the physician because of persistent nausea and vomiting. His symptoms improve significantly after the administration of metoclopramide. This patient's symptoms were most likely due to the effect of chemotherapy ... | [
"Vestibular nerve",
"Intestinal smooth muscle",
"Vagus nerve",
"Area postrema"
] | Area postrema | D |
f89e98f5-bf15-4504-bda5-16e6f34e68fe | A 45-year-old mechanic presents to the emergency department complaining of acute-onset shortness of breath while repairing a plowing tractor for his neighbor. The patient denies having any history of asthma or respiratory symptoms, and does not smoke. His temperature is 99.8°F (37.7°C), pulse is 65/min, blood pressure ... | [
"Succinylcholine",
"Inhaled ipratropium and oxygen",
"Atropine and pralidoxime",
"Inhaled albuterol and oxygen"
] | Atropine and pralidoxime | C |
30b1ef02-a35c-47e9-b929-e49f6975c90e | An 18-year-old male presents to the emergency department trauma bay with a gunshot wound to the abdomen. The patient undergoes an exploratory laparotomy, during which, it is discovered that his splenic artery was damaged at its origin from the celiac trunk. The surgeon ligates the splenic artery at its origin. Which of... | [
"Left gastric artery",
"Gastroduodenal artery",
"Left gastroepiploic artery",
"Common hepatic artery"
] | Left gastroepiploic artery | C |
c51043bd-c03c-48db-8e64-f84533bd9291 | A 64-year-old man with multiple sclerosis comes to the physician because of a 4-month history of urinary incontinence. The urge to urinate occurs suddenly, and he often is unable to make it to the bathroom before leaking urine. He has no incontinence with coughing or laughing. Digital rectal examination shows no abnorm... | [
"Midodrine",
"Rivastigmine",
"Mirtazapine",
"Tolterodine"
] | Tolterodine | D |
54efd8a9-bfb2-4f5c-b8d3-5684dfbc208b | A 70-year-old man with a history of hypertension and atrial fibrillation comes to the physician for shortness of breath with mild exertion, progressive weakness, and a dry cough that has persisted for 6 months. He has smoked a pack of cigarettes daily for 45 years. His medications include warfarin, enalapril, and amiod... | [
"Chronic airway inflammation",
"Bronchial hyperresponsiveness and obstruction",
"Pleural scarring",
"Excess collagen deposition in the extracellular matrix of the lung"
] | Excess collagen deposition in the extracellular matrix of the lung | D |
afc31a62-0542-4d95-adcc-3b4766e4b91b | A 45-year-old woman presents to the physician with a history of headache, palpitations, and episodic diaphoresis. She was diagnosed with hypertension in the past and is now regularly taking antihypertensive medication (amlodipine 10 mg once daily). She has had a diffuse thyroid swelling for the past 4 months. She compl... | [
"Von Hippel-Lindau syndrome",
"Multiple endocrine neoplasia (MEN) 2A",
"Multiple endocrine neoplasia (MEN) 2B",
"Neurofibromatosis"
] | Multiple endocrine neoplasia (MEN) 2A | B |
654f3e0c-c228-44c8-97f3-c765540fa427 | A 40-year-old man is referred to an optometrist. He complains of mild vision impairment over the last 6 months. His vision has continued to slowly deteriorate and his condition is now affecting his night driving. Past medical history is significant for well-controlled schizophrenia. He takes a low-potency typical antip... | [
"Decrease medication dosage",
"Reassurance",
"Ocular examination under anesthesia",
"Slit-lamp examination"
] | Slit-lamp examination | D |
6549c3b4-478f-401c-8b5e-c0352c0a6302 | A 30-year-old G4P3 woman at 38 weeks gestation is admitted to the labor and delivery unit complaining of contractions every 5 minutes for the past hour. Her previous births have been via uncomplicated caesarean sections, but she wishes to attempt vaginal delivery this time. Her prenatal care is notable for gestational ... | [
"Hysterectomy",
"Intravenous oxytocin",
"Elevate posterior fornix",
"Red blood cell transfusion"
] | Elevate posterior fornix | C |
4f5e7aa5-d712-463c-aaa1-7cfb9451d9ab | A 67-year-old woman presents from home hospice with a change in her mental status. She has seemed more confused lately and is unable to verbalize her symptoms. Her temperature is 102°F (38.9°C), blood pressure is 117/65 mmHg, pulse is 110/min, respirations are 19/min, and oxygen saturation is 95% on room air. Physical ... | [
"Acalculous cholecystitis",
"Calculous cholescystitis",
"Choledocholithiasis",
"Emphysematous cholecystitis"
] | Acalculous cholecystitis | A |
ac1edb40-1294-442e-87ea-880190a38814 | A 56-year-old man comes to the physician because of a 1-day history of sudden severe pain in his right great toe. Four months ago, he had an episode of severe joint pain involving his left knee that lasted several days and resolved with over-the-counter analgesics. He has a history of hypertension treated with hydrochl... | [
"Increased conversion of uric acid to allantoin",
"Inhibition of phospholipase A",
"Inhibition of xanthine oxidase",
"Increased renal excretion of urate"
] | Inhibition of xanthine oxidase | C |
aa85b08f-b29c-449a-b647-95d59c5185ea | A 40-year old man presents to the clinic with vague upper abdominal pain that has been worsening for the last several days. He says that he often gets similar pain but less severe and that it worsens with meals. The pain sometimes radiates to his back. He recently lost 15 kg (33.6 lb) of weight secondary to his lack of... | [
"Pancreas",
"Jejunum",
"Duodenum",
"Gall bladder"
] | Pancreas | A |
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