Physician Assistant Clinical Knowledge Rating and Assessment Tool (PACKRAT) 3 Practice Exam

These questions are part of the practice quiz. Start practicing

• Diuretics and a low-salt diet are used to treat which condition?
• Which medication is most useful in maintaining remission in ulcerative colitis?
• Alpha-fetoprotein is typically measured during pregnancy for neural tube defect screening at which gestational weeks?
• A patient with known drug dependence mentions that he commonly sees sounds and hears colors. What is his drug of choice?
• Which organism is the underlying pathogen for Lyme disease?
• Which portion of the nephron is responsible for absorbing about 90% of the ultrafiltrate?
• You evaluate a patient with asthma and perform spirometry before and after a short-acting bronchodilator. Which result after bronchodilator indicates reversibility?
• Hypersecretion of cortisol leads to which syndrome?
• Which antiarrhythmic drug can be associated with hyper- or hypothyroidism following long-term use?
• Which description best fits a lipoma?
• Which condition is most closely associated with an increased intensity of the P2 heart sound?
• Barrett's esophagus increases the risk of which type of esophageal cancer?
• Adults with a compromised immune system should not receive which of the following vaccines?
• A female patient presents with fatigue and macrocytic anemia. Which finding would be most consistent with megaloblastic anemia due to vitamin B12 deficiency?
• A pregnant patient at 30 weeks gestation presents with fatigue and microcytic, hypochromic anemia. Which type is most likely?
• Which diagnostic study is considered the strategy of choice for symptomatic patients with recurrent ischemia, hemodynamic instability or impaired left ventricular dysfunction?
• What is the mechanism responsible for retinal hemorrhages and neurologic complications in a patient with infective endocarditis?
• A 26-year-old sexually active woman presents with lower abdominal colicky pain, vaginal spotting, and adnexal tenderness; LMP was 6 weeks ago. Which diagnosis is most likely?
• Which of the following is a risk factor for pancreatic cancer?
• Which drug neutralizes tumor necrosis factor in rheumatoid arthritis?
• Which is an extra-articular manifestation of rheumatoid arthritis?
• A 50-year-old reports sudden eye pain and decreased vision with nausea. On examination, the pupil is moderately dilated and nonreactive to light. Which diagnosis is most likely?
• For a hemodynamically stable patient with suspected ectopic pregnancy, which diagnostic test is preferred?
• A patient with acute onset of dyspnea and tachypnea and radiographs consistent with ARDS requires what as the most important initial treatment?
• Which constellation of findings is typical of nephrotic syndrome?
• A patient presents with fever, dysphonia, drooling, and dysphagia, sitting forward with inspiratory retractions. The most likely diagnosis is:
• Which is the most appropriate treatment for a 9-year-old with severe allergic rhinitis unresponsive to avoidance, antihistamines, and intranasal steroids?
• Which physical examination sign is characteristic of pericarditis?
• Which chest x-ray abnormality would most likely be seen in hypersensitivity pneumonitis?
• In a patient with incidentally found hematuria, which diagnostic test should be performed next to evaluate the urinary tract?
• Which infectious agent is most commonly associated with chronic gastritis and peptic ulcers due to mucosal inflammation?
• Which imaging modality is preferred for evaluation of the upper urinary tract and has largely replaced intravenous pyelography?
• Which medication class is considered first-line therapy for patients with Raynaud's phenomenon?
• Drusen are tiny yellowish spots seen in the retina and are most commonly associated with which condition?
• Which of the following is characterized by epidermal hyperplasia and an increase in the epidermal turnover?
• What is the principal pathophysiologic process in pneumoconiosis due to chronic inhalation of mineral dusts?
• A 17-year-old girl with asthma uses albuterol; symptoms 3-4 days per week; nighttime symptoms ≤ once a month; spirometry normal. What is the appropriate medical management?
• If acute pyelonephritis requires inpatient management, which regimen is typically started empirically?
• On auscultation, a patient has harsh, hollow breath sounds with a long inspiratory component at the suprasternal notch and softer sounds at the periphery. Which description best fits these findings?
• In a patient with a first-degree relative diagnosed with colorectal cancer before age 60, when should colonoscopy screening begin?
