Property:Prompt
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A 2-month-old boy is brought the pediatrician’s office for a history of multiple fractures with minor trauma. Work-up reveals the patient has osteogenesis imperfecta. The pediatrician explains to the family that the disease is most commonly inherited in an autosomal dominant pattern. Genetic analysis of both parents reveals that the child’s mother has a genotype similar to that of her son, but is not affected by the disease. Which of the following genetic characteristics best explains this finding? +
A 2-year-old boy is brought by his mother to the physician’s office for seizures. The mother describes that the her son has been developing "unusually" when compared to his siblings. Work-up reveals cortical and retinal hamartomas, renal angiomyolipoma, astrocytoma, and cardiac rhabdomyoma. Which of the following additional findings will most likely be present in this patient? +
A 62-year-old woman presents to the physician’s office for multiple syncopal episodes. The patient reports that she has not been feeling well lately and is fatigued. She denies other associated symptoms or use of any medication. On cardiac auscultation, the physician hears a systolic crescendo-decrescendo murmur with ejection click best heard at the right second intercostal space and radiating to both carotids. Which of the following findings is most likely not associated with severity of the patient’s murmur? +
A 25-year-old woman presents to the physician’s office for the management of hypertension. During physical examination, the physician notes that the patient has a short stature and shows signs of lymphedema in her hands and feet bilaterally. The patient’s medical chart reveals that she has recently received 6 weeks of chemotherapy for dysgerminoma and has an anatomical kidney defect detected at a very young age. Which of the following is the most likely cause of hypertension in this patient? +
A 78-year-old man with heart failure is brought to the emergency department with complaints of severe shortness of breath at rest. Following evaluation, the patient is diagnosed with decompensated heart failure. His cardiologist decides to start the patient on a recombinant form of B-type natriuretic peptide. Which of the following agents most likely fits this description? +
A researcher, assessing difference between the intravenous (IV) and the oral forms of metoprolol, administers 20 mg of the IV formulation of metoprolol to one group of mice and 40 mg of the PO formulation to another group. He then records the plasma concentrations every 5 minutes until the drug levels become undetectable. He records an AUC for the IV form of 97.8 mg.hr/L and an AUC of 65.3 mg.hr/L for the PO form. What is the bioavailability of the oral form of metoprolol? +
A researcher is studying the intracellular signaling pathways of anti-diuretic hormone (ADH) prior to its terminal hormonal effects. He observes that ADH molecules have several different binding sites in renal tissues. Which of the following intracellular signaling pathways is utilized by ADH V2 receptors to increase water reabsorption in the collecting ducts? +
A 28-year-old man is brought to the emergency department for excessive somnolence and impaired motor function. Suspecting a benzodiazepine overdose, flumazenil is immediately administered. A few seconds following the administration of flumazenil, the patient’s wife arrives to the emergency department and confirms that her husband likely attempted suicide by ingesting a handful of her anxiety pills which include lorazepam and fluoxetine. Which of the following symptoms will the patient most likely experience following the administration of flumazenil? +
A 45-year-old woman presents to the physician’s office with complaints of severe diarrhea of several days duration. The patient’s medical history is significant for recurrent kidney stones and a parathyroidectomy 8 years ago. Her fasting gastrin level is elevated and endoscopy reveals multiple ulcers in the stomach, duodenum, and jejunum. Which of the following findings is most frequently associated with this patient's condition? +
A 42-year-old man presents to the emergency department for severe epigastric pain that started early in the morning. The patient reports that he had one episode of coffee ground emesis, leading the physician to suspect a bleeding gastric ulcer. Gastroscopy reveals a clean-based benign ulcer in the proximal greater curvature of the stomach, which is believed to be the cause of the patient’s bleeding. Which of the following arteries is most likely perforated in this patient, causing the gastric bleeding? +
A 35-year-old male, who sustained a recent trauma, presents to the physician’s office with flattening of the shoulder muscle. Upon physical examination, the patient is unable to abduct his shoulder. Which of the following traumatic injuries is most likely responsible for the patient’s symptoms? +
