Repeated USMLE Questions Step 1- Review- 62

Q- A patient complains of loss of vision of the right half of the left eye and the left half of the right eye. Color vision and intraocular pressure are normal. Which of the following is the most likely diagnosis?

A- Calcification of the internal carotid artery

B- Optic neuritis

C- Pituitary macroadenoma

D-Retrobulbar neuritis

A- Calcification of the internal carotid artery- Lesions that cause bilateral compression of the optic chiasm bilaterally cause binasal hemianopia as described in this patient.

Q- An 82-year-old woman underwent open reduction with internal fixation due to fracture of the radius head. After surgery, she was prescribed heparin for prophylaxis and drip of morphine for pain. On admission, the patient has labs of 12.8 Hgb and platelet count of 210,000. Today, her labs show 12.6 Hgb and platelet count of 102,000. Which of the following is the most likely diagnosis?

A- Disseminated intravascular coagulation

B- Drug-induced thrombocytopenia

C- Idiopathic thrombocytopenic purpura

D- Thrombotic-thrombocytopenic purpura

B- Drug-induced thrombocytopenia- In rare occasions, heparin can cause drop in platelet account due to developing antibodies as in this case. Low molecular weight heparin less likely causes this condition.

Q- A 7-year-old boy has a difficult time at school. He sleeps during most of the classes and doesn’t interact with his teachers in class. He is fighting with many of his classmates because of stealing their lunches but he has never started a fight. When teachers tried to contact his family, they found out that his family left fake address and phone number.

Which of the following is the most likely diagnosis?

A- Attention-deficit-hyperactive disorder (ADHD)

B- Antisocial personality

C- Child abuse

D- Oppositional defiant disorder (ODD)

E- Mental retardation

C- Child abuse- This boy sleeps in class because he does not sleep well at home. He also steals because he doesn’t eat or bring food from home. There is no certain abnormality in his behavior.

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