200 REAL EXAM QUESTIONS AND CORRECT ANSWERS (
VERIFIED ANSWERS ) ALREADY GRADED A+ (ASSURED!!)
2025 NEWEST EXAM / JUST RELEASED!!
45yo woman follow-up exam after 8 weeks tamoxifen therapy
for estrogen- and progesterone-positive invasive ductal
carcinoma of breast. 50yo sister also hormone-sensitive breast
cancer. Physical exam normal. Serum decreased
concentrations of endoxifen, active metabolite of prodrug
tamoxifen. Genetic analysis shows homozygous cytochrome
P450 2D6*4 alleles. Likelihood patient's sisters has same
alleles? - ANSWER-25%
60yo man progressive shortness of breath past 3 months.
Worked in shipyard.
Respirations 25. Bilateral basilar crepitant crackles. Xray chest
reticulonodular
pulmonary infiltrates consistent with interstitial fibrosis.
Picture: sputum sample
of elongate structures (ferruginous body). Fibrosis initiated
by interaction of
,structures with which cell? - ANSWER-Alveolar
macrophages
30yo woman 20 weeks gestation, uncomplicated pregnancy.
Fundal height is greater than expected for gestational age.
Ultrasound shows increased amniotic fluid. Which abnormality
is cause? - ANSWER-TEF
43yo woman for health maintenance exam. Physician 30
minutes late for appointment because of emergency, when
enters, patients checks watch. Which is best initial response? -
ANSWER-"I'm sorry I got delayed. I hope I haven't made you
late somewhere else."
27yo woman 12-hour history of fever and abdominal pain.
History of recurrent urinary tract infections. Temperature is 39
C (102.2 F). Physical exam tenderness of right flank. Abdominal
xrays bilateral staghorn renal calculi.
Urinalysis pH 8, many RBCs, WBC, bacteria. Calculi composed
of? – ANSWER-Struvite
48yo nulligravid woman with excessive uterine bleeding for 3
months. Bleeding during menses and at irregular intervals.
Menses were regular before. BMI 27. Pelvic exam: adnexae are
nonpalpable. Endometrial curettage shows abundant tissue.
,Which is cause of symptoms? - ANSWER-Endometrial
hyperplasia
65yo woman surgical repair of aneurysm right internal carotid
artery in cavernous sinus. Three days later, physical exam right
pupil larger than left pupil. Weakness of eye movement.
Diagram of coronal section through middle cranial fossa
shown. Which nerve is damaged? - ANSWER-CN III (first nerve
on the lateral side) III-->IV-->V1-->V2; VI in the middle
55yo woman 6-week history low energy, irritability, crying
spells, difficulty falling asleep, wakes up during night, cannot
focus. Taking lorazepam for 15y for generalized anxiety
disorder. Taking estrogen replacement therapy for
postmenopausal symptoms. Vital signs normal. Physical exam
normal. Mental status shows constricted affect. Mood is
"testy." Speech is slowed. No psychosis. Wishes she wouldn't
wake up but doesn't plan to harm herself.
Cause of symptoms? - ANSWER-Major depressive disorder
Ten years after total gastrectomy, 60yo man difficulty walking.
Diffuse spasticity in arms and legs, impaired proprioception in
his feet, increased muscle stretch reflexes in arms and knees,
absence of muscle stretch reflexes in ankles, bilateral extensor
plantar responses. Which vitamin is deficient? – ANSWER-B12
, 80yo man type 2 diabetes 2-month history severe constipation.
Laxatives haven't relieved symptoms. Abdominal exam shows
distention. Colonoscopy shows no abnormalities. Patient has
dysfunction of which nerve? – ANSWER-Pelvic splanchnic
34yo man lightheaded after running 12 miles of marathon hot
day. Pulse 130 bp
80/60. Which changes to autonomic nervous system
occurred? - ANSWER-
Increased SNS, decreased PNS--> orthostatic
hypotension
6-Mercaptopurine (6-MP) used to treat acute lymphoblastic
leukemia (ALL). 6MP acted on by enzymes to make 6-
thioguanine nucleotides (6-TGN). Efficacy and toxicity of 6-MP
correlated with 6-TGN. 6-MP acted on by xanthine oxidase (XO),
thiopurine methyltransferase (TPMT), leading to inactive
metabolites. Which are clinical consequences of ALL patients
homozygous for low-activity alleles of TPMT? - ANSWER-Give
decreased doses of 6-MP--> slow metabolizer
Ten human subjects given new oral drug to monitor drug effect
and toxicity. Blood analyzed for human pharmacokinetics of
drug for first time. Which trial type? - ANSWER-Type I