Property:Prompt
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A 38-year-old woman presents to the clinic with complain of gradual onset pain in her right leg. She denies any history of trauma to the leg. She is a known case of diabetes, but on her last regular checkup three months before, her blood sugar and Hemoglobin A1c levels were normal. She is on oral contraceptive pills. On physical examination, she is in good nutritional status, and her vital signs are followings: temperature - 99.0 F, HR - 88/minute, BP - 136/78mmHg, and RR - 18/minute. There is an erythematous, swollen cord like area on her right calf, which is tender and warm on palpation. What is the most likely diagnosis? +
A 38-year-old woman presents to the physician's office complaining of pain and swelling in her left leg. Upon further questioning, she informs the physician that she recently returned to the United States from a vacation in Europe. Physical examination is remarkable for erythema, non-pitting edema, and tenderness of the left calf. In contrast, the right leg appears normal. Following appropriate work-up and imaging, the patient is diagnosed with May-Thurner syndrome. Which of the following anatomic findings best characterizes May-Thurner syndrome? +
A 58-year-old woman with no past medical history presents to the physician's office for a breast lump that she discovered incidentally while showering. Upon further questioning, she reports that she never visits her primary care physician and does not undergo yearly mammography screening. Following appropriate work-up, needle biopsy of the mass is performed. Two days later, results of the needle biopsy return, and the diagnosis of comedocarcinoma of the breast is made. Which of the following pathological findings is characteristic of comedocarcinoma of the breast? +
An 8-year-old girl is brought by her mother to the physician's office for progressive abdominal swelling and premature development of the breasts. On physical examination, the physician notes bilateral non-tender enlargement of the breasts. Abdominal inspection reveals moderate distention. Deep palpation of the abdomen is remarkable for a solid mass at the left lower quadrant. Following appropriate work-up, a large left ovarian mass is detected on CT scan. The patient is scheduled for surgical management. Resection of the tumor is performed, and the mass is sent to pathological analysis. Grossly, the mass is a solid white-gray tumor with a multilocular cystic appearance. Microscopic analysis shows Call-Exner bodies separated by thin fibrous septae. What is the most likely diagnosis of this patient's condition? +
A 62-year-old man presents to the physician's office for bilateral breast enlargement. He has a past medical history significant for coronary artery disease, status-post coronary artery bypass graft (CABG), advanced congestive heart failure, gastroesophageal reflux disease (GERD), dyslipidemia, and hypertension. He is currently taking aspirin, ramipril, metoprolol, furosemide, omeprazole, cimetidine, simvastatin, and fenofibrate. He denies smoking, alcohol intake, or use of illicit drugs. The physician suspects his condition is an adverse effect of a medication he is taking. Which of the patient's medications is most likely responsible for his condition? +
A 52-year-old man, with a history of heavy tobacco use, presents to the physician's office for dyspnea and weight loss. Following appropriate work-up, he is diagnosed with limited stage small cell lung carcinoma (SCLC). The patient is then scheduled to undergo chemotherapy sessions. Before the intravenous (IV) administration of the chemotherapeutic agent, the physician prescribes a prophylactic medication to prevent the occurrence of nausea or vomiting during chemotherapy administration. What is the most likely mechanism of action of the administered agent to manage the patient's nausea and vomiting? +
A 48-year-old man presents to the physician's office complaining of heartburn. Following appropriate work-up, he is diagnosed with gastro-esophageal reflux disease (GERD). The patient informs the physician that he has recently been using over-the-counter aluminum hydroxide, which has been effectively relieving his symptoms. Chronic use of aluminum hydroxide is associated with which of the following conditions? +
A 47-year-old man, with a history of chronic alcohol consumption, presents to the physician's office for recurrent abdominal pain that radiates to the back. The patient's past medical history is significant for cholecystectomy and several episodes of pancreatitis for the past 10 years. Upon further questioning, the patient also notes he has stools that are difficult to flush and has been recently diagnosed with diabetes mellitus. Following appropriate work-up, a wedge biopsy of the pancreas is performed, and the diagnosis of alcoholic chronic pancreatitis is made. Which of the following statements is true about alcoholic chronic pancreatitis? +
A researcher is studying the role of lisinopril in the renin-angiotensin pathway. He conducts an experiment to compare the pathway with and without the administration of lisinopril. During his experiment, he notes the inhibition of the normal secretion of a compound from the adrenal gland with the administration of lisinopril. Which area(s) in the adrenal gland is/are most likely involved in the researcher's experiment? +
