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usmle step 1 Flashcards

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1
Q

67 yr. pt w/bilateral ankle edema. Large v waves, soft pansystolic murmur audible at left sternal edge. F.Aid 2019, pg 288-9)

A

Tricuspid regurgitation

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2
Q

33 yr. pt attempting suicide injected w/molecular weight heparin. pain in flanks, BP 50/30. Blood sugar 20mg/dl. Cause of death? F.Aid 2019 Pg. 334

A

Acute adrenal insufficiency

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3
Q

12 month pt. w/rash in his face. over a week ago with slight cold and frebile. complication with his illness? F. Aid 2019 pg. 164

A

Fetal death if a pregnant woman becomes infected

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4
Q

60 yr old pt. with muscle pain and dark color urine. rx erythromycin for bacterial infection. ischemic heart disease, hypercholesterolemia and taking multiple medications. Responsible for pts symptoms? F. Aid 2019 pg. 249

A

Rhabdomyolysis

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5
Q

75 yr old pt. constipated, diarrhea and weight loss over the past 3 months. appears cachectic and nodular hepatomegaly. Not jaundiced and liver function tests are normal. Diagnosis? F. Aid 2019 pg. 382, 386

A

Liver metastasis

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6
Q

43 yr pt right upper quadrant pain (ultrasound) showing dilated gall bladder and dilated biliary tree. Symptoms if she’s left untreated? F. Aid 2019 pg. 66

A

Difficulty seeing at night

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7
Q

24 yr old pt. w/intermittent pain, numbness and weakness in his left arm. Blue discoloration in his arm. What’s present with the patient? F.Aid 2019 pg. 441

A

Thoracic outlet syndrome

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8
Q

35 yr old man embalmer with acute onset respiratory distress. 3 day history of mild fever and malaise. oxygen saturation is 82% and respirations are 22/min. x rays shows interstitial opacities in both lungs. what’s the underlying pathology? F. Aid 2019 pg. 662

A

Chemical pneumonitis

Exposure to formaldehyde

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9
Q

21 yr old man with 3 day history of dysuria and swollen right knee. 3 sexual partners within the past month without protection. no rashes or overlying skin involvement. His knee culture is plated on Thayer-Martin agar which grows bacterial colonies. The culture would aspirate the following bacteria? F. Aid 2019 pg. 126, 142, 460

A

Gram-negative diplococci within neutrophils

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10
Q

7 yr old girl w/ abdominal pain, large breast for her age. Tanner stage 3 breasts and pubic hair and a palpable tender mass in the left lower quadrant. What’s the condition of the patient? F. Aid 2019 pg. 632

A

Thecoma

estrogen producing non-malignant ovarian mass

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11
Q

16 yr old boy w/itchy skin lesion. diagnosed w/cutaneous dermatophytosis and given a course of griseofulvin. Severe abdominal pain and numbness and tingling in his fingers. The enzyme induced by griseofulvin requires which cofactors? F. Aid 2019 pg. 67, 417

A

Vitamin B6

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12
Q

2 yr old boy w/abdominal pain and bloody stools. colonoscopy is unrevealing. A technetium (99m Tc) pertechnetate scan is positive in the right lower quadrant. Which following embryotic structures most likely failed to obliterate in this patient? F. Aid 2019 pg. 604

A

Vitelline duct

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13
Q

45 yr old man with coronary heart disease, hypertension, diabetes, and seizures w/decreased exercise tolerance. used to walk a mile a day. No history of anemia, denies alcohol intake and eats a normal diet. His Rx: aspirin, atorvastatin, lisinopril, metformin (began taking last yr) and phenytoin. Which rx is responsible for his presentation? F. Aid 2019 pg. 249, 412

A

Phenytoin
Megaloblastic anemia. Type of anemia caused by deficiency of B12, folate and medications that interfere with B12 metabolism such as phenytoin, methotrexate and sulfa drugs.
Decreases mucosal uptake of folate and interferes with folate metabolism, leading to macrocytic anemia

