Repeated USMLE Questions Step 2 CK- Review- 50

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Q- A 5-year-old boy presents with generalized edema and frothy urine. Urinalysis shows proteinuria (+++), but no hematuria. Serum albumin is low, and cholesterol is elevated.

What is the most likely diagnosis?

A- Acute poststreptococcal glomerulonephritis

B- IgA nephropathy

C- Membranous nephropathy

D- Minimal change disease

D- Minimal change disease- Minimal change disease is the most common cause of nephrotic syndrome in children. It causes selective loss of albumin, leading to edema, proteinuria, and hyperlipidemia.

 

Q- A 28-year-old woman presents with acute shortness of breath, pleuritic chest pain, and hemoptysis. She recently had a long flight from Europe. Oxygen saturation is 88%.

What is the most likely diagnosis?

A- Myocardial infarction

B- Pneumonia

C- Pneumothorax

D- Pulmonary embolism

D- Pulmonary embolism- Sudden dyspnea, pleuritic pain, and hemoptysis following prolonged immobilization (flight) are classic for pulmonary embolism due to deep vein thrombosis.

 

Q- A 56-year-old man presents with painless hematuria. He has a 40-pack-year smoking history and works in the chemical dye industry. There is no flank pain or dysuria.

What is the most likely diagnosis?

A- Bladder carcinoma

B- Nephrolithiasis

C- Prostate cancer

D- Renal cell carcinoma

B- Bladder carcinoma- Painless gross hematuria in an older adult—especially with smoking or aromatic amine exposure (dye industry)—is classic for transitional cell carcinoma of the bladder.

 

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