Practice Q's Flashcards
86) A 16-year-old female complains that her menstrual cycles are irregular. She underwent
menarche one year ago and her last menstrual period was two weeks ago. She eats a balanced diet and works out in a gym on weekends. Her past medical history is insignificant, and her BMI is 17 kg/m2. Which of the following is the most likely cause of this patient’s complaints?
A) Endometrial stimulation by progesterone
B) Complex atypical hyperplasia of the endometrium
C) Absent ovulation
D) Increased FSH secretion
E) Endometrial atrophy
C) Absent ovulation
87) A 3 years old boy visited for cough and cold for past one week. History suggestive of having
recurrent respiratory infections in the past 6 months. His weight is below 30% percentile. He has edema in the hands and legs. Skin has multiple hypo and hyperpigmented lesions. His blood studies showed Hb 9mg/dl, serum albumin was low. Which of the following is most likely the cause for his condition?
A) Low calorie intake
B) Recurrent infections
C) Low protein intake
D) Low vitamin A intake
E) Vitamin C deficiency
C) Low protein intake
88) A 43 years old female visited clinic complaining of easy tiredness and increased in frequency of urination mainly at nights for the past 2 months. No previous history of any medical illness. On examination, BMI 42, and systemic examination was normal. Random blood glucose was 290 mg/dl. Patient was diagnosed as type 2 diabetes mellitus. This patient is increased risk of developing breast cancer is due which of the following?
A) Morbid obesity
B) Uncontrolled diabetes
C) Insulin resistance by adipocytes
D) Increased free insulin-like growth factor-1
E) Increased conversion of estradiol by adipocytes
D) Increased free insulin-like growth factor-1
89) A 22-year-old woman visited physician due to feeling of heart beating fast for past 2 weeks.
She feels, she is obese and thinks she might have a heart attack. Upon asking, she says
whenever she goes out, she eats a lot but because of fear of getting fat she induces vomiting. On physical examination, her BMI 26 and has normal sec ondary sex characteristics. Examination of the teeth showed erosion of enamel in the inner aspect. Which of the following is the most likely cause for her cardiac abnormalities?
A) Due to increased cholesterol levels
B) Due to hyponatremia
C) Euthyroid sick syndrome
D) Due to hypokalemia
E) Due to decreased protein intake
D) Due to hypokalemia
90) A 20-year-old man was repairing an electrical appliance, got electrocuted. He was rushed to the ER. On examination, he has burn wounds to the right hand and left foot. He doesn’t have any heartbeat or respirations. ER physician certified him as dead-on arrival. Which of the following is most likely cause for his death?
A) Bronchoconstriction
B) Burns to right hand
C) Atrial fibrillation
D) Ventricular fibrillation
E) Hypovolemic shock
D) Ventricular fibrillation
91) After a thunderstorm, a 16 -year-old boy is found unresponsive under a tree. He is not
breathing when paramedics arrive on the scene. On examination, his pupils are fixed and dilated. Several cutaneous erythematous marks in a fern-leaf pattern are seen on his lower extremities. Second-degree burns are present on both arms. Cardiopulmonary resuscitation is started; however, the patient does not respond and is pronounced dead on arrival at the hospital. Which of the following is most likely to be the primary cause of his death?
A) Cardiac arrhythmia
B) Extensive deep tissue burns
C) Intracranial hemorrhage
D) Myocardial contusion
E) Pulmonary barotrauma
A) Cardiac arrhythmia
92) A 58-year-old Caucasian man has an x-ray of the chest which incidentally reveals pleural
thickening and calcifications along the lower lung fields and diaphragm. There is also a small right-sided pleural effusion. Which of the following would this patient most likely have a history of exposure to?
A) Silica
B) Asbestos
C) Beryllium
D) Coal dust
E) Organic dust
F) Nitrous oxide
B) Asbestos
93) A 52-year-old man visited ER complaining of coughing, shortness of breath and brown
expectorant for past 3 months. He works as a security guard and lives in the basement of
house, downtown, Chicago for the past 15 years. He smokes occasionally and social drinker. CT scan showed mass in the right bronchus. Biopsy from the mass confirmed Squamous Cell
Carcinoma. Most likely risk factor for developing the cancer in this patient is due to.