A 45 year old male who sustained a motor vehicle collision presents to the physician’s office with posterior hip dislocation. The patient undergoes a surgical reduction of the hip and is discharged from the hospital. Several days later, he presents to his physician’s office complaining he cannot abduct his thigh. On physical examination, the patient’s right hip drops when he stands on the left leg. Which of the following nerves is most likely injured in this patient following his trauma? +
A 55 year old male presents to his primary care physicians complaining of dyspnea on exertion for the last 3 months. His past medical history is significant for hypertension, diabetes mellitus and myocardial infarction at the age of 52.Vitals include pulse rate 82/min, blood pressure 140/90 and respiratory rate of 22/min. On cardiac auscultation, a low pitched sound is heard after S2 at the apex. Lung auscultation reveals bilateral rales at the lung bases. What is best initial test to diagnose this patient’s condition? +
A 46 year old female presents to the emergency room with severe dyspnea. Vitals include a pulse rate of 100/min, blood pressure 100/70 mm Hg and respiratory rate 26 /min. Past medical history is significant for hypertension, and hypothyroidism. Her current medications include once daily doses of 100 mcg thyroxine, and 100mg of atenolol. She works as a receptionist, eats meat and cheese for most of the meals and does not exercise. Upon evaluation, congestive heart failure is diagnosed. Which of the following is not associated with a mortality benefit in heart failure? +
A 24-year-old man presents to the physician’s office with watery diarrhea of several weeks duration. Following appropriate work-up, the patient undergoes intestinal biopsy that reveals transmural inflammatory infiltration with granulomatous skip lesions. The patient is then diagnosed with Crohn’s disease. The physician prescribes infliximab and informs the patient of the benefits and risks of infliximab therapy. Which of the following tests must be performed before the initiation of infliximab? +
A 38 year old female presents to the emergency room with sudden severe shortness of breath with respiratory rate of 35/min. Cardiopulmonary auscultation identifies apical rales in lungs, an S3 murmur and jugular venous distension 3 cm above the Angle of Louis .The patient reveals that for the past 3 months she has awoken short of breath several times during the night and sleeping with two pillows helps her rest. Her past medical history is significant for hypertension, hypothyroidism and myocardial infarction at the age of 35 . Her current medications are clopidogrel, atenolol, and atorvastatin . What is the best initial treatment? +
A 30-year-old athletic man is brought to the emergency department in cardiac arrest. The family informs the physician that multiple members of the family died at a young age. Despite resuscitation attempts, the patient is declared dead. During autopsy, the pathologist explains that the patient had a disarray of myocyte organization due to a mutation of the sarcomere gene. Which of the following is the most likely cause of death in this patient? +
A 19-year-old man is brought by his parents to the physician’s office for reporting voices in his head for the past 2 months. Upon further questioning, the parents explain that the patient has been isolating himself in his room, avoiding contact with other people, and neglecting basic personal hygiene. They also report that the patient is always concerned that an alien force is seeking to implant a chip in his brain and is plotting to kill him. Further questioning reveal no signs of depressive or manic episodes. What is the most likely diagnosis of this patient? +
A 56 year old patient presents to his physician’s office for his annual check-up. Appropriate work-up reveals that the patient has elevated levels of triglycerides. The physician decides to initiate therapy with clofibrate. Several weeks later, the patient presents to the emergency department with epigastric pain. The physician in the emergency department suspects the patient’s symptoms are associated with the clofibrate therapy. What is the most likely diagnosis of this patient’s epigastric pain? +
A 56-year-old man presents to the emergency department (ED) with complaints of chest pain and shortness of breath. On arrival, and ECG demonstrates ST-segment elevation in 2 consecutive leads, and blood work-up is remarkable for elevated serum troponin concentration. The diagnosis of STEMI is made, and the patient is transferred to the cardiac catheterization lab for an emergent percutaneous coronary intervention (PCI). Cardiac catheterization reveals a total occlusion of the right coronary artery (RCA). Which of the following anatomical locations of the heart is most likely affected as a result of this patient’s STEMI? +