• According to the Joint National Committee VII guidelines, blood pressure targets are lower in patients with diabetes mellitus and which other condition?
• Which of the following is a proven risk factor for the development of abdominal aortic aneurysm?
• Which organism is most commonly associated with acute bacterial sinusitis in adults?
• A 45-year-old male presents with dizziness and vertigo that occurs when rolling out of bed in the morning. Lateral nystagmus appears after a brief latency. What is the recommended initial treatment?
• An 8-month-old with bronchiolitis and hypoxemia; which medication is indicated?
• A 19-year-old college student presents with a sore throat and flu-like symptoms. Rapid strep screen and culture are negative. Three weeks later, she has exudative pharyngitis, tender enlarged posterior cervical lymphadenopathy, and splenomegaly. What is the most appropriate next step in diagnosis?
• A 14-month-old child presents after being pulled up by the wrists. The child refuses to move the left arm and has no deformity or edema. What is the most likely diagnosis?
• CA-125 testing for ovarian cancer screening is best described as:
• A 26-year-old presents with a generalized nonpruritic rash, fever, and shallow ulcers at the base of the penis with involvement of the palms and soles. Which initial diagnostic study is most appropriate?
• During a pre-participation sports physical in an adolescent athlete, which murmur quality is associated with hypertrophic cardiomyopathy and risk of sudden death during exertion?
• Candidiasis is typically associated with which vaginal pH range?
• A 5-year-old boy with recurrent acute bronchitis and chest X-ray showing platelike atelectasis and tram lines most likely has which diagnosis?
• Ecthyma is caused by infection with which organism?
• Zostavax is contraindicated in which group of patients?
• For plantar fasciitis, which combination is commonly used as part of initial management?
• An 8-year-old child develops fever, sore throat, and a spreading fine macular-papular rash after days; Perioral pallor and anterior cervical lymphadenopathy are present. Which test is most appropriate to establish the diagnosis?
• A 35-week pregnant patient with severe preeclampsia: what is the next step in management?
• Legg-Calve-Perthes disease most commonly affects which demographic group?
• Which histologic type of lung cancer is most typically centrally located?
• Which symptom most strongly suggests acute angle-closure glaucoma?
• A non-displaced mid-shaft ulnar fracture on imaging is best treated with which splint?
• Which class of antihypertensive medications should be used with caution in patients with elevated potassium or intrinsic renal disease?
• In a patient with mastoiditis, what is the treatment of choice?
• Which migraine medication is contraindicated in a patient with known coronary artery disease?
• A 25-year-old male on haloperidol IM develops confusion, an inability to open his mouth, and a temperature of 40 C one hour after injection. Initial treatment should consist of which?
• Which finding is most indicative of a tension pneumothorax, differentiating it from a simple pneumothorax?
• Which is the most characteristic physical examination finding with Graves disease?
• Who is most likely to sexually abuse a child?
• Which lung cancer screening approach is recommended for a asymptomatic former smoker with significant pack-year history?
• A 4 year-old boy presents with pain and irritation of his left ear. Otoscopic examination reveals an insect in the left auditory canal. The tympanic membrane is not completely visualized. Which of the following is the most appropriate management of this patient?
• A patient presents with a pruritic rash on the upper extremities and interdigital spaces with 3-4 mm long, narrow tracks. What is the best treatment?
• Which is the most common presenting symptom of an acute pulmonary embolism in a patient without preexisting cardiac or pulmonary disease?
• Which physical examination finding supports the diagnosis of lobar pneumonia?
• The definitive diagnosis for endometriosis requires which procedure?
• A 53-year-old female massage therapist presents with sudden swelling over the tip of the elbow. The exam shows a 4 cm fluid-filled mass tender to palpation with no erythema or warmth. What is the most appropriate initial management?
• Which finding is typical of retinal detachment?
• A 45-year-old diabetic female with gallstones presents with severe epigastric pain radiating to the shoulder, fever and jaundice. What is the most likely diagnosis?
• In hepatic encephalopathy, lactulose works by which mechanism?
• A 66-year-old male presents with progressive blurred vision over months and a cloudy lens with absent red reflex. What is the most likely diagnosis?
