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Answer the following clinical question (source: step1).
| A 50-year-old HIV-positive male presents to the ER with a two-day history of fever and hemoptysis. Chest radiograph shows a fibrocavitary lesion in the right middle lobe. Biopsy of the afflicted area demonstrates septate hyphae that branch at acute angles. Which of the following is the most likely causal organism? Opti... | Correct option: D - Aspergillus fumigatus | medQA_tb |
Answer the following clinical question (source: step2).
| A 20-year-old male comes into your office two days after falling during a pick up basketball game. The patient states that the lateral aspect of his knee collided with another player's knee. On exam, the patient's right knee appears the same size as his left knee without any swelling or effusion. The patient has intact... | Correct option: C - Medial collateral ligament | medQA_tb |
Answer the following clinical question (source: step2).
| A 26-year-old medical student comes to the physician for a chest x-ray to rule out active pulmonary tuberculosis. He needs a medical and radiological report before starting a medical internship in South Africa. He has no history of serious illness and does not complain of any symptoms. He has smoked 1 pack of cigarette... | Correct option: C - Observation and follow-up x-ray | medQA_tb |
Answer the following clinical question (source: step2).
| A 17-year-old boy comes to the physician 1 week after noticing a lesion on his penis. There is no history of itching or pain associated with the lesion. He is sexually active with two female partners and uses condoms inconsistently. Five weeks ago, he returned from a trip to the Caribbean with some of his football team... | Correct option: E - Treponema pallidum | medQA_tb |
Answer the following clinical question (source: step1).
| A G1P0 34-year-old woman presents to the clinic complaining of difficulty breathing and coughing up blood for 2 days. Past medical history is significant for molar pregnancy 6 months ago. The patient was lost to follow up as she was abruptly laid off and had to stay at a homeless shelter for the past few months. She en... | Correct option: E - Malignant proliferation of trophoblastic tissue | medQA_tb |
Answer the following clinical question (source: step1).
| A 45-year-old man presents to the emergency department with complaint off dizziness and nausea for the past hour. He says that he can feel his heartbeat racing. He also reports of generalized weakness that began in the morning. He was diagnosed with end-stage renal disease 2 years ago and currently on dialysis, but he ... | Correct option: B - Antagonizes the membrane action of hyperkalemia | medQA_tb |
Answer the following clinical question (source: step1).
| A 4-week-old boy is brought to the emergency department with a 2-day history of projectile vomiting after feeding. His parents state that he is their firstborn child and that he was born healthy. He developed normally for several weeks but started to eat less 1 week ago. Physical exam reveals a small, round mass in the... | Correct option: C - Nitric oxide synthase deficiency | medQA_tb |
Answer the following clinical question (source: step2).
| A 36-year-old man comes to the physician because of a 2-week history of productive cough, weight loss, and intermittent fever. He recently returned from a 6-month medical deployment to Indonesia. He appears tired. Physical examination shows nontender, enlarged, palpable cervical lymph nodes. An x-ray of the chest shows... | Correct option: A - Inform the local public health department of the diagnosis | medQA_tb |
Answer the following clinical question (source: step1).
| A 7-year-old girl is brought to the physician because of a 1-month history of worsening fatigue, loss of appetite, and decreased energy. More recently, she has also had intermittent abdominal pain and nausea. She is at the 50th percentile for height and 15th percentile for weight. Her pulse is 119/min and blood pressur... | Correct option: E - Glucocorticoids | medQA_tb |
Answer the following clinical question (source: step2).
| A 23-year-old man presents to the emergency department with shortness of breath. The patient was at a lunch hosted by his employer. He started to feel his symptoms begin when he started playing football outside with a few of the other employees. The patient has a past medical history of atopic dermatitis and asthma. Hi... | Correct option: C - IM epinephrine | medQA_tb |
Answer the following clinical question (source: step1).
| A 52-year-old man presents to the emergency department with chest pain radiating to his left jaw and arm. He states that he had experienced similar symptoms when playing basketball. The medical history is significant for diabetes mellitus, hypertension, and GERD, for which he takes metformin, hydrochlorothiazide, and p... | Correct option: D - Lisinopril | medQA_tb |
Answer the following clinical question (source: step2).
| A 63-year-old male presents to the emergency department complaining of worsening nausea. He reports that the nausea began several months ago and is accompanied by occasional bloating and heartburn. He reports that he frequently feels full even after eating only a little at each meal, and occasionally he will vomit if h... | Correct option: E - Erythromycin | medQA_tb |
Answer the following clinical question (source: step2).
| A 14-year-old boy who has been otherwise healthy presents to his doctor complaining of feeling easily winded and light-headed at basketball practice. He has never felt this way before and is frustrated because he is good enough to make varsity this year. He denies smoking, alcohol, or recreational drug use. His mother ... | Correct option: D - Mitral regurgitation | medQA_tb |
Answer the following clinical question (source: step2).
