Property:Prompt
Jump to navigation
Jump to search
This is a property of type Text.
W
A 57-year-old right-handed man, with a history of uncontrolled hypertension, type 2 diabetes mellitus, and hyperlipidemia, is hospitalized for a stroke. During his hospitalization, he sustains an injury from falling while walking to the bathroom. The nurse also notices that he only seems to eat the food on the right half of his plate and does not seem to respond if a person is standing on his left side. Which of the following regions have most likely been affected by this patient's stroke? +
A 23-year-old man presents to the physician's office for recurrent episodes of excruciating headaches that occur at night. Upon further questioning, the patient reports his headache lasts for 30 minutes, is mostly prominent behind his left eye and associated with lacrimation and runny nose. He denies photophobia, nausea, or aura before the onset of his headache. Which of the following is the best first line treatment for this patient's symptoms? +
A geneticist studies chromatin structure of sperm by undergoing isolation of various chromatin components. He notes that when he eliminates one tripartite structure, but maintains the nucleosome, the stability of the DNA stem is compromised with increased susceptibility to nuclease digestion. Which of the following chromatin components is most likely eliminated by the geneticist? +
A 42-year-old man, with a medical history of coronary artery disease, hypertension, hyperlipidemia, and type 2 diabetes mellitus, is brought to the emergency department with acute flaccid paralysis. The patient recently had bloody diarrhea and cerebrospinal fluid (CSF) analysis demonstrates high levels of proteins and a normal cell count. Which of the following pathologies corresponds to a similar immunological reaction? +
A 32-year-old male is brought to the emergency room with a decreased level of consciousness. Vital signs demonstrate a temperature of 36.3 °C, heart rate of 44 bpm, respiratory rate of 6 breaths/min, and blood pressure of 100/60 mmHg. Upon physical examination, the patient is difficult to arouse, has pinpoint pupils and track marks on his arm. You suspect drug abuse. Which of the following mechanisms corresponds to the pupillary constriction in this patient? +
A 14-year-old male is brought to the physician's office by his mother for recent-onset headache, vomiting, and ataxia. Following appropriate work-up, the patient is found to have hemangioblastoma in the cerebellum and bilateral renal cell carcinomas. Genetic testing leads to a diagnosis. Which of the following findings is most likely associated with the patient's condition? +
A 42-year-old man has been living alone for the past 20 years. His neighbors have always noticed that the man has unusual habits, spending most of his time collecting leaves and burning them in his backyard while chanting. He speaks a weird form of English he calls Janglo which he claims is the language he uses to contact magical creatures from a parallel world. He admits he has never seen or heard from these creatures but he believes they exist. The man is not very fond of socializing although he does not mind being around people. What is the most likely disorder present in this man? +
A 21-year-old woman presents to the out-patient clinic for dyspnea on exertion. Lab workup demonstrates iron deficiency anemia, and appropriate therapy is initiated. As part of her work-up, she is also found to have a bicuspid aortic valve on echocardiogram. Which of the following best represents her predicted pressure-volume loop at age 65 (red curve) compared to a normal individual (black curve)? +
An 18-year-old female softball player presents to her primary care physician with right shoulder pain and weakness. The pain becomes much worse when the patient performs over-the-head activities with her right shoulder and is often relieved by maintaining arm adduction and with NSAID administration. The patient informs the physician that she has been preparing for an upcoming championship and has been practicing several hours a day for the past few weeks. On physical examination, the patient reports pain when as soon as she begins to elevate her arm against the physician's resistance while abducting and forward flexing the shoulder with her thumb pointing downward. Which of the following muscles is most likely injured in this patient? +
A 22-year-old college baseball pitcher presents to his sports medicine physician for left shoulder weakness and pain. He reports feeling a sharp pain in his right posterior shoulder one day after throwing a fastball. The pain was followed by numbness and tingling down his right arm, which persisted for several hours. On physical examination, the patient reports pain as he attempts to laterally rotate the left shoulder against the physician's resistance. All other shoulder maneuvers do not elicit any pain. Which of the following muscles in most likely injured in this patient? +
A 19-year-old female college student presents to the physician's clinic for an episode of palpitations and shortness of breath. She states that her symptoms occurred suddenly, lasted for a few minutes, and then resolved spontaneously without medications. She is worried because these episodes have been occurring more often lately, and she is afraid that they will recur. The patient states that during these episodes, she also experiences "rapid breathing, numbness of the fingers, and fear of impending doom". Her first episode occurred 3 months ago; at the time, she thought she was experiencing a heart attack and visited a nearby emergency department. Her test results were reassuring and she was immediately discharged. Her past medical history is unremarkable, except for regular use of oral contraceptive pills. She has no history of smoking, alcohol intake, or illicit drug use. In the clinic, her temperature is 37.2 °C (98.96 °F), blood pressure is 122/84 mmHg, heart rate is 72/min, and respiratory rate is 14/min. Physical examination is unremarkable. What is the most appropriate long-term pharmacological therapy to treat this patient's condition? +