• An electrocardiogram shows a consistently prolonged PR interval with a missing QRS every two beats. What is the most effective management?
• A 46-year-old woman describes regular, prolonged, heavy menstrual bleeding. This is best described as which of the following?
• Why is lymph node biopsy not performed in suspected mononucleosis?
• Why are monoamine oxidase inhibitors not considered first-line therapy for major depression?
• Elevated levels of Lp(a) lipoprotein are thought to raise cardiovascular risk primarily by which mechanism?
• During a mental status examination, repeating words and phrases out of context is an example of which thought disorder?
• Which lesion is typically a discolored elevated bed/mass of vessels penetrating to or through the epidermis?
• Which diagnosis best fits a patient with severe hyperglycemia (glucose 1200 mg/dL), high serum osmolality (320 mosm/kg), dehydration, normal pH, and absence of ketones?
• A 33-year-old female with sudden, brief episodes of palpitations and no prior heart disease. Which is the most likely explanation?
• During a routine funduscopic examination, fluffy white lesions with irregular borders are observed in a patient with hypertension. This finding is most consistent with which retinal lesion?
• What is the optimal therapy for a 76-year-old patient with chronic atrial fibrillation and no allergies?
• What is the recommendation for primary prevention of stroke in a patient under sixty years of age with atrial fibrillation and no additional risk factors?
• Which biomarker becomes positive earliest after acute myocardial infarction?
• A 3 year-old child bitten by a black widow spider is brought to the emergency department within 20 minutes. Which is the best initial intervention?
• Which of the following clinical characteristics is associated with bicipital tendonitis?
• A 3-year-old child presents with profuse watery diarrhea and dehydration. The most appropriate initial management is?
• Hard exudates in the retina are described as which of the following?
• Which medication inhibits prostaglandin synthesis by blocking cyclooxygenase?
• Batteries in the esophagus can cause mucosal injury in as little as how much contact time?
• A 22-month-old with a barking cough and mildly elevated temperature presents with inspiratory stridor when agitated but no stridor at rest. Which is the most appropriate treatment?
• Murphy's sign is classically associated with which condition?
• Which finding is typical of organophosphate poisoning?
• Actinic keratosis is most likely to progress to which malignancy if left untreated?
• Which fracture is associated with a
• Genotyping for cystic fibrosis mutations: which statement is true?
• A 12-year-old male presents with leg pain worse at night; radiographs show a 1 cm radiolucent nidus surrounded by osteosclerosis. Which is the most likely diagnosis?
• Which pathogen is most frequently implicated in acute viral myocarditis?
• Which imaging study is the diagnostic study of choice for a suspected orbital blowout fracture in an adolescent after blunt trauma?
• Which finding is most characteristic of Coxsackie virus group A infection presenting with sore throat and vesicles on the soft palate?
• Which x-ray view best demonstrates a Scotty dog deformity associated with spondylolysis?
• Which radiographic view is used to visualize the odontoid process and the relationship between C1 and C2?
• Rebound tenderness is best described as pain experienced when...
• Which CSF profile is most consistent with viral meningitis?
• A patient has right-sided extremity weakness and left facial weakness; where is the lesion?
• Which antibiotic may cause a disulfiram-like reaction when alcohol is consumed?
• Which feature best supports a diagnosis of normal pressure hydrocephalus in an elderly patient with dementia?
• Which nephrotic syndrome is most common in children, typically following an upper respiratory infection?
• Which signs are typical of acute angle-closure glaucoma?
• For a peritonsillar abscess in a teenager, the treatment of choice is which procedure?
• A 26-year-old sexually active woman has dysuria with fever and flank tenderness. Which outpatient antibiotic is first-line for pyelonephritis?
• A patient with known relapsing-remitting multiple sclerosis presents with an acute exacerbation. What is the recommended treatment?
• Which symptom is more characteristic of Lewy body dementia than Parkinson's disease?
• Incomplete abortion is best described as partial passage of products of conception with continued bleeding. Which option best describes it?
• Which mechanism is most commonly associated with meniscal tears?
• A patient presents with left eye discharge and matted eyelids. The cornea is clear. Which topical agent is the treatment of choice?
