Repeated USMLE Questions Step 2 CK- Review- 52

Q- A 67-year-old man presents with sudden onset left arm weakness and facial droop that resolved completely within 30 minutes. CT scan of the head is normal.

What is the most likely diagnosis?

A- Intracerebral hemorrhage

B- Ischemic stroke

C- Subarachnoid hemorrhage

D- Transient ischemic attack

D- Transient ischemic attack- A TIA causes transient neurologic deficits that resolve within 24 hours and leaves no acute findings on imaging.

 

Q- A 34-year-old woman presents with heat intolerance, tremor, and palpitations. Labs show low TSH and elevated free T4.

What is the most appropriate initial treatment?

A- Methimazole

B- Propranolol

C- Radioactive iodine

D- Thyroidectomy

B- Propranolol- Beta-blockers are used first to control adrenergic symptoms in hyperthyroidism before definitive therapy.

 

Q- A 72-year-old hospitalized patient develops acute confusion and agitation. He has a fluctuating level of consciousness and visual hallucinations.

What is the most likely diagnosis?

A- Acute psychosis

B- Alzheimer disease

C- Delirium

D- Major depressive disorder

C- Delirium- Delirium presents with an acute onset, fluctuating consciousness, and impaired attention, commonly in hospitalized or elderly patients.

 

Q- A 45-year-old man presents with epigastric pain that improves with meals. Endoscopy shows a duodenal ulcer.

Which organism is most commonly associated with this condition?

A- Campylobacter jejuni

B- Escherichia coli

C- Helicobacter pylori

D- Staphylococcus aureus

C- Helicobacter pylori- H. pylori infection is the most common cause of duodenal ulcers, which typically improve with food.

 

Q- A 60-year-old woman presents with progressive dyspnea and dry cough. CT scan shows bilateral ground-glass opacities. She has been on amiodarone for several years.

What is the most likely diagnosis?

A- Acute respiratory distress syndrome

B- Amiodarone-induced pulmonary toxicity

C- Community-acquired pneumonia

D- Pulmonary embolism

B- Amiodarone-induced pulmonary toxicity- Amiodarone can cause chronic interstitial lung disease with ground-glass opacities and progressive dyspnea.

 

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