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14
Q

2 week old neonate with a 46, XY karyotype is born with ambiguous genitalia. temp is 36.9C (98.4F) BP 120/80mmHg. (>99% for his age) (high). pulse is 110 min. Potassium of 3 mEq/L. (low) Which enzyme deficiencies is most likely present?
F. Aid 2019 pg. 328

A

17 Hydroxylase

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15
Q

26 yr old man w/large macules and freckles in the axilla and groin. Learning difficulties. Family history of other affected individuals. Which is the usual mode of inheritance of this condition? F. Aid 2019 pg. 60, 513

A

Autosomal dominant

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16
Q

22 yr old man w/double vision and impaired balance. medical history fro a surgically resected medulloblastoma during childhood. Neurological exam reveals nystagmus, absent smooth pursuit, head tilting, and truncal ataxia and difficulty performing “finger to nose test” Which is the cause of pt condition? F. Aid 2019 pg. 487, 516

A

Medial lesion involving the flocculonodular lobe of the cerebellum

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17
Q

32 yr old woman w/low mood, weight gain (15lbs), irregular menses. no period for the past 3 months. on exam, she has several bruises, a rounded face, and increased growth of facial hair on her chin and upper lip. Which is the diagnosis? F. Aid 2019 pg. 333

A

Adrenocortical tumor

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18
Q

34 yr old woman w/increase fatigue over the last 6 months. Episodes of pneumonia, UTI. History of atrial fibrillation, hyperthyroidism, gout and schizophrenia. Rx: allopurinol, metroprolol, methimazole, clozapine, pantoprazole and iron. Temp (99.7), BP 124/68 mmHg. pulse is 112 min. respirations are 24 min. Which is responsible? F. Aid 2019 pg. 249, 349

A

Methimazole

known to cause aplastic anemia

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19
Q

23 yr old man w/pelvic fracture when he fell. Perineal pain and inability to void urine. Physical exam shows blood at the urethral meatus. Which is consistent with the diagnosis of a ruptured urethra? F. Aid 2019 pg. 613

A

Swelling over the lower abdominal wall and scrotum

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20
Q

42 yr old man w/3 month history of hand pain. works as a computer programmer. He wakes up in the middle of the night with discomfort and hand hanging off the bed. Numbness along his palm. Which is the most likely etiology of this patient’s symptoms? F. Aid 2019 pg. 451

A

Carpal tunnel syndrome

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21
Q

6 month old Ashkenazi boy w/developmental delay and inability to hear and see. cherry spot on the macula, progressive neurodegeneration and no hepatosplenomegaly. which deficiency is linked to the pathogenesis of this disease? F.Aid 2019 pg. 88

A

Hexosaminidase A

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22
Q

19 yr old woman agitated and believes she can fly. temp (100.5 F), BP (166/100 mmHg), pulse (130/min). pupils dilated, round and reactive to light. what’s the patient’s cause of current clinical condition? F.Aid 2019 pg. 561

A

Cocaine

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23
Q

30 yr old man w/ 2 week history of erectile dysfunction with 2 month history of decreased libido and recurrent headaches. BP (98/70), pulse (85 min), respirations 14 min. what’s elevated in this patient? F.Aid 2019 pg. 326

A

Prolactin

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24
Q

64 yr old american man w/severe low back pain. xray shows severe erosion in his spine and skull. increased levels of IgG in his blood and Bence Jones protein in his urine. Diagnosis? F.Aid 2019 pg. 423

A

Multiple myeloma

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25
Q

A randomized placebo conducted to assess the benefit of stain therapy in primary prevention of cardiovascular disease. After 1 year, the cardiovascular event rate in the active arm is 1% and the placebo arm is 2.5%. which is the number needed to prevent one cardiovascular event over 1 yr? F.Aid pg. 258

A

67
0.025-0.01 =.015
1/.015=6.67

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26
Q

60 yr old woman w/sluggish, weight gain and constipation. brittle hair and skin. she has antibodies against thyroglobulin and thyroperoxidase. A biopsy of the thyroid gland demonstrates? F.Aid pg. 338