A) Legionella pneumophila
B) Air pollution
C) Cigarette smoking
D) Arsenic toxicity
E) Radon
E) Radon
94) A 31-year-old man visited ER due to pain and dark discoloration of the right hand for the past 3 days. He has a history of cigarette smoking 2 pack/day for the past 10 years. History suggestive of no known medical illness. On examination, his right-hand fingertips have dark discoloration and capillary refilling time is decreased. Which of the following will be seen in this patient?
A) Tunica intimal thickening
B) Smooth muscle hypertrophy of arterial wall
C) Segmental thrombotic vasculitis
D) Vasospasm
E) Mural thrombus
C) Segmental thrombotic vasculitis
95) A 56-year-old man with a history of chronic alcoholism has worsening symptoms of
congestive heart failure for the past 4 months. For the past month, he has experienced
increasing confusion, disorientation, and difficulty ambulating. Physical examination shows wide based gait, and decreased sensation in the lower extremities. Echocardiogram showed enlargement of heart with decreased ejection volume. Which of the following most likely cause
for his cardiac symptoms.
A) Lead toxicity
B) Alcohol toxicity
C) Thiamine deficiency
D) Cerebellar degeneration
E) Folic acid deficiency
B) Alcohol toxicity
96) An 8-year-old boy is brought to the ER due to confusion and severe vomiting. The patient’s mother tells you that the boy had fever and she gave him “some over-the-counter pills” and it helped his fever. While you talk to the mother, the boy lapses into a coma. The light microscopy of his liver specimen will reveal:
A) Apoptosis is of hepatocytes
B) Per portal inflammatory infiltration
C) Micro vesicular steatosis
D) Centrilobular congestion
E) Bile duct proliferation
C) Micro vesicular steatosis
97) A 33 weeks old neonate was admitted in neonatal ward for observation. On third day of
formula feeding, neonate suddenly developed abdominal distension, vomiting’s and passing
blood in the stools. His bowel sounds were decreased. Physician ordered X-ray of the abdomen which is show. If you take a biopsy from the arrow shown, which of the following pathological alterations due you see?
A) Ischemic necrosis of mucosal wall
B) Accumulation of air bubbles in the intestinal lumen
C) Infiltration of malignant cells
D) Dilated blood vessels
E) Hemorrhagic necrosis of mucosal wall
E) Hemorrhagic necrosis of mucosal wall
98) A 3-month-old infant bought to well-baby clinic for routine checkup. Past ante-natal
history suggestive of visited clinic only three weeks before the checkup. Mother never went for antenatal blood tests. On examination infant has bilateral cataract and murmur in the left sided pulmonary area of heart. Ophthalmoscopy exam of the eye shown below. Most likely diagnosis is?
A) Congenital cytomegalovirus syndrome
B) Marfan ’syndrome
C) Congenital rubella syndrome
D) Neonatal distress syndrome
E) Fetal Alcohol Syndrome
C) Congenital rubella syndrome
99) A 30-year-old woman, gravida 2, para 0, abortion 1, at 28 weeks’ gestation comes to the
office for a prenatal visit. She has had one previous pregnancy resulting in a spontaneous
abortion at 12 weeks’ gestation. Today, her vital signs are within normal limits. Physical
examination shows a uterus consistent in size with a 28-week gestation. Fetal ultrasonography shows a male fetus with no abnormalities. Her blood group is O, Rh-negative. The father’s blood group is B, Rh-positive. The physician recommends administration of Rho(D) immune globulin
to the patient. This treatment is most likely to prevent which of the following in this mother?
A) Development of natural killer cells
B) Development of polycythemia
C) Formation of antibodies to RhD
D) Generation of IgM antibodies from fixing complement in the fetus
E) Immunosuppression caused by RhD on erythrocytes from the fetus
C) Formation of antibodies to RhD
100) A 19-year-old female brings her 8-month-old child due to fell from the bed while she was doing some work in the kitchen. She told the physician she loves the child very much and she cannot live without him. On examination, infant is hypoactive and has bulging fontanelle.
Bilateral retinal hemorrhages are seen on funduscopic examination. Which of the following should be strongly suspected in this patient?
