Sample test questions
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- Bu səhifədəki naviqasiya:
- Blood Pressure Jugular Venous Pulsus
- Thyroid-stimulating Total Thyroxine Free Thyroid-binding
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44.
A 55-year-old man is brought to the emergency department because of shortness of breath and confusion for 4 hours. He has hypertension and chronic kidney disease requiring hemodialysis. An ECG shows low voltage with electrical alternans. Physical examination is most likely to show which of the following findings?
Jugular Venous Pulsus
Pulse (/min) Pressure Paradoxus (A)
85/60 120
increased increased (B) 85/60
120 increased normal (C)
85/60 120
normal normal
(D) 120/80
80 increased increased (E)
120/80 80
normal increased (F) 120/80
80 normal
normal
45.
A 54-year-old woman comes to the emergency department because of severe jaw pain since undergoing a painful dental procedure 1 day ago. The patient was prescribed codeine after the procedure and instructed to take the medication every 4 hours, but she has continued pain despite adherence to this analgesic regimen. Other members of her family also have experienced poor pain control with codeine. Which of the following is the most likely explanation for this therapeutic failure?
(A) Decreased absorption of codeine (B) Decreased metabolism of codeine to morphine (C) Deficiency of κ receptors (D) Increased plasma protein-binding of codeine (E) Increased renal clearance of codeine
A 14-year-old girl with a 9-year history of type 1 diabetes mellitus is brought to the physician by her mother for a follow-up examination. She has been admitted to the hospital twice in the past 3 months because of diabetic ketoacidosis. She previously had been compliant with monitoring her blood glucose concentration and with her diet and insulin regimen. She acknowledges that, when she is with her peers, she eats whatever she wants and does not check her blood glucose concentration. She adds, "I'm embarrassed to inject myself in front of them." The physician is having a great deal of difficulty with her 15-year-old son who has been truant from school and sneaking out of the house. She says to the patient, "You should be ashamed for not taking care of yourself. We've all worked so hard to keep you healthy." Which of the following terms best describes the physician's reaction to the patient?
(A) Countertransference (B) Identification with the aggressor (C) Projection (D) Splitting (E) Sublimation
A 23-year-old woman with bone marrow failure is treated with a large dose of rabbit antithymocyte globulin. Ten days later, she develops fever, lymphadenopathy, arthralgias, and erythema on her hands and feet. Which of the following is the most likely cause of these symptoms?
(A) Cytokine secretion by natural killer cells (B) Eosinophil degranulation (C) Immune complex deposition in tissues (D) Polyclonal T-lymphocyte activation (E) Widespread apoptosis of B lymphocytes
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48.
A 30-year-old woman comes to the office because of a 1-day history of malaise, darkening of her skin, weakness, low back pain, and dark urine. Four days ago, she began treatment with oral trimethoprim-sulfamethoxazole for a urinary tract infection. Her temperature is 37.3°C (99.2°F), pulse is 106/min, respirations are 14/min, and blood pressure is 110/70 mm Hg. Physical examination shows scleral icterus. Cardiac examination shows a grade 2/6, systolic ejection murmur with no rubs or gallops. Laboratory studies show:
Hemoglobin 8.8 g/dL Hematocrit 27% Mean corpuscular volume 84 μm 3
Red cell distribution width 14% (N=13–15) Leukocyte count 9000/mm
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Platelet count 300,000/mm 3
Serum
Urea nitrogen 20 mg/dL Creatinine 1 mg/dL
A photomicrograph of a peripheral blood smear is shown. Which of the following is the most likely cause of the findings in this patient?
(A) Babesiosis (B) Glucose 6-phosphate dehydrogenase deficiency (C) HIV infection (D) Paroxysmal nocturnal hemoglobinuria (E) Sickle cell crisis (F) West Nile virus infection
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49.
A 42-year-old woman comes to the physician because of anxiety, tremor, and a 5-kg (11-lb) weight loss over the past 4 months despite good appetite. Physical examination shows fine thin hair, exophthalmos, goiter, and warm moist skin. Cardiac examination shows tachycardia and a widened pulse pressure. Which of the following sets of laboratory values is most likely in this patient's serum?
Thyroid-stimulating Total Thyroxine Free Thyroid-binding
(T 4 ) Thyroxine Globulin (A)
↑ ↑ ↑ ↑ (B)
↑ ↑ normal ↓ (C)
↑ normal
↑ ↓ (D) ↓ ↑ ↑ normal (E)
↓ normal
normal ↑ (F) ↓ normal
normal normal
50. A 29-year-old woman is prescribed carbamazepine for trigeminal neuralgia. She has a strong family history of osteoporosis. As a result, the physician also advises her to increase her intake of vitamin D. The most likely reason for this recommendation is that carbamazepine may affect which of the following pharmacokinetic processes?
(A) Absorption (B) Distribution (C) Excretion (D) Metabolism (E) Protein binding
Over 1 year, a study is conducted to assess the antileukemic activity of a new tyrosine kinase inhibitor in patients with chronic myeloid leukemia in blast crisis. All patients enrolled in the study are informed that they would be treated with the tyrosine kinase inhibitor. They are assigned to successive dose cohorts of 300 to 1000 mg/day of the drug. Six to eight patients are assigned to each dose. Treatment efficacy is determined based on the results of complete blood counts and bone marrow assessments conducted regularly throughout the study. This study is best described as which of the following?
(A) Case-control study (B) Crossover study (C) Open-labeled clinical trial (D) Randomized clinical trial (E) Single-blind, randomized, controlled trial
A 64-year-old man with non-Hodgkin lymphoma comes to the physician because of a 3-week history of progressive numbness in his hands and feet and weakness in his legs when he stands. He received his third course of chemotherapy 4 weeks ago. Physical examination shows areflexia. Which of the following drugs is the most likely cause of these adverse effects?
(A) Bleomycin (B) Cyclophosphamide (C) Cytarabine (D) Doxorubicin (E) Fluorouracil (F) Methotrexate (G) Vincristine
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