USMLE QUESTIONS BANK 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moreGeneral Pediatric-related - MCQs 1-10Page 1 of 66 Loading...1. Which one of the following drugs is a Thiazide Diuretic? Fenofibrate Ezetimibe Hydrochlorothiazide Indanyl carbenicillin Atorvastatin Loading...2. Which of the following drug is prototypical phenylalkylamine? Losartan Amlodipine Amiloride Verapamil DiltiazemRead moreThe following represents an essential element to an effective quality council? Loading...3. Which one of the following substances is released by sympathetic postganglionic neurons which innervate renal vascular smooth muscle? Dopamine Norepinephrine Epinephrine Acetyl choline Loading...4. Which of the following medications is a non-drowsy anti-allergic medication? Diphenhydramine Loratadine Cetirizine Chlorpheniramine Loading...5. The cough associated with Captopril is most likely associated with? Decrease in the metabolism of acetylcholine Release of histamine Direct airway irritation Stimulation of adenosine receptors in the lungs Increase in bradykinin levels Loading...6. Which of the following types of protein is encoded by the P53 gene? DNA repair enzyme Transcription factor Caspase Tyrosine kinase Loading...7. An organophosphate drug that has a side effect of cataracts? Acetylcholine Neostigmine Echothiophate Donepezil Edrophonium Loading...8. Following drug consists of an aromatic derivative ring in the structural formula? Simvastatin Lovastatin Pravastatin Atorvastatin Colestipol Loading...9. Which of the following characterizes syndrome of inappropriate antidiuretic hormone secretion? Recommended treatment is desmopressin acetate and hydration Euvolemic hyponatremia with continued Na excretion Serum osmolality is greater than urine osmolality Hyperosmotic volume contraction Loading...10. Which one of the following drugs is a H² receptor Antagonist? Cimetidine Rabeprazole Sucralfate Omeprazole Loading...11. Pemphigus is an autoimmune skin disease associated with which of the following structures? , Desmosomes Cell matrix junctions Tight junctions Gap junctions Loading...12. Which one of the following conditions most likely increases the risk for deep venous thrombosis (DVT)? Coronary heart disease Crohn’s disease Adenocarcinoma Pulmonary tuberculosis Loading...13. Which of the following is the mode of inheritance of cystic fibrosis? X-linked dominant X-linked recessive Autosomal recessive Autosomal dominant Loading...14. Which one of the following statements of tetracycline is wrong? Bind with 50S ribosomal subunit Avoid in Pregnancy Deposition in bones and teeth Causes GIT disturbance Loading...15. Canal of Schlemm is located at which one of the following junctions? Ciliary body and iris Cornea and sclera Cornea and iris Cornea and ciliary body Loading...16. Which of the following hormone belongs to the posterior pituitary? Somatrem A & B Furosemide Oxytocin Urofollitropin Loading...17. Which one of the following agents is insulin? Torsemide Somatostatin Atorvastatin Desmopressin Glargine Loading...18. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? A & B Amphotericin B Ethambutol Furosemide Ibandronate Loading...19. Rocky mountain spotted fever is caused by following? Spirochetes Clostridium tetani Chlamydia trachomatis Rickettsia Rickettsii Loading...20. Which one of the following urine electrolytes in the best to estimate extracellular fluid (ECF) volume in metabolic alkalosis? Urine chloride Urine anion gap Urine sodium Urine urea Loading...21. Which of the following is the most sensitive test for myocardial infarction? Lactose dehydrogenase (LDH) Troponin-C Creatine kinase myocardial fraction (CK-MB) Troponin-1 Loading...22. Which of the following drugs causes Rhabdomyolysis as an adverse effect? Digoxin Warfarin Amikacin Simvastatin Dronedarone Loading...23. Which of the following controls the secretion of thyrotropin? Concentration of iodine in the thyroid gland Concentration of thyroid hormones in the blood Concentration of thyrotropin in the pituitary gland Concentration of thyroid hormones in the thyroid gland Loading...24. Which of the following medications inhibits folic acid synthesis through its effect on dihydropteroate synthetase enzyme?ich of the following is the mechanism of action of misoprostol for the treatment of peptic ulcer? Suppression of secretory responses to food stimulation Formation of a protective coating of the ulcer beds Increased mucus and bicarbonates secretion and decreased HCL secretion Direct inhibition of the proton pump Loading...25. The pericardial cavity is a space lies between which of the following structures? Parietal fibrous pericardium and visceral fibrous pericardium Epicardium and myocardium Parietal serous pericardium and visceral serous pericardium Epicardium and pericardiumPage 2 of 66 Loading...26. Cephalexin belongs to the class of following drugs? Antiviral Antibiotics Antipyretic Anti malaria Antiprotozoal Loading...27. A 43 year-old man presents to the ER with an excruciating chest pain radiates to his jaw and left shoulder. The patient is in moderate distress. Examination reveals a small nodule in his right Achilles tendon. Family history indicates that his father died of a heart attack in the age of 45. His laboratory tests reveal elevated levels of CK-MB, troponin T and very high level of cholesterol (670 mg/dL). A diagnosis of myocardial infarction and familial hypercholesterolemia is made in this patient. The patient is admitted to the intensive care unit (ICU) for urgent treatment. The patient has improved in the following week and is discharged. A list of medications has been prescribed for this patient. Which one of these medications acts through inhibition of the enzyme HMG-CoA reductase? Atenolol Niacin Orlistat Lovastatin Fenofibrate Loading...28. Which one of the following conditions is NOT a common cause of vitamin B12 deficiency? Intrinsic factor deficiency Gastric bypass Diet deficiency of vitamin B12 Malabsorption syndrome Loading...29. Which of the following conditions is the most likely cause of development of velvety rash in the axilla? Testosterone hypersecretion Thyroid hormone deficiency Serotonin hypersecretion Insulin resistance Loading...30. A 45-year-old man is admitted to the hospital for a scheduled surgery. Two days later, he develops fever, chills, cough and chest pain. This hospital has reported several cases of methicillin-resistant Staphylococcus aureus (MRSA) in the last 3 months. What should have been given to this patient to prevent his infection with MRSA? Tobramycin Ampicillin Gentamicin Ciprofloxacin Vancomycin Loading...31. A drug that inhibits replication of the influenza A virus by interfering with viral attachment and uncoating? Acyclovir Oseltamivir Zidovudine Rimantadine Nevirapine Loading...32. Which of the following is the most likely rout of transmission of herpes simplex virus-1? Sexual contact and perinatal Congenital transfusion Respiratory secretions and saliva Food contamination Loading...33. Which one of the following cells secretes glycosaminoglycans and found in the in the terminal and respiratory bronchioles? K cells Pneumocytes type I Pneumocytes type II Macrophages Clara cells Loading...34. Which of the following is responsible for the wrinkled appearance of the scrotum? Tunica albuginea Pampiniform plexus Dartos fascia Thickened keratinized epithelium Loading...35. A 26-year-old man with a history of HIV infection presents with fatigue and nuchal rigidity for 3 days. Lumber puncture shows increased leukocytes. India ink preparation detects which one of the following organisms? Aspergillus fumigatus Toxoplasma gondii Streptococcus pneumonia Cryptococcus neoformans Loading...36. Which of the following hormone belongs to the posterior pituitary? Urofollitropin A & B Somatrem Furosemide Vasopressin Loading...37. A 32-year-old woman with a history of generalized anxiety disorder develops numbness of her face particularly around her mouth. Physical examination and x-ray show no abnormalities other than markedly increased respiratory rate. Laboratory investigations are as follows: Elevated bicarbonate excretion Elevated hydrogen ion excretion Elevated respiratory rate Elevated hydrogen ion concentration Elevated arterial PO22: 100 mmHg PCO2: 30 mmHgich of these findings shows that the body is compensating to this condition? Loading...38. Which one of the following drugs causes cyanide toxicity? Minoxidil Sodium nitroprusside Nicardipine Clonidine Loading...39. A 54 year-old man with a history of chronic obstructive pulmonary disease (COPD) presents by his son to the emergency room semi-unconscious with shortness of breath. He has nausea, diarrhea and restlessness for the last four hours. His arterial oxygen saturation is 88% with room air. His ECG shows normal sinus rhythm with non-specific changes in lateral leads. The patient uses albuterol inhalation, ipratropium bromide, theophylline and Lisinopril. Three days ago, he had an exacerbation of his COPD and was prescribed ciprofloxacin and supplemental oxygen at night and during ambulation. What is the most likely cause of this patient presentation to the ER? Interaction of ciprofloxacin to Lisinopril Interaction of ciprofloxacin to oxygen Interaction of ciprofloxacin to albuterol Interaction of ciprofloxacin to theophylline Interaction of ciprofloxacin to ipratropium bromide Loading...40. A 33-year-old butcher comes to the clinic because he developed eye problems. On taking history, the patient states that he eats raw hamburgers in a regular basis. The physician orders Sabin-Feldman dye test and the results come back positive. Which is the most likely cause of this patient’s condition? Trichinosis Giardiasis Schistosomiasis Toxoplasmosis Loading...41. Which one of the following drugs is the first line medication in transplant immunopharmacology? Cyclosporine Methotrexate Thalidomide Sulfasalazine Loading...42. Which of the following drug is Non-NucleoSide Reverse Transcriptase inhibitors(NNRTIs)? Saquinavir Acyclovir Amprenavir Zidovudine Nevirapine Loading...43. Which of the following factors directly stimulates the release of antidiuretic hormone (ADH)? Decreased temperature Increased extracellular fluid osmolality Increased blood volume Decreased extracellular fluid osmolality Loading...44. Which one of the following drugs results in disulfiram- like action when it is accompanied with alcohol? Cefotetan Dipyridamole Cimetidine Ampicillin Loading...45. A 40-year-old male presents with dysphagia of fluids and solids for 2 months. Which of the following is the most appropriate next step of action? Barium swallow Acid perfusion test Endoscopy Motility studies Loading...46. A direct-acting adrenergic agonist is following? Albuterol Acetylcholine Amphetamine Clonidine A & B Loading...47. A 56-year-old woman is found to have elevated intraocular pressure during a routine eye examination. Examination also reveals normal optic disc and open angle of the eye. Her doctor explains to her that her condition is probably due to increased secretion of aqueous fluid. This fluid is produced by which of the following structures? Epithelia cells of the cornea Epithelial cells of the ciliary body Endothelial cells of the cornea Epithelial cells of the retina Loading...48. Which of the following histamine H1 antagonists is identified for its serotonin-blocking effect? Desloratadine Loratadine Fexofenadine Cyproheptadine Loading...49. Which one of the following drugs is most likely to cause severe bone marrow depression? Prednisone Cyclosporine Sirolimus Tacrolimus Loading...50. A 40 year old woman with a history of type 1 diabetes presents to the clinic for left ear pain and fullness. She also complains of decrease of hearing on the affected side. The patient didn’t measure her blood sugar for 6 months although she has glucometer at home. Her temperature is 99.8 F. Examination reveals tenderness and erythema of the left targus extending to the left side of the face. It also reveals edema of the left external auditory meatus with inflammatory debris. The tympanic membrane appears intact and mobile. Her blood glucose is 340 mg/dL. What is the most appropriate next step in management? Hospitalization for intravenous antibiotics and control of diabetes Initiation of left myringotomy and induction of topical treatment Antibiotic ear drops and follow up in three days Empiric oral antibiotic therapy and follow up in one weekPage 3 of 66 Loading...51. A 27-year-old man complains of 2-week history of watery diarrhea and 5 lb. weight loss. He had no similar episodes in the past, did not travel recently, did not eat out or take antibiotics. He quit smoking last month after 1 PPD for 5 years. His family history is significant of some relatives who are diagnosed with inflammatory bowel syndrome. His examination reveals diffuse mild abdominal tenderness and hyperactive bowel sounds. Stool analysis is negative for blood and ova. What is in the history and/or examination could support the diagnosis of ulcerative colitis rather than Crohn’s disease in this patient? Family history of inflammatory bowel syndrome Having first attack in his twenties History of diarrhea and weight loss Negative stool analysis Smoking cessation Loading...52. A 72- year old man with a long history of hypertension and coronary artery disease presents for follow up examination. He takes metoprolol for many years. He started taking enalapril last week. His blood pressure is now under control. Physical and laboratory examinations are unremarkable except for slight increase in serum creatinine. What is the best explanation for this abnormality? Increased glomerular filtration rate (GFR) Drug-induced tubular obstruction Increase absorption of water in the proximal convoluted tubules Renal interstitial nephritis Blocking of efferent arteriole vasoconstriction Loading...53. Which of the following is the most important risk factor for coronary artery disease? Low HDL cholesterol High total cholesterol High LDL cholesterol Obesity Loading...54. Which one of the following enzymes is extremely important in muscle energy metabolism through its role in purine nucleotide cycle? Myo-inositol monophosphatase Adenosine deaminase Myoadenylate deaminase Hypoxanthine-guanine phosphoribosyltransferase (HGPRT) Loading...55. A 66-year-old man complains of difficult micturition and drippling at the end of urination. Laboratory investigations and imaging studies confirm the diagnosis of senile enlarged prostate and exclude prostate cancer. Which these drugs is the most appropriate for this patient? Abiraterone Tadalafil Finasteride Pergolide Flutamide Loading...56. Imidazoline derivative drug with Alpha1 adrenoceptors effect? Oxymetazoline Apraclonidine Brimonidine Phenylephrine Clonidine Loading...57. Which one of the following fractures is incomplete and involving the cortex of only one side of the bone? Greenstick fracture Nursemaid’s elbow Torus fracture Osgood-Schlatter disease Loading...58. A 43 year-old woman visits her physician for a follow up after abdominal hysterectomy. During surgery, the obturator nerve was served. What is the most likely lost due to this injury? Abduction of the hip joint Dorsiflexion of the ankle joint Flexion of the knee joint Extension of the knee joint Adduction of the hip joint Loading...59. Which one of the following medications is the best recommended for induction of medical abortion? Mifepristone Estrogen Ergotamine Progesterone Loading...60. The structural formula of the following drugs contains the Biphenyl methyl group except? Olmesartan Valsartan Candesartan Eprosartan Losartan Loading...61. Antipseudomonal penicillin is one of the following? Carbenicillin Methicillin Amoxicillin Penicillin G Loading...62. Which one of the following substances is used to acidify the urine? Sodium bicarbonate Acetazolamide Ammonium chloride Loading...63. Which one of the following cranial openings is located at the greater wing of sphenoid and contains the middle meningeal artery? Foramen rotundum Foramen spinosum Foramen lacerum Foramen ovale Loading...64. Which of the following drugs is used for respiratory virus infections? Naftifine Zanamivir Ibandronate Miconazole Capecitabine Loading...65. A 32-year-old woman with a long history of irregular menstrual periods visits her physician for consultation. She is married for 8 years and has been unable to conceive. Her menstrual period occurs once every 2-4 months. She had normal Pap smear last year. Her height is 5.2″. Her weight is 205 pounds. Her vital signs are within normal limits. She has acne and excessive facial hair. This patient is at risk of which one of the following diseases? Liver cirrhosis Cervical cancer Endometrial cancer Ovarian cancer Lung cancer Loading...66. A 12-year-old female is evaluated for enlarged phallus at puberty. Examination reveals no breast development, a blind vaginal pouch and no uterus. Laboratory tests show normal levels of testosterone and estrogen and very low levels of dihydrotestosterone (DHT). What is the most likely diagnosis? True hermaphrodite Male pseudohermaphrodite Turner’s syndrome Female pseudohermaphrodite Loading...67. Mafenamic acid belongs to following class? Acetic acid Propionic acid Fenamates Oxicam Salicylic acid Loading...68. A 37-week-pregnant woman is brought to the ER for fainting, severe abdominal pain and massive vaginal bleeding. She is pale, diaphoretic, her pulse is 130 and her blood pressure is 90/60. Which of the following is the most likely diagnosis? Abruptio placenta Placenta previa Amniotic fluid embolism Pre-eclampsia Loading...69. A 57 year-old man presents to the ER complaining of sudden dizziness and heart racing for 2 hours. He is a CEO of a big corporation and those symptoms started during a stressful meeting. At first, he felt irregular heartbeats and ignored it but he felt dizzy soon after and his staff drove him to the ER. There is NO chest pain, shortness of breath or loss of consciousness. His vital signs are temp 97.8 F, Pulse 138/min and irregular, blood pressure 107/60 and oxygen saturation is 96% on room air. His ECG shows irregular irregularity with absence of P waves. What is the appropriate treatment to improve his symptoms in this current situation? Metoprolol Aspirin Cardioversion Refer to cardiologist Heparin Loading...70. What is the mechanism of action of finasteride? Inhibition of 5-alpha-reductase Inhibition of testosterone negative feedback Stimulation of the posterior lobe of pituitary gland Gonadotropin-releasing hormone analog Loading...71. A 32-year-old woman who is recently divorced visits her physician for visual disturbances. The patient complains of trouble vision for 3 days. On examination, tunnel vision is detected along with marked weakness of planter flexion although the patient can walk on her tiptoes without any complaint. All laboratory tests and imaging studies are normal. What is the most likely diagnosis of this patient? Transient ischemic attack Meningioma Multiple sclerosis Conversion disorder Loading...72. A 58-year-old woman is brought to the emergency room complaining of lightheadedness for 4 hours. She has diarrhea with loose stool for 2 days. She explains her symptoms as flu and she drinks lots of water as her neighbor advised her to avoid dehydration. Her physician told her that she should take combined solution of sodium chloride (NaCl) and glucose to prevent dehydration. What is the mechanism of action of this mixture to improve dehydration? The mixture helps to increase secretion of water and Na through the large intestine Cotransport of glucose and NaCl across the intestinal membrane facilitates absorption of water and Na. Glucose provides energy for NaCl to increase gastric emptiness It reduces bowel contractions and consequently improves diarrhea Loading...73. Which of the following differentiate neostigmine from pilocarpine? Stimulation of salivary glands Prolonged skeletal muscle contraction Acceleration of heart rate Stimulation of bowel motility Loading...74. Which one of the following drugs is commonly contributing to hypokalemia? Spironolactone Verapamil Furosemide Lisinopril Loading...75. Which one of the following medications increases the threshold for angina? Furosemide Digoxin Metoprolol BenazeprilPage 4 of 66 Loading...76. Which of the following are the primary vessels responsible for the regulation of blood pressure? Capillaries Arterioles Arteries Venuses Veins Loading...77. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Succinylcholine Tamsulosin Acetylcholine Benztropine Atropine Loading...78. Which of the following activity of Acetaminophen is weak? Anti inflammatory A & B A & C Analgesic Antipyretic Loading...79. A 40 year-old woman presents to her regular physician for evaluation of a left adrenal mass. This mass was seen by accident last week on a CT scan during a visit to the emergency room for abdominal pain. Her vital signs, physical examination and review of systems are all normal. Her past history and family history are unremarkable. What is the first step in management for this patient? Refer to surgery for removal of the adrenal mass Order MRI of the mass Order hormonal assay to evaluate if the mass is functional or not Perform a needle biopsy Assure the patient and schedule another CT scan after 6 months Loading...80. Which one of these drugs is more beneficial to treat hypertension in diabetic patients? Verapamil Amlodipine Furosemide Enalapril Loading...81. Paraneoplastic hypercalcemia is most likely caused by tumor cells secreting which one of the following substances? Parathyroid hormone Parathyroid hormone-related peptide Calcitonin-related peptide Calcitonin Loading...82. Which of the following explains the benefit of lactulose in hepatic encephalopathy? Lactulose decreases stress of the liver to produce glucose Lactulose removes circulating toxins from the blood Lactulose converts to lactic acid by intestinal bacteria which decreases ammonia Lactulose antagonize the action of ammonia on hepatic cells Loading...83. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Ibandronate Rabeprazole Ethambutol Furosemide A & B Loading...84. Cimetidine is used to treat one of the following diseases? Viral infection Blood pressure Diabetes Stomach Ulcer Malaria Loading...85. Which one of the following drugs has a synergistic effect with Flucytosine? Griseofulvin Nystatin Caspofungin Amphotericin B Loading...86. Studies are done on normal volunteers for phase 1 clinical trials of a new drug. The volume of distribution and clearance has been measured. The researchers now are calculating the half-life of the drug. Assuming that the volume of distribution is 60 L and the clearance is 3 L/hour, what is the approximate half-life of this drug? 12 hours 14 hours 18 hours 6 hours 1/2 an hour Loading...87. A 63-year-old man with a history of atrial fibrillation visits the clinic for evaluation of his current medications. His physician orders laboratory tests including prothrombin time. Which one of these drugs is used to reduce the possibility of blood clotting in this patient through its action on the enzyme epoxide reductase? Aspirin Heparin Streptokinase Warfarin Dipyridamole Loading...88. Which one of the following medications enters the cell and acts on a cytoplasmic receptor? Propranolol Dexamethasone Insulin Adrenaline Loading...89. What is the proper treatment of adrenal insufficiency? Adrenaline Fludrocortisone Prednisone Prednisone and fludrocortisone Loading...90. Insulin dependent Diabetes mellitus? Gestational Diabetes mellitus A & D Type 1 diabetes Mellitus Pseudo hypoglycemia Type 2. Diabetic mellitus Loading...91. A 65 year old man presents to the clinic complaining of weakness and recurrent infections for 6 months. He has no significant medical, surgical or family history. Physical examination reveals multiple enlarged lymph nodes. Histopathology reveals excessive mature B cells that mark strongly with CD5 and CD23 and weekly with CD22. They also have weak expression of kappa chains on the plasma membrane. What is the most likely diagnosis? Chronic lymphocytic leukemia Sezary syndrome Acute lymphatic leukemia Chronic myeloid leukemia Hairy cell leukemia Loading...92. Which of the following tests is most likely used to rule out congestive heart failure in a case of cardiomegaly during pregnancy? Arterial blood gas MRI of the chest Echocardiography Electrocardiogram (ECG) Loading...93. A 70-year-old man is brought to the doctor having a sudden onset of severe lower back pain. Upon conducting a physical examination of the patient, severe kyphosis is revealed. An x-ray of the back shows a compression fracture in the lumbar area of a vertebral body. This is followed by marked thinning of the bones as well. Laboratory tests measuring serum calcium, alkaline phosphatase, phosphorus, and parathyroid hormone levels, all come back within the normal range. What is the most likely reason behind the bone changes in the patient? Osteoporosis Osteitis fibrosa cystica Osteomalacia Osteopetrosis Loading...94. Which of the following layers of the heart forms the cardiac valves and continues with the intima of the aorta? Pericardium Epicardium Myocardium Endocardium Loading...95. A 6-year-old boy presents with fever, malaise, cough, running nose and conjunctivitis. His past medical history indicates that he did not receive any immunizations due to his parents’ religious belief. On examination, his temperature is 102.7 F and there are white spots on a red base close to his second molar teeth. He also has non-pruritic, maculopapular rash on his face, behind his ears and spreading to his chest. What is the most likely diagnosis? Measles Smallpox German measles Mumps Chicken pox Loading...96. Which of the following is the most common etiology of type II diabetes? Low insulin production Increased hepatic glycogen breakdown Insulin receptor deficiency Altered hormone-receptor complex Loading...97. Which one of the following cholinomimetic agents is used in the challenge test for diagnosis of asthma? Methacholine Bethanechol Pilocarpine Carbachol Loading...98. Which one of the following drugs is a 2nd generation Cephalosporin? All of the above Cefprozil A & B Cefaclor Cefdinir Loading...99. Which one of the following is characteristic of Chlamydia? Gram-negative diplococci Anaerobic bacteria Facultative intracellular Obligate intracellular Loading...100. Aspirin has anti-platelet effect that lasts for the life of the platelet. What is the average life of a platelet? 120 days 24 hours 7-10 days 2-4 daysPage 5 of 66 Loading...101. Which of the following medications is considered a selective beta-1 adrenergic agonist? Amrinone Dopamine Dobutamine Prazosin Loading...102. A patient with HIV history develops fecal urgency and bloody diarrhea. Which of the following is the most likely causative organism? Entamoeba histolytica Clostridium difficile Cytomegalovirus Giardia lamblia Loading...103. Which of the following conditions is characterized by irregular blotchy patches of hyperpigmentation localized mostly on the face caused by sun exposure, pregnancy and contraceptive pills? Benign lentigo Freckles Melasma Vitiligo Loading...104. A 68 year-old woman complains of fever, anorexia and right flank pain for 2 days. She vomited twice today. On physical examination, her temperature is 101.3 F and there is moderate tenderness on the right costovertebral angle. Her urinalysis shows leukocytes and pus cells. What is the most appropriate next step of management? Outpatient wide spectrum antibiotics and schedule a visit after 3 days Schedule MRI of the abdomen and pelvis Hospitalization and intravenous antibiotics Collect blood and urine samples for culture Schedule Intravenous pyelogram Loading...105. Varicella zoster vaccine is not recommended if an elderly patient already developed shingles. False True Loading...106. Which one of the following antiretroviral drugs is a protease inhibitor? Ritonavir Zidovudine Lamivudine Tenofovir Etravirine Loading...107. Which of the following is the epithelial covering of vocal cords? Simple cuboidal Simple columnar Simple squamous Stratified squamous Loading...108. Which of the following is the central action of cocaine? Stimulation of dopamine release Inhibition of reuptake of dopamine and epinephrine Inhibition of phosphodiesterase Inhibition of reuptake of serotonin Loading...109. A 75-year-old man develops sudden onset of shortness of breath at the orthopedic department. He was admitted for suspected pathological fracture of femur 3 days ago. On examination, his pulse is 122, blood pressure 90/60, respiratory rate 34/min and oxygen saturation is 92%. Lung sounds are clear bilaterally. Heart rhythm is regular with no murmurs or gallops. What is the appropriate immediate step to improve this patient’s condition? Intravenous injection of broad spectrum antibiotics Call the cardiology attendant Intravenous injection of heparin Electric cardioversion Subcutaneous injection of epinephrine Loading...110. Which of the following conditions could be a serious side effect of sumatriptan? Cutaneous flushing Dilated cardiomyopathy Torsades de pointes Coronary vasospasm Loading...111. Which of these medications is contraindicated in a case of cardiogenic shock? Norepinephrine Metoprolol Intravenous fluids Dopamine Loading...112. Which of the following drug contain sulfonamide structure in the structural formula? Meloxicam Mefenamic acid Celecoxib None of these Acetaminophen Loading...113. A 76 year old woman comes to your office for a consultation. Yesterday, she had left hemiparesis for 30 minutes. She thought it was a stroke but now she is completely asymptomatic. She has a history of atrial fibrillation, angina and hypertension. She takes aspirin 81 mg and propranolol 80 mg. What is your appropriate initial management for this patient? Obtain CT scan of the head Schedule transesophageal echocardiography Schedule carotid duplex ultrasonography Schedule another appointment whenever she has symptoms Schedule MRI to the brain Loading...114. A 1-day old full term baby of a 23-year old mother who was delivered yesterday by normal vaginal delivery is coughing, choking and ejecting the formula from his nose and mouth. He also turns blue during feeding. What is the primary diagnosis of this boy? Tracheoesophageal fistula Tracheomalacia Imperforate anus Pyloric stenosis Tetralogy of Fallot Loading...115. Which one of the following treatment most likely prevents meningeal leukemia in a young boy diagnosed with acute lymphoblastic leukemia? Cyclophosphamide High dose of cortisone Radiotherapy Intrathecal methotrexate Loading...116. Which one of the following joints is the only articulation between the upper limb and the trunk? Sternoclavicular joint Glenohumeral joint Coracoclavicular joint Acromioclavicular joint Loading...117. Which of the following is the first line therapy for gastroparesis in patients with diabetes? Cimetidine Ondansetron Metoclopramide Omeprazole Loading...118. Dull, Persistent, and tightening is the characteristics of the following type of headache? Migraine Headache Tension-Type Headache A & B Cluster Headache Loading...119. Congenital heart diseases are defects of the heart and/or great arteries that are present at birth. They may be manifested at birth or hidden until later in life. Cyanosis is an important sign to diagnose and differentiate between types of congenital heart disease. What is the most common congenital heart disease? Atrial septal defect Patent ductus arteriosus Transposition of the great arteries Tetralogy of Fallot Ventricular septal defect Loading...120. Administration of which one of the following substances most likely reverses the course of Wernicke-Korsakoff syndrome? Riboflavin Thiamine Niacin Vitamin K Loading...121. Which of the following is NOT an adverse effect of aspirin? Gastritis Tolerance Bleeding Renal problems Loading...122. Which one of the following statements about the use of Alpha-methyldopa is incorrect? Cardiac output is decreased Reduce peripheral resistance Alpha² agonist activity Causes Sedation and drowsiness Loading...123. Ganglion blocker drug is following? Mecamylamine B & C Nicotine Atracurium Atropine Loading...124. Which of the following is the main role of hydroxyurea in treatment of sickle cell anemia? Decrease levels of HbF in red blood cells Increase ability of HbS to bind 2.3-bisphosphoglycerate Increase levels of HbF in red blood cells Decrease oxygen affinity to HbS Loading...125. Which one of the following drugs blocks the urinary excretion of penicillin which leads to prolonged high serum concentration? Cimetidine Rifampicin Probenecid ChloramphenicolPage 6 of 66 Loading...126. A drug that inhibits xanthine oxidase through the formation of a stable complex with xanthine oxidase is the following? Colchicine Allopurinol Pegloticase Febuxostate Probenecid Loading...127. Which of the following muscles are the primary abductors of the arm at the shoulder? Deltoid and infraspinatus Deltoid and coracobrachialis Deltoid and biceps Deltoid and supraspinatus Loading...128. Bioavailability of a medication is maximal when it has which of the following factors? High water solubility High ionization High lipid solubility High plasma binding Loading...129. Which one of the following drugs belongs to drugs for hepatic viral infections? Capreomycin Interferon Ezetimibe Aluminium hydroxide Indanyl carbenicillin Loading...130. Which of the following is characteristic of Alzheimer’s disease? Nuclear atypia Neurofibrillary tangles Lewy bodies Negri bodies Loading...131. Which one of the following conditions is characterized by painless blisters on the back of the hands and hyperpigmentation of the face? Porphyria cutanea tarda Contact dermatitis Herpes zoster Dermatitis herpetiformis Loading...132. Which of the following is the target LDL in a patient with diabetes? 100-130 70-100 Less than 70 More than 130 Loading...133. Which of the following statements correctly describes the volume of distribution of a drug? It is the rate of diffusion of the drug through intracellular component It is the capacity of a drug to attach to plasma protein It is a kinetic parameter that correlates dose with plasma level of a drug at zero time It is the concentration of the drug in plasma at a certain time Loading...134. A 62-year-old farmer visits his physician at his wife’s request who noticed that he had an irregular dark pigmented lesion on his back. According to his wife, he has had this lesion since their wedding 35 years ago but lately it became darker and irregular. What is the most important prognostic factor in this case? Color of the lesion Diameter of the lesion Depth of the lesion Age of the patient Loading...135. Which of the following drug is Phenoxy acetic acid derivative diuretic? Ethacrynic acid Chlorthalidone Benzthiazide Furosemide Torasemide Loading...136. Which of the following is the mechanism of action of cromolyn for asthmatic patients? Blocks adenosine receptors in bronchial smooth muscle Inhibits phosphodiesterase Prevents degradation of mast cells Inhibits COX 2 Loading...137. Which of the following tests is diagnostic in case of a 2-week old boy with persistent vomiting of non-bilious material after feeding? Chest x-ray Esophagostomy Barium studies Abdominal ultrasound Loading...138. Following are the 17 alpha-Hydroxyprogesterone derivatives Having a pregnane nucleus in the structural formula? Fexofenadine Promethazine Hydroxyzine Cetirizine Cyproheptadine Loading...139. A single injection of leuprolide was given to a man 2 weeks ago. Which of the following changes could be revealed today? Decreased testosterone production Increased FSH receptors Increased LH receptors Increased testosterone production Loading...140. Which one of the following cell markers is unique for NK cells? CD56 CD16 CD40 CD14 Loading...141. What is the antidote to organophosphates toxicity? All of above Pralidoxime Dimercaprol Atropine B & C Loading...142. A 25 year old woman presents to her physician at 28 weeks of gestation with general itching for one week. Itching is worse at night and more prominent at soles and palms. She has no history of allergy or dermatological diseases. She is compliant with regular examinations and her pregnancy is uncomplicated. Her physical and obstetric examinations are unremarkable. Laboratory tests reveal normal full blood count, renal function tests and blood coagulations tests. Her liver function tests are as follows: ALT 47 IU/L AST 55 IU/L Alkaline phosphatase 356 IU/L Total bilirubin 1.9 Bile acids 15 micromol/L Serology for hepatitis is negative What is the best treatment for this woman’s itching? No treatment and repeat liver function tests in a week Hospitalization and induction of labor Ursodeoxycholic acid and vitamin K Diphenhydramine Loading...143. Which of the following in the most likely cause of spontaneous abortion in the first trimester? Maternal drug use Congenital infection Chromosomal abnormalities Toxemia of pregnancy Loading...144. What is the most common cause of abdominal aortic aneurysm? Atherosclerosis Post-inflammatory Complication of coronary artery disease Post-operative Loading...145. Sulindac belongs to one of the following class? Acetic acid derivative Propionic acid Fenamates Oxicam derivative Loading...146. Which of the following differentiates Dubin-Johnson syndrome from Rotor syndrome? Black pigmentation of the liver Mode of inheritance Level of liver enzymes Conjugated hyperbilirubinemia Loading...147. Hypertriglyceridemia and hypercholesterolemia are the adverse effects of following drugs? Entry inhibitors Nucleoside analogs Integrase inhibitors Protease inhibitors Loading...148. A 65-year-old man presents with gradual low back pain increasing in intensity for the last six months. X-ray shows several osteoblastic lesions on lower vertebra and pelvic bones. Additional investigations reveal that those lesions are metastases. Which of these is most likely the primary cancer in this patient? Chronic lymphocytic leukemia Thyroid follicular carcinoma Hodgkin’s lymphoma Renal cell carcinoma Prostatic cancer Loading...149. High levels of which one of the following substances signals the initiation of gluconeogenesis? Oxalate Adenosine triphosphate (ATP) Citrate Acetyl CoA Loading...150. A drug that belongs to Loop Diuretics is one of the following? All of the following Bumetanide A & B Bumetanide FurosemidePage 7 of 66 Loading...151. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Indanyl carbenicillin Ethionamide Nizatidine Aluminium hydroxide Ezetimibe Loading...152. Increased level of bradykinin causes? Fatigue Headache Vertigo Dry cough Fever Loading...153. Which of the following organisms is associated with toxic shock syndrome due to exotoxin A? Vibrio cholera Staphylococcus aureus Clostridium perfringens Streptococcus pyogenes Loading...154. Which one of the following drugs belongs to drugs for hepatic viral infections? Indanyl carbenicillin Ezetimibe Capreomycin Adefovir Aluminium hydroxide Loading...155. Which of the following drug is a part of proton pump inhibitors? A & B Pantoprazole Furosemide Mannitol Acetazolamide Loading...156. Which of the following characterizes intravenous (IV) route of administration? Undergo first pass metabolism Efficacy is affected by liver disorders Maximum bioavailability Rabidly excreted Loading...157. Amphotericin B belongs to the class of following drugs? Antifungal Antiviral Antipyretic Antibiotics Antiprotozoal Loading...158. Which of the following is the most common inherited cause of hypercoagulability? Congenital antithrombin III deficiency Protein C deficiency Prothrombin gene mutation Factor V Leiden mutation Loading...159. Which of the following drug is a PGF2-Alpha analog? Carboprost Treprostinil Misoprostol Epoprostenol Dinoprostone Loading...160. A 62-year-old man complains of fatigue, progressive weakness and numbness of his arms and legs. Complete blood count shows decreased numbers of erythrocytes and increase in the mean cell volume. Removal of which of these structures requires lifelong administration of the vitamin involved in this case? Tonsils Left kidney Gall bladder Ascending colon Ileum Loading...161. Gonadotropin-releasing hormones are synthesized by which of the following nuclei of the hypothalamus? Anterior nuclei Ventromedial nuclei Arcuate nuclei Dorsomedial nuclei Loading...162. Which one of the following drugs is Nonsteroidal antiestrogens? Exemestane Tamoxifen Estrogen Estradiol acetate Estradiol Loading...163. A 42 year-old woman presents to the clinic with progressive fatigue and weakness for 6 months. She also complains of tingling and numbness of her arms and legs. Physical examination reveals decreased both superficial and deep sensations in her arms and legs. Blood count reveals decreased numbers of erythrocytes, leucocytes and platelets along with increased mean red blood cell volume. Peripheral blood smear shows enlarged erythrocytes and hypersegmented neutrophils. Which one of these biochemical reactions is involved in this case? Conversion of methylmalonyl-CoA to succinyl-CoA Conversion of malonyl-CoA to palmitate Conversion of propionyl –CoA to methylmalonyl –CoA Conversion of succinyl-CoA to fumarate Loading...164. What is the proper treatment of ventricular fibrillation? Digoxin and verapamil Morphine and nitroglycerin Metoprolol and heparin Immediate cardioversion Loading...165. A 75-year-old man presents to his physician for a routine examination. He has a history of hypertension, hypercholesterolemia and osteoarthritis. He takes atenolol, simvastatin and ibuprofen as needed. His pulse is 76/min and irregular. Blood pressure is 130/74. Physical examination and imaging studies are normal except for asymptomatic atrial fibrillation. What is the most appropriate next step in management of this patient? Start low molecular weight heparin and warfarin Start aspirin Start warfarin Start heparin Assurance and follow up in 3 months Loading...166. Which of the following laboratory tests could be slightly increased in Gilbert’s syndrome? Triglyceride Haptoglobin Bilirubin, indirect Bilirubin, direct Loading...167. Which of the following is considered an indication of first-generation histamine H1-receptor blockers? Peptic ulcer Cough Apoplexy Allergy Loading...168. Gonadotropin-releasing hormone is produced by which of the following nuclei of hypothalamus? Arcuate nucleus Dorsomedial nucleus Anterior nucleus Ventromedial nucleus Loading...169. A 48-year old man presents to the emergency room with severe headache and blurred vision. His blood pressure is 230/140. Ophthalmologic examination reveals blurred optic discs with indistinct margins. An intravenous drip of nitroprusside is started. What is the mechanism of action of this medication? ACE inhibitor Direct smooth muscle vasodilator Beta adrenergic antagonist Alpha adrenergic antagonist Ganglion blocker Loading...170. A 46 year old woman with systemic lupus erythematosus presents to the clinic for follow up. She takes prednisone daily for 3 months. Her condition is stable and she has no complaints since her last visit 3 months ago. She smokes a pack of cigarette daily for 15 years. She said that she is not faithful on her diet and exercise program. On physical examination, her pulse is 84/min; blood pressure is 140/90, no cardiac or pulmonary abnormalities and no organomegaly.at is the most appropriate lab test you should order on this visit? Blood glucose and serum lipids Serum thyroid stimulating hormone Serum cortisol Blood urea nitrogen and serum creatinine Loading...171. Which of the following drug is a Dihydropyridine antihypertensive drug? Carvedilol Bumetanide Diltiazem Amlodipine Ethacrynic Loading...172. Lactic acidosis is the adverse effect of one of the following drugs? Metformin Aspirin All of the above Glyburide Loading...173. A 23-year-old woman presents to the clinic with a complaint of pain in her left breast since last night. She is breastfeeding her 1-week-old girl. On examination, her temperature is 99.8 F, her pulse is 88/min. and her blood pressure is 120/80. Local examination of the left breast reveals a localized soft tender 1-inch area. Her past medical, surgical and family histories are unremarkable. What is the most likely diagnosis? Inflammatory carcinoma A clogged milk duct Milk engorgement Mastitis A breast abscess Loading...174. Which of the following is the most likely cause of death in cases of overdose of hypnotics? Hypothermia Status epilepticus Depression of the medullary respiratory center Cerebral edema Loading...175. Which one of the following drugs is the most effective in improvement of ascites? Hydrochlorothiazide Digoxin Spironolactone LisinoprilPage 8 of 66 Loading...176. Which of the following drug belongs to H2 histamine receptor blocker? Glimepiride Cefoxitin Nizatidine Oxacillin Niacin Loading...177. A patient is brought to the emergency room in a deep coma following a motor car accident. Vital signs, general examination and local chest and abdominal examinations are normal. Head CT scan is normal. Which of the following is the most likely initial diagnosis? Cerebral contusion Epidural hematoma Diffuse axonal injury Subdural hematoma Loading...178. Which of the following organisms is associated with pneumonia precipitated by aerosolized water (air conditions)? Pneumocystis jirovecii Legionella pneumophila Chlamydophila pneumonia Mycoplasma pneumonia Loading...179. The following drug is a peripheral dopamine-1 receptor agonist? Fenoldopam Hydralazine Alpha-Methyldopa Minoxidil Loading...180. Which of the following is the most abused drug for all ages in the United States? Methamphetamine Marijuana Cocaine Alcohol Loading...181. Gonadotropin-releasing hormones are synthesized by which of the following nuclei of the hypothalamus? Anterior nuclei Arcuate nuclei Dorsomedial nuclei Ventromedial nuclei Loading...182. Which of the following is the most common etiology of type II diabetes? Altered hormone-receptor complex Increased hepatic glycogen breakdown Insulin receptor deficiency Low insulin production Loading...183. Your 8-year-old daughter wakes you up in the middle of the night complaining of severe coughing. You bring the child to the doctor the next day and upon examination, the following is revealed: noisy breathing on inspiration, flaring of the nostrils, marked retractions of the chest wall, and a severe barking cough. She has also developed an upper respiratory tract infection. What would be the best diagnosis for the patient? Bronchiolitis Asthma Foreign body stuck in the main bronchus Viral croup Loading...184. Which one of the following structures is involved in a case of tarsal tunnel syndrome? Deep peroneal nerve Anterior tibial artery Peroneal artery Tibial nerve Loading...185. Which of the following drug are indandione derivative oral anticoagulants? Dicumarol Menadione Phytonadione Heparin Phenindione Loading...186. A child is brought to the emergency room after ingestion of a full bottle of a medication two hours ago. The child is in coma with tachypnea, tachycardia and metabolic acidosis. Which of the following is the responsible medication? Vitamin C Hydrocodone Acetaminophen Aspirin Loading...187. