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3,531 questions
A 48-year-old woman had a biopsy of a friable, bleeding lesion on her cervix. She had not had a pelvic examination or Pap smear for about 12 years. The biopsy is reported as invasive squamous cell carcinoma of the cervix. On bimanual examination, there is induration to the side wall of her pelvis. Which of the following is the stage of her cervical cancer?
A 1-year-old African American infant is in for well-child care. He is primarily breast-fed. His parents do not give him much solid food because he has no teeth. He receives no medications or supplements. His parents are concerned about his bowed legs. On examination, you note some other bony abnormalities including frontal bossing, enlargement of the costochondral junctions, a protuberant sternum (pigeon chest), and severe bowing of the legs. You obtain x-rays to confirm your clinical diagnosis and also note a healing fracture of the left femur. Which of the following is the most likely diagnosis?
A23-year-old presents with the history of a suspected spider bite to the left groin. On questioning, no one saw a spider. The patient has been healthy except occasional boils under his arms and in the groin. The patient is afebrile. No family members are sick. Appropriate treatment would include which of the following?
A 48-year-old woman had a biopsy of a friable, bleeding lesion on her cervix. She had not had a pelvic examination or Pap smear for about 12 years. The biopsy is reported as invasive squamous cell carcinoma of the cervix. On bimanual examination, there is induration to the side wall of her pelvis. To complete the staging of her cancer according o International Federation of Gynecology and Obstetrics (FIGO) standards, she should have hich of the following?
A 48-year-old woman had a biopsy of a friable, bleeding lesion on her cervix. She had not had a pelvic examination or Pap smear for about 12 years. The biopsy is reported as invasive squamous cell carcinoma of the cervix. On bimanual examination, there is induration to the side wall of her pelvis. Which of the following is the most important prognostic factor for 5-year survival after appropriate treatment of cervical cancer?
A 45-year-old male has received intravenous contrast dye prior to CT scan of the abdomen. Twenty minutes later the patient reports severe pruritus. He denies respiratory distress, syncope, or palpitations. His blood pressure is 98/54, pulse is 90, and respiratory rate is 22. On physical examination, he has widespread urticaria. His lungs are clear to auscultation. The next appropriate step would be which of the following?
A 35-year-old G3P3 woman has been experiencing bilateral breast pain for the past year. Breast examination and mammography are normal. Conservative measures have failed. Which of the following medications is most likely to bring relief?
A 45-year-old male has received intravenous contrast dye prior to CT scan of the abdomen. Twenty minutes later the patient reports severe pruritus. He denies respiratory distress, syncope, or palpitations. His blood pressure is 98/54, pulse is 90, and respiratory rate is 22. On physical examination, he has widespread urticaria. His lungs are clear to auscultation. The next appropriate step would be which of the following This intervention works well in cases such as this due to activity directed toward which of these receptors?
A20-year-old male has had a recent wide local excision of a 1.5 mm melanoma from the right ankle. There is no evidence of metastatic disease. The most important prognostic factor for this patient is which of the following?
A20-year-old male has had a recent wide local excision of a 1.5 mm melanoma from the right ankle. There is no evidence of metastatic disease. The most important prognostic factor for this patient is which of the following? Which of the following interventions is most appropriate in addition to wide local excision of the patient's melanoma?
A20-year-old male has had a recent wide local excision of a 1.5 mm melanoma from the right ankle. There is no evidence of metastatic disease. The most important prognostic factor for this patient is which of the following? One year after his initial diagnosis and treatment, the patient develops a palpable right inguinal lymph node. Inguinal lymph node dissection reveals one node positive for metastatic melanoma; the remaining nodes are negative. Acomplete restaging workup shows no evidence of any additional metastatic disease. What is the correct stage for this patient?
A55-year-old man with a 50 pack-year history of smoking presents with hemoptysis. CXR shows a left upper lobe mass and laboratory evaluation reveals hypercalcemia. Which of the following is the most likely diagnosis?
A20-year-old male has had a recent wide local excision of a 1.5 mm melanoma from the right ankle. There is no evidence of metastatic disease. The most important prognostic factor for this patient is which of the following? Which of the following is true regarding melanoma?
A 43-year-old patient presents with his fourth episode of culture-proven shingles in a T7 distribution. What is the most likely associated underlying condition?
A 22-year-old woman with cystic fibrosis is engaged to be married and asks you about childbearing. How should you advise her?
On the first pelvic examination of an 18-yearold nulligravida, a soft, fluctuant mass is found in the superior aspect of the right labia majora. This is asymptomatic. She tells you it has been present for several years and seems to be enlarging slightly. There is no defect in the inguinal ring. Which of the following is the most likely diagnosis?
A2-year-old girl has severe dental caries of the upper and lower incisors. Her teeth are brushed twice daily with a small amount of fluoride-containing toothpaste. What is the feeding practice most likely to result in this pattern of dental caries?
A24-year-old female presents to your office for excision of a nevus. After obtaining consent and prepping the site, you anesthetize the area with 1% lidocaine. However, as you start the procedure, you note that the patient is not sufficiently anesthetized. Your partner suggests the use of lidocaine with epinephrine. The addition of epinephrine with local anesthetics is useful because of which of the following properties?
Your patient has just had twins and wonders if there is any way to determine whether the twins are identical. You correctly tell her which of the following?
C1 deficiency has three subcomponents, of which the most common is deficiency of C1q. Most of those patients will have clinical and serologic findings typical of which of these?