Q- A 67-year-old man with a history of chronic kidney disease presents with progressive shortness of breath and lower extremity edema. Echocardiography shows concentric left ventricular hypertrophy with normal ejection fraction. BNP is elevated.
Which of the following pathophysiologic mechanisms is most responsible for this patient’s condition?
A- Decreased myocardial contractility
B- Impaired ventricular relaxation
C- Increased preload due to valvular regurgitation
D- Reduced coronary perfusion
Q- A 58-year-old woman presents with progressive proximal muscle weakness and dysphagia. She also reports a photosensitive rash over her upper chest and shoulders. Laboratory studies show elevated creatine kinase levels.
Which of the following additional findings is most likely present?
A- Anti–acetylcholine receptor antibodies
B- Anti–Jo-1 antibodies
C- Malignancy on age-appropriate screening
D- Thymoma on chest imaging
Q- A 45-year-old man presents with recurrent episodes of palpitations and syncope. ECG shows polymorphic ventricular tachycardia with prolonged QT interval. He recently started an antibiotic for pneumonia.
Which of the following medications most likely precipitated this arrhythmia?
A- Azithromycin
B- Ceftriaxone
C- Doxycycline
D- Penicillin
Q- A 72-year-old woman presents with painless jaundice, weight loss, and pruritus. Labs show elevated alkaline phosphatase and direct bilirubin. CT scan reveals a mass in the head of the pancreas.
Which additional finding is most likely present?
A- Courvoisier sign
B- Grey Turner sign
C- Kehr sign
D- Murphy sign
Q- A 34-year-old woman presents with recurrent miscarriages and a history of deep vein thrombosis. Laboratory testing shows prolonged aPTT that does not correct with mixing studies.
What is the most likely underlying condition?
A- Factor V Leiden mutation
B- Protein C deficiency
C- Protein S deficiency
D- Antiphospholipid antibody syndrome