• A patient has left lower facial droop with preserved forehead movement; this pattern is most consistent with damage to which neural pathway?
• A newborn male with the meatal opening on the dorsal surface of the penile shaft just behind the coronal sulcus has what condition?
• When injecting a corticosteroid into a joint to relieve pain, which agent is most commonly mixed in the syringe?
• What is the major side effect associated with glycoprotein IIb/IIIa inhibitors used in PCI or revascularization?
• Malar rash is most characteristic of which condition?
• A patient presents with persistent worry for more than six months accompanied by sleep disturbance, poor concentration, and irritability. What is the most likely diagnosis?
• A 66-year-old male with hypertension and benign prostatic hyperplasia asks which medication would most likely benefit both conditions.
• Which finding most strongly supports a diagnosis of hyperosmolar hyperglycemic state rather than diabetic ketoacidosis?
• In the treatment of a patient with a first episode of major depression and no significant medical history, which class of antidepressants is considered the first-line option?
• A 15-year-old male has upper body blood pressure higher than the lower body with delayed femoral pulses. What is the most likely underlying diagnosis?
• Which statement about Zostavax administration is true regarding patients who have recovered from shingles?
• Gout is most definitively diagnosed by which test?
• Which antibiotic class is most nephrotoxic?
• In suspected mononucleosis with splenomegaly, which activity should be avoided to reduce the risk of splenic rupture?
• A 25 year-old man with odynophagia and dysphagia; endoscopy shows small white patches with surrounding erythema and silver stain positive for hyphae. Best treatment option?
• Higher doses of selective serotonin reuptake inhibitors are usually required to achieve benefit in which condition?
• For generalized anxiety disorder, symptoms must be present for at least how long?
• In a patient with irritative urethral discharge and a Gram stain negative for intracellular diplococci, which drug is the treatment of choice for non-gonococcal urethritis?
• A 50-year-old male presents with unilateral severe headaches accompanied by nasal congestion and rhinorrhea; alcohol is a known trigger. Which acute treatment is most effective?
• In a patient with granulomatous lung disease and a negative PPD, which diagnosis is most likely?
• Which imaging modality is invasive and involves radiation and contrast and is not suitable for office-based evaluation?
• Which prescription medication is best to relieve premenstrual syndrome symptoms such as irritability and weight gain?
• In a patient with suspected ectopic pregnancy who is unstable, what is the next best step in evaluation or management?
• A patient with adrenal insufficiency is taking hydrocortisone 25 mg daily. What should the patient do with the hydrocortisone dose when they develop a minor illness such as a cold?
• Which of the following is the most common cause of conductive hearing loss in an adult patient?
• In women in their 40s with large intramural fibroids, what is the most common indication for hysterectomy?
• A 56-year-old man with polycythemia presents with sudden leg pain, cool limb, cyanosis, and absent pulses. The most likely diagnosis is which of the following?
• An 18-month-old female swallows a hearing aid battery. Radiograph shows a radiopaque object in the distal esophagus. What is the most appropriate treatment?
• A 30 year-old female presents with generalized weakness, eyelid ptosis, proximal muscle weakness, and normal reflexes. Which is the most likely diagnosis?
• Lp(a) lipoproteins are secreted by the liver and have a main component that is what?
• To prevent progression of diabetic nephropathy, which medication should be started?
• During a routine prenatal visit, fundal height is at the umbilical level. Approximately how many weeks gestation does this correspond to?
• Osgood-Schlatter disease is inflammation of the tibial tuberosity affecting mainly boys in which age range?
• Which antiviral agents are indicated for prophylaxis against influenza A or B?
• A positive drawer test would indicate injury to which structure?
• When instituting diuretic therapy for patients with heart failure and reduced kidney function, which diuretic is considered first-line due to improved sodium clearance?
• In patients with acute myocardial infarction, which valvular abnormality is most likely on echocardiography?
• At 12 weeks gestation with vaginal bleeding and a dilated cervix, which is the most likely diagnosis?
• A 75-year-old male presents with a stroke characterized by right-sided hemiparesis, right homonymous hemianopia, and aphasia. Where is the lesion located?
• A positive direct Coombs' test is most likely seen in which condition?
