1. A 21 year old male is diagnosed with metastatic testicular cancer. He started on a regimen which includes an agent that induces breaks in DNA strands by generating free radicals. Shortly after starting this regimen, he develops worsening pulmonary function. Which medication was the patient most likely started on?

Question 1 of 20

2. A 6 year old healthy female is brought to your clinic due to new onset of a rash. A picture of the lesions is shown below. Which of the following is correct regarding the causative agent of this condition.

 

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Question 2 of 20

3. A new mutation in the CFTR gene is identified. The protein products of this mutated CFTR gene is isolated from a population of clonal cells and compared to the wild type CFTR gene products. It is discovered that the proteins synthesized from the mutated CFTR gene are significantly shorter and less functional compared to those synthesized by the wild type CFTR gene. What kind of mutation has most likely occurred in the mutated CFTR gene?

Question 3 of 20

4. Which cranial nerves (CN) are responsible for gustatory sensation in the tongue?

Question 4 of 20

5. A newborn infant is diagnosed with neonatal conjunctivitis at 10 days of age. Which of the following scenarios best aligns with this diagnosis?

Question 5 of 20

6. A 2 year old toddler is brought to the pediatrician due to frequent episodes of crying and agitation which are associated with a bluish discoloration of the skin. These symptoms improve when the child squats. On exam, the child is in the 20th for weight and 40th percentile for height. A heart murmur is appreciated. What is the mechanism by which squatting improves the symptoms of this condition?

Question 6 of 20

7. Which of the following metabolic abnormalities is not seen in renal failure?

Question 7 of 20

8. Granulomas are foci of activated macrophages, lymphocytes and multinucleated giant cells observed in many kinds of infectious and autoimmune conditions. Which cytokine is believed to play a crucial role in the development of granulomas?

Question 8 of 20

9. Which of the following is not an example of a lymphocyte?

Question 9 of 20

10. A 58 year old male presents to the ED with acute onset chest pain, nausea and diaphoresis. An ECG shows ST segment elevations in leads V1-V4. Which of the following histologic changes occurs first during the natural progression of a myocardial infarction?

Question 10 of 20

11. A 51 year old women presents to her primary care provider due to generalized fatigue, bone pain, forgetfulness, increased urination and thirst. She has passed two kidney stones in the past 2 years. Initial work up is significant for a calcium level of 11.8 and a parathyroid hormone (PTH) of 100 (Normal 15-65). Which of the following histologic changes most accurately describes this patient's condition?

Question 11 of 20

12. A 55 year old female from Brazil presents to her primary care provider for a physical exam. She has smoked 1 pack of cigarets daily for 30 years. Past medical history is significant for a colectomy due to toxic megacolon 10 years ago. She undergoes an echocardiogram which reveals dilated cardiomyopathy. What is the most likely etiology of her condition?

Question 12 of 20

13. Which of the following drugs would be expected to have the highest volume of distribution?

Question 13 of 20

14. A 41 year old male presents to the office with a complaint of crampy abdominal pain, flatulence and diarrhea several hours after eating dairy. A lactose hydrogen breath test demonstrates elevated hydrogen levels. Where is the enzyme that is deficient in this man normally synthesized?

Question 14 of 20

15. A 47 year old female presents to her primary care provider due to new onset irregular menstruation, weight gain, galactorrhea and low libido. Past medical history is significant for diabetes mellitus type II, HTN, morbid obesity and Tobacco use disorder. Laboratory studies are shown below. A brain MRI shows a sellar mass.

 

  • TSH: 4.3
  • Cr: 0.98
  • WBC: 8.3
  • Prolactin: 97  ng/mL

Which visual abnormality is this patient most likely to have?

Question 15 of 20

16. A 65 year old nulliparous women presents with a 3 month history of weight loss, vomiting, distended abdomen and early satiety. A CT scan of the abdomen shows bilateral adnexal masses. She has an elevated CA 125 and normal LDH, AFP and b-hCG levels. Biopsies are obtained and on histology, the following feature is observed. What is the name of this histologic feature?

 

Question 16 of 20

17. A 78 year old man is brought by his daughter to the office due to several months of worsening confusion and forgetfulness. The daughter refers that for the past 4 months, he has forgotten to take his antihypertensive medications and no longer gets along with his grandchild. Last week he was found wandering around the neighborhood because he couldn’t find his way back to home. Mini Montreal cognitive assessment is 24/30 ( normal >26). A brain MRI shows cortical atrophy, narrowing of gyri and widening of sulci. Which of the following is expected on histopathologic examination?

 

Question 17 of 20

18. A healthy 25 year old man completes a half marathon on a hot day. Following a period of extensive aerobic exercise, his hemoglobin molecules have decreased affinity for Oxygen and his oxygen-hemoglobin dissociation curve is shifted to the right. All of the following decrease the affinity of hemoglobin to oxygen except?

Question 18 of 20

19. A 16 year old boy from Indonesia comes to the emergency department complaining of odynophagia and dysphagia. He has had 3 days of sore throat, fever and chills. He has no known medical condition and vaccination status is not updated. Physical examination reveals grayish-white membranes in the pharynx and cervical lymphadenopathy. Which of the following would have prevented this condition

 

Question 19 of 20

20. A 62 year old woman presents to the emergency department with epigastric pain, diaphoresis and hypotension. An EKG shows ST elevation in II, III, aVF and serum troponin levels 20 ug ( normal 14ug). Which of the following is the most common complication at this stage?

 

 

Question 20 of 20


 

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