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Ethambutol Caspofungin Ibandronate A & B Furosemide Loading...188. Which one of the following drugs is used to treat asthma? Theophylline Hydrochlorothiazide Repaglinide Indanyl carbenicillin Ezetimibe Loading...189. Which of the following is the mechanism of action of selegiline in treating Parkinson’s disease? Blocks catechol-O-methyltransferase (COMT) Inhibition of MAO type B to reserve dopamine Precursor of dopamine Agonist at dopamine receptors Loading...190. Which of the following medications is useful to distinguish nephrogenic from neurogenic diabetes insipidus? Demeclocycline Acetazolamide Hydrochlorothiazide Desmopressin Loading...191. Which one of the following drugs induce Dose Dumping syndrome? Erythromycin Amiodarone Digoxin Ethanol Rifampin Loading...192. Which one of the following factors is the most accurate measure for the severity of diabetic ketoacidosis? Urine ketones Blood ketones Serum bicarbonate level Serum glucose level Loading...193. Which one of the following agent is a insulin? Torsemide Aspart Atorvastatin Somatostatin Desmopressin Loading...194. A drug that causes REACTIVATION OF ACETYLCHOLINESTERASE? Pralidoxime Tacrine Neostigmine Echothiophate Loading...195. A 25-year-old woman presents to the clinic complaining of general aches for two years. Pain is getting worse over the past 3 months. Every morning, she has stiffness all over her body, which is usually relieved in about 5-10 min. She has no history of trauma or any medical condition. Her BMI is 21 and she has no rash or joint swelling. She has multiple tender points. All laboratory investigations are within normal limits. What is the most appropriate management of this patient? Start hydrocodone Perform nerve conduction studies Start prednisone Start duloxetine Perform electromyogram (EMG) Loading...196. Prostaglandin is derived from prostanoic acid, prostanoic acid contains 20 carbon fatty acids, how many carbons rings in the structural formula of prostanoic acid? 4 carbon ring 2 carbon ring 3 carbon ring 6 carbon ring 5 carbon ring Loading...197. A patient is suffering from xerostomia due to the Sjogren’s syndrome he has been afflicted with for the last few months. Which one of the following is the best for treating xerostomia? Bethanechol Carbachol Scopolamine Methacholine Cevimeline Loading...198. Peripheral resistance is linked with one of the following issue? Blood pressure Headache Aids Fever Loading...199. A 58-year-old woman comes to the emergency room complaining that her skin is turning yellow. The doctor performs a physical examination, which reveals that the woman is suffering from moderate jaundice. There is no abdominal pain and she also has a negative Murphy’s sign. The physician becomes concerned that he is able to feel the patient’s non-tender gallbladder. A CT scan is therefore ordered. What could be the most likely cause of the woman’s jaundice? Hemolytic anemia Acute hepatitis Gall bladder stones Pancreatic cancer Loading...200. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? A & B Furosemide Anidulafungin Ethambutol IbandronatePage 9 of 66 Loading...201. Which of the following is a frequent side effect of amphetamine? Constipation Hair loss Diarrhea Depression Loading...202. Which one of the following enzymes catalyzes the rate limiting step in glycolysis? Phosphofructokinase-2 6-Phosphofructo-1 kinase Glyceraldehyde-3-phosphate dehydrogenase Pyruvate kinase Loading...203. Type of hypoglycemia in which patient feels hypoglycemic symptoms but the blood glucose level is normal or slightly above normal? Type 1 diabetes Mellitus Gestational Diabetes mellitus Pseudo hypoglycemia Type 2. Diabetic mellitus Loading...204. An 8-month-old boy presents to the clinic with his mother. She tells you that her son had several bowel movements today and his stool was like red jelly. He vomited all food and water. He is also weak, fussy and holding his belly. He has no fever or signs of dehydration. On abdominal examination, there is a palpable abdominal mass in the right hypochondrium and emptiness in the right lower abdomen. Ultrasonography is performed to confirm the diagnosis. What is the next step of management for this patient? Colonoscopy MRI of the abdomen IV hydration and antibiotics Refer to surgery for bowel resection Contrast enema Loading...205. Which one of the following drugs belongs to drugs for hepatic viral infections? Aluminium hydroxide Capreomycin Ezetimibe Indanyl carbenicillin Lamivudine Loading...206. Which one of the following agents is a muscarinic cholinomimetic? Tubocurarine Atropine Hexamethonium Pilocarpine Loading...207. Which of the following is the substance released from the parietal cells of the stomach? Gastrin Pepsinogen Hydrochloric acid Mucus Loading...208. A 79-year-old woman presents with back pain for 3 months. Radiology of the spines shows compression of T11 and T12 vertebrae. There is no other lesion detected. Which of the following is the most likely diagnosis? Metastatic adenocarcinoma Ewing sarcoma Osteosarcoma Osteoporosis Loading...209. Which one of these drugs can lead to weight gain and constipation? Clozapine Bromocriptine Ziprasidone Pimozide Loading...210. Which of the following is the reason that nitroglycerin is given sublingually? It improves patient compliance It has less reflex tachycardia than other routes It diminishes the odds of developing methemoglobinemia It avoids first pass metabolism Loading...211. Which one of the following conditions is characterized by joint space narrowing and osteophyte formation while bone density appears normal? Gout Pseudogout Rheumatoid arthritis Osteoarthritis Loading...212. A 17-year-old girl visits the clinic with her mother who is concerned that her daughter had not menstruated yet and her breast had not been significantly developed. She also notes that her daughter is color blind. The girl denies any sexual relationship or using any recreational drugs. Examination reveals normally appearing girl with small non-developed breasts. There is lack of pubic hair and her vagina and cervix are not fully developed. She is 5f5in tall and weighs 130 Ib. Cardiac, chest and abdominal examinations are unremarkable. What is the most likely initial diagnosis? Early pregnancy Kallmann’s syndrome Androgen insensitivity disorder Kartagener’s syndrome Turner’s syndrome Loading...213. A 39 year-old man presents to the ER by his wife. They were watching TV when she noticed that her husband was confused and stumbling. He is not usually at home at this time but he did not feel good all the day. He used to drink every night with his friends at the bar but he did not go with them in the last two nights. He assumed that he is tired because he drank too much last time two days ago. He denied chest pain, shortness of breath or any abdominal symptoms. His CT scan is negative for any mass or bleeding. His lab tests show: Alcohol withdrawalctose dehydrogenase 267 U/L What is the most likely diagnosis of this patient condition? Stroke Heart attack Alcohol toxicity Loading...214. Which one of the following drugs can be used as a patch to avoid sea sickness? Digoxin Scopolamine Adrenaline Nicotine Loading...215. Which of the following locations is the most common site of gastrinoma? Pancreas Ileum Liver Stomach Loading...216. A 78-year-old woman presents to the office with her daughter. Last week, she fell twice while she was walking with her daughter. She was not shaking or lost her consciousness and she got up in a minute. Her medical history is significant for hypertension and osteoarthritis. She takes Lisinopril daily and ibuprofen as needed. She also takes diphenhydramine to help her sleeping during the night. Her vital signs are within normal limits on sitting and standing. All her laboratory tests are within normal ranges. Her mini-mental status test is normal. What is the best explanation for this patient’s fallings? Postural hypotension Osteoarthritis Old age Alzheimer’s disease Side effect of one of her medications Loading...217. Which of the following drug is a Non-dihydropyridine antihypertensive drug? Amlodipine Diltiazem Carvedilol Bumetanide Nifedipine Loading...218. Which one of the following drugs is a Proteas inhibitor? Abacavir Maraviroc Indanyl carbenicillin Delavirdine Atazanavir Loading...219. A drug that is a part of Macrolide is following? Clarithromycin Cefepime Cefdinir Cefaclor Loading...220. Which one of the following disorders is accompanied by blue sclera? Systemic lupus erythematosus Neurofibromatosis type 2 Duchenne muscular dystrophy Osteogenesis imperfecta Loading...221. In a case of methemoglobinemia, which one of the following is the most likely cause of the brown color of the patient’s blood? Reduced hemoglobin Carbon monoxide Decreased oxygen affinity Oxidized hemoglobin Loading...222. A 3-month-old baby is recognized to have a horseshoe kidney. In this case, which of the following structure is known to prevent this abnormally shaped kidney from occupying the correct position? Superior mesenteric artery Abdominal aorta Inferior mesenteric artery Celiac trunk Loading...223. Deficiency of which of the following enzymes most likely result in the development of Cori disease? Muscle glycogen phosphorylase Lysosomal alpha-1,4 glucosidase Glucose-6-phosphatase Debranching enzyme (alpha-1,6-glucoside) Loading...224. A 56-year-old man presents to the clinic due to recurrent attacks of severe pain in his right big toe for the last few weeks. During the attacks, his toe becomes painful, red, warm and swollen. Significant improvement occurs after treatment with colchicine. Synovial fluid analysis is performed to confirm the diagnosis. What is the most likely finding to confirm the diagnosis? Calcium pyrophosphate dehydrate crystals Cloudy, reddish fluid, with leucocytes’ count equal to the blood count Calcium oxalate crystals Negatively birefringent urate crystals Cholesterol crystals Loading...225. A 23-year-old man presents to the emergency room complaining of massive watery diarrhea for 6 hours. He doesn’t have any vomiting or abdominal pain. Stool culture reveals a curved; gram negative rod which secretes an enterotoxin contains subunit A and a binding subunit B. What is the most likely reason for this patient’s massive diarrhea? Destruction of the absorptive epithelium Deficiency in the brush border enzymes Increased motility of the small intestine Decreased production of cAMP Increased production of cAMPPage 10 of 66 Loading...226. A 23-year-old woman represents to her physician with ptosis, meiosis and anhidrosis in the left eye. Which one of the following drugs is used to determine whether this lesion is preganglionic or postganglionic? Phenylephrine Albuterol Cocaine Atenolol Epinephrine Loading...227. A 52-year-old man who is recently diagnosed with gout is presented to his physician to discuss his treatment plan. One of the treatments that will be taken is allopurinol. Which of these enzymes is targeted by this medication? Hypoxanthine guanine phosphoribosyltransferase Phosphoribosylpyrophosphate synthase Guanase Xanthine oxidase Loading...228. Which one of the following phases of the cell cycle is affected by binding p53 to DNA? G2 G0 G1 M Loading...229. Which one of the following defines the drug efficacy? The impact of the drug on a wide range of patients The dose of a drug needed to produce a maximal effect The minimal amount of drug administered that leads to toxicity The capacity a drug to affect a condition irrespective of the dose Loading...230. Which of the following is considered a dynamic stabilizer of the glenohumeral joint? Subscapularis muscle Coracohumeral ligament Glenoid fossa Inferior glenohumeral ligament Loading...231. A 5-year-old boy is brought to the emergency room for cough and trouble breathing. His parents mention that he was playing with some coins a short time ago. The coin is most likely lodged in which of the following lobar bronchi? Left middle lobar bronchus Right middle lobar bronchus Left superior lobar bronchus Right superior lobar bronchus Loading...232. Which one of the following contraceptive methods is contraindicated in women with a history of deep venous thrombosis (DVT)? Depo-Provera injections Combined oral contraceptive Norplant Intrauterine contraceptive device (IUD) Loading...233. Which of the following is the nonessential amino acid? Leucine Methionine Alanine Histidine Lycine Loading...234. What is the mechanism of action of aminoglycosides? Disruption of cell wall hemostasis Blocking pathogens recognition of the host Disruption of ribosomal protein synthesis Inhibition of general metabolic pathways Loading...235. A 56 year old man is taken to the emergency room after having grand mal seizure during a staff meeting. He has no history of seizure but he complains lately of recurrent headaches on the morning and decrease in intensity later in the day. Laboratory investigations and imaging studies are performed. Which of these tests will confirm the diagnosis of glioblastoma multiform? Head CT scan MRI of the brain CSF analysis Brain biopsy Loading...236. A young man presents to the ER with a head injury. He lost his consciousness after the accident but he is alert now. A CT scan shows convex-shaped area of hemorrhage over the left parietal region. Which of the following structures is the most likely injured due to this accident? Inferior cerebral artery Middle meningeal artery Cavernous sinus Superior cerebellar artery Loading...237. A patient presents to the ER with acute myocardial infarction. After administration of aspirin and oxygen what is the nest step of action? Check cardiac biomarkers Initiate perfusion therapy Administer metoprolol Send for echocardiography Loading...238. An alcoholic patient presents with progressive fatigue and lethargy. He has a history of liver cirrhosis. Hepatic encephalopathy is expected. Which of the following is the first line of treatment? Oral lorazepam Broad spectrum antibiotics Oral lactulose Intravenous thiamine Loading...239. A 19 year old college student is brought to the emergency room with a police officer because of a cut wound on his arm. The student was arrested during committing a robbery at a convenient store. His record shows two fights with his neighbors on different occasions because he used to hit their pets. He also had two incidence of shoplifting. Which is the most likely diagnosis? Histrionic personality disorder Conduct disorder Antisocial personality disorder Borderline personality disorder Obsessive compulsive disorder Loading...240. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Capreomycin Nizatidine Indanyl carbenicillin Aluminium hydroxide Ezetimibe Loading...241. Which one of the following muscles is most likely at risk due to injury of the pelvic floor during delivery of a large-size baby? Pubococcygeus Iliococcygeus Coccygeus Loading...242. Which of the following is the best screening test for colon cancer? Blood in stool (FOBT) Barium enema Colonoscopy Sigmoidoscopy Loading...243. Which of the following side effect occurs in most of the patients when Alkylating agents and antimetabolites drugs are given in a therapeutically effective dose? Gastrointestinal toxicity Gonadal toxicity Myelosuppression Nausea Thinning of hair Loading...244. A 23-year-old man with a long history of duodenal ulcer has been treated with cimetidine (Tagamet) for 6 months. What is the mechanism of action of this drug? Blocks H2 receptors Adds a protective membrane to gastric mucosa Stimulates H2 receptors Inhibits H+,K+-ATPase Loading...245. Which of the following cell types is responsible for forming the blood brain barrier (BBB)? Astrocytes Microglia Oligodendrocytes Schwann cells Loading...246. Which one of the following drugs has irritation of the respiratory tract and should avoid in severe reactive asthma? None of these Zanamivir Oseltamivir Amantadine Rimantadine Loading...247. Which of the following drugs is used to treat pulmonary embolism? Oxacillin Niacin Tolbutamide Cefoxitin Dalteparin Loading...248. Which one of the following hypertensive drug is poisonous when given orally? Fenoldopam Hydralazine Minoxidil Sodium nitroprusside Loading...249. A 22-year-old man visits his physician for evaluation of new symptoms after the use of isoniazid treatment for TB. His skin is inflamed, had diarrhea and feeling like not himself. What is the vitamin deficiency responsible for this patient’s new symptoms? Vitamin B12 deficiency Riboflavin deficiency Thiamine deficiency Niacin deficiency Folic acid deficiency Loading...250. A 58-year-old woman comes to the emergency room complaining that her skin is turning yellow. The doctor performs a physical examination, which reveals that the woman is suffering from moderate jaundice. There is no abdominal pain and she also has a negative Murphy’s sign. The physician becomes concerned that he is able to feel the patient’s non-tender gallbladder. A CT scan is therefore ordered. What could be the most likely cause of the woman’s jaundice? Hemolytic anemia Pancreatic cancer Acute hepatitis Gall bladder stonesPage 11 of 66 Loading...251. Which one of the following drugs is 4th generation cephalosporin drug? Cefixime Cefepime Cefuroxime Cefadroxil Loading...252. Foci of hemorrhage and necrosis in which of the following parts of the brain is characteristic of Wernicke’s encephalopathy? Anterior pituitary Mamillary bodies Posterior pituitary Basal ganglia Loading...253. Which of the following medications prevents cholesterol absorption at small intestine brush border? Fenofibrate Colestipol Niacin Ezetimibe Loading...254. Chronic Daily ingestion of 5 g or more acetaminophen for longer than 1 month causes? GI disturbance Bleeding compilations Hypersensitivity to NSAIDs Hypersensitivity to Salicylates Liver damage Loading...255. Which one of the following drugs belongs to 1st generation Cephalosporins? A & B Cefadroxil All of the above Cefdinir Cefazolin Loading...256. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Aluminium hydroxide Indanyl carbenicillin Ezetimibe Macrolides Nizatidine Loading...257. Which one of the following drugs belongs to Antidiarreals? Atorvastatin Ezetimibe Aluminium hydroxide Indanyl carbenicillin Nizatidine Loading...258. Erythromycin belongs to the class of following drugs? Anti-malaria Antipyretic Antiprotozoal Antibiotics Antiviral Loading...259. A drug that belongs to proton pump inhibitor is one of the following? A & B Ethacrynic Acid Rosiglitazone Sulbactam Omeprazole Loading...260. Butoconazole belongs to the class of following drugs? Antifungal Antiprotozoal Antiviral Antibiotics Antipyretic Loading...261. A college student is brought to the ER for fever and agitation. Examination reveals high temperature, tachycardia, constricted pupils and horizontal nystagmus. Which of the following is the responsible substance? Cocaine Alcohol Phencyclidine Lysergic acid diethylamide Loading...262. Which one of the following conditions is the most likely cause of acute lower gastrointestinal bleeding in patients older than 40? Diverticulosis Colorectal cancer Varicose veins Ulcerative colitis Loading...263. Which one of the following conditions is associated with Acanthosis Nigricans? Amyloidosis Diabetes mellitus Hemochromatosis Diabetes insipidus Loading...264. Reflex tachycardia caused by systemic albuterol can be blocked by which of the following medications? Metoprolol Prazosin Dobutamine Phenylephrine Loading...265. Administration of spironolactone and furosemide leads to which of the following? Reduce sodium loss Increase potassium loss Reduce magnesium loss Reduce potassium loss Loading...266. Which of the following predicts better prognosis in cases of breast cancer? No metastases in the nearest lymph nodes Positive estrogen receptor Family history of breast cancer Tumor stage 2 Loading...267. Which one of the following nicotinic antagonist drugs has the ability to lower blood pressure, a vasodilator? Tubocurarine Succinylcholine Trimethaphan Ipratropium Loading...268. PITUITARY HORMONE is synthesized in the pituitary gland. The pituitary gland is divided into two anatomical lobes, one of these lobes is called the Anterior lobe. The anterior lobe is also called as following? Adenohypophysis Neurohyperphysis Adenohyperphysis Neurohypophysis Uterohypophysis Loading...269. Which one of the following drugs belongs to an alkylating agent? Fludarabine Lamivudine Gemcitabine Cladribine Melphalan Loading...270. Which one of the following conditions is the most common cause of aortic stenosis in the the elderly patients? Subacute bacterial endocarditis Calcification of the aortic valve Rheumatic fever Bicuspid aorta Loading...271. Which of the following is the correct statement about the difference between a strain and a sprain? Strain affects ligaments while sprain affects muscles and tendons Strain affects muscles or tendons while sprain affects ligaments Strain affects tendons and ligaments while sprain affects muscles Strain affects muscles or ligaments while sprain affects tendons Loading...272. Which of the following is the most common cause of death in an old patient with uncontrolled diabetes? Hyperosmolar coma Myocardial infarction Pulmonary embolism Cerebral hemorrhage Loading...273. A 4-month-old boy is brought to the clinic for a routine examination. Which of the following vaccines should be administered at this visit? DTaP Oral polio vaccine Varicella MMR Loading...274. What is the pKa of a drug? The pH at which 100% drug becomes completely ionized The pH at which 50% of the drug is ionized and 50% unionized The pH at which 100% drug becomes completely unionized Loading...275. Which one of the following anticonvulsant drugs in used only in the treatment of absence seizures? Carbamazepine Levetiracetam Lorazepam EthosuximidePage 12 of 66 Loading...276. Deficiency of which of the following enzymes results in elevated serum levels of alanine and lactate? Pyruvate dehydrogenase Glucose-6-phosphatase Alanine aminotransferase Lactate dehydrogenase Loading...277. A 64 year old woman complains of low back pain for 1 week. Her pain and tenderness is localized over the lumbar spine and exaggerated by movement. Her physician prescribes her a phosphonate drug. What is the mechanism of action of this drug for this patient? Decrease parathormone activity Increase osteoblast activity Increase urinary calcium reabsorption Increase vitamin D absorption Decrease osteoclast activity Loading...278. A 74-year-old man with a long history of emphysema presents to the office for a routine examination. He is complaining of fatigue and shortness of breath for 2 weeks. Physical examination is remarkable for scattered wheezes on both lung bases. Arterial blood gas is ordered for the patient. Which one of these results reflects the shift of oxygen dissociation curve to the right? pH 7.50, bicarbonate 24, Pco2 40 and Po2 90 pH 7.05, bicarbonate 15, Pco2 30 and Po2 90 pH 7.60, bicarbonate 24, Pco2 60 and Po2 90 pH 7.47, bicarbonate 15, Pco2 30 and Po2 90 pH 7.00, bicarbonate 15, Pco2 60 and Po2 90 Loading...279. A 26 year old woman is brought to the emergency room due to 2-hour history of hematemesis. She was invited to a banquet at her work and she vomited twice with a considerable amount of blood. Her medical, surgical and family histories are unremarkable. She visits her dentist regularly for recurrent dental caries. She doesn’t smoke or drink alcohol. Her pulse is 100/min, blood pressure is 104/66 and her temperature is 97.8 F. Abdomen is soft, nontender without organomegaly. Her laboratory tests are as follows: Serum sodium 136 meq/L. Serum potassium 2.6 meq/L. Serum chloride 84 meq/L. Serum bicarbonate 38 meq/L. Endoscopic examination reveals erosive esophagitis without any scars or adhesions. What is the most likely diagnosis? Staphylococcal food poisoning CREST syndrome NSAID-induced esophagitis Bulimia nervosa Mallory-Weiss syndrome Loading...280. Which one of the following medications is a non-selective beta receptor agonist? Phenylephrine Epinephrine Isoproterenol Ephedrine Loading...281. Which one of the following drugs acts mainly by blocking the synthesis of leukotrienes? Montelukast Ipratropium Cromolyn Zileuton Loading...282. Which one of the following drugs is a Inducer of the P-GP (glycoprotein) efflux pumps? Digoxin All of the above Rifampin Erythromycin Amiodarone Loading...283. Taste and visual disturbance is the adverse effect of the following drug? Griseofulvin Terbinafine Miconazole Nystatin Loading...284. Which of the following is the coagulation parameter affected by warfarin? Partial thromboplastin time (PTT) Bleeding time Prothrombin time (PT) Loading...285. Which of the following drug belongs to the Nonnucleoside reverse transcriptase inhibitor? Indanyl carbenicillin Abacavir Atazanavir Efavirenz Maraviroc Loading...286. Which of the following drugs is used after chemotherapy to increase the leukocyte count if it drops? Interleukin-2 Filgrastim Dexamethasone Prednisone Loading...287. Reflex bradycardia caused by alpha-1-agonists is blocked by which of the following medications? Atropine Adrenaline Metoprolol Phenylephrine Loading...288. Which of the following is the classic electrocardiogram (ECG) finding in inferior myocardial infarction (MI)? S-T segment elevation in anterior leads (V1-V4) S-T segment elevation in