A

Hurthle cells

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27
Q

81 yr old woman w/throbbing headache. gets worse in the mornings, when coughing, sneezes or strains. History of 2 non-small cell lung cancer and received chemo and radiotherapy. Failure of abduction of her right eye. which treatment is indicated. F. Aid pg. 526

A

Radiation therapy

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28
Q

5 yr old boy w/right hip pain. Trendelenburg’s sign when standing on the right leg. xray shows right hip swelling in soft tissue. Bone scan shows reduced activity in the anterolateral right capital femoral epiphysis. what’s the diagnosis? F.Aid pg. 453

A

Legg-Calve-Perthes disease

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29
Q

62 yr old woman fell w/fracture of the distal radius. xray shows more than 2.5 standard deviations below that of normal healthy adults. shes prescribed meds for future fractures. which drug will be prescribed?

A

Foscarnet

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30
Q

A newborn w/respiratory distress and fever. Child is Ashkenazi jewish heritage. chest xray reveal multi-lobar
pneumonia and sweet chloride test is positive. Sputum culture grows gram-positive cocci in clusters with golden-yellow pigment. which pathogen is responsible?
F.Aid pg. 179

A

Staphylococcus aureus

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31
Q

35 yr old obese woman w/hirsutism and abnormal menses that vary in duration, timing and amount of bleeding. she’s diagnosed with impaired glucose tolerance 2 years ago. lab shows luteinizing hormone is elevated. serum androstenedione and testosterone are mildly elevated. sex hormone binding is decreased. 17-hydroxyprogesterone is normal. ultrasound shows bilaterally enlarged ovaries with multiple cysts. what’s the diagnosis? F.Aid pg. 631

A

Polycystic ovarian syndrome

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32
Q

83 yr old woman w/increased difficulty breathing. pain in left ear. serum impaction in left ear and mild otitis externa. Weber and Rinne exam is done with 512 Hz tuning fork. what are the test results? F.Aid pg. 521

A

Weber lateralizes left, BC>AC left

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33
Q

61 yr old man w/ muscle stiffness, slow movements, and hand tremors. schizophrenic taking haloperidol. Temp (99.5), BP 120/81 pulse 98. decreased facial expression, pill rolling tremor, cogwheel rigidity and festinating gait. F.Aid pg. 561

A

Pseudoparkinsonism

side effect of antipsychotic meds

34
Q

45 yr old man w/nausea, chest pains, profuse sweating, rapid heartbeat, blurred vision and difficulty breathing, he was drinking scotch when symptoms appeared. recently taking meds for peptic ulcer. which med is responsible? F.Aid pg. 195

A

Metronidazole

pt having a disulfam like reaction by taking nitromidazole including metronidazole

35
Q

85 yr od woman w/lethargy, two episodes of severe diarrhea and vomiting. frequent dark urine.history of HBP and diabetes. physical exams shows bilateral crackles at the lung bases, an S3 gallop at the heart apex, and displaced point of maximal impulse (PMI). her creatinine was 1.0 mg/dl 2 months ago. F.Aid pg. 590

A

0.5%
The fraction of sodium excreted in the urine will be very low with less than 1% because the nephron will actively reabsorb Na+. Increased BUN (pre-renal azotemia) will also be seen

36
Q

59 yr old man w/history of myocardial infarction 8 months ago, coronary heart disease, hypertension and congestive heart failure. he is taking an rx to prolong survival with congestive heart failure. his breast enlarged and become tender. Which drug is responsible? F.Aid pg. 595

A

Spironolactone

side effect is gynecomastia with breast tenderness due to its weak antagonist effect at the androgen receptor

37
Q

25 yr old man w/intermittent diarrhea, wheezing, flushing, and hypotension. he has abdominal pain. Exam shows systolic murmur, increased bowel sounds, and dermatitis. A cardiac echo shows endocardial fibrosis. Which biochemical is depleted in this pt? F.Aid pg. 335