| Antituberculosis treatment is started. Two months later, the patient comes to the physician for a follow-up examination. The patient feels well. She reports that she has had tingling and bilateral numbness of her feet for the past 6 days. Her vital signs are within normal limits. Her lips are dry, scaly, and slightly s... | Correct option: D - Pyridoxine | medQA_tb |
Answer the following clinical question (source: step1).
| A 62-year-old man is found unconscious in the park on a bench, early in the morning in January. The temperature outside is -4.0°C (25°F). He is barefoot and is wearing nothing more than sweatpants, a tee-shirt, and a light coat. Upon arrival at the emergency department, his vitals include: heart rate 45/min, blood pres... | Correct option: D - Frostbite | medQA_tb |
Answer the following clinical question (source: step1).
| A 43-year-old man is brought to the physician for a follow-up examination. He has a history of epilepsy that has been treated with a stable dose of phenytoin for 15 years. He was recently seen by another physician who added a drug to his medications, but he cannot recall the name. Shortly after, he started noticing occ... | Correct option: C - Cimetidine | medQA_tb |
Answer the following clinical question (source: step1).
| A 27-year-old man comes to the physician with throbbing right scrotal pain for 1 day. He has also had a burning sensation on urination during the last 4 days. He is sexually active with multiple female partners and does not use condoms. Physical examination shows a tender, palpable swelling on the upper pole of the rig... | Correct option: F - Chlamydia trachomatis | medQA_tb |
Answer the following clinical question (source: step2).
| A 68-year-old man presents to the emergency department with chest pain and shortness of breath. These symptoms have been worsening over the past year and are now restricting him from his activities of daily living. The patient has a past medical history of obesity, diabetes, constipation, dyslipidemia, and hypertension... | Correct option: D - Viral illness | medQA_tb |
Answer the following clinical question (source: step1).
| A previously healthy 20-year-old man is brought to the emergency department 15 minutes after collapsing while playing basketball. He has no history of serious illness. On arrival, there is no palpable pulse or respiratory effort observed. He is declared dead. The family agrees to an autopsy. Cardiac workup prior to thi... | Correct option: A - Systolic anterior motion of the mitral valve | medQA_tb |
Answer the following clinical question (source: step1).
| A 40-year-old male presents to the physician's office complaining of an inability to push doors open. He has had this problem since he was playing football with his children and was tackled underneath his right arm on his lateral chest. On examination, he has a winged scapula on the right side. Which of the following n... | Correct option: B - Long thoracic nerve | medQA_tb |
Answer the following clinical question (source: step1).
| A 46-year-old man who recently immigrated from Mexico comes to the physician for a pre-employment wellness examination. A tuberculin skin test is administered and he develops a raised, erythematous 12 mm lesion on his forearm within 48 hours. An x-ray of the chest shows no abnormalities. He is started on the recommende... | Correct option: D - Inhibition of mycolic acid synthesis | medQA_tb |
Answer the following clinical question (source: step1).
| A 16-year-old teenage boy is brought to the emergency room for severe left groin pain. He reports feeling feverish this morning but insisted on going to his basketball practice this afternoon. Shortly after the practice, he began experiencing severe pain at his left groin that is described as sharp and burning in quali... | Correct option: B - Inflammation of the testicles due to a viral infection | medQA_tb |
Answer the following clinical question (source: step1).
| Accurate and rapid identification of individuals with tuberculosis (TB) is crucial to accomplishing the goal of the World Health Organization (WHO) to eliminate this disease. One of the key strategies for the detection of TB is the use of tuberculin skin testing as a globally pertinent screening method, due to its low ... | Correct option: D - Negative predictive value | medQA_tb |
Answer the following clinical question (source: step1).
| A 19-year-old man presents to the office for a routine physical exam and a meningitis vaccination prior to attending college on a basketball scholarship. Also present at the appointment is his father who appears to be in his mid-sixties and is much shorter. The patient’s pulse is 70/min, respirations are 18/min, temper... | Correct option: D - FBN1 | medQA_tb |
Answer the following clinical question (source: step1).
| A 60-year-old man who recently immigrated from South America schedules an appointment with a physician to complete his pre-employment health clearance form. According to company policy, a skin test for tuberculosis must be administered to all new employees. Thus, he received an intradermal injection of purified protein... | Correct option: D - They need thymus for their maturation. | medQA_tb |
Answer the following clinical question (source: step2).
| A 62-year-old man presents to the emergency department with a 2-day history of fatigue, exertional dyspnea, and the sensation of his heartbeat roaring in the ears. He informs you that he recently had an acute upper respiratory infection. He is a retired car salesman, and he informs you that he and his partner enjoy tra... | Correct option: E - Direct Coombs Test | medQA_tb |
Answer the following clinical question (source: step2).
