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…

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…

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…

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…

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?…

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…

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…

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…

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…

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…

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…

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…

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…

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.…

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.…

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…

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…