• A 35-year-old male on fluoxetine 20 mg daily for 5 weeks still feels depressed without suicidality. What is the best course of action?
• Atrophic vaginitis is associated with a vaginal pH that is typically which of the following?
• In suspected acute appendicitis, which sign is Rovsing's sign?
• In HIV infection, what induration size on a purified protein derivative (PPD) test is considered positive?
• Which condition is caused by a disorder in the red blood cell membrane?
• In scoliosis, which imaging modality is used to determine the Cobb angle and quantify the degree of curvature?
• Unequal thigh folds in a neonate most likely indicate which condition?
• A child with type 2 diabetes on a twice-daily regimen of NPH and regular insulin experiences midafternoon hypoglycemia. Which modification is most appropriate to reduce these events?
• Which medication class is recommended for patients with an anterior wall myocardial infarction and poor left ventricular function?
• Which antibody is commonly positive in Sjögren's syndrome?
• In a patient with suspected mononucleosis after more than 3 weeks of symptoms, which test is most likely to be positive?
• A 60-year-old male presents with a one-centimeter firm nodule at the right temple with heavy keratinization. There is no fluctuance. Which is the most likely diagnosis?
• Which medication is considered the treatment of choice for pruritus in primary biliary cirrhosis?
• Which features are typical of acute nongranulomatous anterior uveitis?
• Which diagnosis best explains a slow-growing, mobile subcutaneous mass without skin changes in the upper back?
• Which insulin type has rapid onset and is typically used around meals to control postprandial glucose?
• Which sign is not typical of acute angle-closure glaucoma?
• High ventricular filling pressures are indicated by a rise in which biomarker?
• Which radiographic finding is commonly seen in bronchiectasis?
• Which of the following is classically associated with an atrial septal defect in addition to a loud P2?
• A 72-year-old man presents with LLQ pain, fever, leukocytosis; which is most likely diagnosis?
• What is the most accurate way to determine the exact degree of spinal curvature in a child with scoliosis?
• Which underlying cardiac abnormality is most likely indicated by widened P waves in lead II and a large initial P wave in V1?
• Long-term exposure to silica, coal dust, and asbestos may lead to which complication?
• Decreased tactile fremitus and dullness to percussion are most consistent with which condition?
• An unconscious patient with prolonged immobilization develops dark urine and a positive dipstick for heme but no red blood cells on microscopy. The most likely diagnosis is?
• Nursemaid's elbow occurs most commonly when a caregiver pulls a child by the forearm, causing which injury?
• Rovsing's sign is classically observed in which condition?
• Spina bifida occulta is usually detected by which initial diagnostic evaluation?
• A patient with a 90% lesion in the left main coronary artery should undergo which intervention?
• DDAVP works by releasing which factors from storage sites to aid hemostasis?
• An 18 year-old male is involved in a motor vehicle accident with a question of cervical spine fracture. What is the imaging test of choice to initially evaluate this patient and clear his cervical spine?
• A patient on heparin with suspected heparin-induced thrombocytopenia should be managed by which action first?
• Endometriosis most commonly presents with which symptom combination?
• A 46-year-old woman with a large intramural fibroid and heavy menses: what is the most appropriate management?
• A patient with syncope and a decreased pulse on the right radial artery during exertion most likely has which condition?
• Which group is most likely to present with Duchenne muscular dystrophy?
• Which vulvar condition is described as the most common benign inflammatory disorder of the vulva?
• Breath sounds over an area of atelectasis are typically?
• Which complication can occur in post-pubertal males with mumps?
• In a patient with pheochromocytoma undergoing surgery, what is the most appropriate acute antihypertensive management?
• In acute myocardial infarction, which diagnostic test best assesses the severity of mitral regurgitation and detects a ventricular septal defect if present?
• Which statement is true about keratoacanthoma?
• A 24-year-old man presents with two months of bizarre behavior, disorganized speech, and delusions. What is the most likely diagnosis?
• A 32-year-old male with sleep apnea undergoes polysomnography showing apneic episodes with desaturation. What is the first-line treatment?
• Which statement about CA-125 in endometriosis is true?
• Which prophylaxis is recommended in all individuals with HIV regardless of disease stage?
