Repeated USMLE Questions Step 2 CK- Review- 46

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Q- A 70-year-old man presents with difficulty starting urination and a weak urine stream. Digital rectal examination reveals a smooth, enlarged prostate.

What is the best initial treatment?

A- Antibiotics

B- Finasteride

C- Tamsulosin

D- Surgery

C- Tamsulosin- This presentation is consistent with benign prostatic hyperplasia (BPH). First-line therapy is an alpha-1 blocker such as tamsulosin, which relaxes smooth muscle in the bladder neck and prostate.

 

Q- A 29-year-old woman presents with fever, right lower quadrant abdominal pain, and vaginal discharge. On pelvic examination, there is cervical motion tenderness.
What is the most likely diagnosis?

A- Appendicitis

B- Ectopic pregnancy

C- Endometriosis

D- Pelvic inflammatory disease

D- Pelvic inflammatory disease- The classic triad of lower abdominal pain, fever, and cervical motion tenderness strongly suggests pelvic inflammatory disease (PID), often caused by Chlamydia trachomatis or Neisseria gonorrhoeae.

 

Q- A 50-year-old woman presents with tremor, palpitations, and weight loss despite a good appetite. She also has heat intolerance and a diffusely enlarged thyroid gland.
Which of the following is the most appropriate initial diagnostic test?

A- Radioactive iodine uptake scan

B- Serum TSH level

C- Thyroid biopsy

D- Thyroid ultrasound

B- Serum TSH level- TSH is the first step in evaluating suspected hyperthyroidism. If low, follow with free T4 and radioactive iodine uptake to determine the cause (e.g., Graves’ disease).

 

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