@ _Safari__File_Edit_View History Bookmarks Window _Help | Ooms 4) Shs 58) Tue 6:12AM 1. AZT-yearcld woman comes io physician because ofa 1-weok history of pain wit urination, Sheis sexually active wih one male pariner, and they use condoms, ‘noonsstonty. Physical examination enows a hick, yollow vaginal lecharge, There are pathy, macular, orfematovs lewone onthe corn. Th vaginal Hie 86. ‘wel mount preparaon of te discharge shows numerous lecxocyes and mete, oved-shaped organisms tat are 15 2m in eng Which afte allowing Is Ne most ‘Sppropsie parmaccterapy? OA)Ciprooxacin © B)Cindamycin ©.©) Doxyeyetine (0D) Fluconazole 0 E)Mevonidazale4. Safari_Fle_Edit_View History Bookmarks Window Help OM 0) So wos WesAM Oo 2. ASB.yearcld man wit alcoholism comes tothe physician because of 2-month history of inceasingy severe somach pain and increased volumes of fousmaling sok he also has had a 9-.g (20D) weigh! oss during is period. He has a history of mulipe vit fo the emergency department because of severe abdominal pain. He has consumed one bot ofred wine dally oS years, His lemperatre fs 37°C (98 'F) Physical examination shows epigastctendemess His fasting serum Glucose concentrations 150 mgldLA CT scan cf the abdomen shows pancreatic ealsicalons. The most kal cause of his palents curent symploms Is 2 docrease Inwich of te fliowing? © Ale cis stress © B) Colonie bactara © ©) Duodenal pH (© D) Fees elastase 0 £) Tetiyaroxyase actlyMS _ Sie File Ee Vie History Rockers vedo tise, TE le MEE S55) Tue B12 AM 3. A2t-yearcld woman hes a mechanical aoc valve implanted after resolution of severe subacute bactoral endocarits. She begins syste anticoagulation wih ‘waren, Wararn proverts cerebrovascular embolém by inion of whieh othe flowing? (© A) Carboxylafon of coagulation fects © B)Fibin.induced aggregation of platoets © ©)Plasmin binding te erin (© D)Prteoysis of coaguation factorsMS _ Sie File Ee Vie History Rockers vedo tise, LD. octet MBE 25h Te B02 4 During an experiment, an inves igator compares th immune response ofymphooyies rom -montold mice wth that of year-old mie. There is # decrease in responses to Chlamydophila pneumoniae nthe older mice. An ago-olated cnango in which of to flowing call ypesi tbe moat kely caus of tis docreasod Immune response? OA)B monocytes © B) Macrophages: © C)Newtophits (0 D)Plasma cols © E)T lymphocytes4. Safari_Fle_Edit_View History Bookmarks Window Help ome Fv S35) Te sZAM_O 5. Astudys conducted ofnarve regeneration atrinjury in an expefmental animal, A nerve guidance conduits placad within 2 4-mm gap of severed ner. The Conduit filed win a keratin go! exacted fom human har, is found wo enhance vsble nove regeneration across the gap. Microscope examinaton of fa regeneration ‘Se afer inva exposure to re Kevan gel would most ikely sow mitt actly In which ate folowing cals? 0 A) Fibroblasts © B) Macrophages (© ©) Neurons (0D) Plasma cols © E) Schwann eels © F)Unciterenated stom colisMS _ Sie File Ee Vie History Rockers vedo tise, TE le MEE S55) Tue B12 AM Ao a 6, A25.year-ola woman comes tothe physician because ofa 2-wesk history of facia ash. She says hat her joints perodicay ache and {hat she has occasional chest pan, which she describes as sharp and pariculay noticeable when she akes a Geep breath Het temperature 378°C (100"F) Physical examination shows adetonal aes of erythema scared ove stn No jin deformities ‘are noted. A photograph af ne rah is shown, Which of the folowing aboralry teats haste grentes pectin consing the ‘agnosis? (© A)Exytvooye sedimentation rato (© B) Serum anb-double-srandes DNA antibody assay ) Serum antinuclear antibody assay (© D) Serum C-eactve protein concentration 0 E) Urinalysis © F) Culture ofjcint aspirate (©. 