• A patient with an acute anxiety attack has lab values suggesting respiratory alkalosis. Which ABG pattern would be expected?
• A 30-year-old man sustains a blow to the lateral leg with pain on weight bearing and tenderness along the lateral aspect of the leg, but no tibial point tenderness or knee swelling. Which diagnosis is most likely?
• Cerebrospinal fluid analysis showing elevated neutrophils, glucose decreased to 35 mg/dL, and high protein is most consistent with which diagnosis?
• In the setting of severe left ventricular dysfunction after myocardial infarction, which drug class should be used with caution due to potential worsening of contractility?
• If a patient had a non-ST-elevation myocardial infarction, which study would most likely remain positive?
• What is the most common exam finding in a patient diagnosed with mumps?
• A 62-year-old female is admitted during an influenza outbreak. She did not receive the flu vaccine this year. Which of the following is the most appropriate drug of choice for influenza prophylaxis in this patient?
• Vesicles in dyshidrotic eczema are most commonly located on which area?
• Which antidepressant class is associated with a high risk of death with overdose?
• For wrist immobilization due to tendinitis or wrist pain, which splint is appropriate?
• An elderly patient presents with a painless brown-colored ulceration near the medial malleolus. Which is the most likely diagnosis?
• Which presentation is most characteristic of nursemaid's elbow?
• Which condition is most likely in a 32-week preterm infant with tachypnea, expiratory grunting, and a chest x-ray showing air bronchograms with a fine reticular granular pattern?
• In suspected infectious diarrhea, which antidiarrheal is contraindicated due to the risk of toxic megacolon?
• Which of the following is the first-line treatment for symptomatic bradyarrhythmia due to sick sinus syndrome?
• Which medication is most likely to cause acute tubular necrosis?
• A 20-year-old male with three weeks of constitutional symptoms and a subacute course has diffuse crackles on lung examination. Which infectious agent is most likely responsible?
• By approximately what time does a newborn typically triple its birth weight?
• The lateral view of the cervical spine detects up to what percent of traumatic spine injuries?
• In infective endocarditis, which phenomenon results from immune complex deposition leading to glomerulonephritis and arthritis?
• Which maneuver would typically decrease the murmur intensity of hypertrophic cardiomyopathy?
• Following thyroidectomy, a patient develops cramps and paresthesias. Which electrolyte abnormality is most likely present?
• Which medication is described as potentially slowing the progression of primary biliary cirrhosis by improving biochemical abnormalities?
• Which medication blocks the tubular reabsorption of filtered urate and is used to treat hyperuricemia?
• Which serum hormone peaks at ovulation in a normal menstrual cycle?
• In Sjögren's syndrome with dry eyes and mouth and positive Anti-La antibodies, which class of medications should be avoided?
• Rubella typically presents with which features?
• A patient with sudden chest pain and dyspnea has tracheal deviation to the left, faint breath sounds on the right, and the right chest is hyperresonant. The most appropriate initial intervention is which?
• In central diabetes insipidus, which electrolyte abnormality is commonly seen due to free water loss?
• To interpret this sensation after a sharp needle-stick, which areas must be intact?
• An afebrile 22-year-old female presents with a tender, bluish, swollen anal mass at the margin that worsens with defecation. What is the most likely diagnosis?
• For birth control in a 25-year-old with prior DVT who wants to avoid pregnancy for several years, which method is best?
• An adult with acute eye pain and photophobia after removing a torn contact lens: which diagnostic study is of choice?
• Which radiographic finding is typical of respiratory distress syndrome in a preterm infant?
• Granuloma annulare is best described as which of the following?
• Which statement is true regarding desmopressin use in diabetes insipidus?
• Which sign is described by pain in the right lower quadrant with internal rotation of the hip while the hip and knee are flexed?
• Which electrocardiogram pattern indicates left atrial enlargement (P-mitrale)?
• Which biomarker remains elevated the longest after myocardial infarction?
• Naloxone is used for treatment of intoxication with which substance?
• Bronchial breath sounds are normally heard at which location in a healthy adult?
• What is the standard diagnostic modality for confirming cystic fibrosis?
• Which etiologic agent is most commonly associated with infectious mononucleosis?
