1. A 55-year-old man with a history of alcohol abuse presents with new-onset ascites. Which of the following is the most appropriate next step in management? A. Initiate diuretic therapy B. Recommend large-volume paracentesis C. Recommend liver transplantation D. Recommend salt restriction and fluid restriction E. Recommend transjugular intrahepatic portosystemic shunt (TIPS) 2. A 62-year-old… Read More »
1. A 65-year-old man with cirrhosis secondary to hepatitis C is found to have a 3 cm liver mass on routine abdominal imaging. Which of the following is the most appropriate next step in management? A. Initiate treatment with sorafenib B. Perform contrast-enhanced CT or MRI of the abdomen C. Recommend liver biopsy D. Recommend… Read More »
1. A 55-year-old man with alcohol-related cirrhosis presents with new-onset ascites. Which of the following is the most appropriate next step in management? A. Initiate diuretic therapy B. Recommend large-volume paracentesis C. Recommend liver transplantation D. Recommend salt restriction and fluid restriction E. Recommend transjugular intrahepatic portosystemic shunt (TIPS) 2. A 62-year-old woman with decompensated… Read More »
1. A 35-year-old man presents with acute hepatitis, nausea, vomiting, and jaundice. Serologic testing is positive for IgM anti-hepatitis E virus (HEV) antibodies. Which of the following is the most appropriate next step in management? A. Initiate treatment with ribavirin B. Initiate treatment with pegylated interferon C. Recommend hospitalization for supportive care D. Recommend liver… Read More »
1. A 55-year-old man presents with fatigue and jaundice. Laboratory tests reveal elevated AST, ALT, and bilirubin levels. Hepatitis C antibody is positive, and HCV RNA is detected. Which of the following is the most appropriate next step in management? A. Initiate treatment with pegylated interferon and ribavirin B. Initiate treatment with sofosbuvir and ledipasvir… Read More »
1. A 35-year-old man is found to have positive hepatitis B surface antigen (HBsAg) and positive hepatitis B e antigen (HBeAg) on routine screening. Which of the following is the most appropriate next step in management? A. Initiate treatment with pegylated interferon B. Initiate treatment with entecavir C. Initiate treatment with lamivudine D. Recommend hepatitis… Read More »
1. A 30-year-old man presents with 1 week of nausea, vomiting, and abdominal pain. Physical examination reveals scleral icterus and hepatomegaly. Laboratory testing shows elevated transaminases and positive IgM anti-hepatitis A virus (HAV) antibodies. Which of the following is the most appropriate management? A. Initiate treatment with pegylated interferon and ribavirin B. Initiate treatment with… Read More »
1. A 50-year-old obese man with a history of type 2 diabetes presents with fatigue and right upper quadrant abdominal pain. Liver function tests reveal elevated aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. Ultrasonography shows a hyperechoic liver consistent with fatty infiltration. Which of the following is the most likely diagnosis? A. Alcoholic fatty… Read More »
1. A 65-year-old man with a history of hypertension and coronary artery disease presents with palpitations, shortness of breath, and decreased exercise tolerance. Electrocardiography reveals irregular, chaotic atrial activity and an irregularly irregular ventricular response. Which of the following is the most likely diagnosis? A. Atrial flutter B. Atrial fibrillation C. Ventricular tachycardia D. Supraventricular… Read More »
1. A 65-year-old man with a history of hypertension and myocardial infarction presents with progressive dyspnea, orthopnea, and lower extremity edema. Echocardiography reveals a left ventricular ejection fraction of 35%. Which of the following is the most likely cause of his heart failure? A. Dilated cardiomyopathy B. Ischemic cardiomyopathy C. Hypertrophic cardiomyopathy D. Valvular heart… Read More »
1. A 70-year-old man with a history of hypertension presents with progressive exertional dyspnea and angina. Physical examination reveals a harsh systolic murmur best heard at the right upper sternal border. Which of the following is the most appropriate next step in management? A. Initiate medical therapy with diuretics and vasodilators B. Perform stress echocardiography… Read More »
1. A 25-year-old woman presents with a history of recurrent episodes of fever, joint pain, and migratory polyarthritis. Physical examination reveals a new diastolic murmur. Which of the following is the most likely diagnosis? A. Acute rheumatic fever B. Chronic rheumatic heart disease C. Systemic lupus erythematosus D. Rheumatoid arthritis E. Ankylosing spondylitis 2. A… Read More »
1. A 45-year-old man presents with sudden-onset chest pain that worsens with inspiration and lying down. Electrocardiography (ECG) shows diffuse ST-segment elevation. Which of the following is the most likely diagnosis? A. Acute myocardial infarction B. Acute pericarditis C. Acute aortic dissection D. Acute pulmonary embolism E. Acute myocarditis 2. A 60-year-old man with a… Read More »
1. A 45-year-old man with a history of hypertrophic cardiomyopathy presents with syncope during exercise. Echocardiography reveals severe left ventricular outflow tract obstruction. Which of the following is the most appropriate next step in management? A. Initiate beta-blocker therapy B. Initiate disopyramide therapy C. Perform septal myectomy D. Perform alcohol septal ablation E. Recommend implantable… Read More »
1. A 58-year-old woman with a history of hyperlipidemia presents with progressive exercise intolerance and shortness of breath. An echocardiogram reveals severe aortic stenosis. Which of the following is the most likely underlying mechanism for this patient’s aortic stenosis? A. Calcific degeneration of the aortic valve B. Rheumatic heart disease C. Congenital bicuspid aortic valve… Read More »
1. A 55-year-old man presents to the emergency department with sudden onset of chest pain, shortness of breath, and diaphoresis. An ECG shows ST-segment elevation in the anterior leads. Which of the following is the most likely diagnosis? A. Unstable angina B. Non-ST-elevation myocardial infarction C. ST-elevation myocardial infarction D. Aortic dissection E. Pulmonary embolism… Read More »
1. A newborn infant presents with cyanosis and a harsh systolic murmur at the left upper sternal border. Which of the following congenital heart defects is most likely? a) Atrial septal defect b) Tetralogy of Fallot c) Ventricular septal defect d) Coarctation of the aorta 2. A 2-year-old child is brought in for evaluation of… Read More »
1. Which of the following is NOT a surface feature of the tibia? a) Medial malleolus b) Lateral condyle c) Tuberosity d) Anterior crest 2. The tibia articulates with which of the following bones? a) Femur and fibula b) Femur and talus c) Talus and calcaneus d) Calcaneus and fibula 3. The nutrient artery of… Read More »
1. A 5-year-old child presents with acute flaccid paralysis of the lower extremities. Which of the following viruses is the most likely causative agent? A. Influenza virus B. Poliovirus C. Rotavirus D. Varicella-zoster virus 2. A 3-year-old child has not received any vaccinations. Which of the following vaccines is recommended to prevent polio? A. Measles-mumps-rubella… Read More »
1. What is the primary mode of transmission for hepatitis C? a) Fecal-oral b) Parenteral (Blood) c) Sexual d) Respiratory Answer: b) Parenteral (Blood) 2. Which of the following viruses is responsible for causing hepatitis C? a) HAV b) HBV c) HCV d) HDV Answer: c) HCV 3. What is the primary antigen found on… Read More »