1. Which of the following is not a type of renal dialysis? A) Hemodialysis B) Peritoneal dialysis C) Renal transplantation D) Conservative management 2. Hemodialysis access is usually achieved through: A) Arteriovenous fistula B) Peritoneal catheter C) Renal vein catheterization D) Renal artery bypass 3. All of the following are indications for initiation of dialysis… Read More »
1. A 28-year-old woman presents for a routine prenatal ultrasound at 20 weeks’ gestation. The ultrasound shows a single umbilical artery. The most appropriate next step is: A. Amniocentesis B. Detailed fetal echocardiogram C. Repeat ultrasound in 4 weeks D. No further action required 2. A 32-year-old woman presents for a prenatal ultrasound at 18… Read More »
1. A 45-year-old woman presents with chronic cough and hemoptysis. A chest radiograph shows a spiculated mass in the right upper lobe. The most appropriate next step in the management of this patient is: A. CT-guided biopsy B. Bronchoscopy C. Surgical resection D. Watchful waiting 2. A 60-year-old man with a history of smoking presents… Read More »
1. Which of the following BEST describes a public health approach to dental care? A) focuses on individual treatment B) emphasizes prevention for populations C) provides care primarily through private practices D) relies on out-of-pocket payments from patients 2. Which group is MOST vulnerable to poor oral health outcomes according to Healthy People 2020 objectives?… Read More »
1. A researcher wants to investigate the effect of a new medication on blood pressure. Which of the following is the most appropriate null hypothesis? A) The new medication has no effect on blood pressure. B) The new medication significantly lowers blood pressure. C) The new medication significantly raises blood pressure. D) The new… Read More »
1. Which of the following is NOT used in sample size calculation? a) Type I error rate b) Type II error rate c) Randomization ratio d) Hypothesized difference between groups 2. The Type I error rate is usually set at: a) 0.05 b) 0.01 c) 0.1 d) 0.2 3. The Type II error rate is… Read More »
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 »