• Which description best identifies Koplik spots in measles?
• Which test can be used as an alternative method to diagnose cystic fibrosis when sweat testing is inconclusive?
• A patient experiences syncope when changing position. Which is the most likely explanation?
• Preretinal hemorrhages are described as which of the following?
• Which nephron segment is responsible for some water and sodium reabsorption but is not the major site of ultrafiltrate reabsorption?
• Roseola is caused by which virus?
• A 54-year-old woman with vulvar itching, postmenopause, pale thin mucosa, yellow discharge and a pH of 6.0. The most likely diagnosis is which of the following?
• Which of the following is NOT a risk factor for retinopathy of prematurity?
• In a patient with advanced COPD, which intervention has been shown to alter the course of the disease?
• Which condition results from hypersecretion of growth hormone in a 27-year-old?
• Which noninvasive test is most useful for evaluating suspected lower-extremity arterial insufficiency?
• A 34-year-old woman who recently underwent trans-sphenoidal resection of a pituitary adenoma presents with polyuria and polydipsia. Her urine osmolality is low and she has mild hypernatremia. What is the treatment of choice?
• In acute pericarditis, which complication is most commonly observed?
• Which laboratory test should be routinely followed every six to twelve months in patients taking lithium?
• The pathologic process responsible for the renal damage in post-streptococcal glomerulonephritis is which of the following?
• Which test is not cost-effective for diagnosing mononucleosis in this setting?
• A 32-year-old male with chronic cough and burning chest sensations for six months most closely suggests which diagnosis?
• Which medication is used for alcohol detoxification?
• Which rheumatoid arthritis medication is contraindicated in patients with chronic hepatitis?
• A 4-year-old with pertussis exposure in a daycare center: what is the most appropriate treatment for close contacts?
• A 28 year-old male burns on the hand; initial intervention of choice?
• Bronzing of the skin is most commonly associated with which conditions?
• A patient presents with a three-month history of progressive severe muscle cramps, extremity paresthesias, and lethargy soon after thyroidectomy for a malignant thyroid lesion. Which diagnosis is most likely?
• A patient with otitis externa presents with purulent canal exudate and tragus tenderness. What is the treatment of choice?
• A patient with end-stage renal disease and a pericardial friction rub requires which immediate intervention?
• A 30 year-old female with a history of gestational diabetes during pregnancy asks about recurrence risk. What is the approximate risk of developing diabetes within 10-15 years after a pregnancy affected by gestational diabetes?
• Which sign is the most important in suspected urethral injury with a pelvic fracture?
• Relief of scrotal pain upon elevation of the affected testicle is known as which sign?
• At what age should a child's eyes be consistently well aligned?
• A 29-year-old female with infertility due to anovulation; which medication is most appropriate to increase FSH by blocking estrogen feedback to the hypothalamus?
• A patient reports sudden vertigo lasting about 30 seconds when rolling onto the left side, with associated nausea but no hearing loss. Most likely diagnosis?
• A 23-year-old presents with 3 days of frequent, watery diarrhea. Initial management should focus on which of the following?
• Which diagnostic test is most appropriate to establish the initial diagnosis of polycystic ovarian syndrome in a young woman with hirsutism and oligomenorrhea?
• Which condition presents with insidious onset of vertigo and unilateral sensorineural hearing loss with tinnitus?
• A 23-year-old male with acute bacterial prostatitis develops acute urinary retention after starting antibiotics; what is the most appropriate next step?
• After a motor vehicle crash with blood at the urinary meatus and suspected pelvic fracture, which test should be performed to evaluate urethral integrity?
• Which test is most appropriate as an initial diagnostic study for suspected Cushing's syndrome?
• A 56-year-old woman requests screening for ovarian cancer. Which recommendation aligns with current screening guidelines?
• Most pancreatic cancers are located in which part of the pancreas?
• During the stages of fracture healing which of the following is responsible for producing collagen?
• In thyroid storm, which drug is the initial treatment of choice?
• A 75-year-old patient with a history of macular degeneration and hypertension presents with sudden, painless visual loss in the left eye. On examination you note a dome-shaped retina and subretinal fluid that shifts with position changes. What is the most likely diagnosis?