| A previously healthy 1-year-old boy is brought to the emergency department because of irritability and fever for 2 days. His symptoms began shortly after returning from a family trip to Canada. He was born at term. His immunizations are up-to-date. His 6-year-old brother is healthy and there is no family history of ser... | Correct option: D - Ceftriaxone and vancomycin therapy for the patient and rifampin prophylaxis for close contacts | medQA_tb |
Answer the following clinical question (source: step1).
| A 61-year-old man comes to the physician because of a 2-month history of a cough productive of clear mucoid sputum. He has smoked one pack of cigarettes daily for 33 years. Physical examination shows no abnormalities. Chest x-ray shows a 2-cm solid nodule in the periphery of the lower left lobe. A bronchial biopsy of t... | Correct option: D - Adenocarcinoma in situ | medQA_tb |
Answer the following clinical question (source: step1).
| A 19-year-old Caucasian male collapsed from sudden cardiac arrest while playing in a college basketball game. Attempts at resuscitation were unsuccessful. Post-mortem pathologic and histologic examination found asymmetric left ventricular hypertrophy and myocardial disarray. Assuming this was an inherited condition, th... | Correct option: A - Cardiac cell sarcomere proteins | medQA_tb |
Answer the following clinical question (source: step1).
| A 35-year-old male nurse presents to the emergency room complaining of fever and malaise. He recently returned from a medical trip to Liberia to help with a deadly outbreak of a highly infectious disease. He reports severe generalized muscle pain, malaise, fatigue, and a sore throat. He has recently developed some diff... | Correct option: E - Marburg virus | medQA_tb |
Answer the following clinical question (source: step1).
| A 65-year-old Asian male presents to the emergency department complaining of shortness of breath. He reports a three-month history of progressively worsening shortness of breath and cough. One week ago, he started noticing blood in his handkerchief whenever he coughed. The patient immigrated from China ten years ago an... | Correct option: E - Septate hyphae branching at acute angles | medQA_tb |
Answer the following clinical question (source: step2).
| A 6-year-old boy is brought to the clinic for fever and cough for the past 2 days. Per the mom, his daycare had a “flu outbreak” and since coming home 2 days ago, the patient has been coughing up sputum. He endorses headaches, rhinorrhea, and congestion but denies chest pain, shortness of breath, or abdominal pain. His... | Correct option: D - Antibiotics, prophylactic antibiotics, and immunoglobulin replacement | medQA_tb |
Answer the following clinical question (source: step1).
| A 55-year-old woman with diabetes presents to the emergency department due to swelling of her left leg, fever, and chills for the past 2 days. The woman’s maximum recorded temperature at home was 38.3°C (101.0°F). Her left leg is red and swollen from her ankle to the calf, with an ill-defined edge. Her vital signs incl... | Correct option: B - PGE2 | medQA_tb |
Answer the following clinical question (source: step1).
| A 37-year-old man presents to the clinic because of painful, severe blistering over his buttocks for the past week. About a year ago, he noticed a similar outbreak on his inner thighs, but it receded within a few days on its own. Physical examination shows the blisters are tense, and rubbing the affected skin does not ... | Correct option: B - Hemidesmosomes | medQA_tb |
Answer the following clinical question (source: step1).
| A 62-year-old man comes to the physician for hematemesis and progressive heartburn over the past 5 days. Ten days ago, he was started on a medication to treat a condition that causes hearing difficulties and pain of the lower legs. He has no other history of serious illness. He has smoked 1 pack of cigarettes daily for... | Correct option: C - Risedronate | medQA_tb |
Answer the following clinical question (source: step1).
| A 30-year-old man is diagnosed with multi-drug resistant tuberculosis after a recent trip to Eastern Europe. After drug susceptibility testing is completed, he is given a regimen of antibiotics as treatment. He returns two weeks later complaining of decreased visual acuity and color-blindness. Which drug of the followi... | Correct option: B - Inhibition of arabinogalactan synthesis | medQA_tb |
Answer the following clinical question (source: step1).
| A 53-year-old man is brought to the physician by his wife because of strange behavior and emotional outbursts for the past 6 months. He was previously healthy and physically active, but he recently started binge-eating candy and stopped exercising. He was fired from his job for inappropriate behavior after he undressed... | Correct option: A - Frontal cortex | medQA_tb |
Answer the following clinical question (source: step2).
| A 65-year-old male is evaluated in clinic approximately six months after resolution of a herpes zoster outbreak on his left flank. He states that despite the lesions having resolved, he is still experiencing constant burning and hypersensitivity to touch in the distribution of the old rash. You explain to him that this... | Correct option: C - Post-herpetic neuralgia | medQA_tb |
Answer the following clinical question (source: step1).