6)Prowal biopsy4. Safari_Fle_Edit_View History Bookmarks Window Help ome Fv S35) Te sZAM_O 7. A 7O.yearcld man s brought the emergency department because of bured vison, dy mouth, dysarvia, and weakness inthe upper extremities hat began 8 hours ‘er ang donor at home. His meal includod home-canned greon beans. Afow noure afer arval in he ororgency doparmant he goos ino respiratory arost and is placed on mechanical ventlaion Which of alowing best desanbes the mechaniam of hs lines? (0A) Antibodies binding to acoycholine receptors © B) Decreased release of acetlenoine 0 ©) Decreased reurtake of srctnin 6 D)Deetuetion of meuromuscular junctione © E) neceased acetyichoine clearance © F)nceased release of sertonin 0 6) Reversible injury of muscle coll membranes4. Safari_Fle_Edit_View History Bookmarks Window Help ome Fv S35) Te sZAM_O 8. A 22yearold man whois a miltary recits brought othe physician 15 minutes afar siting while wating inline to raceve a series ofinoculaons before deparing ‘versoas. immediatly aor he faintog his pulse was 4S/min, and Ns palpable ystlic blood pressure was 50 mim Hg, His pulse now e BBin, and bioed rossuro is 400170 men Hg. Physical examination snows no abronralies, Which of he folowing is the most likely cause of fs paents syncope? © A)Aotte stonosis © B) Hypetrophic cardiomyopathy 0 ©) nereased parasympathetic ione (0 D) Third ogre atioventiutar block © E)VentrculartacyeariaMS _ Sie File Ee Vie History Rockers vedo tise, LD. octet MBE 25h Te B02 8. A 3yearld boys brought to the emergency department by his moter 1 hour aflerhavng a gensralizedtoncconic seizure. Ha has had faquent vomiing and propreesive stupor during the past 24 hours. His mothor says at sho gava him aspinn 2 days ago bocaus ofa tempsralure of 39.5 (103.1F). Physical examination Shows hepatomegaly it no jaundice. Serum stdies show an increased ammonia concentration, ane lnereases AST anc ALT activites, Dystuncion of whieh of he folowing lathe rest kal cause of ths patents disor? © A)Gluamate transporters © B) Golgi complex 0.6) Micretbio (0.0) Mitochondria (© E)Rough endoplasmic eiculumMS _ Sie File Ee Vie History Rockers vedo tise, TE le MEE S55) Tue B12 AM 10. A2-year-olé man comes isthe physician because of a 4-month history of premature ejaculation He states hat about haf of ho time,he ejaculates priorto sexual Intareourse, and te ofter ha of the time, he ejaculates immediately on vaginal eoaton. Physical examinaton shows no abnonmalies. pharmacotherapy is, Inaleates,waich of he ollowing is most aperopeate? © A Atropine (© B)Cypreheptadine 0.0) Parexetne (0D) Siléonani 0 E) TrazodoneMS _ Sie File Ee Vie History Rockers vedo tise, LD. inst MEE 03) Tus 6:12 All 11. A'S8:year-olé woman who isa ered teacher comes othe physician o lea th resuls of @ recent evaluation for jaundice. The physician tls her she has unresectable pancreatic cancer, and toroughly dlecuseos her dlagncais an toatmont options with her. She doos not have a mood dora. One weak ator, she retums the physician and siales that she Ras desdes decline alae chemoherapy, whien coud protong here by 6 mons. She says," would ater de of ‘Cancor now than be tetured by stematirapy only eller" Walch of to flowing rgponses by the prysisan is mes! appropia? (©.A) "Have you consulted your clergy before choosing such a path7* (© B)"Irespact your choice. will make you (© 6) I ink you are making bad decision. Why would you want'o choose todo sooner?" (© 0)"Ithink you are making an unwise decision. You never know what kinds of new treaments are just round the comer” (© E) woul tke involve your fein this decision *MS _ Sie File Ee Vie History Rockers vedo tise, LD. A ee een 12, A6S:year-olé woman with severe sensorineural hearing oss undergoes surgical placement of cochlear implant. This neural prosthesis converts sound energy to ‘local elgnal, which obuls in eimulaon of whch of tho following euctros? © A) Auditory nerve endings in the cochlea © B) Cochlear newe asitentors to pons © C)inerhaireals ofte cochien (© D) Olwocachleareforent axons © £) Oval window oft cocniea innervate outer hai calls4. Safari_Fle_Edit_View History Bookmarks Window Help ome Fo