Repeated USMLE Questions

Repeated USMLE Questions- Step 1-1

Dr Ray Makar

Q- A 72-year-old man presents to the office for evaluation of new symptoms. He has a history of cancer and takes chemotherapeutic treatment. Now he complains of dyspnea and mild fatigue since last week. Examination reveals temperature of 98.3 F, pulse of 80/min, blood pressure of 140/86 and respiratory rate of 22/min. On chest auscultation, there are crackles on both lung bases with no wheezes. A chest x-ray shows bilateral diffuse interstitial markings. Which of the following agents is responsible for this patient’s new features?

A- Bleomycin

B- Cisplatin

C- Cyclophosphamide

D- Etoposide

E- Paclitaxel

A- Bleomycin- It is the only drug of the above list that causes pulmonary fibrosis. It is age- and dose-dependent.




Q- Which of these medications is contraindicated in a case of cardiogenic shock?

A- Dopamine

B- Intravenous fluids

C- Metoprolol

D- Norepinephrine

C- Metoprolol- The treatment of all types of shock should include supportive care, intravenous fluids and other medications depends on the cause of shock. Beta blockers are contraindicated in cardiogenic shock as it worsens hypotension. Dopamine and norepinephrine can be used in case of very low ejection fraction and hypotension.



Q- Which one of the following types of drug interactions occurs when aspirin is given with acetaminophen?

A- Additive

B- Permissive

C- Synergistic

D- Tachyphylactic

A- Additive- This occurs when the effect of the 2 medications is equal to the sum of their individual effects.  



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