| A 58-year-old man comes to the emergency department for cough and fever for the past week. The cough is described as wet and productive of a yellow/greenish colored sputum with no blood. His past medical history is significant for diabetes, end-stage renal disease secondary to reflux nephropathy, and mild asthma. The p... | Correct option: A - Amphotericin B | medQA_tb |
Answer the following clinical question (source: step2).
| A 58-year-old woman presents to the office after receiving a bone mineral density screening test result with a T score of -4.1 and a Z score of -3.8. She is diagnosed with osteoporosis. A review of her medical history reveals that she has taken estrogen-containing oral contraceptive pills from the age of 20 to 30. She ... | Correct option: A - Lansoprazole | medQA_tb |
Answer the following clinical question (source: step1).
| A 27-year-old female presents to her primary care physician because she is concerned about lighter colored patches on her skin. She recently went sunbathing and noticed that these areas also did not tan. Her doctor explains that she has a fungal infection of the skin that damages melanocytes by producing acids. She is ... | Correct option: E - "Spaghetti and meatballs" fungus | medQA_tb |
Answer the following clinical question (source: step1).
| A 30-year-old African American man comes to the doctor's office for an annual checkup. He feels healthy and his only concern is an occasional headache after work. Past medical history is significant for an appendectomy 10 years ago and a fractured arm playing football in high school. His mother has type 2 diabetes mell... | Correct option: E - Recommend weight loss, more exercise, and a salt-restricted diet. | medQA_tb |
Answer the following clinical question (source: step2).
| A 33-year-old man is brought to the emergency department by his partner for 24 hours of fever, severe headache, and neck stiffness. His companion also comments that he has been vomiting several times in the past 8 hours and looks confused. His personal medical history is unremarkable. Upon examination, his blood pressu... | Correct option: B - Prophylaxis with rifampin for close contacts | medQA_tb |
Answer the following clinical question (source: step1).
| A 22-year old active duty soldier presents to your clinic with complaints of intense fatigue, fevers, abdominal pain, and a nonproductive cough. Her symptoms began a few days ago, but she returned from a tour of duty in Malawi and Mozambique four weeks ago. She endorses sleeping outside, using minimal bug spray, and sw... | Correct option: B - Schistosoma mansoni | medQA_tb |
Answer the following clinical question (source: step2).
| A 24-year-old man comes to the emergency department because of progressive shortness of breath and intermittent cough with blood-tinged sputum for the past 10 days. During this time, he had three episodes of blood in his urine. Six years ago, he was diagnosed with latent tuberculosis after a positive routine tuberculin... | Correct option: A - Goodpasture syndrome | medQA_tb |
Answer the following clinical question (source: step1).
| A 35-year-old woman that has recently immigrated from Southeast Asia is brought to the emergency department due to a 3-week history of fatigue, night sweats, and enlarged lymph nodes and persistent fever. These symptoms have been getting worse during the past week. She has no history of any cardiac or pulmonary disease... | Correct option: B - Isoniazid | medQA_tb |
Answer the following clinical question (source: step1).
| A medical research study is looking to assess the efficacy of an adult vaccine for Mycobacterium tuberculosis. The vaccine has been successfully tested for safety on mice. Researchers propose the idea to involve members of the federal prison population, a common setting for M. tuberculosis to spread. Participating pris... | Correct option: B - Offering early parole | medQA_tb |
Answer the following clinical question (source: step1).
| An outbreak of diphtheria has occurred for the third time in a decade in a small village in South Africa. Diphtheria is endemic to the area with many healthy villagers colonized with different bacterial strains. Vaccine distribution in this area is difficult due to treacherous terrain. A team of doctors is sent to th... | Correct option: C - Lysogenic conversion | medQA_tb |
Answer the following clinical question (source: step1).
| A 16-year-old man is brought to the emergency department for left arm pain. Per the patient, he was playing at his high-school football game when a member of the opposing team tackled him from behind, which resulted in him landing on his left arm. He felt a “popping” sensation and immediate, sharp pain at his left shou... | Correct option: D - Loss of sensation over the lateral arm | medQA_tb |
Answer the following clinical question (source: step2).
| A 33-year-old Hispanic woman who recently immigrated to the United States with her newborn daughter is presenting to a free clinic for a wellness checkup for her baby. As part of screening for those immigrating or seeking refuge in the United States, she and her child are both evaluated for tuberculosis. The child’s pu... | Correct option: E - “You may breastfeed your baby because you are asymptomatic and because neither isoniazid nor pyridoxine will harm your child.” | medQA_tb |
Answer the following clinical question (source: step1).
