USMLE practice questions set 3

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21. An adult patient presents with persistent headaches. A CT scan of the head demonstrates a 2-cm spherical mass at the junction of the white and gray matter of the lateral aspect of the cerebral hemisphere. Which of the following would most likely produce this lesion?

(A) Astrocytoma
(B) Ependymoma
(C) Glioblastoma multiforme
(D) Meningioma
(E) Metastatic carcinoma
Answer 21

 

22. A 37-year-old woman presents to the emergency department with a fever. Chest x-ray film shows multiple patchy infiltrates in both lungs. Echocardiography and blood cultures suggest a diagnosis of acute bacterial endocarditis limited to the tricuspid valve. Which of the following is the most probable etiology?

(A) Congenital heart disease
(B) Illicit drug use
(C) Rheumatic fever
(D) Rheumatoid arthritis
(E) Systemic lupus erythematosus
Answer 22

 

23. A 5-year-old child, who has not had routine pediatric care, develops a febrile disease with cough and a blotchy rash and is brought to the emergency department. On physical examination, there is cervical and axillary lymphadenopathy. Also noted is an erythematous, maculopapular rash behind the ears and along the hairline, involving the neck and, to a lesser extent, the trunk. Examination of this patient's oropharynx would most likely reveal which of the following lesions?

(A) Adherent thin, whitish patch on gingiva
(B) Cold sores on the lips
(C) Curdy white material overlying an erythematous base on the oral mucosa
(D) Large shallow ulcers on the oral mucosa
(E) Multiple small white spots on the buccal mucosa
Answer 23

 

24. A 57-year-old man is brought to the emergency room for a suspected myocardial infarction. An electrocardiogram indicates the appearance of a wide-complex ventricular tachycardia with a rate of 126 beats per minute. The physician prescribes a drug to decrease SA node automaticity, increase AV node refractoriness, and decrease AV node conduction velocity. Which of the following agents was most likely prescribed?

(A) Amiodarone
(B) Disopyramide
(C) Lidocaine
(D) Propranolol
(E) Verapamil
Answer 24

 

25. While performing a subtotal thyroidectomy, a surgeon inadvertently sections the recurrent laryngeal nerve. Which of the following muscles would retain its innervation subsequent to this injury?

(A) Cricothyroid
(B) Lateral cricoarytenoid
(C) Posterior cricoarytenoid
(D) Thyroarytenoid
(E) Vocalis
Answer 25

 

26. A newborn infant who was apparently healthy at birth develops aspiration pneumonia in the first 2 days of life. All attempts to feed the infant cause it to cough and choke. Which of the following abnormalities is the most likely cause of the infant's difficulties?

(A) Bronchogenic cysts
(B) Congenital pulmonary cysts
(C) Posterior deviation of the tracheoesophageal septum
(D) Pulmonary immaturity
(E) Pulmonary sequestration
Answer 26

 

27. A 46-year-old man sustains a spider bite on his upper eyelid, and an infection develops. The physician is very concerned about spread of the infection to the dural venous sinuses of the brain via emissary veins. With which of the following dural venous sinuses does the superior ophthalmic vein directly communicate?

(A) Cavernous sinus
(B) Occipital sinus
(C) Sigmoid sinus
(D) Straight sinus
(E) Superior petrosal sinus
Answer 27

 

28. A 15-year-old high school student and several of her friends ate lunch at a local Chinese restaurant. They all were served the daily luncheon special, which consisted of sweet and sour pork with vegetables and fried rice. All the girls developed nausea, vomiting, abdominal pain, and diarrhea within 6 hours of eating lunch. Which of the following is the most likely cause of these symptoms?

(A) Bacillus cereus
(B) Clostridium botulinum
(C) Clostridium perfringens
(D) EHEC (Enterohemorrhagic Escherichia coli)
(E) Staphylococcus aureus
(F) Vibrio cholerae
Answer 28

 

29. A 24-year-old woman with a history of allergic rhinitis is involved in an automobile accident and sustains a splenic laceration. She undergoes abdominal surgery and is then transfused with four units of blood of the appropriate ABO and Rh type. As the transfusion progresses, she becomes rapidly hypotensive and develops airway edema, consistent with anaphylaxis. Which of the following pre-existing conditions best accounts for these symptoms?

(A) AIDS
(B) C1 esterase inhibitor deficiency
(C) DiGeorge syndrome
(D) Selective IgA deficiency
(E) Wiskott-Aldrich syndrome
Answer 29

 

30. A couple presents to a clinic for workup of infertility after 5 years of unprotected intercourse. The wife denies any medical problems and notes regular menstrual cycles. The husband states that he has had chronic sinusitis and lower respiratory tract infections. Physical examination of the woman is unremarkable. Examination of the man is remarkable for dextrocardia. Further workup of the husband will most likely reveal

(A) azoospermia
(B) germinal cell aplasia
(C) immotile sperm
(D) isolated gonadotropin deficiency
(E) varicocele
Answer 30

 


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