Repeated USMLE Questions Step 1 Review- 141- Pathology

Q- A 48-year-old man presents with jaundice, dark urine, and pale stools. Lab tests show elevated direct bilirubin and markedly elevated alkaline phosphatase. Ultrasound reveals dilation of intrahepatic bile ducts.
What is the most likely cause?

A-Gilbert disease

B-Hemolytic anemia

C-Obstruction of the common bile duct

D-Viral hepatitis

C-Obstruction of the common bile duct- Post-hepatic (obstructive) jaundice causes elevated direct bilirubin, pale stools, dark urine, and high ALP due to blocked bile flow.

 

Q- A 22-year-old man presents with a sudden onset of severe chest pain. Imaging reveals a spontaneous pneumothorax. Lung biopsy shows rupture of small subpleural blebs.
Which condition is most commonly associated?

A-Asthma

B-Chronic smoking history

C-Pulmonary fibrosis

D-Tall, thin body habitus

D-Tall, thin body habitus- Primary spontaneous pneumothorax is most common in tall, thin young men due to rupture of apical blebs.

 

Q- A 70-year-old man presents with worsening bone pain. His alkaline phosphatase is markedly elevated, but calcium and phosphate levels are normal. X-ray shows thickened cortical bone with a mosaic pattern.
What is the most likely diagnosis?

A-Hyperparathyroidism

B-Osteomalacia

C-Osteoporosis

D-Paget disease of bone

D-Paget disease of bone- Paget disease causes disorganized bone remodeling, elevated ALP, normal Ca/Pi, and mosaic (jigsaw) bone pattern.

 

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