Repeated USMLE Questions Step 1- Review-162

Q- A 2-year-old child has recurrent infections with catalase-positive organisms. Neutrophils show absent oxidative burst on flow cytometry. Which enzyme is defective?

A- Adenosine deaminase

B- Glucose-6-phosphate dehydrogenase

C- NADPH oxidase

D- Myeloperoxidase

C- NADPH oxidase- Chronic granulomatous disease is due to NADPH oxidase deficiency → decreased ROS → susceptibility to catalase-positive organisms.

 

Q- A patient has difficulty rising from a chair and climbing stairs. Biopsy shows endomysial inflammation and CD8+ T-cell infiltration. Which condition is most likely?

A- Becker muscular dystrophy

B- Dermatomyositis

C- Polymyositis

D- Spinal muscular atrophy

C- Polymyositis- Polymyositis causes proximal muscle weakness with endomysial inflammation and CD8+ T cells.

 

Q- A 35-year-old woman has heat intolerance, weight loss, and palpitations. Lab: ↓TSH, ↑T3/T4. Which finding is most consistent with Graves disease?

A- Anti-thyroid peroxidase antibodies

B- Anti-TSH receptor antibodies

C- Decreased radioactive iodine uptake

D- Non-tender thyroid with fibrosis

B- Anti-TSH receptor antibodies- Graves is caused by stimulating antibodies against the TSH receptor → hyperthyroidism and diffuse uptake.

 

Q- A patient has episodes of hematuria and hearing loss. Electron microscopy shows splitting of the glomerular basement membrane. Which collagen is defective?

A- Type I collagen

B- Type II collagen

C- Type III collagen

D- Type IV collagen

D- Type IV collagen- Alport syndrome involves defective type IV collagen → GBM abnormalities + hearing loss.

 

Q- A patient with peptic ulcer disease is treated with a drug that irreversibly inhibits the H+/K+ ATPase. Which drug was given?

A- Cimetidine

B- Omeprazole

C- Ranitidine

D- Sucralfate

B- Omeprazole- PPIs (omeprazole) irreversibly block the gastric proton pump.

 

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