S509 Tessa 13, A.SS-year-ld man is scheduled io receive highly emetogenic chemotherapy forcolon cancer. A drug thats an antagonist a wich ofthe following receptors is most Italy fe Bo efloctvo in provening ts paionts nausea and voriing? © A) BeAcronorecepior © B)y-Aminobutyric acid A (GABA) © ©) Hitamine-2 (H,) receptor (© D)Muscarine| 0 £) Serotonin (HT, recopior4. Safari_Fle_Edit_View History Bookmarks Window Help OM 0 ) SH S509 wes AMO “4. Inccorto nvesigat possible treatment options for acute respiratory distress syndrome (ARDS), experimental animals ae anesthetized and subjected io smoke innalaton (ton smoke) according to a wall-osabishec experenalprotsco. The expermancl animals are fen gion compound designed io uproguatospectic ‘mediator Inived n ne ntamratoy cascade. Usreguiation of which of folowing meio woud most Key prevet or ameliorate Be 15g injury Induced In {hs experimantsl model of ARDS? © A)intereukin- (Lt) oByLD © ©) Nudlearfactorkappa 0 D) Tolt-ike receptors (© E) Tumornecross factorMS _ Sie File Ee Vie History Rockers vedo tise, le MEE S25) Tue B12 AM 15, A.Ss-year-olé woman has had vaginal bleeding forthe past’3 days. A previous episode 2 weeks ago stopped afar 24 hours. Menopause occumed 6 years ago. She Used hormone replacement nerapy or approximatly 2 yoers But d/econtnved Westmont 4 yoar age. EndomatalYeeve obtained on cilaation and curotage shows ‘encometial hyperplasia Which of he folowing isthe most kely cause of ese ndings? © A) Ovarian tumor producing estogon (© B) Ovarian tumor producing progesterone (© ©) Pituitary ture reducing flicle-simulating hormone (0 D) Pituitary tuner preducing luteinizing hormone4. Safari_Fle_Edit_View History Bookmarks Window Help OM 0 ) SH S509 wes AMO 16. Six hundred women between the ages of 50 and 60 with palpable beast lumps and who lve in upstate New York undergo mammography. Three hundred ofthese ‘women have an abnormal mammogram, The remaining eee hundred woman have normal mammograms The results of lope in these women are show Biopsy Results Present" Absont Mammogram Abnormal [200 “00, 200 Nomal 0 250. 300 250 350, 500 Which ofthe fotowing sth sonsitvty of mammography inthis group of woman? © A)200800 =0.33 © 8) 200700 «067 © ©) 2007260 =080 0 D)300350=0.874. Safari_Fle_Edit_View History Bookmarks Window Help ome Fi S509 Twes13AM_O 17. A 20-year-old woman is brought tothe emergency depariment by her roommate 30 minutes after she ingested a large quanityofacetarinophen tablets during a ‘uleide atorot The physician asks nor why she ed kil hore. Sho opi carly, "My boyttend ted me that ho dovsnt wanto sos me again and he won't fetum any of my phone call. loved him more than Ive loved anyone ese n my entre Ie. | was going o mary hil Now Ite his gus for what he's done tome. Just warted le" On futher questioning, te physician loams that she had anly wo datos with tla man. She tals he physician "ust cart boar being alone. But! ‘San tel thatyou Understana, Youre te aly doctor who's ever undestond how fea!” This pabent most iksly has which ote following pas of paronally ‘sores? © A)Boréerino © B) Dependent 0 ©)Histionic (0 D) Narcssiste © E) Obsessive-compulsve4. Safari_Fle_Edit_View History Bookmarks Window Help OM 0 ) SH S509 wes3AM Oo 18, Apreviously haalhy S2syear-ald man comes othe physician bacausa of 2-montn history of difculyataning an erection, He has narra bid and has ne istry ‘oforecslo dysfunction. Pnyical examination and dagnostc ising show no abnormalities. A drug wit whic af he following mecnanisme of acon mast ‘appropriate orthis paent? (© A)Acton asa synfotic version of prostaglandin E, diverting blood into the penis © B) Blockade of peripheral acetyicholinestrase actly, nereasing parasympathetic activity in the penis (0 ©) nezeasing conceritaions of cGMP, relaxing smoot: muscle in the penis © D) Prevention of peripheral a adronergie activity. lowing ineroaces blood Now to the penis (© E) Transient incense