A 
Tryptophan
carcinoid syndrome (usually located in the appendix or liver) diagnosis can be achieved by checking urinary 5-HIAA (5-Hydroxyindoleacetic acid) levels.
38
Q

62 yr old woman w/firm lump in her right breast. no nipple discharge but has skin puckering. weight loss, chills, night sweats, and back pain. exam shows a 1 cm x 2 cm stony mass which is biopsied. what’s the diagnosis? F.Aid pg. 636

A

Invasive ductal carcinoma
represents 75% of breast carcinomas. it represents a hard nodule due to increase in fibrous stromal tissue. 1-2 cm in diameter and rarely exceed 4 cm

39
Q

65 yr old woman can’t hear out of her left ear. turning fork close to her left ear sounds softer than when you press the butt of the tuning fork against her mastoid bone. when performing turning fork on her head, she claims it sounds louder on her left side. F.Aid pg. 521

A

Cerumen Impaction

cerumen (wax) impaction

40
Q

15 yr old boy w/acne itchy face and arms. many honey-colored crusts on his nose, forearms, and the palms of his hands. a sample is sent to the lab. Which test can be done to determine the bacterial organism? F. Aid pg. 134-5, 470

A

Catalase test
Honey colored crusts are consistent with a diagnosis of impetigo. Two organisms that can cause impetigo are:
S aureus (Catalase +)
S pyogeneses (Catalase -)

41
Q

40 yr old man w/ headache, sore neck, and double vision. Temp (103.1 F), pulse 112 min, lethargic and slow to commands. difficulty abducting the eye, aversion to penlight, inability to flex the neck passively due to muscle stiffness. lumbar puncture is performed. cerebrospinal fluid is sent to for analysis and meningitis diagnosis is given while waiting for results. F.Aid pg. 136, 180

A

Streptococcus pneumoniae

42
Q

30 yr old woman w/3 day history of pain in the anterior of neck and fever. pain from side to side radiating jaw and ears that gets worse when swallowing and turning the head. anxious, palpitations and insomnia, lack of energy and fatigue. BP 150/80. pulse 100 min. thyroid gland is asymmetrically enlarged, firm and tender. a thyroid function test will show.. F.Aid pg. 338

A

Low TSH, high free T4, high free T3, decreased radioiodine uptake

43
Q

11 yr old w/tinnitus, pain in both ears, and decreased hearing. MRI shows bilateral acoustic neuromas. F.Aid pg. 60, 513

A

Autosomal dominant

44
Q

60 yr old man w/ history of chronic cancer and pancreatic cancer. 2 day history of increased drowsiness, and seizures like activity and became unresponsive. no nausea or pain. BP 120/80 mmHg, pulse 72/min. Doctor started him on demeclocycline. which drug would benefit him? F.Aid pg. 350

A

Decrease the sensitivity of the renal tubules to the action of anti-diuretic hormone

45
Q

40 yr old woman w/fever and joint pain. Physical exam shows a rash on both cheeks. kidney biopsy shows immunoglobulin, C3, and fibrogen in the basement membrane. lab shows high levels of anti-DNA antibody. F.Aid pg. 459

A

systemic lupus erythematous

46
Q

62 yr old man w/right endarterectomy for symptomatic carotid stenosis. following the operation, he has difficulty swallowing and altered taste sensation. gag is abnormal with it being elicited on stimulation of the left side of the pharyngeal mucosa only. taste sensation is absent over the posterior one-third of his tongue on the right side. F. Aid pg. 494

A

Right-sided glossopharyngeal nerve

47
Q

52 yr old woman w/ischemic attack, hypertension and gastroesophageal disease. meds are aspirin, lisinopril, pravastatin, pantoprazole, and a multivitamin. hard to hear high-pitched sounds. when trying to sleep at night or in a quiet room, she hears a faint buzzing or humming sound that’s mildly bothersome. tuning fork close to her ear sounds louder than when you press the butt of the tuning fork against her mastoid bone. tuning fork against her forehead it sounds equal on both sides. what’s likely the cause of her symptoms? F.Aid pg. 521