The "HDL hypothesis" suggests that high density lipoprotein-cholesterol (HDL-C) is inversely associated with atherosclerosis, and HDL-C has a protective role against cardiovascular disease. What is the main mechanism involved in the anti-atherogenic properties of HDL-C? +
A 17-year-old college student is brought to the ED because of shortness of breath and palpitation. The symptoms came on suddenly about one hour after she got back from the airport where she had arrived from a 6-hour flight visiting her parents. She tells you, "I can't get my breath and I'm having pains in my chest. My face is numb. I think I'm dying. Do something!" The past medical history is unremarkable, except for the oral contraceptive pills that she takes occasionally. Physical examination is normal except for tachypnea and tachycardia. Electrocardiogram shows sinus tachycardia but is otherwise normal. Arterial blood gas values while breathing room air show:
PO2 – 90 mm Hg
PCO2 – 42 mm Hg
pH – 7.38
Which of the following is the best next step towards the management of this patient? +
A 45-year-old man with a past medical history of diabetes mellitus presents to your office for follow up of his dyslipidemia that was diagnosed 5 months ago. He was advised on daily aerobic exercises with a reduced fat diet, and he has been fairly compliant. He presents for a follow up visit today. His social history is significant for smoking 1 pack per day for the past 25 years. He reports drinking about 1 pint vodka per day for the past 10 years because he read online that drinking alcohol would boost his “good” cholesterol. A repeat fasting lipid profile reveals:
Total Cholesterol: 350 mg/dl
HDL cholesterol: 35 mg/dl
Triglycerides: 380 mg/dl
What is the most important step at this time to address his lipid abnormalities? +
A 54-year-old man presents to the orthopedic surgeon with weakness and pain in his left shoulder. The pain began suddenly when the patient attempted to lift a heavy box one month ago. While the pain has largely subsided, the patient is still unable to initiate shoulder abduction. Physical examination of the left shoulder reveals decreased muscle bulk on the superior aspect of the scapula when compared to the right shoulder. MRI of the shoulder reveals a torn tendon. Which of the following areas of the brachial plexus gives rise to the nerve that normally innervates the injured muscle in this patient? +
A 14-year-old boy presents to the ER with cough, fever, and malaise for the past 5 days. Since yesterday he has complaints of fatigue, rapid breathing, and breathlessness while walking. On physical examination, he is dyspneic with cyanosis and pedal edema. His HR is 120/min. On cardiac auscultation, gallop rhythm is present and heart sounds are muffled. Peripheral pulses are very difficult to get and jugular venous pressure is raised. Liver is palpable 5cm below costal margin with tenderness. ECG shows low voltage QRS complexes in the limb leads. Diffuse ST segment elevation and T-wave inversion are present. Chest X ray shows massive cardiomegaly with hilar vascular congestion and pulmonary edema. What is the most likely clinical diagnosis? +
A 40-year-old man presents to the ER with abdominal pain in the right upper quadrant for the past 3 days. It is sharp pain of moderate severity that makes it difficult to breathe. He also reports frequent nausea, belching, and generalized malaise. He has been "partying" all weekend despite the pain. He has a past medical history of type II diabetes mellitus for which he takes metformin. He admits to being non-compliant with his medication. His social history is positive for smoking and alcohol and he is an ex-cocaine abuser. On physical examination, his temperature is 98.4°F, HR is 90/minute, BP is 148/92 mm Hg, and RR is 18/minute. His cardiovascular and respiratory exams are normal. Abdominal examination shows tenderness in the right upper quadrant area. What should be the most appropriate next step in the management of this patient after taking his blood and urine for analysis? +
A 44-year-old man presents to the ER with chest pain and shortness of breath. He has no cough or daytime fatigue. He is a known case of hypertension and chronic kidney disease, the kidney disease is presumed secondary to his hypertension. He has had 3 similar ER visits, and seen a cardiologist for this problem, where he found to be positive for hematuria and cocaine use. On physical examination, he is thin and dyspneic. His BP is 188/98 mm Hg. His in-office blood pressures have been approximately 135-140/80-85 mm Hg, and he reports similar readings when he monitors his own blood pressure, using a self-inflating blood pressure cuff at home. He is on ramipril, metoprolol, furosemide, and clonidine. He is a habitual cocaine abuser. His creatinine has risen a bit more quickly than expected. His EKG shows non-specific ST changes. His lab results are pending. What is the most likely cause of his acute blood pressure elevation? +
A 2-month-old boy is brought by his mother to the pediatrician's office for convulsions and irritability. On physical examination, the patient is found to have hydrocephalus and spina bifida. Following appropriate work-up, the physician informs the mother that the boy has a cystic dilatation of the 4th ventricle with enlargement of the posterior fossa. Which of the following errors in organ morphogenesis most likely affected this patient's cerebellar vermis? +
A 37-year-old woman diagnosed with HIV three months ago is started on highly-active antiretroviral therapy (HAART) therapy consisting of ritonavir, emtricitabine, and tenofovir. Two months later, the patient presents for a follow-up appointment having stopped two of her medications because of severe nausea. The patient continued taking ritonavir alone because she felt she was tolerating it well. You order follow-up labs that reveal an absolute increase in viral load and a drop in her CD4 count from 423 cells/mL to 144 cells/mL. Which of the following genes would you expect to be mutated in this patient? +