USMLE Practice Questions Set 6
51. The table below depicts blood pressure values taken from six adults. Which set of values is most consistent with aortic regurgitation?
|Systolic pressure (mm Hg)||Diastolic pressure (mm Hg)|
52. In a hospital cardiac care unit, there are three patients with different cardiac conditions: a 52-year-old man with dilated cardiomyopathy, an 18-year-old girl with mitral valve prolapse, and a 30-year-old man with infective endocarditis of the mitral valve. Which of the following features do all these patients most likely share?
53. A 68-year-old man sustains a myocardial infarct resulting from thrombotic occlusion at the origin of the left circumflex artery. Cardiac catheterization demonstrates that the patient has a left dominant coronary circulation. In which of the following areas of the heart has ischemic necrosis most likely occurred?
54. A patient arrives in the emergency department after having been stabbed. He has sustained a penetrating wound in the left fourth intercostal space immediately lateral to the sternal border. Which of the following thoracic structures is most likely to have been injured?
55. A 14-year-old boy has just moved with his family from Brazil to the U.S. He starts complaining of shortness of breath and palpitations. Chest x-ray films demonstrate pulmonary congestion, and EKG shows alterations in heart rhythm. Echocardiography reveals biventricular dilatation with massive cardiac enlargement. An endomyocardial biopsy shows diffuse interstitial fibrosis, myocyte necrosis, chronic inflammation, and the presence of intracellular protozoan parasites. The patient may also develop which of the following complications?
56. A 65 year-old man is admitted to the coronary care unit with a diagnosis of a large myocardial infarct (MI) of the left ventricle. On his 6th postinfarct day, he goes into shock and dies, manifesting signs and symptoms of cardiac tamponade. Which of the following complications is the most likely cause of this patient’s death?
57. A 15-year-old is brought to the emergency department in a coma. An alert ambulance attendant notes that the patient’s breath smells like acetone. This observation is most consistent with which of the following diagnoses?
58. A 24-year-old woman in her third trimester of pregnancy presents with urinary frequency and burning for the past few days. She denies fever, nausea, vomiting, or chills. She takes no medications besides prenatal vitamins and is generally in good health. Physical examination is remarkable for mild suprapubic tenderness, and a urine dipstick is positive for white blood cells, protein, and a small amount of blood. Culture produces greater than 100,000 colonies of gram-negative bacilli. Which of the following attributes of this uropathogenic organism is most strongly associated with its virulence?
59. A 12-year-old girl has a temperature of 102.5 F and a sore throat. Two days later, she develops a diffuse erythematous rash and is taken to her pediatrician. On physical examination, there is circumoral pallor, and an erythematous rash with areas of desquamation is noted. The myocardial damage that can follow this infection is produced in a manner similar to the damage associated with which of the following disorders?
60. A 45-year-old man with cirrhosis due to alpha1-antitrypsin deficiency receives a liver transplant. Although currently in good health, he is at increased risk of developing which of the following types of emphysema?
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