| An 18-year-old boy is brought to the emergency department by his parents because he suddenly collapsed while playing football. His parents mention that he had complained of dizziness while playing before, but never fainted in the middle of a game. On physical examination, the blood pressure is 130/90 mm Hg, the respira... | Correct option: D - Nitrates | medQA_tb |
Answer the following clinical question (source: step2).
| A 56-year-old woman with a history of alcoholic cirrhosis and recurrent esophageal varices who recently underwent transjugular intrahepatic portosystemic shunt (TIPS) placement is brought to the emergency room by her daughter due to confusion and agitation. Starting this morning, the patient has appeared sleepy, diffic... | Correct option: B - Lactulose | medQA_tb |
Answer the following clinical question (source: step2).
| A 28-year-old man comes to the physician because of increasing shortness of breath, abdominal fullness, and pedal edema for 3 months. Four months ago, he was diagnosed with pulmonary tuberculosis and is currently receiving therapy with isoniazid, rifampin, pyrazinamide, and ethambutol. His temperature is 37°C (98.6°F),... | Correct option: D - Pericardiectomy | medQA_tb |
Answer the following clinical question (source: step1).
| A 7-year-old boy is rushed to the emergency room after losing consciousness 30 mins ago at home. The patient’s mother says that he has had a “running nose” for the past few days However, he did not receive any treatment for it, and his condition rapidly worsened today. He does not have any significant past medical hist... | Correct option: D - Adrenocortical insufficiency | medQA_tb |
Answer the following clinical question (source: step1).
| A 14-year-old male basketball player presents to his pediatrician with right knee pain. He reports that he has experienced intermittent right knee pain localized to an area just inferior to his patella. He is fully ambulatory and has not experienced any knee instability. He recently increased the frequency of basketbal... | Correct option: D - Traction apophysitis by the patellar tendon | medQA_tb |
Answer the following clinical question (source: step2).
| A 23-year-old man comes to the physician because of lightening of his skin on both hands, under his eyes, and on his neck for 2 years. During this period the lesions slowly grew in size. There is no itchiness or pain. He regularly visits his family in India. Vital signs are within normal limits. Examination shows sharp... | Correct option: C - Elevated anti-TPO antibody levels | medQA_tb |
Answer the following clinical question (source: step1).
| A 51-year-old man seeks evaluation from his family physician with a complaint of heartburn, which has been gradually increasing over the last 10 years. The heartburn gets worse after eating spicy foods and improves with antacids. The past medical history is benign. He is a security guard and works long hours at night. ... | Correct option: C - Urease | medQA_tb |
Answer the following clinical question (source: step2).
| A 29-year-old primigravid woman at 35 weeks' gestation is admitted to the hospital in labor. She has no history of serious medical illness. She has had an uncomplicated pregnancy. Her last ultrasound at 22 weeks' gestation was normal. On admission, fetal heartbeats cannot be detected by fetal doppler monitor. Ultrasoun... | Correct option: B - Recommend autopsy of the infant | medQA_tb |
Answer the following clinical question (source: step1).
| A 38-year-old man comes to the physician because of an 8-month history of upper abdominal pain. During this period, he has also had nausea, heartburn, and multiple episodes of diarrhea with no blood or mucus. He has smoked one pack of cigarettes daily for the past 18 years. He does not use alcohol or illicit drugs. Cur... | Correct option: B - Fasting serum gastrin level | medQA_tb |
Answer the following clinical question (source: step2).
| A 44-year-old man, with a history of intravenous (IV) drug use, presented to the emergency department due to worsening non-productive cough, exertional dyspnea, and night sweats. His cough started 3 weeks ago and progressively worsened. He is homeless and well-known by the hospital staff. He was previously admitted to ... | Correct option: F - Trimethoprim-sulfamethoxazole | medQA_tb |
Answer the following clinical question (source: step2).
| A 26-year-old man comes to the physician because of high-grade fever, fatigue, nausea, and headache for 4 days. The headache is constant and feels like a tight band around his head. He also reports that his eyes hurt while looking at bright lights. He has been taking acetaminophen and using cold towels to help relieve ... | Correct option: E - Coxsackievirus | medQA_tb |
Answer the following clinical question (source: step2).
| A 28-year-old woman is brought to the emergency department 30 minutes after being involved in a high-speed motor vehicle collision in which she was the unrestrained driver. On arrival, she is semiconscious and incoherent. She has shortness of breath and is cyanotic. Her pulse is 112/min, respirations are 59/min, and bl... | Correct option: C - Bronchial rupture | medQA_tb |
Answer the following clinical question (source: step1).
| A previously healthy 27-year-old woman comes to the physician because of a 3-week history of fatigue, headache, and dry cough. She does not smoke or use illicit drugs. Her temperature is 37.8°C (100°F). Chest examination shows mild inspiratory crackles in both lung fields. An x-ray of the chest shows diffuse interstiti... | Correct option: D - Mycoplasma pneumoniae | medQA_tb |
Answer the following clinical question (source: step1).