A

Aspirin

48
Q

6 yr old boy w/fever, dry cough, 1-week history of ear pain and runny nose. has all vaccines with normal medical history. blood culture is positive for Streptococcus mutans. which liver cells help the body clear the bacterium? F.Aid pg. 361

A

Kupffer cells
pt has ear infection caused by moraxella catarrhalis, streptococcus pneumonia, or Haemophilus influenzae

Kupffer cells are found in the liver

49
Q

32 yr old woman w/5 day history of fever, chills, dry cough, loss of appetite, body aches, and nausea. dizziness upon standing. eats little, vomits and doesn’t drink liquids. BP 90/60. blood gas analysis shows a metabolic alkalosis. what caused her metabolic alkalosis? F.Aid pg. 576, 580

A

Increased H+ excretion in the distal tubule and increased net bicarbonate reabsorption in the proximal tubule

50
Q

25 yr old man w/ history of panic attacks with right-sided headache. stressed and with pain he describes as sharp, located in the orbiotemporal region associated with rhinorrhea. had an episode a day before which lasted 3 hours. what’s associated with his headache? F.Aid pg. 506

A

Ptosis

associated with ipsilateral lacrimation, rhinorrhea, and horner’s syndrome including ptosis

51
Q

Full-term male newborn w/bilateral flank masses, oliguria and respiratory distress. tri-semester ultrasound showed severe oligohydramnios. Also shows multiple renal cysts.
what’s the cause? F.Aid pg.

A

Autosomal-recessive polycystic kidney disease

52
Q

33 yr old woman w/blurry vision and heavy eyelids. it’s difficult for her to read documents at the end of the day. which is the underlying pathogenesis of the patient’s symptoms? F.Aid pg. 112

A

Type II hypersensitivity

53
Q

clinical study conducted to assess the effect on the incidence of a heart attack. 100 pts are enrolled. before the study begins, the pts complete a survey indicating their weekly exercise. the pts are told they have to complete similar surveys at weekly visits. after 2 wks, 75% of the study subjects reported increased exercise frequency. F.Aid pg. 260

A

Hawthorne effect

study whose population behavior changed when knowing that they are being observed

54
Q

45 yr old man w/endless nagging and no interest of being here. he says that his wife doesn’t do things the right away. the pt feels frustrated when his wife loads dishes her way. the patient wants to learn if there are better ways of effectively communicating the right way to do things. F.Aid pg. 553

A

Obsessive-compulsive personality disorder

(OCPD) he wants to know how to better teach his wife. entirely about control,

55
Q

32yr old prison inmate w/vomiting, aches, and loss of appetite. received a tattoo oh his arm 2 months ago by a fellow inmate. physical shows mild jaundice. temp (99.7c)viral hepatitis is suspected. lab shows: HBsAg positive, HBcAb positive, HBeAg positive, HBeAb negative. what’s the patient status? F.Aid pg. 174

A

Acute infection

the potential exposure to the tattoo and lab results indicate an acute infection

56
Q

22 yr old stabbed in the abdomen 2.5 cm (1 in) superior to the umbilicus in the midline. assuming the knife entered the peritoneal cavity, which abdominal wall structures would the knife penetrate first? F.Aid pg. 363

A

Aponeurosis of the external oblique and internal oblique muscles
abdominal wall deepness as follows:
1. skin
2. superficial fascia
3. fusion of the external oblique and internal oblique aponeurosis (anterior rectus sheath)
4. rectus abdominis muscle
5. fusion of the internal oblique and transversus muscle aponeurosis (posterior rectus shealth)
6. transversalis fascia
7. extraperitoneal fat
8. peritoneum

57
Q

65 yr old man w/right swollen calf. severe renal failure with an estimated GFR of 28 ml/min. a D-dimer is elevated and ultrasonography identifies a DVT in his right calf. Rx is subcutaneous LMWH for 10 days then oral drug. blood needs to be monitored to determine the correct dose and the diet can affect how well the anticoagulant works. which is the mechanism of action of the prescribed oral anticoagulant? F.Aid pg. 401, 424