leads II. III and aVF Sawtooth P waves Diffuse S-T segment elevation Loading...289. A 9-month- old girl is brought by her grandmother to the clinic for routine examination. She told you that the girl is totally fine but she noticed yellow discoloration of her teeth. The physician asks if her mother took any medications during her pregnancy. She remembers that she was taking an antibiotic for bronchitis. Which of these antibiotics is the most likely responsible for this condition? Tetracycline Chloramphenicol Cephalexin Ampicillin Erythromycin Loading...290. Which one of the following drugs reverses the effects of heparin? Chloroquine Protamine Epinephrine Warfarin Loading...291. Which one of the following drugs is associated with optic neuritis? Ethambutol Capreomycin Isoniazid Rifampin Loading...292. A 28-year-old man presents to the emergency room after a bar fight in which he was shot. He is mildly distressed but oriented to place and time. Neurological examination reveals weakness of the right extremities with loss of touch, position and vibratory sensations on the same side accompanied by loss of pain and temperature on the left side. What is the most likely diagnosis? Central cord syndrome Anterior cord syndrome Conus medullaris syndrome Transverse myopathy Brown-Sequard syndrome Loading...293. Which of the following receptors are membrane receptors (not intracellular)? Receptors for thyroid hormones Receptors for vitamin D The nicotinic receptors for acetylcholine Receptors for steroids Loading...294. Which of the following substances is responsible for growth of the prostate at puberty? Testosterone Progesterone Dihydrotestosterone Estrogen Loading...295. Workers in the aniline dye industry are more susceptible to bladder cancer than general population. Meanwhile, studies show that animals, when exposed to beta-naphthylamine develop liver cancer but not bladder cancer. What is the most likely explanation of this finding? Detoxification of beta-naphthylamine by glucuronic acid conjugation. Metabolism of beta-naphthylamine by human cytochrome 450 system in the liver Human urinary glucuronidase splits beta-naphthylamine into glucuronic acid and a toxic metabolite. Beta-naphthylamine is directly carcinogenic to human bladder Loading...296. Which of the following errors is considered if the researcher states that there is no difference when one exists? Type 1 error Type II error Loading...297. A 73-year-old patient with multiple myeloma has been treated with high doses of doxorubicin. Which of the following may develop during this treatment? Bladder hemorrhage Hemolytic anemia Papilledema Cardiomyopathy Loading...298. Which of the following is the most likely developmental defect associated with tetralogy of Fallot? Patent ductus arteriosus Transportation of the great vessels Anterosuperior displacement of the infundibular septum Bicuspid pulmonary artery Loading...299. A drug that belongs to DPP-IV inhibitors is one of the following? A & B Sulbactam Sitagliptin Ethacrynic Acid Rosiglitazone Loading...300. Which one of the following nerves would be likely affected if a stab injury is established to the lower brachial plexus (C8-T1)? Ulnar nerve Radial nerve Axillary nerve Musculocutaneous nervePage 13 of 66 Loading...301. A patient presents with multiple ecchymosis of the skin, high prothrombin and partial thromboplastin times, Low serum He, low platelet count and positive D-Dimer test. Which of the following is the most likely diagnosis? Hemophilia A Vitamin K deficiency von Willebrand disease Disseminated intravascular coagulopathy Loading...302. Which of the following is not a feature of Tetralogy of Fallot? Pulmonary stenosis Right ventricular hypertrophy Overriding aorta Atrial septal defect Loading...303. Reabsorption of Na+ & Cl– in the distal convoluted tubules that results in retention of water in the tubules. Which of the following diuretic is used? Chlorothiazide Furosemide Bumetanide Acetazolamide Spironolactone Loading...304. Which one of the following cells is derived from monocytes and lying within the alveoli? Pneumocytes type I K cells Clara cells Pneumocytes type II Macrophages Loading...305. Which one of the following drugs inhibits ribonucleotide reductase? Ribavirin Mycophenolate Hydroxyurea 5-Fluorouracil Loading...306. All of the following are currently used in hyperthyroidism EXCEPT? Methimazole Potassium perchlorate Propylthiouracil Diatrizoate sodium Loading...307. Which one of the following medications stimulates muscarinic receptors in airways when inhaled? Bethanechol Methacholine Pilocarpine Carbachol Loading...308. Pellagra is a disease that causes inflammation of the skin, diarrhea, dementia, and sore in the mouth. It's also characterized by 4D's diarrhea, dermatitis, dementia, and death. Which vitamin deficiency cause pellagra? Vitamin A (Retinol) Vitamin B6 (Pyridoxine) Vitamin D (Cholecalciferol) Vitamin C (Ascorbic Acid) Vitamin B3 (Niacin) Loading...309. Which one of the following statements about dobutamine is incorrect? Positive inotropic effect Treat acute heart failure Increase contractility Decrease myocardial cAMP Loading...310. Beta-Blocker drug is following? Nicotine Atracurium Mecamylamine Atropine Pindolol Loading...311. All of the following drugs have anti-inflammatory effects except? Mefenamic acid Acetaminophen ketorolac Naproxen Piroxicam Loading...312. Which of the following drugs has the shortest half-life and used in acute anxiety? Flurazepam Alprazolam Chlordiazepoxide Clonazepam Loading...313. A young man is involved in a car accident which results in laceration to some great vessels and is admitted for surgery. Which of the following organs is the LEAST affected by loss of blood for a an extended period of time? Retina Small intestine Skeletal muscles Liver Brain Loading...314. Which of the following are the characteristics of Beck’s triad? Stasis, hypercoagulability and endothelial damage Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) Hypotension, distant heart sounds and jugular vein distention (JVD) Loading...315. Alkylating agents are associated with bone marrow depression and for this reason they are inappropriate for this patient. Missing of a chromosome Replication of a chromosome Duplication of a gene on the affected chromosome Deletion of a gene on the affected chromosome Presence of an extra chromosome Loading...316. Which of the following features are most likely seen in a case of Takayasu arteritis? Major organ failures Blanching and cyanosis of the fingers and toes Blindness and pulseless upper extremities Febrile lymphadenopathy with rah Loading...317. Which one of the following statements about the Digoxin is wrong? A cardiac glycosides Has a half-life of 36 hours None of these Positive Inotropic drug Inhibit Na+/K+ exchange Loading...318. Which one of the following drugs is a 2nd generation Cephalosporin? Cefepime Cefadroxil Cefdinir Cefoxitin Loading...319. The drug which inhibits the action of histamine at parietal cells results in a reduction of hydrogen ions concentration and volume of gastric acid? Sucralfate Rabeprazole Omeprazole Cimetidine Loading...320. What is the antidote to Atenolol? Glucagon atropine Pyridoxine Flumazenil Loading...321. Which of the following is the most common cancer of the lower third of esophagus in non-alcoholic, non-smoker patients? Melanoma Sarcoma Squamous cell carcinoma Adenocarcinoma Loading...322. A 22-year-old man with testicular cancer begins chemotherapy. One week later he develops edema of the legs and eyelids and is also found to have a substantial decrease in bilateral auditory acuity. Which of the following agents is most likely responsible for these adverse effects? Cisplatin Vincristine Methotrexate Daunorubicin Cyclophosphamide Loading...323. Clopidogrel belongs to which of the following class of antiplatelet agents? Dipyridamole Glycoproteins inhibitors Polyamines Fabric acid derivatives Theinopyridines Loading...324. Ethacrynic acid belongs to one of the following classes of diuretics? Carbonic anhydrase inhibitors Thiazide Diuretic Potassium-sparing diuretics Loop Diuretics Loading...325. Cefaclor belongs to one of the following generations of the cephalosporin? 2nd generation 4th generation 1st generation 3rd generationPage 14 of 66 Loading...326. A 36-year-old man comes to the office for evaluation of involuntary movements of his hands and feet. These movements developed gradually over the past 3 years. He is otherwise in a good health and takes no medication. He does not smoke or drink alcohol. He does not drink any caffeinated beverages or use any recreational drugs. His family noticed recent personality changes over the same period. On examination, there are abnormal involuntary movements of his hands with no certain pattern. He walks in dancing like-movements that make him almost losing his balance. Mental status examination shows abnormal low score. What is the most likely diagnosis of this patient? Drug-induced tremors Tourette’s syndrome Creutzfeldt-Jakob disease Parkinson’s disease Huntington’s disease Loading...327. A 62 year-old man complains of fever and diminished consciousness for 2 days. He has been healthy all his life and he doesn’t take any medications. On examination, he responds inconsistently to commands. His temperature is 103 F, pulse 110/min and blood pressure is 80/56 mmHg. His physical examination is otherwise normal. There is no bleeding. Laboratory test are as follows: Hemoglobin: 12 g/dlat is the most likely diagnosis? Hemophilia b Idiopathic thrombocytopenic purpura Hemophilia a Disseminated intravascular coagulationukocyte count: 25,000 – 80% neutrophils Platelet count: 20,000 Thrombotic thrombocytopenic purpura Loading...328. A 32-year old woman presents with burning micturition, frequency and pain in the suprapubic region. There is no fever, vaginal discharge or pruritus. She had no similar episodes and she is not taken any medications. Which of the following is the most likely causative organism of this condition? Campylobacter Streptococcus viridans Escherichia coli Staphylococcus aureus Loading...329. What is the most likely explanation of this finding? Metabolism of beta-naphthylamine by human cytochrome 450 system in the liver Human urinary glucuronidase splits beta-naphthylamine into glucuronic acid and a toxic metabolite. Beta-naphthylamine is directly carcinogenic to human bladder Detoxification of beta-naphthylamine by glucuronic acid conjugation. Loading...330. Adrenal insufficiency is commonly combined with which one of the following findings? Hypernatremia Hyperglycemia Hypercalcemia Hyperkalemia Loading...331. A young man was stuck on his leg by a falling rack a week ago. Today, a purple bruise developed on the site of injury. Which one of the following substances is responsible for the color at the site of injury? Thromboplastin Bilirubin Melanin Hemosiderin Loading...332. A drugs interfere with metabolism of azathioprine requiring a reduction in dosage? Allopurinol Colchicine Probenecid Sulfinpyrazone Loading...333. Which one of the following tumors is commonly associated with mutations affecting tumor suppressor gene (APC) and TP 53? Invasive ductal carcinoma of the breast Hepatocellular carcinoma Small cell carcinoma of the lung Colorectal adenocarcinoma Loading...334. Which one of the following oral anti-diabetic drugs is associated with lactic acidosis? Pioglitazone Metformin Nateglinide Glipizide Loading...335. If the half-life of a certain drug is 5 hours, how long it takes until the drug level reaches 25% of the initial dose? 7.5 hours 15 hours 10 hours 5 hours Loading...336. Which one of the following drugs belongs to 3st generation Cephalosporins? Cefaclor Cefepime Cefdinir Cefadroxil Loading...337. Which of the following is the effect of digoxin on a case of heart failure? Decreased stroke volume and vagal activity Increased sympathetic tone and decreased vagal activity Rapid conduction through AV node Increased stroke volume and cardiac output Loading...338. Which of the following is absolute contraindication of fibrinolytic therapy in MI? History of diabetes History of ischemic stroke 4 years ago History of hemorrhagic stroke 9 years ago History of hypertension Loading...339. Which one of the following conditions most likely occurs during normal delivery when the shoulders of the baby are impacted behind the maternal bony pelvis? Tendinitis Rotator cuff tear Frozen shoulder Shoulder dystocia Loading...340. Chronic use of which of the following drugs may increase the toxicity of acetaminophen? Ethanol Cimetidine Ketoconazole Verapamil Loading...341. Which of the following is the most likely cause of decreased visual acuity in pregnancy? Thickening of the cornea Optic nerve degeneration Macular degeneration Retinal detachment Loading...342. A 69-year-old male with angina develops severe constipation following treatment with: Verapamil Dobutamine Nitroglycerin Propranolol Captopril Loading...343. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Aluminium hydroxide Cycloserine Ezetimibe Nizatidine Indanyl carbenicillin Loading...344. A 19 year old college student is brought to the emergency room with a police officer because of a cut wound on his arm. The student was arrested during committing a robbery at a convenient store. His record shows two fights with his neighbors on different occasions because he used to hit their pets. He also had two incidence of shoplifting. Which is the most likely diagnosis? Antisocial personality disorder Conduct disorder Histrionic personality disorder Obsessive compulsive disorder Borderline personality disorder Loading...345. A patient presents with itching on his arms and legs for 2 weeks. Erythematous plaques covered with silvery scale are seen on his legs and back of his arms. Which of the following treatment most likely improves this condition? Oral acetaminophen Topical betamethasone Oral amoxicillin Topical mupirocin Loading...346. A neonate presents by renal failure and pulmonary hypoplasia. What is your diagnosis? Recessive polycystic kidney disease Pompe disease Niemann-Pick disease Phenylketonuria Loading...347. A drug is more effective when combined with Flucytosine to treat candidiasis or cryptococcosis? Amphotericin B Caspofungin Griseofulvin Itraconazole Loading...348. Gingival hyperplasia, granulocytopenia and facial hirsutism are possible side effects of which one of the following medications? Phenytoin Phenobarbital Carbamazepine Valproic acid Loading...349. A 6 year old girl presents to the emergency room with her mother for a deep wound on her right forearm. Her mother tells you that her daughter was playing at school today and wounded herself when she fell on a big rock. When you ask her about her vaccination, she tells you that her daughter had all her vaccinations before the school started this year. What is the most appropriate therapy for this girl? Both tetanus toxoid and antitoxin Tetanus antitoxin Tetanus toxoid Neither tetanus toxoid or antitoxin Loading...350. Gastric inhibitory peptide (GIP) and Glucagon-like peptide-1 (GLP-1) are secreted by? Intestine's Liver Kidney Adrenal glandsPage 15 of 66 Loading...351. Which one of the following drugs belongs to an alkylating agent? Gemcitabine Indanyl carbenicillin Lamivudine Capreomycin Streptozocin Loading...352. Which of the following cell types is responsible for forming the blood brain barrier (BBB)? Astrocytes Schwann cells Oligodendrocytes Microglia Loading...353. A drug that is used to treat HIV infections is one of the following? Niclosamide Praziquantel Etidronate Cladribine Atazanavir Loading...354. Which of the following is a poor prognostic sign of acute pancreatitis a day after initiation of hydration and appropriate treatment? Blood urea nitrogen (BUN) rises 6 mg/dL Random serum glucose of 70 mg/dL Hematocrit drops by 4% Serum amylase of 900 IU/L Loading...355. A 69 year-old man with a long history of poorly controlled diabetes presents to his physician complaining of pain and drainage in his left ear. His vital signs are within normal limits. The pinna of his left ear is tender. The external meatus is swollen and covered with purulent drainage. What is the most likely organism responsible for his condition? Streptococcus pneumoniae Candida albicans Moraxella catarrhalis Homophilus influenzae Pseudomonas aeruginosa Loading...356. Which of the following hormone belongs to the posterior pituitary? Furosemide A & B Somatrem Urofollitropin Desmopressin Loading...357. A 54 year old man presents to the emergency room complaining of progressive shortness of breath for 3 weeks. He has a long history of left sided heart failure treated by enalapril. Chest x-ray reveals bilateral pulmonary edema. After receiving the appropriate treatment, he is hospitalized for further investigations. Which of these findings is most likely revealed after further investigations? Increased pulmonary venous pressure Decreased pulmonary artery pressure Normal arterial CO2 partial pressure Normal arterial O2 partial pressure Normal respiratory function tests Loading...358. You are the physician in charge of a nursing home where several patients develop influenza A symptoms. None of the residents received flu vaccine yet. What is the best next step of action? Administer flu vaccine to all residents Administer flu vaccine plus oseltamivir for 2 weeks to all residents Treat only patients with oseltamivir until their symptoms subside Administer oseltamivir for 2 weeks to all residents Loading...359. Which one of the following enzyme deficiencies is related to Tay-Sachs disease? Hexosaminidase A deficiency Sphingomyelinase deficiency Glucocerebrosidase deficiency Arylsulfatase A deficiency Loading...360. Which of the following is a characteristic finding in isopropanol poisoning? Ketosis without acidosis Blindness due to ocular accumulation Elevated anion gap Elevated serum BUN and creatinine Loading...361. Which of the following group of medications prolongs GABA activity in the brain? Methamphetamines Benzodiazepines Alcohols Barbiturates Loading...362. Which of the following is the earliest abnormal test after infection with hepatitis B? Serum bilirubin Surface antigen Anti-hepatitis B antibodies ALT Loading...363. Combination of levodopa and carbidopa is recommended. Which of the following explains the significance of this combination? Unknown mechanism Carbidopa enhances the conversion of peripheral levodopa into dopamine Carbidopa enhances the absorption of levodopa Carbidopa enhances the entry of levodopa into brain Loading...364. A 23-year-old nursing student presents with confusion, fatigue and sweating. Her blood sugar is 40 mg/dL. Lab tests show a high insulin level and a very low C peptide level. Which of the following is the most likely diagnosis? Insulinoma Factitious hypoglycemia Pheochromocytoma Reactive hypoglycemia Loading...365. A group of people are assigned for a research study about the effect of a new hypoglycemia medication. Because they are aware of the study, they eat less carbohydrate. Which type of bias is involved in this study? Information bias Hawthorne effect Confounding bias Sample distortion bias Loading...366. Which one of the following drugs is a more effective drug and drug of choice for fungal infection with a shorter duration of therapy? Delavirdine Griseofulvin Terbinafine Itraconazole Loading...367. Which of the following defense mechanisms is most likely associated with paranoia? Projection Splitting Superego lacunae Undoing Loading...368. Which of the following drug is Pyrazolone Derivative NSAID? Phenylbutazone Ketorolac Indomethacin Nimesulide Diclofenac Loading...369. Select Phenyl Alkylamine Calcium channel blocker drug? Nifedipine Triamterene Diltiazem Triamcinolone Verapamil Loading...370. Which of the following is the best initial management of esophageal candidiasis in an HIV patient? Oral fluconazole Upper endoscopy Oral nystatin Intravenous amphotericin Loading...371. Which of the following is a characteristic finding in isopropanol poisoning? Ketosis without acidosis Elevated anion gap Elevated serum BUN and creatinine Blindness due to ocular accumulation Loading...372. A 1-year-old boy with a diagnosis of stable small ventricular septal defect is scheduled for a dental procedure. Which of the following medications should be administered prior to this procedure? No medication Amoxicillin Azithromycin Ampicillin Loading...373. Which of the following drug belongs to the Oxazolidinone class of Antibiotics? Linezolid Oxytetracycline Sulbactam Ciprofloxacin Erythromycin Loading...374. Which one of the following is the adverse effect of ACE inhibitors? Skin rashes Dry cough hypokalaemia All of the above A & B Loading...375. Which of the following is calculated by dividing the incidence rate of a disease in exposed by the incident rate of unexposed? Relative risk Attributable risk Positive predictive value Odds ratioPage 16 of 66 Loading...376. Which one of the following drugs blocks dopamine uptake transporter? Alcohol Marijuana Nicotine Cocaine Loading...377. Which of the following is the mechanism of action of pioglitazone in diabetic patients? Increases glucose excretion Increases insulin release Increases glucose uptake in muscle cells Decreases insulin breakdown Loading...378. Which one of the following is an antimuscarinic agent? Tacrine Pralidoxime Neostigmine Scopolamine Echothiophate Loading...379. Phentolamine and Tolazoline have similar structures to imidazoline Alpha Agonists due to lack of? Hydrophilic substitutions on the Cyclic ring Lipophilic substitutions on the aromatic ring None of these Hydrophilic substitutions on the aromatic ring Lipophilic substitutions on the Cyclic ring Loading...380. Which one of the following drugs is a neuromuscular blocker drug? Neostigmine Atropine Benztropine Mecamylamine Succinylcholine Loading...381. An Acrobat player fell from a height of about 30 feet on her back during her performance and sustained a serious injury. Her thoracic and abdominal muscles are completely paralyzed. She is still able to breathe as the diaphragm is not paralyzed by this injury. What is the most likely level of her injury? Third lumbar Seventh cervical First lumbar Fifth thoracic Second cervical Loading...382. Which of the following types of sensations is carried to the thalamus by the anterolateral tracts after crossing the spinal cord? Vibrations Position Crude touch Fine touch Loading...383. Incretin mimetic is one of the following? A & B Pramlintide Exenatide Furosemide Bumetanide Loading...384. Which one of the following drugs belongs to H2 histamine receptor blocker? Torsemide Ranitidine Indanyl carbenicillin Atorvastatin Ezetimibe Loading...385. The only type of insulin that should be given intravenously is one of the following? A & B Detemir Glargine Regular Lispro Loading...386. A drug that elevate bronchial smooth muscle cAMP leading to decreased intracellular calcium and prompt bronchodilation. Epinephrine Clonidine Phenylephrine Dipivefrin Albuterol Loading...387. Which of the following pathological terms describes the disordered, non-neoplastic cell growth? Dysplasia Anaplasia Neoplasia Metaplasia Loading...388. An empty scrotal sac is found upon examination of a newborn male. Which of the following is the most likely abnormality? Venous atresia Hypogonadism Undescended testis Agenesis Loading...389. A 73-year-old man with a history of benign prostatic hyperplasia (BPH) presents to the emergency room complaining of repeated falls. His wife admits that during the past 3 weeks he has had unsteady gait, urinary incontinence and memory disturbances. His medical, surgical and family histories are unremarkable. He has never smoked or taken any recreational drugs. He drinks alcohol socially. His laboratory tests are all normal. A CT scan of the head shows slightly enlarged ventricles and slightly compressed gyri. What is the most likely diagnosis of this patient’s condition? Alzheimer’s disease Anterior pituitary adenoma Middle cerebral artery stroke Normal pressure hydrocephalus Trauma to the head due to elderly abuse Loading...390. An old woman is having difficulty in holding or keeping her head up. She also mentions that she experiences fatigue in her hands shortly after washing dishes. Physical examination reveals neck flexion weakness as well as proximal weakness in the arms. Which of the following is the initial diagnosis for her condition? Meningitis Peripheral neuropathy Myasthenia gravis Spinal cord compression Loading...391. A 27 year old man presents with a 3 month history of heartburn and epigastric discomfort. His symptoms are exaggerated after meals especially if he eats spicy food. He takes no medications, doesn’t smoke or drink alcohol. He exercises regularly and has an active lifestyle. On physical examination, he has slight epigastric tenderness. His routine lab tests are normal What is the most appropriate intervention at this time? Barium swallow Trial of a proton-pump inhibitor 24-hour pH monitoring Esophageal manometry Upper endoscopy Loading...392. Which of these drugs inhibits epoxide reductase? Heparin Aspirin Warfarin Streptokinase Loading...393. A 72-year-old woman presents for her routine examination. She is healthy and exercising regularly. Her weight is 145 lb. and her height is 5’5. She has a family history of breast cancer. Her pulse is 70/min and blood pressure is 120/80. Her lipid panel is within normal limits. Which one of the following is the most likely risk factor to develop atherosclerosis in this woman? Family history of breast cancer Age Exercise Blood pressure Weight Loading...394. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefepime Cefaclor Cefadroxil Ceftibuten Loading...395. A 45-year-old man is rushed to the emergency room having severe headaches and recurrent fever started 1 week ago, a week after he came back from a trip to Africa. Physical examination reveals high fever and splenomegaly. Brain imaging reveals signs of cerebral involvement. Which of these following parasites is likely causing the patient’s symptoms? Plasmodium malariae Plasmodium vivax Plasmodium falciparum Babesia microti Loading...396. A drug that blocks the glycoprotein GP IIb/IIIa receptors of platelets? Dipyridamole Clopidogrel Ticlopidine Aspirin Tirofiban Loading...397. Canrenone is an active metabolite of one of the following Diuretic drug? Bumetanide Furosemide Spironolactone Acetazolamide Triamterene Loading...398. Which of the following is the most dangerous adverse effect of chronic alcohol abuse? Cutaneous vasodilation Live cirrhosis Impaired judgment Respiratory depression Loading...399. Which of the following drug are coumarin derivative oral anticoagulants? Phytonadione Phenindione Heparin Dicumarol Menadione Loading...400. Which one of the following drugs is tertiary amine antispasmodic? Biperiden Propantheline Cyclopentolate Oxybutynin DicyclominePage 17 of 66 Loading...401. Which one of the following is the wrong statement about the use of Acetylcholine as a neurotransmitter? Neurotransmitter of somatic nerves Neurotransmitter of parasympathetic nerves Acetylcholine has a positive chronotropic effect Rapidly inactivated by cholinesterase In preganglionic fibers terminated at the adrenal medulla Loading...402. Generally, Passive diffusion of Water-soluble drugs inside the cell membrane occurs by one of the following processes? Readily move across by facilitated diffusion Readily move due to lipid solubility Readily move across by active transport Penetrate through aqueous pores Loading...403. Which one the following parts of the large intestine is extraperitoneal? Sigmoid colon Descending colon Cecum Transverse colon Loading...404. Duration of action of nitroprusside is following? 15 to 30 minutes 30 minutes 3 to 6 hours 1 to 2 minutes Loading...405. Sjögren syndrome is characterized by a dry mouth and lack of tears. what is the recommended drug for this syndrome? Pilocarpine Atropine Tropicamide Cyclopentolate Bethanechol Loading...406. Which of the following medications is used in opioid overdose? Phencyclidine Norepinephrine Naloxone Flumazenil Loading...407. A person( 57 years) suffering from atrial arrhythmia is treated with one of the following drugs and during treatment, he complains of having dizziness, Headache, and tinnitus. Which drug is involved? Amiodarone Propranolol Aspirin Quinidine Verapamil Loading...408. At which of these vertebral levels does the trachea bifurcate? Fourth thoracic Seventh cervical Sixth thoracic First thoracic Loading...409. Which of the following is the appropriate next step of action to parents who refuse to vaccinate their child? Obtain a court order Report to Department of Health Services (DHS) Proceed with immunizations Explain the risks and benefits to them and document the conversation Loading...410. Which one of the following drugs belongs to Antidiarreals? Nizatidine Indanyl carbenicillin Ezetimibe Atorvastatin Methyl cellulose Loading...411. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Mecamylamine Tacrine Atracurium Phenoxybenzamine Metoprolol Loading...412. A 23-year-old woman was involved in a motor car accident three days ago. She was hypotensive and diagnosed with internal bleeding. She received several units of blood. Today her urine output is very low for the last six hours. Her urinalysis showed hematuria, proteinuria, muddy brown epithelial cells and granular casts. Her lab tests also show BUN: 26 mg/dL and serum creatinine: 2.6 mg/dL. What is the most likely diagnosis of her renal pathology? Interstitial nephritis Traumatic avulsion of the ureter Acute glomerulonephritis Acute tubular necrosis Loading...413. A newborn infant presents with cleft palate and hypocalcemia. Genetic testing of the blood shows 22q 11.2 deletion. Which of the following is the most likely diagnosis? DiGeorge Syndrome Down syndrome Turner’s syndrome Stickler syndrome Loading...414. A 43 year-old man presents to his physician with a complaint of progressive difficulty in swallowing solid food. He has a 10-year history of heartburn which increases with spicy food and relieves by antacids. He does not smoke or drink alcohol. His weight is the same since last visit six months ago. He is scheduled for endoscopy next week. What is the most likely initial diagnosis for this patient? Peptic esophageal stricture Achalasia Cancer esophagus Diffuse esophageal spasm Lower esophageal ring Loading...415. A 61-year-old man with a history of recurrent angina and hypertension presents to the clinic for routine examination. His vital signs are within normal limits and his cardiac examination is satisfactory. Reviewing his medication, his physician noticed that he had been prescribed labetalol for 2 years. He discussed with his patient replacing it with atenolol. What is the difference between the mechanism of action of atenolol and labetalol? Atenolol is both beta and alpha-blocker while labetalol is a beta-blocker only Atenolol is a beta1 blocker while labetalol is a beta 2 blocker Atenolol is a beta1 blocker while labetalol is both alpha and beta-blocker Atenolol is a non-selective beta-blocker while labetalol is a beta1 blocker Atenolol is a beta 2 blocker while labetalol is a beta1 blocker Loading...416. When a intravascular clot started floating in the blood termed as one of the following option? Coagulation All of above Thrombus Embolus Loading...417. A drug that belongs to Loop Diuretics is one of the following? A & B Cefazolin Doripenem Sulbactam Furosemide Loading...418. Following is the Structural analog of the aldosterone antagonist spironolactone with androgenic activity but to a little extent? Bicalutamide Mifepristone Megestrol Acetate Drospirenone Fluoxymesterone Loading...419. A 60-year-old man complains of shortness of breath. Examination reveals bilateral pleural effusions and pitting edema up to the thighs’ level. Which of the following is the most likely laboratory finding in this patient? Hypoalbuminemia Neutrophilia Anemia Hypoglycemia Loading...420. Which of the following statements correctly describe the lag time of a drug? Time in which plasma concentration remains the same Time from administration of the drug to reaching maximal effect concentration. Time from administration of the drug to appearance in blood Time from administration of the drug to reaching minimal effect concentration Loading...421. Which of the following treatments should be used in cases of methanol or ethylene glycol poisoning? Glucagon Ethanol Sodium bicarbonate Pyridoxine Loading...422. Oxytocin is an agent used to increase uterine contractions during labor and also control postpartum bleeding and hemorrhage has the following adverse effects except? Neonatal jaundice Bradycardia Phlebitis Hyponatremia Uterine Hypertonicity Loading...423. Which of the following side effects occurs with both tricyclic antidepressants and phenothiazines? Seizures Weight loss Orthostatic hypotension Excessive salivation Loading...424. Reversible neutropenia and thrombocytopenia is the adverse effect of following drug? Nystatin Ketoconazole Amphotericin B Flucytosine Loading...425. Bleeding and thrombocytopenia is an adverse effects of one of the following drugs? Aprotinin Vitamin K Protamine sulphate HeparinPage 18 of 66 Loading...426. Which one of the following medications can be used safely in cases of lack of liver function? Diazepam Lorazepam Midazolam Clonazepam Loading...427. Which one of the following drugs form insoluble chelates that are not absorbed? All of the above Levofloxacin & magnesium A & B Rabeprazole & Sitaglipton Pioglitazone & Calcium Loading...428. The mechanism of action of etidronate disodium is most likely related to An unusual form of phosphorus (P) Inhibition of both normal and abnormal bone resorptions Hyperphosphatemia Inhibition of the formation of hydroxyapatite crystals Excretion unchanged in the urine Loading...429. Which of the following drug is belong to the dihydropyridines class of antihypertension? Losartan Diltiazem Verapamil Amiloride Amlodipine Loading...430. A female patient presents to the emergency room with a suspicious ruptured abdominal aortic aneurysm. Which of the following is the appropriate test needed at this situation? Abdominal CT scan Abdominal ultrasonography Abdominal MRI Abdominal X-ray Loading...431. A 4-year-old boy visits you in the clinic with his mother for evaluation of an increasing size of his genitalia. She tells you that her boy had aggressive behavior for the last six months. Besides progressive increase of the length of his penis, he has excessive pubic hair. On examination, his pulse is 80/min. and blood pressure is 140/92 mmHg. You send blood and urine samples for lab testing. What is the most likely initial diagnosis of this boy’s condition? C-11 hydroxylase deficiency C-17 hydroxylase deficiency Conn syndrome C-21 hydroxylase deficiency Loading...432. Which one of the following medications can be reversed by administration of vitamin K? Heparin Clopidogrel Warfarin Tirofiban Loading...433. Which one of the following drugs is the most fatal in suicidal overdose? Bupropion Phenelzine Imipramine Citalopram Loading...434. A 58-year-old man takes verapamil for hypertension and angina. Which of the following is a common adverse effect of high dose of this drug? Constipation Diarrhea Sexual dysfunction Hyperglycemia Loading...435. Following statements about the use of the Metformin is incorrect? Promotes insulin secretion A biguanide Insulin sensitiser Requires insulin for action Hypoglycaemia risk is low Loading...436. Which one of the following viruses most likely causes aplastic crisis in sickle cell disease? Parvovirus B19 Herpes simplex virus Hepatitis C virus Rotavirus Loading...437. Which of the following side effects is the most common after prolonged use of SSRIs? Insomnia Sexual dysfunction Nausea Headache Loading...438. Penicillin type antibiotics half-life is increased due to inhibition of tubular secretion by which of the following drug? Pegloticase Colchicine Probenecid Aspirin Celecoxib Loading...439. A drug has black box warning due to severe hematologic ADRs? Ticlopidine Dipyridamole Clopidogrel Digoxin Aspirin Loading...440. N-Substitutions of the catecholamine pharmacophore with isopropyl groups or aryl-alkyl groups improve the selectivity of which receptor? Alpha Receptor Muscarinic Receptor Beta Receptor Dopaminergic receptor Neuromuscular Activity Loading...441. A drug that blocks the viral membrane matrix protein M2 and its ability to modulate intracellular PH? Zanamivir Acyclovir Ribavirin Oseltamivir Rimantadine Loading...442. Which of the following explains the reason for the formation of atheroma at the bifurcations of arteries such as aorta and carotid? Cholesterol breakdown Endothelial dysfunction Regular blood flow Hypoxemia Loading...443. Which one of the following drugs is the best treatment for seizures of eclampsia? Haloperidol Magnesium sulfate Carbamazepine Phenobarbital Loading...444. Ganglion blocker drug is following? Atropine Atracurium Mecamylamine Neostigmine Benztropine Loading...445. Which one of the following conditions characterized by hemolytic episodes caused by increased erythrocyte sensitivity to complement lytic actions? Sickle cell anemia Paroxysmal nocturnal hemoglobinuria Glucose-6-phosphate dehydrogenase deficiency anemia Hereditary spherocytosis Loading...446. A 30-year-old man with hypertension is prescribed labetalol. It antagonizes which of the following receptors to be effective against hypertension? Alpha-adrenoceptors Beta-adrenoceptors Nicotinic receptors Both alpha and beta adrenoceptors Loading...447. A 40-year-old man presents with shortness of breath after a motor vehicle accident. Examination reveals decreased breath sounds in the right side, hypotension and subcutaneous emphysema. What is the most likely diagnosis? Injury to the right bronchus Injury to the myocardium Injury to the lung tissue Injury to the esophagus Loading...448. Which of the following is the classic electrocardiogram (ECG) finding in atrial flutter? S-T segment elevation in leads II. III and aVF Diffuse S-T segment elevation S-T segment elevation in anterior leads (V1-V4) Sawtooth P waves Loading...449. A 7-year-old boy has a difficult time at school. He sleeps during most of the classes and doesn’t interact with his teachers in class. He is fighting with many of his classmates because of stealing their lunches but he has never started a fight. When teachers tried to contact his family, they found out that his family left a fake address and phone number. What is the most likely cause of this boy’s behavior? Attention-deficit-hyperactive disorder (ADHD) Antisocial personality Mental retardation Oppositional defiant disorder (ODD) Child abuse Loading...450. Which one of the following stain is most likely relevant to diagnose Cryptococcus neoformans? Giemsa stain India ink stain Ziehl-Neelsen stain Silver stainPage 19 of 66 Loading...451. Which of the following types of cells predominantly lines the conducting airways of the lung and is considered an important defense mechanism? Goblet cells Endocrine cells Ciliated cells Basal cells Loading...452. Serotonin Receptor which acts presynaptically at Serotonergic and adrenergic neurons to reduce neurotransmitter release is following? 5HT4 5HT² 5HT³ 5HT5 5HT¹ Loading...453. Which one of the following local anesthesia is mainly used for regional nerve block? Bupivacaine Cocaine Tetracaine Dibucaine Loading...454. Which one of the following drugs is used to treat constipation? Sodium polystyrene sulfonate Metamucil Sevelamer A & B Alendronate Loading...455. Which of the following drug is a part of drugs for osteoporosis? Rabeprazole Acetazolamide Furosemide A & B Calcitonin Loading...456. Which one of the following is the most common cause of ruptured aortic aneurysm? Hypertension Atherosclerosis Cardiomyopathy History of intravenous drug use Loading...457. A 29-year-old woman presents with bloody discharge from her right breast for 3 weeks. There is no pain, fever or swellings. There is no breast mass or lymphadenopathy. Which of the following is the most likely diagnosis? Intraductal papilloma Metastatic carcinoma Prolactinoma Pregnancy Loading...458. A 68 year-old woman complains of fever, anorexia and right flank pain for 2 days. She vomited twice today. On physical examination, her temperature is 101.3 F and there is moderate tenderness on the right costovertebral angle. Her urinalysis shows leukocytes and pus cells. What is the most appropriate next step of management? Schedule Intravenous pyelogram Schedule MRI of the abdomen and pelvis Hospitalization and intravenous antibiotics Collect blood and urine samples for culture Outpatient wide spectrum antibiotics and schedule a visit after 3 days Loading...459. What is the mechanism of action of zileuton? Inhibition of muscarinic receptor action Inhibition of mediator release Inhibition of calcium (Ca2+) channel activity Inhibition of cytokine production Inhibition of leukotriene production Loading...460. Deferoxamine is an antidote used for toxicity of the following? Atropine Calcium bicarbonate Iron Isoniazid Loading...461. An old man presents with acute severe back pain, tachycardia, hypotension and syncope. Which of the following is the most likely diagnosis? Acute mesenteric ischemia Pulmonary embolism Rupture of abdominal aortic aneurysm Acute myocardial infarction Loading...462. Which one of the following oral hypoglycemic drugs is the initial therapy for patients with type 2 diabetes? Repaglinide Metformin Acarbose Glyburide Loading...463. A 62-year-old man visits his physician with a complaint of a breast lump. On examination, there is no fever and vital signs are within normal limits. There is a hard lump in his right breast and nipple retraction. What is the most appropriate next step of action? MRI of the chest Whole body CT scan X-Ray of the chest Ultrasound guided biopsy Mammography Loading...464. An antihyperlipidemic drug that consists of a closed six-membered lactone ring in the structural formula? Atorvastatin Simvastatin Pravastatin Rosuvastatin Fluvastatin Loading...465. A patient with cystic fibrosis is treated by gene therapy. Which of the following types of cells should be targeted as host cells? Hemopoietic stem cells Germ cells Epithelial cells T-cells Loading...466. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Fluconazole Ibandronate A & B Furosemide Ethambutol Loading...467. Which of the following regions of the brain is most likely affected in patients with Huntington’s disease? Caudate nucleus Substantia nigra Temporal lobe Anterior frontal lobe Loading...468. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Capreomycin Indanyl carbenicillin 6-thioguanine Lamivudine Ezetimibe Loading...469. Action of incretin hormone GLP-1 is following except? Increase beta-cell growth Inhibit inappropriate glucagon secretion Increase glucose-dependent insulin secretion Enhance appetite slow gastric emptying Loading...470. Which of the following is the mechanism of action of vinblastine? Interferes with microtubule disassembly Interferes with microtubule assembly Interferes with purine synthesis Interferes with DNA mobilization and replication Loading...471. A 54-year-old woman with a 6-year history of type 2 diabetes visits her physician for a regular examination. She was initially treated with oral hypoglycemic but her HbA1c had gotten worse so, her physician switched to insulin last year. Six-month ago, she had surgery in her wrist to release compression caused by carpal tunnel syndrome. Now, she complains of progressive increase in her feet size. Examination reveals coarse facial features with prominent supraorbital ridge. What is the most appropriate test to help reach the diagnosis of this case? Measurement of HbA1c Assessment of insulin-like growth factor 1 (IGF-1) Fasting serum glucose test Measurement of thyroid stimulating hormone (TSH) Dexamethasone suppression test Loading...472. A 28-year-old woman with a history of normal delivery 3 days ago after an uneventful pregnancy is admitted to the ICU because of high fever and foul-smelling vaginal discharge. General examination reveals temperature of 103.3 F, pulse 96/min and blood pressure 100/70 mmHg. Pelvic examination reveals bloody yellowish discharge and dilated, enlarged and bulky cervix. What is the next step of action? CT scans of the abdomen and pelvis Observation and waiting for the results of blood culture MRI of the pelvis Blood samples and intravenous antibiotics Oral ampicillin and gentamicin Loading...473. Megaloblastic anemia is caused by folic acid or Vitamin B12 deficiency. Which of these reactions is directly affected by vitamin B12 deficiency? Malonyl CoA >> palmitate Methylmalonyl CoA >> succinyl CoA Propionyl CoA >> methylmalonyl CoA Succinyl CoA >> fumarate Loading...474. M1 Receptors are primarily located in: Cerebral cortex, Sympathetic ganglia, myenteric ganglia Myocardium, smooth muscles Postganglionic neurons Skeletal muscle neuromuscular endplates Exocrine glands, vessels (smooth muscles & endothelium) Loading...475. Which one of these medication groups is contraindicated in a patient with narrow-angle glaucoma? Cholinomimetics Diuretics Muscarinic-receptor antagonists Beta blockersPage 20 of 66 Loading...476. Aztreonam belongs to the one of the following class? Cephalosporin Carbapenems Penicillins Monobactams Loading...477. Didanosine belongs to the class of the following drugs? Antibiotics Antiprotozoal Antipyretic Antiviral Anti-malaria Loading...478. In which of the following Diuretic, cyclic sulfonamide is replaced by an Amide? Bendroflumethiazide Chlorothiazide Hydrochlorothiazide Methylchlorothiazide Chlorthalidone Loading...479. Which of the following drugs is used for respiratory virus infections? Ibandronate Oseltamivir Miconazole Naftifine Capecitabine Loading...480. A 1-year-old boy is brought to the clinic by his mother due to recurrent upper respiratory tract infections and oral fungal infections. Physical examination reveals low set ears and fish-like mouth. Laboratory tests reveal hypocalcemia and chest x-ray shows no thymus shadow. What is the most likely etiology of hypocalcemia in this case? End-organ hyposensitivity to calcitonin End-organ hyposensitivity to parathyroid hormone Increased secretion of parathyroid hormone Decreased secretion of parathyroid hormone Increased secretion of calcitonin Loading...481. Aldosterone production is reduced by using one of the following drugs? Erythromycin Lisinopril Aspirin Diltiazem Loading...482. Which of the following are the characteristics of Virchow’s triad? Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) Hypotension, distant heart sounds and jugular vein distention (JVD) Stasis, hypercoagulability and endothelial damage Loading...483. An 80-year-old man is diagnosed with severe atherosclerosis. He has been a heavy smoker for 62 years and also has a long history of hypercholesterolemia. Atherosclerotic occlusion of which of these arteries will cause insufficient perfusion of the urinary bladder? Inferior epigastric External iliac Lateral sacral Internal iliac Loading...484. Primitive spermatogenic germ cells are located in which one of the following sites? Seminal vesicles Seminiferous tubules Interstitium of the testes Vas deferens Loading...485. A patient is given epinephrine and an agonistic effect is produced on a certain organ. But when he is given Norepinephrine no such effect is produced. Which one of the following organs is it? It has no direct neural control. Cutaneous blood vessels Radial muscle of the iris Splanchnic blood vessels SA Node Respiratory smooth muscle Loading...486. Which of the following is the proper treatment for a case of chronic emphysema in a stable patient with a resting oxygen saturation of 86%? Continuous supplemental oxygen Supplemental oxygen at night Daily oral prednisone Albuterol inhaler as needed Loading...487. Which of the following statements about ACh release and deactivation is true? Acetylcholinesterase (AChE) inhibitors, such as pyridostigmine, are not effective in the treatment of myasthenia gravis, because patients with myasthenia gravis have no cholinergic nerve terminals to release ACh Uptake of ACh into the presynaptic receptor is the most important mechanism in terminating the ACh signal ACh release is blocked by the toxin associated with clostridium tetani MAO inhibitors are important in the treatment of depression because they inhibit the breakdown of ACh into its constituents acetic acid and choline The influx of Na+ into the depolarized axon terminal is a prerequisite for the release of stored ACh Loading...488. Which of the following virus infections mostly develops chronic hepatitis? Hepatitis C Hepatitis A Hepatitis B Loading...489. Maraviroc belongs to the class of following drugs? Antiviral Antipyretic Anti malaria Antifungal Antiprotozoal Loading...490. A patient is suffering from gouty arthritis along with hyperuricemia, which of the following drugs is indicated to give relief to this patient? Febuxostate Allopurinol Colchicine Probenecid Pegloticase Loading...491. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Rabeprazole Furosemide A & B Ibandronate Pyrazinamide Loading...492. Which one of the following is the most appropriate next step in suspected scaphoid fracture (with normal radiology)? Admission and observation Emergent orthopedic consultation Assurance and follow up in 2 weeks Thumb spica splint Loading...493. Zalcitabine belongs to the class of following drugs? Antifungal Antipyretic Antiviral Antiprotozoal Anti malaria Loading...494. A 42-year-old African-American woman presents to the clinic because of dyspnea that worsens over the last 6 months. She has no fever, chest pain or loss of weight. The patient works as a preschool teacher. Physical examination is unremarkable. Chest x-ray shows bilateral hilar lymphadenopathy. What is the most likely diagnosis? Tuberculosis Sarcoidosis Lung cancer Pneumonia Asbestosis Loading...495. Which one of the following statements about the use of Leflunomide is incorrect? Immunomodulatory agent Inhibit Dihydroorotate dehydrogenase Can't be used as monotherapy Reduce pain & inflammation Loading...496. An old patient underwent percutaneous coronary intervention due to anterior myocardial infarction. Now, his ejection fraction is 45. Which of the following medications increases his survival? Digoxin Atenolol Furosemide Lisinopril Loading...497. Which of the following statements about the use of aminoglycoside is wrong? Bind to 50S subunit cross the placental barrier Causes ototoxicity Accumulate in endolymph and perilymph Accumulate in renal cortex Loading...498. Which of the following drug belongs to Osmotic Diuretic? Cefoxitin Oxacillin Mannitol Niacin Ampicillin Loading...499. Which one of the following drugs is a Proteas inhibitor? Abacavir Indanyl carbenicillin Delavirdine Darunavir Maraviroc Loading...500. An 83-year-old man presents to the clinic with progressive pain and swelling of the left knee for 8 months. He has a history of well-controlled type 2 diabetes for 15 years. He does not smoke or take any recreational drugs. He drinks alcohol socially. His surgical and family histories are unremarkable. Physical examination reveals a medial parapatellar hard movable mass and limited movement of the left knee. Excisional biopsy of the mass reveals glossy white calcified deposits, which show positive birefringence under polarized light. What is the most likely diagnosis? Gout Osteosarcoma Acute arthritis Osteoarthritis PseudogoutPage 21 of 66 Loading...501. Niemann-Pick disease is characterized by deficiency of which one of the following enzymes? Sphingomyelinase Alpha-glucosidase Arylsulfatase Beta-glucosidase Loading...502. Thyroid hormone can cause which one of the following effects? Lowers oxygen consumption Lowers body temperature Hypoglycemia Lowers blood cholesterol Loading...503. A patient is diagnosed with posterior dislocation of the hip. Which one of the following ligaments is most likely torn? Ischiofemoral ligament Sacrotuberous ligament Lacunar ligament Iliofemoral ligament Loading...504. Which of the following types of receptors are associated with the slowest response time? Ion channel receptors G-protein coupled receptors Transmembrane enzyme receptors Steroid receptors Loading...505. A patient presents with recurrent urinary tract infections with episodes of compulsive diarrhea over the past year. Urine sample shows gas bubbles. Which of the following is the most likely initial diagnosis? Polycystic kidney disease Crohn’s disease Ulcerative colitis Irritable bowel syndrome Loading...506. A 15-year-old girl presents with potential growth delay. She had traumatic brain injury two years ago due to a car accident. Her secondary sex characteristics are absent. Endocrine profile shows low FSH, LH, estradiol, DTEAS and prolactin. What is the most likely diagnosis? Hashimoto’s disease Tanner syndrome Primary adrenal insufficiency Post-traumatic hypopituitarism Loading...507. Which of the following drugs has the longest duration of bronchodilation? Albuterol Epinephrine Metaproterenol Isoproterenol Salmeterol Loading...508. Terbinafine blood levels are decreased by the following the drug? Rifampin Caspofungin Cimetidine Griseofulvin Loading...509. A patient represents with a neck mass. Which of the following suggests the possibility of cancer? History of hypothyroidism History of hoarseness of voice for 3 months Pain or tenderness Recent complaint of toothache Loading...510. Which of the following medications should be given to a patient that exhibits severe adverse reactions after administration of IV midazolam? Flumazenil Glucagon Naloxone Protamine Loading...511. Which one of the following medications effectively lowers intraocular pressure? Ergonovine Latanoprost Morphine Atropine Loading...512. Alendronate is effective in which one of the following conditions? Spinal cord lesions Hypoparathyroidism Hyperthyroidism Osteoporosis Loading...513. An 18-year-old male complains of nausea and slight icterus for 2 weeks. Medical, surgical and family histories are unremarkable. Physical examination reveals slight jaundice and tenderness on the right upper side of the abdomen. Laboratory findings include positive IgM anti-HAV and marked elevation of ALT and AST levels. What is the appropriate management of this patient at this time? Famciclovir HBV vaccine Acyclovir Interferon alfa Supportive treatment Loading...514. Which one of the following drugs is a 4th generation Cephalosporin? Cefepime Cefdinir Cefaclor Cefadroxil Loading...515. A 64-year-old man arrives to the emergency room after recurrent vomiting of blood for the last 2 hours. He recently underwent right hip replacement and had taken heparin to prevent thromboembolic complications. Internal bleeding is suspected and treatment with protamine has begun. What kind of antagonism is related to this treatment? Competitive Chemical Irreversible Physiological Loading...516. Which of the following drug is a part of drugs for osteoporosis? A & B Furosemide Acetazolamide Alendronate Rabeprazole Loading...517. A 35-year-old woman begins treatment for an acute urinary tract infection. A few days later, she experiences hemolysis. Which of the following drugs is most likely to be da cause of the hemolysis? Tetracycline Trimethoprim Gentamycin Metronidazole Nalidixic acid Loading...518. N-acetylcysteine is an antidote, which restores the glutathione levels in the hepatocytes decreased by the toxicity of which of the following specific drug? Meloxicam Ketorolac Acetaminophen Naproxen Mefenamic acid Loading...519. Which one of the following drugs is a Tetracycline? Minocycline Cefdinir Cefadroxil Cefepime Loading...520. A 75-year-old man presents to his physician for a routine examination. He has a history of hypertension, hypercholesterolemia and osteoarthritis. He takes atenolol, simvastatin and ibuprofen as needed. His pulse is 76/min and irregular. Blood pressure is 130/74. Physical examination and imaging studies are normal except for asymptomatic atrial fibrillation. What is the most appropriate next step in management of this patient? Start low molecular weight heparin and warfarin Start heparin Start warfarin Start aspirin Assurance and follow up in 3 months Loading...521. Vertebral artery arises from which one of the following arteries? Subclavian artery Common carotid artery External carotid artery Internal carotid artery Loading...522. Which of the following is the active form of vitamin D? Cholecalciferol 1-dihydroxycholecalciferol 1,25-dihydroxycholecalciferol 25-hydroxycholecalciferol Loading...523. A 55 year-old man underwent internal fixation of fractured femur after a motorcar accident and massive bleeding 24 hours ago. He was stable after the surgery and his urine output was normal after he received intravenous fluids. Now he complains of substernal chest pain and shortness of breath. On examination, His temperature is 98.8 F, Pulse is 110/min, blood pressure is 160/100 mmHg and his respiratory rate is 24/min. There is no jugular vein distention. His extremities have established pulses bilaterally and good perfusion. Auscultation reveals harsh systolic murmur across the precordium and crackles on both lung bases. ECG shows sinus tachycardia with delayed precordial transition and no other changes. Laboratory tests including cardiac enzymes are all normal. What is the most likely diagnosis? Hypertrophic cardiomyopathy Pericardial effusion Septic shock Left bundle branch block (LBBB) Acute myocardial infarction Loading...524. Which of the following is the mechanism of action of benzodiazepines in the treatment of insomnia? Alpha adrenergic antagonist Binds to serotonin receptors Binds to GABA receptors Dopamine receptor agonist Loading...525. Atropine is an antimuscarinic agent block the binding of acetylcholine to muscarinic receptors. Which of the following Antagonist is required to counteract the poison of Atropine? Flumazenil Neostigmine Nalaxone Fomepizole PhysostigminePage 22 of 66 Loading...526. Which one of the following anti-acne drugs act by induction of apoptosis in sebaceous glands? Isotretinoin Benzoyl peroxide Tetracycline Azelaic acid Loading...527. Which one of the following parts of lymph nodes has T lymphocyte as the predominate cell? Paracortex Medulla Cortex Germinal center Loading...528. A patient becomes tetanic because of a recent thyroidectomy. Rapid Reversal of this problem can be done by giving the patient? PTH Calcium gluconate (CaG) Vitamin D Plicamycin (mithramycin) Calcitonin Loading...529. A decrease of J chain due to a genetic defect will cause a decrease of the which of the following? Serum IgM Serum IgE Mature B lymphocytes Mature T lymphocytes Loading...530. A certain drug has a high serum protein binding. Which of the following is increased as a result of injecting this drug? Distribution of the drug Renal excretion Liver metabolism Drug interaction Loading...531. Dose related bone marrow depression is the adverse effect of following drug? Ketoconazole Probenecid Caspofungin Flucytosine Loading...532. Which one of the following drugs is a loop Diuretics drug? Acetazolamide Amiloride Bumetanide Chlorthalidone Loading...533. A 26-year-old woman visits her physician with a complaint of discomfort in her left knee for 2 weeks. It is exaggerated when she is sitting for a long time and relieved with analgesics. She admits that she had this discomfort on and off since she was at high school. On examination, the left knee does not show any signs of inflammation. It shows induration and tenderness on the back of the knee. X-ray shows local opacity on the back of the left knee joint. Baker cyst Acute arthritisat is the most likely diagnosis? Hydrarthrosis Tear of posterior collateral ligament Osteoarthritis Loading...534. Which of the following drug is a part of proton pump inhibitors? Furosemide Mannitol A & B Rabeprazole Acetazolamide Loading...535. Which of the following drugs should NOT be initiated in case of acute decompensated heart failure? Lisinopril Digoxin Potassium supplements Metoprolol Loading...536. Which one of the following results of Tensilon test confirms the diagnosis myasthenia gravis Slow and gradual amelioration of symptoms Rapid amelioration of symptoms Exaggeration of weakness No effect Loading...537. Ranitidine is used to treat one of the following diseases? Malaria Diabetes Stomach Ulcer Viral infection Blood pressure Loading...538. Which of the following is the most prominent side effect of scopolamine? Mydriasis Profuse sweating Bradycardia Miosis Loading...539. Which one of the following drugs is a Thiazide Diuretic? Atorvastatin Indanyl carbenicillin Metolazone Ezetimibe Fenofibrate Loading...540. Which of the following hormone belongs to the oral diabetic agent? A & B Oxytocin Acarbose Somatrem Furosemide Loading...541. Prolonged use of which one of the following diuretics can lead to hyperkalemia and gynecomastia? Furosemide Spironolactone Acetazolamide Hydrochlorothiazide Loading...542. Which of the following organs is the most commonly affected one by a blunt trauma to the abdomen? Liver Large intestine Small intestine Spleen Loading...543. Which of the following drugs are protein synthesis inhibitor? Erythromycin Gentamicin Tetracyclin Linezolid All of the above Loading...544. An 88-year-old woman complains of fatigue and loss of weight over the past 6 months. She lives alone and she has no children. She has a long history of controlled hypertension with atenolol. Vital signs are within normal limits. Her weight is 5Ib less than it was in her last medical visit . Physical examination is unremarkable. Laboratory tests including CBC, thyroid panel and creatinine are normal. Her health screening tests are up-to-date and are unremarkable. What is the appropriate next step? Discontinue atenolol Arrange nursing and supportive assistance Begin anti-depressive medication MRI of the brain Further investigations including liver function test Loading...545. Which of the following drug causes Calcium reabsorption that leads to hypercalcemia? Furosemide Triamterene Acetazolamide Hydrochlorothiazide Spironolactone Loading...546. What is the meaning of Dose Dumping phenomenon? Excess release of control released drugs Excess release of glucose High dose of IV drugs Excess release of Insulin Excess release of gastric acid Loading...547. A 16-month-old boy is brought to the clinic by his mother who is concerned that her boy turns blue and becomes short of breath several times during last three months. During these episodes, he becomes irritable and stays in squatting position until he relieves. Cardiac examination reveals systolic ejection murmur over the upper right sternal border. X-ray shows boot-shaped heart. What is the most likely diagnosis? Tetralogy of Fallot Tricuspid atresia Total anomalous pulmonary venous return Truncus arteriosus Transposition of the great arteries Loading...548. A 33-year-old woman presents to the clinic for her regular yearly physical examination. She has a long history of depression and takes fluoxetine regularly for two years. Which amino acid is the precursor of the neurotransmitter affected by this drug? Tryptophan Phenylalanine Methionine Glutamate Glycine Loading...549. Retention of sodium and water is decreased by using one of the following drugs? Enalapril Diltiazem Methyldopa Acetaminophen Loading...550. A 26 year old woman is brought to the emergency room due to 2-hour history of hematemesis. She was invited to a banquet at her work and she vomited twice with a considerable amount of blood. Her medical, surgical and family histories are unremarkable. She visits her dentist regularly for recurrent dental caries. She doesn’t smoke or drink alcohol. Her pulse is 100/min, blood pressure is 104/66 and her temperature is 97.8 F. Abdomen is soft, non-tender with no organomegaly. Her laboratory tests are as follows: Serum sodium 136 meq/L. Serum potassium 2.6 meq/L. Serum chloride 84 meq/L. Serum bicarbonate 38 meq/L. Endoscopic examination reveals erosive esophagitis without any scars or adhesions. What is the most likely diagnosis? Mallory-Weiss syndrome Bulimia nervosa NSAID-induced esophagitis Staphylococcal food poisoning CREST syndromePage 23 of 66 Loading...551. Which of the following is most likely to occur with carbonic anhydrase inhibitors? Acidic urine Hyperkalemia Hyperuricemia Alkalosis Hyperchloremia Loading...552. A 55-year-old man has a long history of liver cirrhosis visits his physician with a new complaint. Recently he noticed abnormal lesion on his abdomen. His physician recognized these lesions as caput medusae. Which veins are most likely involved in this case? Esophageal venous plexus Splenic and external iliac veins Azygos and hemiazygos veins Paraumbilical and epigastric veins Superior, middle and inferior rectal veins Loading...553. An enolic acid derivative of Nonsteroidal anti-inflammatory drugs also called? Acetic acid Oxicam derivative Salicylates N-arylanthranilic acids Propionic acid Loading...554. Which one of the following conditions most likely shows lower than normal erythrocyte sedimentation rate (ESR)? Polycythemia Giant cell arteritis Pregnancy Multiple myeloma Loading...555. A 21-year-old Chinese student presents to the clinic for her pre-college physical examination. She tells her physician that she is worried about a solid mass in the roof of her mouth for about 3 years. The patient does not smoke or drink alcohol. She did not lose or gain weight in the last 3 years. On local examination, there is 1.5 inch non-tender mass on her hard palate with definite edges. There are no palpable lymph nodes. What is the most likely diagnosis of this mass? Malignant melanoma of the palate Palatal abscess Torus palatinus Kaposi’s sarcoma of the palate Lymphoproliferative disease Loading...556. Indomethacin belongs to one of the following class? Propionic acid Fenamates Acetic acid derivative Oxicam derivative Loading...557. Which of the following local anesthetics causes vasoconstriction and may lead to an increase of blood pressure? Lidocaine Cocaine Benzocaine Tetracaine Loading...558. Which of the following statements correctly describes the therapeutic dose of medication? The amount of medication that produces maximal rate of distribution The amount of medication that produces the highest plasma concentration of the drug The amount of medication that produces the required effect in the majority of patients The amount of medication that produces minimal biological effect Loading...559. Which of the following is the percentage of thymine in a DsDNA if it contains 20% guanine? 40% 50% 30% 20% Loading...560. A 6-year-old boy presents with fever, malaise, cough, running nose and conjunctivitis. His past medical history indicates that he did not receive any immunizations due to his parents’ religious belief. On examination, his temperature is 102.7 F and there are white spots on a red base close to his second molar teeth. He also has non-pruritic, maculopapular rash on his face, behind his ears and spreading to his chest. What is the most likely diagnosis? Chicken pox Mumps German measles Measles Smallpox Loading...561. Indinavir belongs to the class of following drugs? Antiprotozoal Antiviral Anti malaria Antibiotics Antipyretic Loading...562. Which of the following arteries is the most common site of coronary artery occlusion? Left anterior descending artery Left circumflex artery Posterior descending artery Right coronary artery Loading...563. Which of the following laboratory tests is diagnostic for adrenal insufficiency? ACTH stimulation test Serum ACTH CT scan of adrenal gland Serum cortisol Loading...564. A 29-year-old woman with a history of rheumatic heart disease and prosthetic aortic valve presents to her physician for consultation. She is referred by her dentist for prophylaxis before she undergoes an oral surgery next month. She has no history of bacterial endocarditis. She is allergic to penicillin. Which of the following is the prophylactic drug of choice for this patient? Vancomycin Azithromycin Gentamicin Ampicillin Amoxicillin Loading...565. A 72-year-old man complains of itchy skin lesions in the axilla, groin and medial aspect of the thigh. Examination reveals pruritic lesions and bullae in the areas mentioned above and also on forearms and lower legs. There are also painful oral lesions. There is no eye involvement and Nikolsky sign is negative. What is the most likely diagnosis? Dermatitis herpetiformis Bullous pemphigoid Scabies Cicatricial pemphigoid Pemphigus vulgaris Loading...566. A 78- year-old-man who is recently diagnosed with a malignant brain tumor visits his physician with his wife to discuss his treatment options with radiotherapy and chemotherapy. When the physician explains the benefits and risks of each option, he notices that the patient does not understand everything he is saying. Meanwhile, his wife understands and asks questions. The physician knows them very well as they both share their own values and make their medical decisions together for a long time. They both agree to proceed with radiation and chemotherapy. What is the most appropriate next step in management? Refer the patient for psychiatric evaluation Start treatment after obtaining a written consent from his wife Start treatment immediately Schedule another appointment for the patient only to be sure of his own decision Seek guardianship through the court Loading...567. Tazobactam belongs to the one of the following class? Monobactams Cephalosporin Beta lactamase inhibitor Penicillins Carbapenems Loading...568. At low doses, one of the following drugs irreversible inhibit thromboxane production in platelets leading to a decrease in platelets aggregation? Clopidogrel A & B Aspirin Ticlopidine Loading...569. Which of the following receptors is the most likely affected in patients with diabetes mellitus? Pacinian corpuscle Ruffini’s end organ End-bulbs of Krause Meissner’s corpuscle Loading...570. Which of the following substances is used in mercury poisoning? Succimer Flumazenil Fomepizole Methylene blue Loading...571. Atropine is often used prior to administration of inhalant anesthetics to reduce which of the following? Muscle tone Secretions Vomiting Heart rate Loading...572. A 35-year-old man with a history of Marfan syndrome presents to the emergency room complaining of chest pain radiating to his upper back between shoulder blades. His blood pressure is 170/90 mmHg in his right arm and 90/60 in left arm. His pulse is 98/min. Cardiac examination reveals regular rhythm with diastolic murmur on the left lower sternal border. Lung examination reveals clear bilateral breath sounds. An echocardiogram shows dissection of the thoracic aorta involving the left subclavian artery. Which of these is the recommended immediate drug of choice? Labetalol Calcium gluconate Sodium nitroprusside Clopidogrel Heparin Loading...573. An 82-year-old man is brought to the clinic by his son who is concerned about his father’s mental status. He told you that his father has recently become more forgetful and angry. He doesn’t remember recent events and he gets frustrated when he fails to complete simple tasks. On examination, the patient is unkempt. His vital signs are within normal limits. Mini-mental status test scores 12/30. MRI of the brain shows some areas of degeneration in the temporal lobe. What is the most appropriate treatment of this condition? Citalopram Diazepam Fluoxetine Metoclopramide Donepezil Loading...574. Acetazolamide and other carbonic anhydrase inhibitors act at which part of the kidney? Collecting duct Descending loop of Henle Distal tubule Proximal tubule Loading...575. Which of the following is the best immediate treatment for unresponsive patient with diabetic ketoacidosis? Metformin Bicarbonate Insulin and glucose Observation and hospitalizationPage 24 of 66 Loading...576. Which of the following drugs is beneficial in treatment of glaucoma through increased outflow of aqueous fluid by causing contraction of ciliary muscle? Alpha agonists Beta blockers Diuretics Cholinomimetics Loading...577. A 9-month-old boy is brought to the clinic by his mother who is concerned that the boy developed swelling in his right scrotum. On examination, there is a scrotal mass that disappears when pushing it back to the external inguinal ring. When the boy cries, the mass is felt again protruding out of the external inguinal ring. What is the most likely etiology of this condition? Defect in the inguinal