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Repeated USMLE Questions Step 2 CK- Review- 21

Q- A 68-year-old man is brought to the emergency room after her experienced syncope and shortness of breath while he was mowing the lawn. Records from previous visits show that his vital signs are pulse 70/min and blood pressure of 120/80. Cardiac examination shows a soft second heart sound and a systolic ejection murmur radiates to the carotid arteries. Which of the following is the most likely blood pressure of this patient at this time?

A- 120/80 mmHg

B- 110/60 mmHg

C- 106/80 mmHg

D- 100/40 mmHg

C- 106/80 mmHg- This condition is most likely aortic stenosis. Because the amount of blood ejected through the aorta is reduced due to aortic stenosis, systolic pressure will go down. Diastolic blood pressure should be normal so; blood pressure of 106/80 is the most predicted one.



Q- A 50-year-old man presents with massive splenomegaly and abnormal peripheral blood cells that stain positively with tartrate-resistant acid phosphatase (TRAP). Which of the following is the most likely diagnosis?

A- Chronic lymphocytic leukemia

B- Hairy cell leukemia

C- Hodgkin’s lymphoma

D- Multiple myeloma

B- Hairy cell leukemia- It is characterized by the presence of abnormal cells containing hairy-like cytoplasmic projections and positively stained with TRAP.



Q- Which one of the following is more likely to be found in a patient diagnosed with Tourette syndrome?

A- Articulation deficiency

B- Coprolalia

C- Cluttering

D- Stammering

B- Coprolalia- It is involuntary swearing and/or instant socially inappropriate remarks. It occurs in 10% of patients with Tourette syndrome which is characterized by chronic motor and vocal tics.



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