A 42-year-old African-American woman presents to the clinic because of dyspnea that worsens over the last 6 months. She has no fever, chest pain or loss of weight. The patient works as a preschool teacher. Physical examination is unremarkable. Chest x-ray shows bilateral hilar lymphadenopathy. What is the most likely diagnosis? A-Asbestosis B-Pneumonia C-Sarcoidosis D-Tuberculosis […]
Repeated USMLE Questions Step 1- 268
A 19-year-old man presents to the clinic with a complaint of tremors and incoordination. Serum transaminases are slightly elevated. Slit lamp examination shows brownish corneal deposits. What is the element directly involved in this condition? A-Arsenic B-Lead C-Copper D-Iron E-Zinc Answer This is a presentation of Wilson’s disease in which cellular copper transport is disturbed […]
Repeated USMLE Questions Step 2 CK- 422
A 22-year-old G2P1 at 28 weeks gestation presents to the emergency room with heavy vaginal bleeding. Which of the following is NOT recommended as the next step of action? A- Admit the patient B- Digital pelvic examination C- Stabilize the patient D- Ultrasound examination of the pelvis Answer Digital pelvic examination is contraindicated unless the […]
Repeated USMLE Questions Step 1- 267
A 5-year-old girl with a mass in her neck is brought to the clinic for an evaluation. Her mother says that this mass appeared 6 months ago and is increasing in size. There is no pain or discomfort. On examination, the mass is in the midline, inferior to the hyoid bone. Laboratory tests reveal normal […]
Medical Question of the Day- 33
Workers in the aniline dye industry are more susceptible to bladder cancer than general population. Meanwhile, studies show that animals, when exposed to beta-naphthylamine develop liver cancer but not bladder cancer. What is the most likely explanation of this finding? A-Metabolism of beta-naphthylamine by human cytochrome 450 system in the liver B-Detoxification of beta-naphthylamine by […]
Repeated USMLE Questions Step 1- 266
A 12-year-old girl visits her physician for follow up after treatment with methotrexate for acute lymphoblastic leukemia. Stool analysis reveals blood in stool. Her platelet count is very low. Which of these substances should be administered immediately? A-Vitamin K B-Leucovorin C-Deferoxamine D-Amitriptyline E-Penicillamine Answer This is a case of methotrexate toxicity. Leucovorin is the active […]
Repeated USMLE Questions Step 2 CK- 421
A 48-year-old man with a long history of type 1 diabetes and hypertension develops sudden chest pain and dizziness. On examination, pulse is 110, blood pressure is 80/50, no pulsus paradoxus, lungs are clear and jugular veins are dilated. ECG shows sinus tachycardia with ST elevation in leads II, III and AVF. What is the […]
Repeated USMLE Questions Step 1- 265
As physicians, we need to know some definitions in Genetics, which are related directly to our practice and guide us to diagnose and treat many genetic disorders. These items include genome, genotype, phenotype, genetic code, gene expression, etc. Which one of the following choices describes the definition of a phenotype? A- Genetic constitution of an […]
Repeated USMLE Questions Step 2 CK- 420
A 74-year-old woman visits her physician complaining of a new onset of fatigue and temporal headache. She lost about 5-7 pounds over the last year. She also has morning stiffness for one hour accompanied by aching in the shoulders and hips. He noticed that his vision was deteriorating during the last year. Physical examination is […]
Repeated USMLE Questions Step 2 CK- 419
A 62-year-old woman visits her physician for a routine physical examination. She has a long history of lower back pain and she takes ibuprofen as needed. She also takes levothyroxine for hypothyroidism. She exercises daily for 30 minutes and follows a regular diet. On examination, her pulse is 45/min. Holter monitor reveals a regular pulse […]