canal Defect in the pelvic floor Defective closure of tunica vaginalis Patent processus vaginalis Undescended testis Loading...578. A middle-aged woman presents to the clinic complaining of visual difficulty. Examination is normal except one abnormal sign. When light is shined in the right eye, both pupils constrict while if it is shined in the left eye, both pupils dilate to the normal size. Which one of the following nerves is affected in this patient? Left optic nerve Left oculomotor nerve Right oculomotor nerve Right optic nerve Loading...579. Which of the following is the common cause of secondary dyslipidemia? Diabetes mellitus Apo C-II deficiency Familial combined hyperlipidemia Familial hypercholesterolemia Loading...580. A 55 year-old man presents to the clinic because today he noticed that his left scrotum has suddenly gotten larger. He has no fever or pain. Examination reveals enlarged left scrotum with no tenderness or any signs of inflammation. There is a worm-like mass posterior to the left testicle. The mass illuminates and is not reducible on compression or when the patient lying down. What is the best next step in management? MRI of the pelvis Assurance and follow up in 2 weeks Urine culture Refer to surgery for urgent reduction Abdominal CT scan Loading...581. In a case of esophageal dysphagia, which one of the following is considered a mechanical obstruction versus motility disorder? Achalasia Extrinsic compression Diffuse esophageal spasm Chagas disease Loading...582. A 29-year-old man is brought to the ER by a policeman. He was driving his car under the influence of alcohol. The policeman asks the ER physician to get a sample of this patient’s gastric contents for analysis. The physician explains the procedure to him but the patient refuses to go through it. What is the best next action? Inject the patient with anesthesia and do the procedure Force the patient to do the procedure Convince the patient falsely that this procedure is part of treatment and do it Respect the patient’s wishes and don’t do this procedure Loading...583. Ibuprofen belongs to one of the following class? Oxicam derivative Acetic acid derivative Fenamates Propionic acid Loading...584. Decreased production of which type of collagen may result in osteogenesis imperfecta? Type I Type II Type III Type IV Loading...585. Uric acid excretion is Increased by using one of the following options? Allopurinol A & B Probenecid Sulfinpyrazone All of the above Loading...586. Which of the following is the mechanism of action of metoprolol in angina? Reduces requirement of the heart for oxygen Increases peripheral resistance Increases central venous pressure Reduces production of epinephrine Loading...587. A drug that inhibit the guanosine triphosphate formation thus preventing viral mRNA capping and RNA dependent RNA polymerase blockage? Amantadine All of the above Ribavirin Oseltamivir Both A & B Loading...588. Propranolol is used to treat one of the following diseases? Diabetes High Blood pressure Malaria Viral infection Stomach Ulcer Loading...589. Which one of the following medications is used for cases of Parkinson’s disease and influenza type A? Bromocriptine Amantadine Benztropine Ribavirin Loading...590. A young boy presents with echolalia, frequent eye blinking, repetitive frowning and head shaking to the left. These movements subside when he answers the questions or clears his throat. Which of the following is the most likely diagnosis? Parkinsonism Epilepsy Tourette syndrome Huntington disease Loading...591. A patient develops severe diarrhea after 2 weeks of treating pneumonia with broad spectrum antibiotics. Which of the following is the first line of treatment of this condition? Vancomycin Methicillin Ciprofloxacin Ampicillin Loading...592. Which one of the following drugs is used to treat hyperphosphatemia? Sevelamer Sodium polystyrene sulfonate Alendronate Metamucil A & B Loading...593. Which of the following conditions is caused by a frameshift mutation? Becker muscular dystrophy Sickle cell disease Hereditary nonpolyposis colorectal cancer Duchenne muscular dystrophy Loading...594. A 69-year-old man presents to the clinic with his wife for evaluation of his memory problem. His wife tells you that her husband has begun to forget recent events insidiously since last year. He forgets recent conversations and recent appointments. He is no longer able to manage his checkbook and daily budget as he used to do. He has no history of general medical condition and he only takes baby aspirin daily. His examination is normal. Mini mental status examination reveals prominent memory loss. MRI shows a few areas of cerebral atrophy. Which of the following is the most likely diagnosis? Old age dementia Creutzfeldt-Jakob disease Alzheimer’s disease Lewy body dementia Vascular dementia Loading...595. Which one of the following statements about the platelets is wrong? Platelet have nuclei PG2 decrease aggregation Can't synthesize the new enzyme Life of platelet 3-7 days TXA2 enhance aggregation Loading...596. A fireman presents to the ER with headache and dizziness after putting out a fire. Which of the following is the best first step of action? Obtain CT scan of the head Obtain MRI of the brain Check carboxyhemoglobin level Obtain EKG Loading...597. Three boys are brought to the urgent care clinic complaining of fever, sore throat and itchy eyes. On examination, their temperature range from 101.2 F to 102.7 F. Their conjunctivas are red and inflamed. They are a part of a group of five kids from alimentary school camp out on the lake. Which of these is the most likely causative organism of this illness? Echovirus Coxsackie virus Measles Adenovirus Rubella Loading...598. Terbinafine is a drug of choice for treating dermatophytoses, it's blood levels are Increased by following drug? Cimetidine Rifampin Nystatin Caspofungin Loading...599. Which one of the following drugs is 2nd generation flouroquinolone? Moxifloxacin Nalidixic acid Ciprofloxacin Levofloxacin Loading...600. In cases of atrial septal defect (ASD), foramen ovale is formed by incomplete development of which one of the following structures? Ostium primum Ostium secundum Septum secundum Septum primumPage 25 of 66 Loading...601. Drugs that show capacity-limited elimination have which of the following property? As the administered dose increases the elimination half-life (t½) increases The elimination half-life(t½) remains constant A constant ratio of drug metabolites are formed as the administered dose increases First-order elimination kinetics is followed by low and high doses both Loading...602. Heparin acts by binding to which of the following substances to achieve its anticoagulant activity? Factor V Antithrombin III Factor VIII Prothrombin Loading...603. A 21 year-old college student complains of the appearance of yellowish coloration on her sclera. She mentions that she had been dizzy and weak for the last 3 days but did not feel any pain or fever and no change in stool color. Abdominal examination reveals normal bowel sounds and no tenderness or organomegaly. Laboratory tests show normal levels of liver enzymes and serum bilirubin. Which is the most likely initial diagnosis? Hepatocellular disease Hemolysis Obstructive jaundice Gallstones Pancreatic cancer Loading...604. A drug that act as laxative is one of the following? Castor oil Sulbactam A & B Furosemide Bumetanide Loading...605. The therapeutic indication of Tamoxifen Drug specifically is to treat one of the following diseases? Treat osteoporosis Estrogen-dependent Breast Cancer Fluid retention Thromboembolic disease Induce ovulation Loading...606. Which one of the following anti-depressants is most likely effective in bulimia nervosa? Imipramine Tranylcypromine Fluoxetine Amitriptyline Loading...607. In an acute attack of gout, Indomethacin is preferred over Colchicine because of which characteristic? More likely to reduce inflammation Less likely to cause diarrhea Less likely to cause GI bleeding More likely to prevent further acute attacks Less likely to cause acute renal failure Loading...608. Which of the following placental sites of insertion most likely predispose to an inverted uterus? Anterior Posterior Fundal Lower Loading...609. Which one of the following is the most common etiology of abdominal aortic aneurysm in the United States? Atherosclerosis Rheumatic heart disease Cystic medial necrosis Turner syndrome Loading...610. While you were conducting the morning round in internal medicine department, one of the patients told you that the nurses are insensitive and irresponsible. You asked him for the reason. He said: “they are not good as doctors”. All doctors I’d seen here are sensitive and responsible. Which of these is the most likely defense mechanism involved in this case? Repression Splitting Projection Regression Reaction formation Loading...611. A 28 year old woman visits her physician for evaluation of bilateral proximal muscle weakness and muscle pain. Her symptoms started last week and her pain is getting worse. Her records indicate alcohol abuse and cocaine addiction. She is HIV positive and she takes zidovudine. She also takes simvastatin for hypercholesterolemia. A muscle biopsy shows significant changes in mitochondrial histology. What is the most likely etiology of this patient’s condition Zidovudine Alcohol abuse HIV infection Simvastatin Cocaine addiction Loading...612. Which one of the following antibiotics has NO effect on anaerobes? Tobramycin Ampicillin Metronidazole Clindamycin Loading...613. A female patient is found to have an absent right kidney. Which of the following may also be found in this patient? Unicornuate uterus Absent right ovary Imperforate hymen Pelvic testis Loading...614. A-62-old woman presents to the ER in coma. Examination reveals temp of 90 F, pulse of 50, blood pressure of 100/60 and diffuse hyporeflexia. Thyroid gland is enlarged. What is the best next step? Rapid rewarming Obtain T4 and TSH and wait for results Begin intravenous fluids Intravenous levothyroxine and glucocorticoid Loading...615. Which one of the following drugs is associated with peripheral neuropathy? Capreomycin Ethambutol Isoniazid Rifampin Loading...616. Which one of the following drugs is a selective Beta-2 adrenergic long-acting bronchodilator? Albuterol Metaproterenol Terbutaline Formoterol Pirbuterol Loading...617. ADP mediated platelets aggregation is inhibited by? Tirofiban Clopidogrel Eptifibatide Aspirin Dipyridamole Loading...618. Laboratory tests for a patient are as follows: Plasma creatinine concentration is 0.8 mg/dL 200 ml/min 300 ml/min 100 ml/minine creatinine concentration is 80 mg/dL Urine volume is 1 ml/min 50 ml/minich of the following is the creatinine clearance? Loading...619. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefadroxil Cefaclor Cefotaxime Cefepime Loading...620. To diagnose myasthenia gravis we use? Ambenonium Edrophonium Malathion Pralidoxim Physostigmine Loading...621. A 48-year-old woman is taken for autopsy after she is pronounced dead. Her family found her unresponsive and the ER team performed CPR but she didn’t respond. The autopsy reveals the cause of death as internal hemorrhage from an artery close to the posterior wall of the body of the stomach due to erosion of a gastric ulcer. Which of these arteries is most likely involved in this case? Right gastric artery Left gastric artery Splenic artery Superior mesenteric artery Celiac trunk Loading...622. An 82-year-old man is brought to the clinic by his son who is concerned about his father’s mental status. He told you that his father has recently become more forgetful and angry. He doesn’t remember recent events and he gets frustrated when he fails to complete simple tasks. On examination, the patient is unkempt. His vital signs are within normal limits. Mini-mental status test scores 12/30. MRI of the brain shows some areas of degeneration in the temporal lobe. What is the most appropriate treatment of this condition? Donepezil Diazepam Fluoxetine Metoclopramide Citalopram Loading...623. The World Health Organization develops health care services to help low-economic countries to improve the quality of primary health care for elderly people. What is the most common cause of death in low-economic countries? Stroke Ischemic heart disease Lower respiratory tract infections Diarrheal diseases HIV/AIDS Loading...624. A 34-year-old woman presents with weakness, easy fatigability and numbness and tingling of her arms and legs. CBC reveals pancytopenia and marked increase in the MCV of erythrocytes. More investigations reveal chronic atrophic gastritis. What is the most likely diagnosis? Aplastic anemia Folic acid deficiency anemia Iron deficiency anemia Vitamin B12 deficiency Loading...625. Which of the following is the diagnostic test used when ultrasound is equivocal for cholecystitis? HIDA scan Liver function tests CT scan Abdominal x-rayPage 26 of 66 Loading...626. Which one of the following drugs inhibit the enzyme phosphodiesterase which inactivate the cAMP? Aminocaproic acid Dipyridamole Argatroban Warfarin Loading...627. A 64-year-old man complains of severe headache, dizziness, nausea and deterioration of vision. Workup shows a decrease in oxygen carrying capacity with no change in PO2 of arterial blood. Which of the following is most likely responsible for this patient’s symptoms? Carbon monoxide (CO) Ozone Nitrogen Sulfur dioxide Loading...628. Which of the following is the LEAST factor can lead to urinary tract infection? Diabetes mellitus Pregnancy Urinary tract obstruction Prolonged tetracycline therapy Loading...629. A 26-year-old woman complains of left flank pain and fever for 2 days. She has a history of two episodes of urinary tract infections in the past three years treated with trimethoprim-sulfamethoxazole. She is married, sexually active and takes contraceptive pills. Her last menstrual period was 5 days ago. On physical examination, her pulse is 100/min., blood pressure is 120/80 and her temperature is 103 F. She has left costovertebral angle tenderness on palpation. What is the best next step of management? Administration of wide spectrum antibiotics Collection of urine and blood cultures MRI of the kidney CT scan of abdomen and pelvis Admission to the intensive care unit (ICU) Loading...630. Which substance is degraded by COMT (Catechol-O-Methyl transferase)? Dopamine Epinephrine Norepinephrine All of these Catechol estrogens Loading...631. Which one of the following cells is neuroendocrine and found within the epithelium of the bronchi? Macrophages Pneumocytes type I Pneumocytes type II K cells Clara cells Loading...632. Which one of the following drugs is Quaternary compound antispasmodic? Propantheline Cyclopentolate Biperiden Oxybutynin Dicyclomine Loading...633. A patient presents with pruritic rash on his face, palms and soles, bloody diarrhea and abnormal liver tests two weeks after bone marrow transplantation. Which of the following is the mechanism of this condition? Activation of the donor B-lymphocytes Development of liver failure Activation of the host T-lymphocytes Activation of the donor T -lymphocytes Loading...634. A drug that inhibits the ergosterol synthesis causing disruption of membrane function and Increase permeability? Flucytosine Amphotericin B Nystatin Ketoconazole Loading...635. If the prevalence of a disease is 10%, what is the chance that randomly selected 3 persons out of this population will all have the disease? 0.0001 0.1 0.001 0.0.1 Loading...636. Anemia occurs in cases of multiple myeloma most likely results from which one of the following factors? Infiltration of bone marrow with massive numbers of plasma cells Low production of hemopoietin Loss of blood due to gastrointestinal bleeding Defective absorption of urine Loading...637. A 61-year-old man presents to the clinic due to dyspnea on exertion and palpitation for the last year. Last week, he started to feel chest pain when he was ascending a flight of stairs. He smokes a pack of cigarettes a day for 40 years. His vital signs are pulse 88, blood pressure 156/96 and his respiratory rate is 12/min. Laboratory tests shows high LDL cholesterol and low HDL cholesterol. Deep venous thrombosisich of the following is the most likely vascular abnormality involved in this condition? Medical calcific sclerosis Atherosclerosis Hyperplastic arteriosclerosis Loading...638. Which one of the following symptoms is most likely found in Parkinson’s disease? Visual hallucinations Chorea Cogwheel rigidity Intention tremors Loading...639. Which of the following drugs should NOT be initiated in case of acute decompensated heart failure? Metoprolol Lisinopril Digoxin Potassium supplements Loading...640. Which one of the following anti-depressant drugs is contraindicated if the patient has a history of seizures? Fluoxetine Venlafaxine Imipramine Bupropion Loading...641. A 76 year old woman comes to your office for a consultation. Yesterday, she had left hemiparesis for 30 minutes. She thought it was a stroke but now she is completely asymptomatic. She has a history of atrial fibrillation, angina and hypertension. She takes aspirin 81 mg and propranolol 80 mg. What is your appropriate initial management for this patient? Schedule carotid duplex ultrasonography Schedule another appointment whenever she has symptoms Schedule transesophageal echocardiography Obtain CT scan of the head Schedule MRI to the brain Loading...642. Receptors have a high sensitivity for which of the following drug? All of these A & B Epinephrine Isoproterenol Norepinephrine Loading...643. Which one of the following is the most common cause of non-adherence to administration of prescribed drugs? Forgetfulness Frequent dosing Food restrictions Fear of addiction Loading...644. A 90-year-old man is hospitalized from falling and breaking his hip. He has been already in the hospital for 6 days when he developed a burning sensation upon urinating. An analysis of his urine shows plenty of gram positive cocci and leukocytosis. The attendant physician treats him with trimethoprim-sulfamethoxazole. However, the fever still persists. After 2 more days, the patient develops a diastolic murmur radiating to the axilla and a low-grade fever is still persisting. Out of the following, which would be the first line treatment for the cause of the possible infection? Vancomycin Gentamicin Ampicillin Piperacillin Loading...645. Naphthalene ring containing Antihyperlipidemic drug in the structural formula is the following? Atorvastatin Colestipol Fluvastatin Simvastatin Rosuvastatin Loading...646. Drugs that are taken orally must first cross several biological membranes (diffusion barriers) before they reach their target receptors inside the body. Which of the following drug characteristics would best facilitate this process? protein-bound glucuronidated form quaternary charge ionized form unionized form Loading...647. What is the most common injury resulting from wearing a heavy backpack for a long time? Costoclavicular syndrome Frozen shoulder Shoulder dislocation Rotator cuff injury Loading...648. Which of the following hormone belongs to the oral diabetic agent? Somatrem Pioglitazone Furosemide A & B Oxytocin Loading...649. Infection in body causes one of the following issue? High Blood pressure Headache Fever Aids Loading...650. A 75-year-old man presents to his physician for a routine examination. He has a history of hypertension, hypercholesterolemia and osteoarthritis. He takes atenolol, simvastatin and ibuprofen as needed. His pulse is 76/min and irregular. Blood pressure is 130/74. Physical examination and imaging studies are normal except for asymptomatic atrial fibrillation. What is the most appropriate next step in management of this patient? Start aspirin Start warfarin Assurance and follow up in 3 months Start low molecular weight heparin and warfarin Start heparinPage 27 of 66 Loading...651. Amantadine belongs to the class of following drugs? Antiprotozoal Anti malaria Antipyretic Antiviral Antibiotics Loading...652. Which one of the following is the most common cause of vitiligo? Chemical Autoimmune Trauma Infection Loading...653. Anterior spinal artery arises from which of the following arteries? Internal carotid artery Basilar artery Vertebral artery External carotid artery Loading...654. A 4-year old girl is brought to the clinic by her mother complaining of fever and abdominal pain since yesterday. Today, she looks uncomfortable during micturition. On examination, her temperature is 99.4, her pulse is 100/min. and her suprapubic area is soft and tender. Her blood analysis shows increased neutrophils. Her urinalysis is positive for organisms and leukocytes. What is the drug of choice for this condition? Chloramphenicol Rifampin Ciprofloxacin C0-trimoxazole Loading...655. Which of the following antibiotics is the most appropriate one to treat a case of Legionella pneumonia? Metronidazole Clindamycin Vancomycin Erythromycin Loading...656. Which one of these drugs reverses both muscarinic and nicotinic effects of organophosphorus compounds by restoring cholinesterase? Atracurium Pralidoxime Physostigmine Atropine Loading...657. Which of the following drug is a derivative of Acetic acid? ketorolac Mefenamic Acid Piroxicam Etodolac Diflunisal Loading...658. When a blood clot adhere to vessel wall this is called as one of the following? All of the above Thrombus Embolus Coagulation Loading...659. Which of the following ligaments is most likely torn in a case of posterior dislocation of the hip? Sacrotuberous ligament Iliofemoral ligament Ischiofemoral ligament Loading...660. A 35-year-old man complains of pain and swelling in the sacro-coccygeal region. Which of the following is the most likely diagnosis? Liposarcoma Perianal abscess Pilonidal abscess Suppurative hidradenitis Loading...661. A drug has a large volume of distribution because it accumulates in muscles? Nitroglycerin Digoxin Aspirin Clopidogrel Acetaminophen Loading...662. Which of the following drug contain the Carboxylic group, replaced with tetrazole ring in the structural formula? Telmisartan Losartan Candesartan Irbesartan Valsratan Loading...663. The structural formula of epinephrine and Norepinephrine called? Pyrocatechol Catechol 1,2-dihydroxybenzene All of these Loading...664. Which one of the following tests can be used to distinguish between Folic acid and vitamin B12 deficiencies? Serum methionine level Serum methylmalonate level Serum homocysteine level Serum cystathionine level Loading...665. Which one of the following drugs is a microtubule inhibitor chemotherapeutic drug? Busulfan Vincristine Methotrexate Dactinomycin Loading...666. A 61-year-old male represents to the ER with severe substernal chest pain. He’s given sublingual nitroglycerin and oxygen. His vital signs are within normal limits and ECG is normal. Which of the following is the best next step? Echocardiography Aspirin Thallium stress test Coronary angiography Loading...667. Which one of the following antihypertensive medications is NOT safe in pregnancy? Methyldopa Labetalol Nifedipine Lisinopril Loading...668. A 57-year-old woman presents to the clinic with a complaint of abnormal uterine bleeding. A biopsy is taken for evaluation of endometrial cancer. At which stage endometrial cancer is often diagnosed? I VI III II Loading...669. A liposomal preparation of which one of the following medications may reduce the incidence of renal toxicity? Amphotericin B Ketoconazole Vancomycin Acyclovir Loading...670. A 22-year-old G2P1 at 28 weeks gestation presents to the emergency room with heavy vaginal bleeding. Which of the following is NOT recommended as the next step of action? Admit the patient Ultrasound examination of the pelvis Stabilize the patient Digital pelvic examination Loading...671. Which one of the following drugs has a relatively lowest potential to induce drowsiness? Loratadine Cetirizine Fexofenadine Acrivastine Loading...672. Which of the following drugs has/have beneficial role in Torsades de pointes ? Amiodarone Propranolol Eplerinone Magnesium Sulfate b & c Loading...673. Which one of the following drugs reduce the absorption of phosphate when taken with