Repeated USMLE Questions Step 2 CK- Review- 54

Q- A 67-year-old man with a history of chronic kidney disease presents with progressive shortness of breath and lower extremity edema. Echocardiography shows concentric left ventricular hypertrophy with normal ejection fraction. BNP is elevated. Which of the following pathophysiologic mechanisms is most responsible for this patient’s condition? A- Decreased myocardial contractility B- Impaired ventricular relaxation … Read more

Repeated USMLE Questions Step 1 Review-161- Pharmacology

Q- A patient receiving amphotericin B develops fever, chills, and renal dysfunction. What is the primary mechanism of nephrotoxicity? A- Afferent arteriole vasoconstriction B- Autoimmune tubular injury C- Direct glomerular inflammation D- Inhibition of prostaglandin synthesis A- Afferent arteriole vasoconstriction- Amphotericin B causes dose-dependent nephrotoxicity by constricting the afferent arteriole, reducing renal blood flow and … Read more

Repeated USMLE Questions Step 1- Review-160

Q- A patient with chronic kidney disease develops secondary hyperparathyroidism. Which of the following biochemical changes directly stimulates parathyroid hormone (PTH) secretion in this condition? A- Decreased 1,25-dihydroxyvitamin D levels B- Decreased serum phosphate C- Increased calcium-sensing receptor activation D- Increased intestinal calcium absorption   Q- A mutation prevents phosphorylation of the regulatory light chain … Read more

Repeated USMLE Questions Step 2 CK- Review- 53

Q- A 59-year-old man presents with progressive exertional dyspnea and fatigue. Cardiac exam reveals a harsh systolic murmur best heard at the right upper sternal border that radiates to the carotids. What is the most likely diagnosis? A- Aortic regurgitation B- Aortic stenosis C- Mitral regurgitation D- Mitral stenosis   Q- A 26-year-old woman presents … Read more

Repeated USMLE Questions Step 1 Review-159- Pharmacology

Q- A patient taking allopurinol for gout should be closely monitored for which serious adverse effect? A- Aplastic anemia B- Hepatotoxicity C- Severe hypersensitivity reaction D- Thrombocytopenia   Q- A patient with asthma is prescribed propranolol and develops worsening shortness of breath. What explains this effect? A- Alpha-1 receptor blockade B- Beta-1 receptor stimulation C- … Read more

Repeated USMLE Questions Step 1 Review-158- Pathology

Q- A 59-year-old man presents with progressive dysphagia. Endoscopy reveals an ulcerated mass in the distal esophagus. Biopsy shows malignant gland-forming cells. Which risk factor is most strongly associated with this condition? A- Alcohol consumption B- Chronic gastroesophageal reflux disease C- Human papillomavirus infection D- Iron deficiency anemia   Q- A 66-year-old woman presents with … Read more