| A 19-year-old basketball player unexpectedly collapses on the court. Several minutes later he returns to consciousness and is able to continue playing. This has happened several times before with similar outcomes. He had no significant past medical history. Which of the following is most likely to be found in this pati... | Correct option: C - Septal hypertrophy | medQA_tb |
Answer the following clinical question (source: step1).
| A 44-year-old Caucasian male presents with a fever, recent weight loss, and a cough productive of bloody sputum. A chest X-ray and CT scan were performed, revealing cavities near the apex of his lungs. The patient is started on rifampin, isoniazid, ethambutol and pyrazinamide. Formation of the cavities in the patient's... | Correct option: A - TH1 cells | medQA_tb |
Answer the following clinical question (source: step2).
| A 36-year-old female presents to her primary care provider for tremor. She reports that she has always had a mild tremor but that she has begun noticing it more since learning to paint. She feels that she has trouble dipping her paintbrush in the paint and making precise strokes on the canvas. She has taken to painting... | Correct option: C - Primidone | medQA_tb |
Answer the following clinical question (source: step1).
| Fifteen years ago, a physician was exposed to Mycobacterium tuberculosis during a medical mission trip to Haiti. A current CT scan of his chest reveals respiratory apical granulomas. The formation of this granuloma helped prevent the spread of the infection to other sites. Which pair of cells contributed to the walling... | Correct option: A - TH1 cells and macrophages | medQA_tb |
Answer the following clinical question (source: step1).
| A 23-year-old man presents with swelling of the left knee. He noticed the swelling a day ago while preparing for the college basketball game. He has had approximately 10 different sexual partners in the past 3 months. Synovial fluid tap shows a WBC count of 90,000 cells/mm3. What is the mechanism of action of the drug ... | Correct option: B - Cell wall inhibitor | medQA_tb |
Answer the following clinical question (source: step1).
| A 26-year-old medical student comes to the physician with a 3-week history of night sweats and myalgias. During this time, he has also had a of 3.6-kg (8-lb) weight loss. He returned from a 6-month tropical medicine rotation in Cambodia 1 month ago. A chest x-ray (CXR) shows reticulonodular opacities suggestive of acti... | Correct option: B - 0.25 | medQA_tb |
Answer the following clinical question (source: step2).
| A 47-year-old woman visits the emergency department due to painful, swollen fingers in both of her hands. She has worked as a bus driver for the county school system for the last 20 years. Her past medical history is significant for a transient ischemic attack 5 years ago. She reports that she has lost weight in the la... | Correct option: D - Pneumonitis | medQA_tb |
Answer the following clinical question (source: step1).
| An investigator is studying the growth pattern of a particular bacterial strain that caused a respiratory disease outbreak in children in rural Venezuela. The bacteria are found to be able to grow in a specialized culture that contains sheep blood, cystine, and potassium tellurite; the colonies are black and have a shi... | Correct option: F - Corynebacterium diphtheriae | medQA_tb |
Answer the following clinical question (source: step1).
| A 16-year-old boy comes to the physician because of muscle weakness and cramps for 5 months. He becomes easily fatigued and has severe muscle pain and swelling after 15 minutes of playing basketball with his friends. The symptoms improve after a brief period of rest. After playing, he sometimes also has episodes of red... | Correct option: F - Myophosphorylase deficiency | medQA_tb |
Answer the following clinical question (source: step2).
| A 24-year-old man, who recently migrated from a developing country, presents to a physician because of a 2-year history of cough, blood in his sputum, fever, and weight loss. His sputum smear and culture confirm the diagnosis of pulmonary tuberculosis due to Mycobacterium tuberculosis. His Mantoux test is 2 mm × 3 mm, ... | Correct option: E - Continue antitubercular therapy and antiretroviral therapy without any change | medQA_tb |
Answer the following clinical question (source: step2).
| A 57-year-old man presents to his physician with dyspnea on exertion and rapid heartbeat. He denies any pain during these episodes. He works as a machine operator at a solar panels manufacturer. He has a 21-pack-year history of smoking. The medical history is significant for a perforated ulcer, in which he had to under... | Correct option: D - Smoking | medQA_tb |
Answer the following clinical question (source: step1).
| A 36-year-old nursing home worker presents to the clinic with the complaints of breathlessness, cough, and night sweats for the past 2 months. She further expresses her concerns about the possibility of contracting tuberculosis as one of the patients under her care is being treated for tuberculosis. A PPD skin test is ... | Correct option: E - Decreased ALA synthesis | medQA_tb |
Answer the following clinical question (source: step2).