A

Epoxide reductase inhibitor

58
Q

42 yr old man and a funduscopic exam shows hypertesion (eye vessels red) what’s the medical condition? F.Aid pg. 298

A

Hypertension

59
Q

55 yr old woman doesn’t take meds and no allergies. physical exam shows shorthened 4th and 5th digits. what’s the diagnosis? F.Aid pg. 341

A

Pseudohypoparathyroidism

60
Q

7 yr old fell on his right hand. extensive, taut swelling of the distal arm. elbow in significant pain. pinprick sensation is intact on the ventral aspect of the 3rd fingertip and dostal thumb. a plain film shows a non-displaced supracondylar fracture of the right humerus. what’s the cause of the condition? F.Aid pg, 447

A

Laceration of the brachial artery

61
Q

32 yr old pregnant woman w/paraesthesia and numbness that wakes her at night. symptoms are relieved with shaking or moving fingers. the objects slip from hands in the mornings. gained weight.what’s expected?
F.Aid pg. 440

A

Flattering of the thenar eminence

carpal tunnel syndrome

62
Q

6 yr old boy w/left eye deviated inwards. right eye can look to the left but the left cannot cross midline. “cross-eyed since birth”. the nerve affected arises from which part of the neuraxis? F.Aid pg. 529

A

Pons

63
Q

5 yr old boy w/high-pitched sound when breathing. child was playing with toy cards when sound started. xrays show right mediastinal shift and a hyperinflated left lung. which of the following is the site of obstruction? F.Aid pg. 649

A

Right main bronchus

64
Q

23 yr old man w/abdominal pain. heavy night drinking the night before. temp (100.2 F), BP 120/80 mmHg, pulse 90/min, respirations 18/min. and oxygen saturation is 98% on room air. decreased bowel sounds and tender to palpitations in the epigastric midline. he has amylase of 900 U/L and lipase of 1400 U/L. a scan of the abdomen shows pancreatic edema with questionable necrosis of the pancreatic head. if the pancreatic head undergoes necrosis, which artery will most likely bleed? F.Aid pg. 358, 391

A

Superior pancreaticoduodenal artery

65
Q

47 yr old man w/knee pain for several weeks. he spends most of his time on knees at work. globular liquid filled lump around the patella. pt has normal passive tension, extension, adduction, and abduction of the knee. normal Mcmurray test. what’s the injury? F.Aid pg. 452

A

Prepatellar bursitis

66
Q

55 yr old woman w/ finger locking after it is flexed. pull the finger with other hand and it clicks when straightened.

A

trigger finger

67
Q

8 yr old cannot extend fingers and wrist. Pain in his started in his elbow when his mother pulled his right hand while crossing the street. loss of sensation and muscle weakness over the extensor surface of his right forearm and hand. What’s likely to be injured in this patient? pg. 440

A

Radial nerve

68
Q

28 yr old man unconscious and pale from a motorcycle accident. BP 80/60 pulse 130/min. focused assessment with sonography for trauma shows free fluid within hepatorenal and splenorenal recesses. aside from the collapse, which would be the outcome of injury to the nerve transmitting the patient’s baroreceptor reflex to the hypovolemic shock he is experiencing?
Pg. 294, 494

A

loss of taste in the posterior one-third of the tongue

69
Q

24 yr old man had a motorcycle accident w/severe pain in his right elbow and loss of sensation over his thenar eminence. Tenderness to palpation of the distal humerus, with a suspected fracture. a large ecchymosis is observed, worrisome for a brachial artery laceration. what neurological deficits will the patient experience?
pg. 440

A

loss of palmar sensation in digits 1-3 and half of the digit 4

70
Q

18 yr old woman w/nausea, vomiting, vaginal bleeding, and lower abdominal pain. 2 sexually transmitted diseases that were treated. tenderness in lower abdominal region. ruptured uterine pregnancy with possible spread of infection to the mesovarium, mesometrium, and mesosalpinx. the infected structures are all contained within which of the following ligaments? pg. 611