in penpheralconceavaions of testosterone lowing or eection|4. Safari_Fle_Edit_View History Bookmarks Window Help OM 0 ) SH S509 wes3AM Oo 18, A St-year-cls woman comes fo the physician fora follow-up examinaon. Two manths ago, she was diagrosed wih hypertension; veatment wis hyerochlorobiazde ‘wae bogun at hat ime. Her blood pressure foday Ie 150/100 mm Hg, compared wih 165/108 mm He 2 montis ago. He” eorum potaselum concontaton is 3.2 mEqh. ‘compared wih 4 8 mEgl 2 months ago. Addon of which of he following anthypertensive drugs to his patents medication regimen is most ikely io futher decrease blood pressure and restore potassium concenraten wars bo ference range? OA) Atenolot © 8) Furosemide © ©)Losanan 0 D) Nifepine OE) PrazosinMS _ Sie File Ee Vie History Rockers vedo tise, ele MEE Sh) Tue 6:13 AM 20. Aheaitry 20-year-cld man comes to the physician with his wife for gonetic counseling prior to conception His sister died of cystinosis, an autosomal recessive ‘isorderafecting cyetne ranepor acres yeosomal membranes. The incidence of tvs diecrdr in tre general population i approxmatoly 140,000. The wie’ history is noneanerbutry. The wile’ ek for being 8 camer of hs disorders closest which a the lowlng? oni B28 o.c)1s0 9p) 1100 oe) 1200MS _ Sie File Ee Vie History Rockers vedo tise, ele MEE Sh) Tue 6:13 AM 21. A25year-ld man s losin the desert for 1 week with an ample supply cf water but no fod. Which ofthe following changes in enzyme activites and regulatory ‘moleese concontraions in Ivers moet kay in be pation? Fructose Gwucose _Phosphoanofpyruvate Pyruvate 2,6:bisphosphate G-phosphatase —Carboxykinase Kinase on 1 1MS _ Sie File Ee Vie History Rockers vedo tise, LD. a een 22. A 14-year-old boy is broughtto te physician's ofice because of decreased appetie and abdominal pain over te past’3 weeks. His moter says that curing the same {ie he has withdrawn rom everyone and sleeps constant. He desenbes his symptoms vaguely. Physical examination is nomal. Dring furor histo aking tis ‘most ontea Yr te physician e tan Inlomation about which ofthe flowing? © A) Developmental histo (© B) Famiy history of affective ascrcers (© ©) Orientation time, place, and person (0 B) Schost history (© E) Suieidalideston or tempts4. Safari_Fle_Edit_View History Bookmarks Window Help ome Fi S508 Te s13 AMO 23. AST.year-lé woman comes tothe physician because ofa G-wesk history of aching in her legs. She has been 2 waiess fr 35 years. Examination of he lower ‘exromitos showe soverl bulging, oruous vein, Dyeuncson ef wnich of he follotng stuctures is the most ikaly cause of is problem? © A) intemal elastic lamina © B) Saphonous nerve © ©) Tunica mesia (© D) Vasa vasorum © E) Venous vavesMS _ Sie File Ee Vie History Rockers vedo tise, ele MEE Sh) Tue 6:13 AM 24, A Ta-year-os woman with estaoatns comes to the physician fran iia exarination. She ie otherwise healthy and ves alone. When the physician enters the ‘examination rom, ne deci a elght odor suggestive of une. hie most appropiate forte phyieian to approzeh the tapi of unary incontinence with his paint n ‘whieh of he flowing ways? (© A) ‘Are you having any probloms that you may be too embarassad to ak about? Would you be wilingt tak about thom today? (© B)"lcaudnthelp but natce an odor when leame into the room. Are you having any fcully holding your urine?™ (0.0) lunderstand this can be cficulti ak about, but do you find yourself also having fcalincontrence in adn to urinary incontinence?” © 0) Iikow tie can be an embarassing topic, but people sometimes have atic noiding their une ae hey gtlder i hie ever a problem for your” © E) his not suprising that someone your age is having problems with urinary incontinence. How many accidents do you have a ay?"4. Safari_Fle_Edit_View History Bookmarks Window Help ome Fi S508 Te s13 AMO 25, A 35-year-old woman with HV infection has a fst generalized tonic tonic seizure. An MR show enhancing lasion inthe right