• Which renal condition is most likely to occur after an upper respiratory infection and is characterized by deposition of IgA in the mesangium?
• What is the most common cause of portal hypertension leading to esophageal varices?
• Using Nägele's rule, the estimated delivery date (EDC) is calculated as LMP minus 3 months plus 7 days. If a patient’s LMP was April 4, what is the estimated due date?
• What is the treatment of choice for benzodiazepine intoxication?
• Which drug is indicated for postexposure prophylaxis of anthrax?
• For diagnosing Hirschsprung disease, which study is most appropriate?
• A 69-year-old female presents with fatigue, lymphadenopathy, splenomegaly, and pale conjunctiva. CBC shows normochromic normocytic anemia and WBC 45,000/mm3 with 77% mature lymphocytes. What is the most likely diagnosis?
• Which of the following is a systemic manifestation of infective endocarditis?
• Which diagnostic test assesses intraocular pressure in suspected glaucoma?
• Which description is most typical of acromegaly?
• A 62 year-old male presents with acute hematemesis and signs of portal hypertension (distended abdomen, fluid wave). Which of the following is the most likely diagnosis?
• Routine BRCA1/2 gene testing for ovarian cancer screening is limited because:
• Funduscopic examination reveals AV narrowing and venous nicking with blurred nasal border of the optic disc. What is the most likely underlying cause?
• A patient presents with acute bilateral arm paralysis following a recent sexual assault. What is the most likely diagnosis?
• In acute pericarditis, which cardiac chamber's filling is most likely impaired?
• A 60-year-old patient with risk factors presents with a white, white-to-yellow patch that cannot be wiped off and is premalignant. Which finding is most suspicious for oral carcinoma?
• Which of the following interventions is initially indicated for helping to relieve the symptoms of plantar fasciitis?
• Which factor is the most predictive for the development of osteoarthritis?
• In an elderly patient with epistaxis from posterior nasal sources, what is the treatment of choice?
• A cirrhotic patient with asterixis and delirium should be started on which therapy?
• A 24-year-old female with provocative dress and emotional state; which personality disorder best fits?
• Which medication is preferred for absence seizures?
• Osteoid osteoma imaging characteristically shows which feature?
• Which statement is true about atopic dermatitis?
• In an elderly patient with COPD exacerbation requiring systemic steroids, which pharmacologic agent is warranted at this time for treatment?
• A 66-year-old patient with progressive dysphagia: which initial diagnostic study is most appropriate?
• ACE inhibitors help prevent progression of diabetic nephropathy by which mechanism?
• Which finding would most strongly argue against active tuberculosis in a patient with suspected TB?
• Which description defines the psoas sign?
• Which diuretic is a carbonic anhydrase inhibitor that may cause metabolic acidosis and is generally ineffective in a failing kidney?
• For dental extraction in a patient with type 1 von Willebrand disease with ongoing oozing, which agent should be considered first to control bleeding?
• A 50-year-old male with severe epigastric pain radiating to the back and coffee-ground emesis most likely has which condition?
• A hard nodule on the helix discharging chalky white crystals with no trauma history most likely represents which condition?
• Which intervention is contraindicated in acute bacterial prostatitis due to risk of spreading infection?
• Which is an absolute contraindication for the performance of exercise stress testing?
• A 14-year-old patient fell on an outstretched hand and has point tenderness and swelling over the midshaft of the radius with elbow pain. Which fracture is most likely seen on x-ray?
• In a patient with leg trauma and pain on ambulation, which imaging is mandatory to rule out fibular fracture?
• Which is the treatment of choice for patients with celiac disease?
• A 65 year-old homeless male with a history of pancreatitis presents with weight loss and a palpable abdominal mass. The most likely diagnosis is which of the following?
• In the ACC/AHA heart failure classification, which description defines Stage B?
• What laboratory test must be monitored frequently in patients who are taking clozapine (Clozaril)?
• A 70-year-old man presents with progressive memory loss, urinary incontinence, and a wide-based gait. Which diagnosis is most likely?
• Which organism is cited as causing Rocky Mountain Spotted Fever in the source material?
• Which rheumatoid arthritis medication should be used cautiously in patients with heart failure?