A) Skull fracture
B) Congenital coagulation abnormality
C) Osteogenesis imperfecta
D) Idiopathic thrombocytopenic purpura
E) Shaken baby syndrome
E) Shaken baby syndrome
101) A newborn male has a small, bright red, slightly elevated lesion over left eyelid. You inform
the parents that the lesion is a benign vascular tumor that over time will most likely:
A) Progressively increase in size
B) First increase in size and then regress
C) First regress and then increase in size
D) Progressively regress
E) Stay stable with little growth
B) First increase in size and then regress
102) A 19-year-old primigravida gives birth to a premature male neonate who experiences
severe respiratory distress. After treatment is administered the distress resolves, and by two
weeks of age, the baby has adequate respiratory function. Abnormal retinal vascularization that
extends into the vitreous is discovered on ophthalmic examination. The retinal findings in this
patient are most likely related to which of the following?
A) Maternal terbutaline treatment
B) Maternal corticosteroid therapy
C) Neonatal antibiotic treatment
D) Neonatal oxygen supplementation
E) Neonatal surfactant supplementation
D) Neonatal oxygen supplementation
103) A 44-year-old female is hospitalized with progressive exertional dyspnea, lower extremity
edema and cough. She also describes frequent nocturnal episodes of breathlessness and recent
hoarseness. She does not use tobacco, alcohol, or drugs. Auscultation reveals loud first, and
second heart sounds and a mid-diastolic rumble best heard at the cardiac apex. This patient’s
hoarseness is most likely caused by:
A) Laryngeal edema
B) Impaired arterial supply
C) Nerve impingement
D) Epithelial sloughing
E) Vocal cord polyps
C) Nerve impingement
104) A 63-year-old male with advanced visceral cancer dies of extensive myocardial infarction.
Autopsy also reveals sterile non-destructive vegetations along the mitral leaflet edges. The
Neoplasia
pathogenesis of this patient’s vegetations is most similar to that of:
A) Hypercalcemia of malignancy
B) Distant metastases
C) Lambert-Eaton syndrome
D) Trousseau syndrome
E) Raynaud phenomenon
D) Trousseau syndrome
109) After discovering a mass in her right breast, a 36-year-old Caucasian female is sent for a biopsy by her primary care physician. Histological evaluation of a biopsy specimen is shown below. What is the most likely diagnosis?
A) Ductal carcinoma in situ (DCIS)
B) Paget disease
C) Fibroadenoma
D) Sclerosing adenosis
E) Mammary duct ectasia
F) Medullary carcinoma
C) Fibroadenoma
115) A 46-year-old male undergoes upper gastrointestinal endoscopy. He has a long history of nocturnal cough and sore throat. Microscopic findings on esophageal biopsy are shown on the slide below. Which of the following is this patient at greatest risk of developing?
A) Achalasia
B) Squamous cell carcinoma
C) Adenocarcinoma
D) Variceal bleeding
E) Leiomyoma
F) Crohn’s disease
C) Adenocarcinoma
116) During a routine screening colonoscopy, a 66-year-old Caucasian male is found to have a small mucosal lesion (- 1cm) in his sigmoid colon. A histology of the biopsied lesion is shown below. Which of the following gene mutations is most likely demonstrated by the epithelial
cells forming the lesion?
A) APC
B) DCC
C) K-RAS
D) p53
E) MSH2
A) APC
118) A 67-year-old male presents with anorexia and weight loss. Physical examination shows non-tender hepatomegaly. Laboratory tests revealed elevated serum alkaline phosphatase level and elevated alanine aminotransferase (ALT) level. CT scan of the abdomen is shown below.
The most likely cause of this patient’s liver changes is:
A) Hepatic adenoma
B) Hepatic angiosarcoma
C) Hepatocellular carcinoma
D) intrahepatic cholangiocarcinoma
E) Hepatoblastoma
F) Metastatic liver tumor
F) Metastatic liver tumor
134) A 38-year-old female visited ER for a sore throat and difficulty in swallowing for the past 3 days. She smokes 6-8 cigarettes/day and occasionally drinks alcohol. Physical examination revealed, temp 100.2F, right cervical lymph node enlargement was present. After one week of antibiotic therapy her throat symptoms improved but lymph nodes remained the same. Biopsy
from the lymph node is taken which is shown. Which of the following is the most likely
diagnosis?
A) Burkitt lymphoma
B) Follicular lymphoma
C) Anaplastic large cell lymphoma
D) Acute lymphoid leukemia
E) Mycosis fungoides
F) Hairy cell leukemia
B) Follicular lymphoma
