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3,531 questions
A 1-day-old infant who received silver nitrate eye drops in the delivery room is suffering from bilateral purulent conjunctival discharge. Which of the following is the most likely cause of this child's condition?
The most common cause of surgery in a patient with Crohn's disease is which of the following?
A 2-year-old girl presents with fever of 39.3°C and irritability. She has had an upper respiratory tract infection for 4 days. On examination, the right ear is bulging and has poor movement on insufflation. Which of the following organisms is most likely responsible for these findings?
A 13-year-old boy presents for evaluation of short stature. His growth chart from ages 2 through 12 years is shown in Figure. His growth in the first 2 years of life was typically at the 25th percentile. He has been healthy, has a good appetite, and is doing well in school. He lives with his parents and is an only child. His parents' heights are both at the 50th percentile. His father states that he grew several inches after he completed high school. A complete physical examination is normal. His Tanner stage is Which of the following is the most likely cause of this patient's short stature? constitutional delay
A patient presents to the ED complaining of abdominal pain out of proportion to her examination. Initial vital signs are: BP 70/30, HR 120. The patient does report a prior history of abdominal pain after eating. Which of the following statements regarding this condition is most accurate?
A 26-year-old male presents with abdominal pain and bloody diarrhea. On examination, he has a low-grade fever and mildly tender abdomen. Lower endoscopy is performed which reveals edematous mucosa with contiguous involvement from the rectum to the left colon. Random biopsies are performed which reveals acute and chronic inflammation of the mucosa and submucosa with multiple crypt abscesses. There are no granulomas seen. What can you tell this patient about his condition?
Afew weeks after a presumed viral respiratory infection, a 4-year-old girl presents with bruising and petechiae. Bone marrow examination reveals increased numbers of megakaryocytes but is otherwise normal. Hb is 13.5 g/100 mL. Platelet count is 30,000/mm3. Which of the following would be appropriate for this child at this time?
A 46-year-old female presents to your office with rectal bleeding, itching, and irritation. On examination, a 3-cm ulcerating lesion is seen in the anal canal. Biopsy of the lesion reveals squamous cell carcinoma (SCC). Which of the following is the most appropriate treatment?
A4-month-old child presents with a 2-day history of vomiting and intermittent irritability. On examination, "currant jelly" stool is noted in the diaper, and a sausage-shaped mass is palpated in the right upper quadrant of the abdomen. Which of the following conditions is most likely to cause this?
During initial exploration in a patient scheduled to undergo a right hemicolectomy for colon cancer, a deep 4-cm liver mass is seen in the right lobe of the liver. The left lobe appears to be normal. Intraoperative biopsy of the lesion is positive for metastatic colon cancer. The best management of this patient includes which of the following?
During a routine yearly checkup, a 10-year-old boy is found to have 2 + proteinuria on urinalysis. Which of the following would be the most appropriate diagnostic test?
A mobile mass is found on rectal examination in a 77-year-old male with complaints of blood in his stool. On workup, he is found to have a stage I (Dukes' A), well-differentiated adenocarcinoma. The most appropriate intervention is which of the following?
An 18-month-old boy has received 5 days of amoxicillin for otitis media. He continues to have fever, and on physical examination, the right tympanic membrane is bulging with purulent fluid behind it. Which of the following is the best antibiotic to use?
Biopsy of a 4-cm sessile polyp of the cecum during a routine screening colonoscopy reveals it to be a villous adenoma with atypia. Attempt at piecemeal snare polypectomy through the colonoscope is unsuccessful. Which of the following is the most appropriate management?
A 56-year-old man comes to the hospital. For the past 5 days he has had colicky abdominal pain, vomiting, abdominal distention, and constipation. The most appropriate measure, after IV hydration and nasogastric decompression, in the initial management of this patient is which of the following?
A 12-year-old girl presents with chest pain when she plays basketball. The pain is substernal, is associated with dyspnea, and occurs after she has been playing vigorously. The pain does not radiate. The pain and dyspnea resolve with rest. She does not have palpitations or any lightheadedness associated with the pain. She does not have pain or dyspnea at other times. There is no history of early cardiac deaths or unexplained deaths of young people in her family. Her physical examination is normal, except for a grade 2/6 systolic vibratory murmur heard at the left lower sternal border. Which of the following is the most likely cause of her symptoms?
A 56-year-old man comes to the hospital. For the past 5 days he has had colicky abdominal pain, vomiting, abdominal distention, and constipation He undergoes barium enema examination. The findings on barium enema, shown in Figure, are most compatible with which of the following diagnoses?
A 12-year-old girl presents with chest pain when she plays basketball. The pain is substernal, is associated with dyspnea, and occurs after she has been playing vigorously. The pain does not radiate. The pain and dyspnea resolve with rest. She does not have palpitations or any lightheadedness associated with the pain. She does not have pain or dyspnea at other times. There is no history of early cardiac deaths or unexplained deaths of young people in her family. Her physical examination is normal, except for a grade 2/6 systolic vibratory murmur heard at the left lower sternal border. The same patient now complains of palpitations and dizziness with the chest pain. Which of the following tests should be ordered for this patient? chest x-ray
Several members of a group of young adults camping, cooking, and traveling together in the developing world develop fever, malaise, nausea, and vomiting, and have dark urine. Two have yellow sclera. How could this best have been prevented?
A 56-year-old man comes to the hospital. For the past 5 days he has had colicky abdominal pain, vomiting, abdominal distention, and constipation During definitive surgical treatment of the lesion shown on the barium enema, the left ureter is accidentally transected at the level of the pelvic brim. What is the most appropriate management of this complication?