ronal lobe. ‘lreatacte biopsy of i losin were performed, would show ntange Infitraton of lymonocys, ‘macroohages and numerous 3 x -mm crescort- ‘Shaped organisms with cental nue. The lesion regresses slowly afer reaiment with sulfonamide and pyrmetnamine. Wnich ofthe following she mostikely mode ‘fttnemisnian ois nection? © A) Blood wanstusion © B)Ingeston| © ©) Migration across the eebitorm plato (0.0) Sexual intercourse © E) Smalropletinvalaion4. Safari_Fle_Edit_View History Bookmarks Window Help OM 0) SH S500 wes3AM Oo 26, A S-yer-lé woman with mule sclerosis is bought to the emergency department by a fiend because ofa ‘our history of increasing confusion; she is now ‘suporous. Sho has been in romssion fr 2 years. Her temperature ie 372°C (99°F), pulae fs 72min, respirations are Gin, and blood pressure is 116/68 mm Hg. Percussion ofthe ches shows decreased lung volumes. The lungs are clear to austutalon. Breath sounds are distant. There's a minimal gag response. When ‘roused, she le midly combetve, maves al aurextemee, and fan dita Back ie stipe Artaral load ges snalls on rom ar shows pH 72 Peo, Pemmiig Po, S0mmHg ‘Which of te otowing most kay cause of is palonts condition? © A) Ace respirator distress syndrome © B)Agpiaton pneumonia (0 ©) Opiia overdose © 0) Pulmonary embolism © E) Upper airway obetucton4. Safari_Fle_Edit_View History Bookmarks Window Help ome Fi S508 Te s13 AMO 27. A 25-year-lé man comes tothe physician 10 days afl injuring his ight lbow wile tying oi an €0-b dumbbell at the gy. When he alte oi he weight ‘rom he rack he ftta popaing eensaton and pain in hie rghtalow. He uese anabolic strode. rie pu'se le 7Blmin and bloodpressure ie 1SUG5 men Hg. Examination ofthe ight upper exvemiy anous swelling ofthe antecubital tose ard ec=nymoses fom the antec essa the mis trearm onthe antonor de “Theres tendernoes to palpation ave he proximal anpect of the anterior forearm, Hels abate fex the aloow acvely,buthe le unable ta fex te albow or aupinata fe {oroarm agains! resistance This patertnas most kal njrod a muscle-tondon unit thats supplied by whieh cf he following nowves? © A) Anterorintrossecus © B) Median 0 ©) Musculocutaneous © D) Radiat 0 E) Ulnar4. Safari_Fle_Edit_View History Bookmarks Window Help ome Fi S508 Te s13 AMO 28, A'5-year-ld man develops fever 3 days afer undergoing a cholecystectomy. He has 22-year history of ntrmitent pain in his igh reat toe. Hes 183 cm (6 tl ‘and woighs 159 kg (360 Ib) BM fs 48 kai His fomporatuo' 38.3°C (101), pulse 1 Tami, and blood pressure ie 13070 mm Hg. laral cackos and ‘Wwheazing are heard on auscultation athe chest Tne Nead sounds are astant Abdomanelexanation showe 9 Healing niscn hat rot iad. Theses sweling ‘and redness of tha right frst mtaiarscphlangeal ant Witch ofthe lowing isthe moat kel cause of the Joint ndings? (© A) Calcium pyrophosphate cysts © B) Staphylococcus aureus infection (© ©) Staptococeus pyogenes (group A) infection (© 0) Synovial vascultis © E)Urtecrystals4. Safari_Fle_Edit_View History Bookmarks Window Help ome Fo Shs Te 63 AMO 29, A 17-year-old boy is brought tote emergency deparment 15 minuies air he was found unarousable ‘oxycoione tablets wore found in his pocket Hoh the high schoo's bathroom. Approximately erty mg istry of using mule ile drugs. Whien of ofllowing Gots of cca fndngs ie moet kal in is patent? Pupil Glasgow Coma Pulse —-Respirations. Examination Score on Incrwased normal consbicted 12 08) ‘morwased © dacreasod noma 5 28) Normal Inoroases Gilted 5 6D) Norma otal Slated 7 OE) Decreased §——ncroasea nomat 2 OF) Decreased decreased constctod 74. Safari_Fle_Edit_View History Bookmarks Window Help Om OSH wes wessAM o ee as ee ae HATES 30. Thesequrc harman .ean gee, te he xo nhl cpl ta, tou in te fg. he tain sat coder ATG orton I-86 arth neler stp can THA osc tf st weursoned Wich te alr mabe fr) wi mae ay Hao acest )0-T at soton + 2) 0A st pain 245 016 Rat poaton 6724. Safari_Fle_Edit_View