| A 37-year-old woman presents to the occupational health clinic for a new employee health screening. She has limited medical records prior to her immigration to the United States several years ago. She denies any current illness or significant medical history. Purified protein derivative (PPD) is injected on the inside ... | Correct option: D - Type IV–cell-mediated (delayed) hypersensitivity reaction | medQA_tb |
Answer the following clinical question (source: step2).
| A 17-year-old boy comes to the emergency department following an injury during football practice. He fell and landed on the lateral aspect of his right shoulder. He is holding his right arm supported by his left arm, with his right arm adducted against his side. He is tender to palpation directly over the middle third ... | Correct option: D - Figure-of-eight splinting | medQA_tb |
Answer the following clinical question (source: step2).
| A 36-year-old woman comes to the physician because of a 12-month history of upper abdominal pain. The pain is worse after eating, which she reports as 7 out of 10 in intensity. Over the last year, she has also had nausea, heartburn, and multiple episodes of diarrhea with no blood or mucus. Eight months ago, she underwe... | Correct option: D - Fasting serum gastrin level | medQA_tb |
Answer the following clinical question (source: step2).
| A 55-year-old man comes to the physician because of heartburn for the past 2 years. He has no chest pain, dysphagia, weight loss, or fever. He has no history of any serious illnesses. He takes omeprazole daily. Vital signs are within normal limits. Body mass index (BMI) is 34 kg/m2. Physical exam shows no abnormalities... | Correct option: E - Multiple endoscopic biopsies | medQA_tb |
Answer the following clinical question (source: step1).
| An 86-year-old male with a past medical history significant for an MCA stroke presents with recurrent fevers. He is currently living in a nursing home facility. A chest radiograph was obtained and is shown in Figure A. Which of the following is the most likely causative organism for this lesion? Options:
A: Mycobacteri... | Correct option: B - Bacteroides spp. | medQA_tb |
Answer the following clinical question (source: step2).
| A 32-year-old man presents to the clinic for follow up for treatment of latent tuberculosis. He is a healthcare worker and began isoniazid 3 months ago after a routine PPD yielded a 12-mm induration. He feels otherwise well and attributes this to his vegetarian diet that he has been following for the past 4 years. His ... | Correct option: C - Pyridoxine supplementation | medQA_tb |
Answer the following clinical question (source: step1).
| A 70-year-old man comes to the physician for evaluation of worsening nocturia, fatigue, and shortness of breath on exertion. While he used to be able to walk for 15 minutes at a time, he now has to pause every 5 minutes. Recently, he has started using two pillows to avoid waking up short of breath at night. He has a hi... | Correct option: A - Constriction of efferent renal arterioles | medQA_tb |
Answer the following clinical question (source: step2).
| A 15-year-old boy presents with a 3-month history of severe muscle cramps and pain. The patient first noticed these symptoms while attending tryouts for the high school football team. Following the tryout, he becomes easily fatigued and complains of severe muscle pain and swelling after 10 minutes of exercising. Howeve... | Correct option: E - Myophosphorylase deficiency | medQA_tb |
Answer the following clinical question (source: step1).
| You are seeing a 34-year-old male in clinic for a new-onset productive cough. The cough has been present for 2 month and is blood-tinged. The patient has also noticed that when he wakes up in the morning his bed sheets are soaked, and that he has recently had to tighten his belt to keep his pants from falling down. Upo... | Correct option: D - Isoniazid | medQA_tb |
Answer the following clinical question (source: step2).
| A 71-year-old woman comes to the physician because of progressive shortness of breath and swollen legs for 4 weeks. She has tried sleeping in a raised position using 2 pillows but still wakes up occasionally from a choking sensation. She returned from a safari tour in Tanzania 3 months ago. She has type 2 diabetes mell... | Correct option: C - Multiple myeloma | medQA_tb |
Answer the following clinical question (source: step2).
| A 69-year-old man with metastatic colon cancer is brought to the emergency department because of shortness of breath, fever, chills, and a productive cough with streaks of blood for the past 5 days. He has a history of emphysema. The patient does not have abdominal pain or headache. He receives chemotherapy with 5-fluo... | Correct option: G - Voriconazole | medQA_tb |
Answer the following clinical question (source: step2).
| A 56-year-old man presents to his family physician for a routine check-up but also states he has been feeling less energetic than usual. He mentions that he has recently been promoted to a nurse manager position at a regional medical center. His medical history is significant for hypertension and hyperlipidemia, for wh... | Correct option: B - Isoniazid, rifampin, ethambutol, and pyrazinamide | medQA_tb |
Answer the following clinical question (source: step1).
| A 44-year-old male presents to the emergency department with complaints of productive cough, fevers, shortness of breath, and increasing fatigue over the last 2 weeks. He also reports several episodes of diarrhea and occasional abdominal pain. His medical history is significant for a diagnosis of HIV infection 10 years... | Correct option: D - Azithromycin | medQA_tb |
Answer the following clinical question (source: step2).