A

Broad ligament

71
Q

31 yr old w/severe onset lower abdominal pain. pain 10/10 radiating to lower back. nausea but not vomiting. BP 110/70, pulse 110 min and respirations 18/min. palpitation of the lower left quadrant does not increase pain she has in the right lower quadrant. which organ is affected? pg. 632

A

Ovary

mimics appendicitis except appendix causes fever

72
Q

55 yr old man passing blood with stool, anal comfort and 4.5 kg (10lb) weight loss over the past 6 months. pt changed in stool caliber. he’s a thin, cachectic patient. a guaiac fecal occult blood test is positive and rectal examination (DRE) shows a deep suspicious mass. which lymph node is most likely involved in this pt? pg. 360

A

Internal iliac

73
Q

70 yr old man w/ 3 week persistent cough. had a trip to the caribbean and came back with a fever of 101.3 F. to confirm viral pneumonia, a chest xray is ordered with a PA and lateral view. a medical student is asked to localize the angle of louis. which anatomical structure does she need to visualize? Pg. 649

A

Carina

74
Q

29 yr old woman w/cough after choking on a peanut 2 days ago. she is in good health otherwise. which of the following is most likely the location of the peanut? pg. 649

A

The right inferior lobar bronchus

75
Q

65 yr old man fell on his outstretched right arm. he is holding his right arm with his left hand. examination shows flattening of the lateral shoulder with weakness and loss of sensation of lateral aspect of his right arm. he has decreased strength of the right upper extremity and difficulty abducting the arm beyond 15 degrees. which nerve is injured? pg. 440

A

The axillary nerve

76
Q

69 yr old man w/diabetes mellitus 2, hypercholesterolemia, and hypertension. comes to the ER 8 hours after the onset of acute chest pain, shortness of breath, diaphoresis which lasted 45 min. short breath with activity. temp of 99.5F. BP is 98/64. pulse is 43min.
respirations are 18/min. oxygen saturation is 95%. EKG shows sinus bradycardia with 2 mm of ST elevation in leads in II, III and VF. which arteries explain the patient’s symptoms? pg. 281, 303

A

Right coronary artery

77
Q

a passenger brought to ER after a car accident w/runny nose, head injury and vomiting, Neurological exam shows anosmia and CT shows anterior base of skull fracture affecting the ethmoid plate. which is the likely to be the level of interruption to the olfactory pathway? pg. 494

A

The first-order sensory neurons

78
Q

28 yr old w/ shoulder pain. inability to abduct the arm voluntary. when the arm is passively abducted a few degrees the patient is actively continue abduction through the full range of motion. which muscle has most likely been injured to produce this patient’s symptoms? pg. 438

A

Supraspinatus

79
Q

22 yr old man assaulted with a baseball bat. multiple bruises, swelling and ecchymosis in the right upper extremity. midshaft fracture of the humerus. the pt has sensory loss of which of the following? pg. 440,447

A

Dorsal aspect of the first of the capometacarpal joint

80
Q

60 yr old woman w/ 2 week history of shoulder pain. increased pain when reaching overhead. inability to shrug shoulders and abduct left arm above 90 degrees from midline. pt cannot rotate head to the right. radiographic imaging shows mild osteoarthritic changes but no fractures or severe damage. which of the cranial nerves is most likely affected? pg. 494

A

XI

81
Q

An investigator is studying thalamic nuclei in the human brain using an animal model whose central nervous system resembles that of the human brain. after electrocautery is used to lesion a specific nucleus in the thalamus, the animal develops contralateral loss of pain, temperature, and proprioception in the body. which of the nuclei was most likely damaged? pg. 486

A

Ventral posterior lateral nucleus

82
Q

19 yr old woman has fallen on her outstretched hand. she has swollen and pain in the anatomic snuffbox x-ray of the wrist shows a fracture of one of the carpal bones. which is a complication of this injury? pg. 439

A

A vascular necrosis of the scaphoid

USMLE STEP 1 CARDS (1 decks)

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