History Bookmarks Window Help OM 0 ) SH wor wes san Oo bruising forthe past month. Heh 2-year histry alcoholic cinhosis wit portal hypertension. Laboratory Hemoglobin 10g. Hematoeat 30% Leukooyte count 44000%mm® Nautoahis| ro Lymphocytes 30% Monecites 4% Eeanophits % Basophis, ox Reiiclooyte count Bi of red cella Moan corpuscular volume 102 um= Paolt count 8,000Rrm® Protirombin ime ‘Bee Partaltrombopiasin tme(sctvated) 28 960 Senm Fibsnogen £200 mata (N=200-400 mgidL) Fiban spit products ‘10 N= 10) ‘Which ofthe followings the most ikely cause ofthe pancytopenia? ©) Dissominatedinkavascularcoagulaton 8 B) Hypersplenism (© ©) ron deficiency (© D) Vitamin B, (hiamine) deficiency © E) Vitamin € defconcy F4. Safari_Fle_Edit_View History Bookmarks Window Help Om O | SH wos wes san o blood pressure is 90/60 mm Hg. Abdominal examination shows diftuse tondemess with rebound and guarding. A splenectomy is done, Six months lator, which ofthe following a most ikely be neled on a peripheral blogs sen”? © A)Howell aly bodies © B) Hypersegmented neutrophils 0 ©) Microyic entrees 0D) Schistoeytos 0 E) Spheroeytes4. Safari_Fle_Edit_View History Bookmarks Window Help Om O | SH wos wes san o 33, ASS:yearcld man s brought unconscious tthe emergency departnent 30 minutes aterhe collapses tinleshovating snow. Hife sad that her husband Nad tinging and weaknans of his le upper snd Towar extremii Just befor he last canesousnese, A Babine signspresonton tele A onennast CT scan of te head Is shown, Wnien of he flloulng ste syongst predisposing Ask Fedor for hese tncings? ‘A Cholesterol plaques B) Cigarette smoking (C) Deep venous vorbosis D) Hyperision Vasculitis4. Safari_Fle_Edit_View History Bookmarks Window Help ome Fv Shs Tessa ‘thes a presen Folowng ie aarunistavon afreessprine. tees provements fe muscle wennese The rat key cise cee srangh ‘etennodrrnber of ecopoon whic athe lowi mvoone corporane? © A)Ciatencontea vesicles © B)bysosames © )Nuearamina © D) Pasa membrane © €) Sen endoplasmic4. Safari_Fle_Edit_View History Bookmarks Window Help OM O | SH wos TessAM Oo Gia 2 '35, A 60-year-old man comes tothe physician because ofa t-mont histor of aporsictot hoarse voc. He has smoked 1 packs of cigars dally fr 40 years. Physical examination iowa ne abnormalities, Laryngoscopy shows 8 lesion on te We vocal cards, Photomicrographs ta bopsy specimen of he lesion are shown \Whien of he following best describes his patients lesion? (© A) Adenocarcinoma, (© B)Adenoma’ (© ©) Squamous cell carcinoma © D) Squamous cl papitoma (© E) Vocal cord poleMS _ Sie File Ee Vie History Rockers vedo tise, le MEE S55) Tue 15 AM 36, During an experiment on fects of ATP on renal function, a kidney is excised fem an experimental arimal nd perused witha mitochondrial inhibit. The kidney Iston studied using micrpunctre of ingle neprrons. In which of ho fllowing nephron sogmentss the greatoe!docroaso In soclum resorption most Ikly? © A) Collecting duct © B) Distal convoluted tubule (© ©) Proxmal convoluted tubule (© D) Thick ascending imb ofloop of Henle (© E) Thin ascending limb ofoop of Henle (© F) Thin descending lim of oop of Henlele MEE S55) Tue 15 AM MS _ Sie File Ee Vie History Rockers vedo tise, ane ional oud of Medical Examine — 37. A 54-year-old man fs brought tothe emergency departnant 30 minutos ator theensetof severe chest pain that bogan wile ho was paying golt Hain sovoro respiratory sites Hie plge i 120!mn, ng reeraions are 28min, Physical examinaton shows palix and caphereas, Craclee are naar haltway up te bases ay is shown Which ote following is the most ely cause of hese findings? fhe lung feds. A chet {Decreased hydrostate pressure inthe pulmonary areal creulaton 8) Decreased osmotic pressure in te bronchial enous culation (©) Decreased osm prseurein tha pulmonary eral circulation D) increased hydrostatic pressure inthe pulonary venous ceuiaon E)|ncreasod osmotic pressure inthe alveolar Iympha creuston