| A 16-year-old male high school basketball player presents to his primary care provider with complaints of fatigue and night sweats for the past month. He also recalls that, after suffering a hand laceration during a game, the nurse had a difficult time achieving hemostasis. Otherwise, the patient has no other medical p... | Correct option: E - Abnormal secretion of coagulation factor III | medQA_tb |
Answer the following clinical question (source: step1).
| A 24-year old woman is brought to the emergency department after a motor vehicle collision. She was a restrained passenger at the time of impact. On examination, the patient is pale and in moderate distress. She complains of a sharp pain in the posterior aspect of the left shoulder. Vitals include temperature is 37.0°C... | Correct option: E - Spleen | medQA_tb |
Answer the following clinical question (source: step2).
| A 40-year-old man presents to the physician for a pre-employment medical check-up. He has no symptoms and his past medical history is insignificant. He is a non-smoker. His temperature is 36.9°C (98.4°F), the heart rate is 76/min, the blood pressure is 124/82 mm Hg, and the respiratory rate is 16/min. His general and s... | Correct option: A - Thin-section computed tomography (CT) through the nodule | medQA_tb |
Answer the following clinical question (source: step1).
| A 38-year-old man comes to the clinic for “numbness and tingling” of his hands for the past 2 months. He immigrated from India 6 months ago and did not have health insurance until now. The patient reports a persistent rash that appeared 4 months ago that he attributes to the change in weather in Detroit compared to Ind... | Correct option: A - Dapsone, rifampin, and clofazimine | medQA_tb |
Answer the following clinical question (source: step2).
| A 17-year-old girl comes to the primary care clinic with her father complaining of right knee pain. She reports that the pain started about a month ago, and since then it has gotten progressively worse. The knee pain is not constant but becomes most noticeable when going up or down the stairs. She also endorses that he... | Correct option: C - Patellar tendonitis | medQA_tb |
Answer the following clinical question (source: step1).
| A 51-year-old woman schedules an appointment with her physician with complaints of upper abdominal pain, nausea, and early satiety for the last 6 months. She has type 1 diabetes for the past 10 years and is on subcutaneous insulin with metformin. She complains of occasional heartburn and lost 4.5 kg (10 lb) in the past... | Correct option: B - Cisapride | medQA_tb |
Answer the following clinical question (source: step1).
| A 17-year-old boy comes to the physician because of a 3-month history of pain in his right shoulder. He reports that he has stopped playing for his high school football team because of persistent difficulty lifting his right arm. Physical examination shows impaired active abduction of the right arm from 0 to 15 degrees... | Correct option: A - Suprascapular nerve | medQA_tb |
Answer the following clinical question (source: step1).
| A 23-year-old female college basketball player presents in Sports Clinic after she felt a "pop" in her knee after coming down with a rebound. To examine the patient, you have her lie down on the table with her knees flexed 90 degrees. With your hand around her knee you are able to draw the tibia toward you from underne... | Correct option: B - The anterior intercondylar area of tibia and the posteromedial aspect of the lateral femur | medQA_tb |
Answer the following clinical question (source: step1).
| An investigator is studying the genetic profile of an isolated pathogen that proliferates within macrophages. The pathogen contains sulfatide on the surface of its cell wall to prevent fusion of the phagosome and lysosome. She finds that some of the organisms under investigation have mutations in a gene that encodes th... | Correct option: B - Rifampin | medQA_tb |
Answer the following clinical question (source: step1).
| A 25-year-old man presents to the emergency department after being rescued from a house fire 30 minutes ago. He is conscious and in distress. On examination, he is noted to have 1st-degree burns involving 54% of his total body surface area. He has type 1 diabetes and takes insulin every day. He is admitted to the burn ... | Correct option: B - Piperacillin with gentamicin | medQA_tb |
Answer the following clinical question (source: step2).
| A hospitalized 45-year-old man has had mild flank pain since awakening 3 hours ago. He also reports a new generalized rash. Two weeks ago, he was diagnosed with pulmonary tuberculosis. Current medications include isoniazid, pyrazinamide, rifampin, ethambutol, and pyridoxine. His temperature is 38.3°C (100.9°F), pulse i... | Correct option: D - Discontinue rifampin | medQA_tb |
Answer the following clinical question (source: step1).
| A family doctor in a rural area is treating a patient for dyspepsia. The patient had chronic heartburn and abdominal pain for the last 2 months and peptic ulcer disease due to a suspected H. pylori infection. For reasons relating to affordability and accessibility, the doctor decides to perform a diagnostic test in the... | Correct option: E - Serology (ELISA testing) | medQA_tb |
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