Medical
Browse, search and filter 3,531 questions.
3,531 questions
A 17-year-old African-American adolescent presents with swelling of her earlobes; she had them pierced a few months ago. She can no longer put her earrings on and is distraught about her appearance. She notes that the involved areas itch and burn. Examination is remarkable for hyperpigmented, shiny, smooth tumors measuring 1 to 2 cm that are located around the areas of her ear piercing. There are small, crablike extensions from the lesions. There is no evidence of erythema or purulence. You believe the patient has developed keloids at the sites of her ear piercing. Which of the following statements about keloids is false?
A 32-year-old woman presents to your office complaining of hair loss. The hair loss is occurring all over her head and seems to spare no area. She notes that it worsens when she showers, and she has begun showering every other day in an attempt to decrease the hair loss. She has been healthy all her life, and other than an uneventful pregnancy and vaginal delivery 3 months ago, she has no medical history. This patient's clinical presentation and history are most consistent with which of the following hair disorders?
A 19-year-old biochemistry student is seen in your clinic worried about her hormone levels. She has been told by her GP that her progesterone is low. You enter into a long discussion about the effects of progesterone on the body. Progesterone:?
A woman was admitted this morning in the medical intensive care unit for elective cholecystectomy. Before surgery, her physical examination, including vital signs, was normal. The procedure went well, and there were no noticeable complications. However, 3 hours after returning to her room, she was noted to be unresponsive and her blood pressure was barely palpable. She was intubated for respiratory failure. Her blood pressure has been refractory to intravenous fluids and pressors. You are consulted to help in the workup of suspected adrenal insufficiency. Which of the following statem.en.ts regarding adrenal insufficiency is true?
A 32-year-old man presents to your clinic for evaluation of headaches. He has had episodic pounding headaches for 6 months. He never had headaches like this before in his life. He denies using illicit drugs. He has no family history of hypertension. On physical examination, the patient is hypertensive, with a blood pressure of 180/105 mm Hg. No further abnormalities are noted. You begin a workup for secondary causes of hypertension. Which of the following statements regarding pheochromocytomas is true?
A 32-year-old man presents to your clinic as a new patient to establish primary care. He has a 2-year history of hypertension, which is managed with a calcium channel blocker. He has no knowledge of the cause of his hypertension. He is currently without complaints and only wants a refill on his medication. His physical examination is unremarkable, but laboratory results show hypokalemia. Which of the following statements regarding hyperaldosteronism is true?
A 37-year-old man presents to the local emergency department with a swollen and tender right calf. The patient has had these symptoms for 4 days. He denies having undergone any trauma. He has no history of cancer, and he has had no similar episodes in the past. He denies having a family history of venous thrombosis. Ultrasound confirms deep vein thrombosis, and the patient is provided with appropriate anticoagulation. Several days later, the patient sees you for a follow-up visit. The laboratory studies made in the emergency department included a factor V Leiden mutation analysis. Which of the following statements is true regarding this patient's test for factor V Leiden mutation?
A 21-year-old man comes to your office to establish primary care. He states that he has been generally healthy but that he has multiple colon polyps. He states that he tested positive for familial adenomatous polyposis (FAP). He says that his former physician told him that this illness can run in families, and he asks your opinion on whether or not his family needs further testing. Which of the following statements regarding FAP and the APC gene mutation is true?
A 12-month-old baby is brought in for a well-baby visit, during which the baby is noted to have leukokoria (a white pupillary reflex). On further evaluation, it is determined that the child has an ablatable, unifocal retinoblastoma, with an RBl cancer-predisposing mutation in a tumor and no evidence of a germline RBl in white cell DNA. The parents are concerned about the risk of retinoblastoma if they have other children. Regarding these parents' concern, which of the following statements is true?
A 25-year-old Ashkenazi Jewish woman is concerned about her risk of breast cancer. Her 60-year-old mother was recently diagnosed with stage II breast cancer and underwent bilateral mastectomy. Her grandmother was killed in World War II, so she does not know whether her grandmother had breast cancer. She read in a newspaper article that the prevalence of BRCAl and BRCA2 genes is increased in Ashkenazi Jewish women and that, as a result, this population is at increased risk for breast cancer. Now she would like to be tested for these genes because she is concerned about her risk status and wonders whether she needs a prophylactic mastectomy. Of the following statements, which would be appropriate to tell this patient?