FIncreaced osmotic preeure in the pulmonary venous cieulaon4. Safari_Fle_Edit_View History Bookmarks Window Help ome Fo Spun Tess AMO 38, A't-year-olé woman comes to the physician because of fin lump inher neck for S months; she also has trod easily during his period. Physical exaination ‘shows modest symmotic enlargement of te thyroid gland Her serum tyroxine (7) concenraon i 1.8 g/dL. Which of te folowing adtenal son findings is ‘most ikely in this patient? ©) Decreased tyrid-etmulating hormene concentation © B) Decreased thyrotropin-eeasing hormone concentration © C) ieceased tyrosine binding globulin concentason (0 D) Presence of antinyroid poroxcase ansbodies (0 E)Presence of hyroid-stmulating antibodies4. Safari_Fle_Edit_View History Bookmarks Window Help ome Fo Spun Tess AMO 139, A 20-year-old man who recent immigrate tothe USA fro Mexico comes tothe physician because of 3-day histor of paicful cer on his penis. He ecenty had Uunprotecteg soxual intercourse win a proetute Physical examination shows a 0.5-c, no-induraied, tondor ulcer onthe sha of fo pers. Culture ofa seraping ct the ueeron nutitonallyenrened chocolate agar grows a srl, oxidase-posive, gram-negative baclus that expresses fiatamase, Which ofthe liowing is te ‘most ly causal organism? © A)Ghlanyaie rechomavs © B)Haemaphius ducreyi © ©) Kepsiona (Catymmatobactorum granuiomats (0 D) Nelssena gononhoeae (© E) Treponema palicum4. Safari_Fle_Edit_View History Bookmarks Window Help OM OSH wesn wessaM o 40, A33-year-clé mans brought tothe emergency depariment hous ater injring his lef ankle while skiing, Examination ofthe la ankle shows sweling and exquisite {endemese. An x-ay shows no abnonnaltes. A nensioridal ani -nfarmatory drug (NSAID) prescribed. Aer nis ymetoms resolve and te patient stops taking the NSAID, the agent continues to have a prolonged efect on his patlet aggregation, Wnich ofthe folowing NSAIDs was most ikely prescribed? CO AASpirn © B)Celecoxio © ©)Diclotenac (© D) buproten (© E) Indomethacin4. Safari_Fle_Edit_View History Bookmarks Window Help ome Fo Spun Tess AMO 41. Aprevously healthy 6-onth-ld boy is bought othe physician because ofa cough or 1 week Illy he had a low-grade fever, sneszing, congestion, and nny noge. Ho men developed a dy intormitent cough. The parents now nolo hat wih an state ne baby chokes and gasps. He has net had any immunizations. Physical ‘examination shows parexyams of machine gun ike coughing with 8 freed explatorygfunt athe end of coughing. LesKocyte counts 90, 000!mm= (70% Iymphceyies) Noutoph chemotaxis and oxidative metabollam aa ceectva Gus a increased Savy of whic ofthe fllowing enzymes? © A)Adenyly cyeiase © B)Mysloperoxidese (© G)NADPH oxidase (0.D) Phospholipase C © E)Proteinkinase cMS _ Sie File Ee Vie History Rockers vedo tise, LD. a Se sn 42. Amale newbom is deivared attr, Physical examination shows hyperilrism, low-set notched ears, shortened philfum and ceftpalat. invite studies of T- Iymonooje uneton and few cytometry to estate mo number oT Iymphocyteg in perpheral blood chow ym aplasia Fer ostng of his newbom is moet lkaly to show which of ie flowing adcitonal abnormalities? © A) Congonita hypoparathyoiism © B) Fermaton ofa branchial est © 0) Hyperinyaicism (© D) Hypepiasia ofthe mancibie (© E)Uncerdevelopment of me zygomate bones4. Safari_Fle_Edit_View History Bookmarks Window Help OM OSH wesn wessaM o 43, 45-year-old mans brought tothe emergency depariment because of sever, substemal, crushing chest pain Pat has been radiating to his let arm fr be past ‘Zhour. ie pulse 10oImin, respirations are ‘4imin, and bloosprosaur e 1701100 mm ig. A grage 376 hologetale mummuie hoard best verte caciae apex ‘After reament wih oxygen aspinn,nioglycerin, morphine, and a tomibolyt, be chest pain resolves, ang his blood pressure cecreases io 12060 mmPig, Repeat ‘auscution ofthe chest doesnot datact#eardiae murmus Which cf the faloming athe mest likely eauoa fhe