Repeated USMLE Questions Step 2 CK- Review- 47

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Q- A 35-year-old man presents with chest pain that worsens when lying flat and improves when leaning forward. ECG shows diffuse ST-segment elevation and PR depression.

What is the most likely diagnosis?

A- Aortic dissection

B- Myocardial infarction

C- Pericarditis

D- Pulmonary embolism

C- Pericarditis- Acute pericarditis presents with pleuritic chest pain relieved by sitting forward and diffuse ST elevation with PR depression on ECG.

 

Q- A 64-year-old man presents with fever, productive cough, and pleuritic chest pain. Chest X-ray shows right lower lobe consolidation. Sputum Gram stain reveals gram-positive diplococci.

What is the most likely causative organism?

A- Haemophilus influenzae

B- Klebsiella pneumoniae

C- Mycoplasma pneumoniae

D- Streptococcus pneumoniae

D- Streptococcus pneumoniae- S. pneumoniae is the most common cause of community-acquired pneumonia, classically showing lobar consolidation and gram-positive diplococci on Gram stain.

 

Q- A 48-year-old woman presents with fatigue, pruritus, and right upper quadrant discomfort. Labs show elevated alkaline phosphatase, positive antimitochondrial antibodies, and normal bilirubin.

What is the most likely diagnosis?

A- Autoimmune hepatitis

B- Primary biliary cholangitis

C- Primary sclerosing cholangitis

D- Viral hepatitis

B- Primary biliary cholangitis- Primary biliary cholangitis (PBC) is an autoimmune destruction of intrahepatic bile ducts, seen mainly in middle-aged women. Antimitochondrial antibodies are characteristic.

 

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