A 5-year-old boy is brought by his mother to the physician's office for excessive urination. The mother also notes that her child is always complaining he has a dry mouth and is drinking water all the time. Upon further questioning, the physician notes that several members of the patient's extended family have a similar condition. Initial work-up of the patient demonstrates that the patient is normoglycemic and has high-normal levels of plasma osmolality. Water restriction test is performed. It shows an elevated urine osmolality that reaches 1000 mOsm/kg upon administration of antidiuretic hormone (ADH). Which of the following structures is derived from the same embryological origin as that responsible for the patient's condition? +
A researcher is evaluating the role of the hypothalamic-pituitary-adrenal (HPA) axis in lifestyle stresses. She enrolls 120 healthy volunteers for the study and measures plasma concentrations of adrenal hormones during several activities. She notes that the main secretory product of the zona fasciculata of the adrenal gland may fluctuate depending on the type of activity performed. Which of the following molecular changes occurs in response to the increased plasma concentration of the compound secreted from the zona fasciculata? +
A researcher is studying the signaling pathways of hormones and their corresponding mechanisms of achieving their regulatory functions. Using mice, he activates liver fat-storing cells (FSCs) using phorbol myristate acetate to increase levels of platelet-derived growth factor (PDGF). ''In vitro'' experiments demonstrate that profiling of an enzyme activity is significantly increased following the increased production of PDGF. Which other endogenous compound will most likely have the same signaling effect as PDGF? +
An 22-year-old female medical student presents to the physician's office for fatigue. She explains that she has recently been unable to continue daily chores and feels unmotivated all the time. She also states that she has recently gained weight despite normal appetite, and has been losing her hair. Physical examination is remarkable for a palpable midline neck mass. Initial work-up reveals elevated TSH levels. Following further investigation, the physician explains to the patient that her condition is best described as an abnormal presence of lymphocytic infiltrates with germinal center formation in the thyroid gland. Which of the following diseases is also associated with the same HLA subtype as that responsible for the patient's condition? +
A 45-year-old man with no past medical history presents to the physician's office with complaints of persistent diarrhea and abdominal pain for the past 3 weeks. The patient also reports recent unintentional weight loss. He denies the use of any medication and has no allergies. On endoscopy, the patient is found to have multiple ulcers in the duodenum and the jejunum. Acid output is measured and is abnormally elevated. Which of the following does not correlate with the severity of the disease in this patient? +
A cardiologist who interprets echocardiograms notes his observations before he reads the relevant clinical history of the patient. After documenting his findings, he retrieves the patient's chart and compares his findings to the patient's clinical data. When asked by his student, the cardiologist replies that this technique is designed to prevent bias. Which type of bias is this technique most likely preventing? +
A 47-year-old man presents to the physician's office for his annual check-up. His past medical history is significant for hypertension, dyslipidemia, and a myocardial infarction 2 years ago. At the time, the patient underwent cardiac catheterization and was prescribed metoprolol, aspirin, and clopidogrel. Before the end of the visit, the patient confesses that he has not been taking his medications for the past 6 months, and he does not feel like he truly needs them. Which of the following questions is the most appropriate to address the patient's non-adherence to his medications? +
A 22-year-old man presents to the emergency department complaining of acute abdominal pain and tenderness. Following initial work-up, he is diagnosed with appendicitis and is cleared for appendectomy. Rushed by the high patient load, the surgeon accidentally performs the appendectomy on a patient admitted for cholecystectomy. What is the best way to approach this mistake? +
A researcher is studying the mechanisms of muscle contraction. As part of his experiment, he develops a new protein that has high affinity to a special component in the muscle complex. The newly developed molecule is capable of binding to a protein that normally covers myosin-binding sites on actin. The protein developed by the researcher most likely binds to which component of the muscle complex? +
A researcher is studying the role of troponin on muscle contraction. His experiment demonstrates that the general physiology of muscle contraction in both cardiac and skeletal muscles is identical. Nonetheless, he describes a specific discrepancy between both phenomena. Which of the following is true when comparing cardiac to skeletal muscle physiology? +
A 40-year-old man with no past medical history presents to the physician's office for foamy urine. He takes no medications and has no allergies. He denies a history of either smoking, alcohol intake, or illicit drug use. A full physical examination is unremarkable. A 24-hour urinary collection reveals 6 grams of urinary proteins. Renal biopsy is performed, and the diagnosis of membranous nephropathy is made. Which of the following findings may distinguish primary from secondary forms of membranous nephropathy? +