mama? (© A) Acute aol valve Insuieiency © B)Aotic dissection 0.6) Atal soptal dooce © D)Papliany muscle iscnemia © E)Patentducus ateriosus © FVenticulr septal detect,4. Safari_Fle_Edit_View History Bookmarks Window Help OM O ) SH wes Tess AM 08 Natal arf Medial names 44, AS8.yearold man who had a ena allograft 2 years ago undergoes a renal biopsy because of decreasing renal fincton. The photomicrograph shows a poton ofa Sesus stained forelastn Which off folowing ithe ‘most ikely cause of me docroase in ranalfuncton? A) Ac collulr grat > B) Chronic gra rejection (¢) Hyperacut grat roocton D)Pyetoneparis > E)Recurance of merrranous glomersionephis ction4. Safari_Fle_Edit_View History Bookmarks Window Help ome Fv Shs) Tess AMO y-lé man wit lung cancer comes tha physician for afllow-up axaminaton, Smaking cessation has been recommended, but he patent says that he is Lunablo qultbocause he experiences a pleasurable senaaion as no rales tne smoko. Ho nas smoked 2 packs of lgaretos dally for 30 yoars, Which ofthe following mechanisms best explains how nicotine produces this sensation leading 0 addiction inthis patient? (© A) Activation of poi ooptor inte midbrain © B) mezeased release of dopamine in the ncteus accumbens (© ©) ibibo ofy-arinobuyric ace (GABA) release inthe hypothalamus © D)Inmibiton of glutamate receptor inthe ayaa © E)Potentation of GABA receptors inthe cerebral cortex4. Safari_Fle_Edit_View History Bookmarks Window Help OM O ) SH wees wessAM o 46, A28-year-cld priigravid woman at 18 weeks’ gestation comes othe physician fra routine prenatal visit Physical examination shows @ vers consstentin size ‘wit 2'4-wook gestaton. Uirasonography snows fetal anencophaly. hic of to fellowing most kl fled te cecurin ts fous? (A) Closure ofthe rostral end ofthe neural tube © B) Development ofthe corbellum (© ©) Development ofthe miabrain (© D) Migration of maul crest call derivatives to theicadut postions (© E) Migration of muons into tho corbral cortx4. Safari_Fle_Edit_View History Bookmarks Window Help OM O ) SH wees wessAM o Ao : 447. A72-year-clé woman who is tgh-handed is brought tote emergency deparimentby her husband 3 hous afer the suden onset of cifclly speaking. She has @ sto of atl tblaton. She i alor. Neurologic examination shows moderate weakness of te lower vo tds othe Taco ont ght She understands vorbal ‘commends, sich a8 raise your night arm Her speech sot apantareus and canals of be prvases wiht nionaton (prosody) Damage whieh of he flowing labeled acta n the drawing fhe ra athe mast sly cause of te language nd nga ints patent? Teel4. Safari_Fle_Edit_View History Bookmarks Window Help ome Fy Shs) Tess AMO 48, A.29-year-old mani brought to he emergency depariment20 minutes alr ne was found lockad in a fuck parked in ful summer sun. He has lost at least 12% of his reported body mass, Pnysical examination shows sovore dehydration. Inravenous fluid administration i begun, and witin 60 minutbe te patontcan aink by mouth. He then fas asleep. Althe te the patient was found, whicn of we flowing physcloge parameters was most ikely dectenseg? © A) Plasma angiotensin il concontation © B)Plasma renin atiy (© ©) Renal adrenergic receptor simulation (© D) Renal atoritarpertusion prossure © E)Renal sympathetic nerve sctvation4. Safari_Fle_Edit_View History Bookmarks Window Help ome Fy Shs) Tess AMO 49, A.30-year old woman with wel-contoled ype 1 diabetes melius has end-stage renal disease. The serum concentaion of which ofthe flowing is most kay tobe inereacod? © A) 1. 25.Dinydroxycholecaletor © B) Enftwopoiatin © ©) Estrogen (© D) Parathyroid hormone © E) Thyroid stinuasng hormone4. Safari_Fle_Edit_View History Bookmarks Window Help Om O | SH wees wesisAM o 50. Tha diagram shows 2 porion ofthe cal cytoplasm containing rough endoplasmic eculum and amitechondin. The ntl glycosylation of proteins dastinad io be exported rom a hepatseyto occurs at whien ote flowing labeled soe nthe ciagram?