A 57-year-old white man presents with a 2-week history of gnawing epigastric pain that seems to be relieved with food and antacid. His medical history is significant for hypertension. His medications include hydrochlorothiazide and 81 mg enteric-coated aspirin. He does not smoke. Which of the following statements regarding ulcerogenesis is true?
Two months ago, a 53-year-old white man was diagnosed by esophagogastroduodenoscopy (EGD) as having an uncomplicated duodenal nicer. At that time, the patient tested positive on rapid urease testing and was appropriately treated with a clarithromycin-based regimen for H. pylori. He now returns with recurrent epigastric pain. He has no other medical conditions. He has been maintained on a proton pump inhibitor. He denies using NSAIDs. His vital signs and physical examination are unremarkable. His complete blood count, serum electrolyte levels, and serum calcium level are all within normal limits. He is referred for an upper GI series and is found to have a recurrent duodenal ulcer. The patient's fasting gastrin level is 500 pg/ml (normal value, < 100 pg/ml). For this patient, which of the following statements is true?
A 43-year-old woman presents to establish primary care. Her medical history is significant for an uncomplicated duodenal ulcer, which she experienced 18 months ago. At the time of diagnosis, she was treated with a clarithromycin-based regimen for H. pylori. She has since been asymptomatic. For this patient, which of the following statem.ents is true?
Two 28-year-old men with inflammatory colonic disease are seen in clinic; one has ulcerative colitis and the other has Crohn disease. Each is concerned about complications of his disease. Which of the following is a correct assessment of these two patients?
A 36-year-old man presents to your clinic complaining of fatigue. His fatigue started 3 or 4 months ago. His medical history is unremarkable. Review of systems is positive for occasional diarrhea, which the patient has been experiencing for several months, and for a 20-lb weight loss. Physical examination shows pallor. Occult blood is found on rectal examination. The rest of the examination is normal. Laboratory tests reveal iron deficiency anemia, and the patient tests positive on a qualitative fecal fat test. Results of an upper endoscopy and a colonoscopy are normal. Which of the following tests would be most likely to provide helpful information in the workup of this patient?
A 44-year-old woman with a history of GSE is evaluated for refractory disease. She was diagnosed with GSE 8 years ago. Her disease was initially well controlled with a gluten-free diet. Over the past few months, she has bad persistent diarrhea and malabsorption that has not responded to her usual diet. Findings on physical examination are consistent with chronic malnutrition. An abdominal CT scan shows no masses or anatomic abnormalities that would account for her symptoms. An endoscopy is obtained, and small bowel biopsy sl1ows villous atrophy and a layer of collagen underneath the enterocytes. Which of the following is the most likely explanation for this patient's symptoms?
A 74-year-old man is transported to the emergency department by ambulance for evaluation of cough, dyspnea, and altered mental status. Upon arrival, the patient is noted to be minimally responsive. Results of physical examination are as follows: temperature, 102.1° F (38.9° C); heart rate, 116 beats/min; blood pressure, 94/62 mm Hg; respiratory rate, 34 breaths/min; and 02 saturation, 72o/o on 100% 02 with a nonrebreather mask. The patient is intubated in the emergency department, and mechanical ventilation is initiated. Coarse rhonchi are noted bilaterally. A portable chest x-ray reveals good placement of the endotracheal tube and lobar consolidation of the right lower lobe. Laboratory data are obtained, including sputum Gram stain and culture and blood cultures. Empirical antimicrobial therapy is initiated, and the patient is admitted to the medical intensive care unit for further management. The intern on call inquires about the appropriateness of initiating nutritional support (enteral or parenteral feeds) at this time. Which of the following statements regarding nutritional support is true?
A 19-year-old woman is giving birth to her first baby. She has been pushing for an hour and the fetal head has been on the perineum for 6 minutes. There seems to be a restriction due to resistance of her tissues. Her midwife carries out a right mediolateral episiotomy. Which of the following structures should not be cut with the episiotomy?
A patient with known chronic hepatitis C and cirrhosis comes to your office wondering about liver transplantation. He read on the Internet that the waiting time for liver transplantation is long and that one should be included ''early'' to improve the chances of getting a timely USMLE IM2e/Basic transplantation. The patient stopped smoking over 20 years ago and does not drink alcohol. He is otherwise in good health. Which of the following is NOT a contraindication for orthotopic liver transplantation?
A 40-year-old man with cirrhosis secondary to hepatitis Bis being evaluated for orthotopic liver transplantation. He asks you what he should expect after his operation. Which of the following statements is true regarding this patient?