diet? Montelukast Sevelamer Hydrochlorothiazide Indanyl carbenicillin Ezetimibe Loading...674. Red man syndrome is caused by cephalosporin vancomycin lincosamine penicilin Loading...675. Which of the following types of sensations is carried to the thalamus by the anterolateral tracts after crossing the spinal cord? Position Vibrations Crude touch Fine touchPage 28 of 66 Loading...676. What is the best first step of action for a case of posterior myocardial infarction? Metoprolol 60 mg administration Aspirin 325 mg administration Tissue plasminogen activator Stress test Loading...677. Which one of the following drugs is a beta blocker (Class II)? Carvedilol Procainamide Verapamil Amiodarone Loading...678. Which of the following drug is a derivative of Propionic acid? Piroxicam Etodolac ketorolac Mefenamic Acid Diflunisal Loading...679. A pregnant woman in her third trimester was in a motor vehicle accident presets to the ER. She is stable and no uterine bleeding or contractions. Fetal heart sounds are normal and placenta is intact. Which of the following is the best next step? Blood type and Rh testing Cesarean section Induction of labor Send her home and follow up the next scheduled visit Loading...680. Which of the following statements is true about warfarin? Warfarin is monitored by PTT Liver is the main site of action of warfarin Warfarin acts by activation of antithrombin Toxicity of warfarin is treated by protamine sulfate Loading...681. Liposomal preparation of one of the following drugs decreases the risk of nephrotoxicity? Ethambutol Isoniazid Amphotericin B Nystatin Loading...682. Deficiency of the enzyme argininosuccinate in urea cycle leads to the accumulation of which one of the following? Arginine Ornithine Argininosuccinate Citrulline Loading...683. Patients with genetic polymorphism have delay in metabolism of drugs by acetylation. Which one of the following drugs is most likely affected by that? Clonidine Nitroglycerin Prazosin Hydralazine Loading...684. Which one of the following drugs is first generation flouroquinolone? Levofloxacin Ciprofloxacin Moxifloxacin Nalidixic acid Loading...685. A 30-year-old female after thyroidectomy needs replacement therapy. The preferred thyroid preparation for maintenance replacement therapy is which of the following drugs? Liotrix Liothyronine Levothyroxine Desiccated thyroid Protirelin Loading...686. Which one of the following glucocorticoids is a short acting? Betamethasone A & B Amiloride Prednisone Hydrocortisone Loading...687. A 17-year-old boy who is being treated for leukemia develops a fever. He begins treatment with antibacterial, antiviral, and antifungal agents and 2 days later develops acute renal failure. Which of the following drugs is most likely responsible for this adverse effect? Acyclovir Ampicillin Vancomycin Amphotericin B Ceftazidime Loading...688. Which one of the following gastrointestinal conditions is NOT associated with blood in stools? Ulcerative colitis Cancer colon Diverticulosis Irritable bowel syndrome Loading...689. A 67-year old man is brought to the emergency room by his colleagues for a possible heart attack. One hour ago, he felt excruciating chest pain, shortness of breath and nausea. ECG shows elevation of ST segment in leads 11, 111 and aVF. Therapy is initiated and the patient starts feeling better. ER physician explains to the patient mechanism of action of different drugs used in the treatment. Which of these drugs is responsible for rapid reperfusion in this patient? Aspirin Argatroban Ticlopidine Tissue plasminogen activator (tPA) Loading...690. A drug that is a part of Aminoglycosides is following? Tobramycin Cefdinir Cefepime Cefaclor Loading...691. Which of the following medications reduces the effectiveness of oral contraceptives? Carbamazepine Ritonavirich of the following medications is the best treatment of absence seizures? Ketoconazole Omeprazole Loading...692. Which one of the following drugs is a Thiazide Diuretic? Fenofibrate Torsemide Ezetimibe Indanyl carbenicillin Atorvastatin Loading...693. Pharmacokinetics of a drug is defined as which one of the following? The movement of a drug within the body Amount of drug needed to produce an effect Effect of a drug on certain body systems Reaction of the body to a drug Loading...694. Which of the following is the cellular mechanism of epinephrine? Activation of acetylcholinesterase Inhibition of adenylyl cyclase Activation of adenylyl cyclase Activation of phospholipase Loading...695. Which one of the following maneuvers is recommended to deliver the baby arms in breech delivery? Lovest maneuver Mauriceau-Smellie-Veit maneuver Pinard maneuver Prague maneuver Loading...696. Which of the following physiological changes is expected in a person comping on a mountain at an altitude of 4500 meters? Decreased 2,3-diphosphoglycerate Increased renal excretion of H ion Decreased arterial Pco2 Decreased erythropoietin production Loading...697. Which one of the following cephalosporins belongs to the third generation? Ceftin Cefaclor Cefoxitin Cefixime Loading...698. Which of the following is the main reason that acetylcholine not used in clinical practice? It is expensive It has a long half-life It is hydrolyzed very quickly It is toxic Loading...699. A patient is having symptoms of nausea and vomiting after cancer Chemotherapy. Which of the following drug is the drug of choice for this patient to relieve his symptoms of Vomiting and nausea? Ondansetron Diphenhydramine Ranitidine Promethazine Hydroxyzine Loading...700. Which of the following is the leading cause of blindness in the USA? Glaucoma Macular degeneration Diabetic retinopathy CataractPage 29 of 66 Loading...701. A drug that belongs to proton pump inhibitor is one of the following? Rosiglitazone Lansoprazole Sulbactam Ethacrynic Acid A & B Loading...702. A 22-year-old female with a history of acquired immunodeficiency syndrome (AIDS) develops low grade fever, headache and blurred vision. Cerebrospinal fluid (CSF) testing for Cryptococcal antigen is positive. Which of these drugs can be given orally to treat Cryptococcal meningitis? Amphotericin B Caspofungin Fluconazole Metronidazole Loading...703. Which one of the following drugs is a potassium channel blocker (Class III)? Carvedilol Verapamil Procainamide Amiodarone Loading...704. Which one of the following cardiac conditions occurs in about 25% of patients with systemic lupus erythematosus (SLE)? Ventricular myxoma Atrial hypertrophy Pericarditis Aortic stenosis Loading...705. Which one of the following drugs increase survival in patients with MI? Furosemide Verapamil Digoxin Atenolol Loading...706. Which one of the following differentiates exudate from transudate? High specific gravity Few leukocytes Low protein content High osmotic pressure Loading...707. An old patient complains of server pain in his right shoulder. He mentions that he had shingles on the same area of skin last week. Which of the following is the most appropriate treatment at this time? Ibuprofen Nortriptyline Morphine Carbamazepine Loading...708. Which one of the following antihypertensive medications is directly acting vasodilator? Labetalol Enalapril Nifedipine Clonidine Loading...709. Which one of these apoproteins is associated with chylomicrons? Apo C-II Apo B-48 Apo D Apo A Apo E Loading...710. Polyuria is an adverse effect of which of the following drug? Vasopressin Desmopressin Oxytocin Conivaptan Loading...711. Which of the following disorders is most likely related to body dysmorphic disorder? Generalized anxiety disorder Post-traumatic stress disorder Malingering Obsessive compulsive disorder Loading...712. Amoxicillin inhibits which one of the following enzymes? Transglycosylase Squalene epoxidase Beta lactamase Transpeptidase Loading...713. Estrogen is the female hormone due to which female sex organs and secondary sexual characteristics developed. Estrogen has the following adverse effects except? Hepatic Adenoma Endometrial cancer Paresthesia Thromboembolic disease Fluid retention Loading...714. Naloxone is the treatment of choice of which one of the following toxicities? Citalopram overdose Methylphenidate overdose Amitriptyline toxicity Hydrocodone toxicity Loading...715. Which one of the following correctly describes nicotinic Ach receptors? Ligand-gated Na+/K+ channels G-protein–coupled receptors Enzyme-linked receptors Loading...716. A 45-year old man presents to the emergency room complaining of breathing difficulty, palpitations, dizziness and chest pain for 15 minutes. He is a new employee at the hospital. He was waiting for a meeting when he experienced these symptoms. He had 3 similar episodes during the past 3 months but they resolved spontaneously. His medical and surgical histories are unremarkable. He has no family history of cardiac disease or sudden death. On examination, he is anxious, vital signs are within normal limits and heart and chest examinations are normal. What is the next step of management for this patient? Assurance and send him home for the rest of the day Call cardiology department and prepare for PCI 12-Lead ECG, random blood glucose and thyroid panel Psychotherapy and alprazolam Loading...717. An agent that contains sulfonamide structure in structural formula and blocks cysLT¹ receptor thus blocking the effect of leukotrienes? Zafirlukast Ergotamine Zileuton Acetaminophen Loading...718. Which one of the following medications act as bacteriostatic by inhibiting bacterial dihydrofolate reductase? Trimethoprim Ciprofloxacin Sulfamethoxazole Dapsone Loading...719. One of the following statements about the use of succinylcholine is wrong? Act like Acetylcholine to depolarize junction Resistance to plasma cholinesterase causes Hyperkalemia prolonged apnea in patients deficient in cholinesterase Malignant hyperthermia with halothane Loading...720. An 8-month-old boy presents to the clinic with his mother. She tells you that her son had several bowel movements today and his stool was like red jelly. He vomited all food and water. He is also weak, fussy and holding his belly. He has no fever or signs of dehydration. On abdominal examination, there is a palpable abdominal mass in the right hypochondrium and emptiness in the right lower abdomen. Ultrasonography is performed to confirm the diagnosis. What is the next step of management for this patient? MRI of the abdomen IV hydration and antibiotics Colonoscopy Refer to surgery for bowel resection Contrast enema Loading...721. Which of the following endocrine disorders is characterized by high blood pressure, sodium and water retention, low potassium level and decreased renin activity? Secondary hyperaldosteronism Primary hyperaldosteronism Pheochromocytoma Addison’s disease Loading...722. Conversion of ethanol to acetate will result in increase production of which of the following? NADH Oxaloacetate NAD Pyruvate Loading...723. Which of the following is the most likely cause of sudden death in a case of portal hypertension? Congestive heart failure Ventricular fibrillation Hepatic encephalopathy Rupture of esophageal varices Loading...724. Which one of the following actions is produced by muscarinic cholinergic agonists? Inhibition of phospholipase C Decreased IP3 production Decreased release of intracellular calcium Activation of inhibitory G protein Loading...725. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefepime Cefadroxil Cefaclor CeftizoximePage 30 of 66 Loading...726. Which one of the following may precipitate to an acute porphyria attack? Mediterranean diet High carbohydrate diet Vegetarian diet Low carbohydrate diet Loading...727. Which of the following adverse effects of L-dopa is the most likely the reason to limit the use of it? Dyskinesia Nausea and occasional vomiting Orthostatic hypotension Depression Loading...728. Which one of the following drugs is a Alpha Glucosidase inhibitors? Acarbose Repaglinide Ezetimibe Hydrochlorothiazide Indanyl carbenicillin Loading...729. Which one of the following drugs treatment usually causes a decrease in intestinal flora? All of the above Calcium supplements Diuretics Antibiotics A & B Loading...730. Which one of the following drugs binds with dietary phosphate & prevents its absorption? Calcitonin Sevelamer Rabeprazole Acetazolamide Furosemide Loading...731. A drug that effects the thyroid hormone is one of the following ? Furosemide Bumetanide Levothyroxine A & B Sulbactam Loading...732. A 47-year-old man with a history of chronic renal failure presents to the clinic for a follow up after a kidney transplant three weeks ago. His surgery was successful and his transplanted kidney started producing urine right after the operation. However, today his urine output drops and his serum creatinine begins to rise. There is no fever or dysuria. Urinalysis shows no abnormality. Biopsy from the transplanted kidney shows cellular infiltrate of cytotoxic cells (CD8). What is the most likely diagnosis of this condition? Acute pyelonephritis Acute rejection Chronic rejection Hyperacute rejection Normal reaction Loading...733. Which of the following is the mechanism of action of ursodiol to reduce the size of gallstones in the common bile duct? Dissolving calcium from the stone Relaxation of common bile duct Reducing bile synthesis Dissolving cholesterol form the stone Loading...734. Which one of the following drugs is a neuromuscular blocker drug? Mecamylamine Benztropine Pancuronium Atropine Neostigmine Loading...735. Which of the following is the indication for surgical repair of abdominal aortic aneurysm (AAA)? Right after been diagnosed Located under the origin of renal arteries Larger than 5.5 cm Larger than 3.5 cm Loading...736. A 15-year-old boy is diagnosed with “Walking pneumonia”. Which of the following is the most effective treatment of this condition? Tetracycline Azithromycin Vancomycin Ampicillin Loading...737. Which of the following differentiates physiologic jaundice from pathologic jaundice? Bilirubin peaks at higher levels (> 15 mg/dL) in physiologic jaundice Physiologic jaundice is present in the first 24 hours of life Direct bilirubin is lower than 10% of total bilirubin in physiologic jaundice Bilirubin in physiologic jaundice rises higher than 5 mg/dL/day Loading...738. A 34-year old woman delivered a girl at her 37-week gestational age through a normal delivery two hours ago. Examination of the newborn girl reveals pink skin, red reflex in both eyes, high arched palate, webbed neck, swollen hands and feet and widely spaced nipples. Heart and lungs auscultation is unremarkable except for a systolic murmur below the left scapula. Which of the following congenital heart diseases is most likely found in this patient? Ventricular septal defect Atrial septal defect Transposition of great vessels Coarctation of the aorta Tetralogy of Fallot Loading...739. Following drug causes Systemic acidosis by binding with cations in antacid? Sodium polystyrene sulfonate Alendronate Sevelamer A & B Metamucil Loading...740. A 32 year-old woman visits her physician because she hasn’t been able to protrude and depress her tongue. Which of the following is the most likely affected muscle? Palatoglossus muscle Hypoglossus muscle Genioglossus muscle Styloglossus muscle Loading...741. Which of the following type of virus causes influenza? Cytomegalovirus A & B Varicella zoster Herpesvirus Orthomyxoviruses Loading...742. Which one of the following drugs is used to treat copper toxicity? Aminocaproic acid Protamine Atropine Penicillamine Loading...743. A medical condition in which a portion of blood from the left heart started flowing back to the lungs flowing through the aorta to the pulmonary artery is called? Ductus arteriosus Atherosclerosis Reye syndrome Hypotrichosis Pulmonary embolism Loading...744. A drug is used in severe alcohol poisoning is the following drug? Calcium Gluconate Amyl Nitrate Fomepizole DIGIBIND Loading...745. A 63-year-old woman visits her physician for a follow up after a week of antibiotic therapy for acute bronchitis. Her condition is deteriorated. Her physician suggested repeating the antibiotic. The patient disagreed saying that she does not like to take the antibiotic and she did not take it as prescribed. Which of the following is the appropriate response? Why don’t you like to take this medication? I am afraid, you have to take this antibiotic otherwise, you will have more complications of the condition. What side effects did you experience? Do you understand the benefits of taking this medication on time? Loading...746. A 19-year-old man presents to the clinic with a complaint of tremors and incoordination. Serum transaminases are slightly elevated. Slit lamp examination shows brownish corneal deposits. What is the element directly involved in this condition? Zinc Iron Copper Lead Arsenic Loading...747. Gynecomastia is the adverse effect of the following drug? Flucytosine Griseofulvin Ketoconazole Fluconazole Loading...748. Which of the following errors is considered if the researcher states that there is no difference when one exists? Type 1 error Type II error Loading...749. Which of the following drug belongs to Sulfonylureas? Cefoxitin Niacin Urae Tolbutamide Oxacillin Loading...750. Bulging of anterior fontanelle is considered after examination of which one of the following anatomic landmarks? Bregma Pterion Lambda Sagittal suturePage 31 of 66 Loading...751. What is the congenital heart disease most likely associated with Turner’s syndrome? Coarctation of the aorta Ventricular septal defect Atrial Septal defect Transposition of the great vessels Loading...752. The sympathomimetic which may promote diuresis by a direct effect on the kidney is: epinephrine Isoproterenol dobutamine dopamine norepinephrine Loading...753. A hypoglycemic drug that decreases insulin resistance by binding with peroxisome proliferator-activated receptor gamma (PPAR-gamma) in muscles, fat, and liver? Glyburide Metformin Pioglitazone Sitagliptin Loading...754. Which of the following antibiotics is the most appropriate treatment of mycoplasma pneumonia? Gentamicin Ampicillin Doxycycline Azithromycin Loading...755. Immune related problem is one of the following? Headache High Blood pressure Fever Aids Loading...756. Which one of the following drugs is worst for causing gastric irritation? Diclofenac Misoprostol Sulindac Acetaminophen Aspirin Loading...757. Administration of which one of the following can increase the excretion of a weak acid i.e. Aspirin toxicity? A weak base A strong acid A neutral salt A weak acid Loading...758. Which one of the following drugs is contraindicated in a case of osteoporosis? Calcium oxalate Albuterol Simvastatin Prednisone Loading...759. A 20-year-old exchange male student from Greece presents to the office for evaluation. Two days ago, he noticed yellow discoloration of his conjunctiva. His family history is significant for hemolytic anemia due to glucose-6-phosphate dehydrogenase deficiency. Which one of these findings is most likely revealed in this patient’s workup? Increased plasma unconjugated bilirubin Increased urobilinogen in urine Clay colored stool Dark brown urine Increased bilirubin in urine Loading...760. Periumbilical discoloration is found in a patient diagnosed with acute pancreatitis. Which of the following signs is considered positive in this patient? Nikolsky’s sign Grey Tunner sign Murphy’s sign Cullen’s sign Loading...761. A child presents with low body weight, edema of lower extremities, enlarged abdomen with ascites and desquamating skin and areas of depigmentation and hyperpigmentation. Which of the following is the most likely diagnosis? Marasmus Kwashiorkor Scurvy Pellagra Loading...762. Which of the following cells of the ovary secretes inhibin, follistatin and activin? Theca externa cells Granulosa cells Surface epithelial cells Theca interna cells Loading...763. Which of the following disorders is considered a nephrotic syndrome? Alport syndrome Goodpasture syndrome IgA nephropathy (Berger disease) Minimal change disease Loading...764. Which of the following is considered a limiting adverse effect of ACE inhibitors? Hyperkalemia Acidosis Hypokalemia Hyponatremia Loading...765. Which of the following are side effects of Aspirin? Bronchoconstriction Peptic ulcer diseased Metabolic acidosis All of the above Urticaria Loading...766. Emotions, judgments and motor aspects of speech are controlled by which one of the following lobes of the brain? Parietal Temporal Occipital Frontal Loading...767. Which of the following signs of infective endocarditis appears as small, tender nodules on the finger and toe pads? Roth’s spots Osler nodes Splinter hemorrhages Janeway lesions Loading...768. A 48-year-old man with a long history of type 1 diabetes and hypertension develops sudden chest pain and dizziness. On examination, pulse is 110, blood pressure is 80/50, no pulsus paradoxus, lungs are clear and jugular veins are dilated. ECG shows sinus tachycardia with ST elevation in leads II, III and AVF. What is the best next step of action? Sublingual glyceryl nitrate (GTN) IV fluids stat IV dobutamine IV calcium gluconate IV heparin Loading...769. Which one of the following agent is a insulin? Torsemide Glulisine Somatostatin Atorvastatin Desmopressin Loading...770. Which one of the following liver disorders occurs due to hepatic vein thrombosis? Budd-Chiari syndrome Alcoholic hepatitis Fatty liver Pyogenic liver abscess Loading...771. Which of the following drug belongs to potassium sparing Diuretics? Urea Acetazolamide Furosemide A & B Amiloride Loading...772. An elderly woman complains of sharp pain in her right hip region after she falls out of bed. Radiological studies show fracture of the right femoral head and compressed fracture of T10. Which of the following is the most likely predisposing to these fractures? Osteoporosis Osteomalacia Metastases Acute osteomyelitis Loading...773. Acyclovir belongs to one of the following classes of drugs? Antifungal Antipyretic Antibiotics Antiprotozoal Antiviral Loading...774. The binding of a drug to plasma proteins will tend to: Increase its concentration in the plasma. Decrease its rate of glomerular filtration. Increase its pharmacological activity Decrease half-life. Increase its rate of biotransformation. Loading...775. A 47-year-old man with a history of chronic renal failure presents to the clinic for a follow up after a kidney transplant three weeks ago. His surgery was successful and his transplanted kidney started producing urine right after the operation. However, today his urine output drops and his serum creatinine begins to rise. There is no fever or dysuria. Urinalysis shows no abnormality. Biopsy from the transplanted kidney shows cellular infiltrate of cytotoxic cells (CD8). What is the most likely diagnosis of this condition? Chronic rejection Acute pyelonephritis Hyperacute rejection Acute rejection Normal reactionPage 32 of 66 Loading...776. A 32-year old diabetic woman delivered a large baby after difficult vaginal delivery. At labor, the head emerged first and then the shoulders were stuck behind the bony pelvis. The obstetrician had to use some tools and maneuvers to deliver the baby. The baby had a good cry and red pink color but his right arm was not moving. It was hanging on his side with medial rotation. Which of these nerve roots are most likely affected? C6 and C7 C7 and C8 C8 and T1 C5 and C6 Loading...777. A 62-year-old man presents to the clinic with rashes all over his body and painful joints. Last month, he was diagnosed with arrhythmia. He is taking one medication for it. Laboratory tests reveal anti-histone antibodies. Propranolol Hydralazine Verapamil Metoprololich of the following drugs is most likely responsible for this condition? Sotalol Loading...778. Which of the following is the main role of colchicine in treating acute attack of gout? Decreased uric acid absorption Inhibition of xanthine oxidase Increased uric acid excretion Reduction of gout symptoms and pain Loading...779. Which of the following is the mechanism of action of misoprostol for the treatment of peptic ulcer? Suppression of secretory responses to food stimulation Direct inhibition of the proton pump Increased mucus and bicarbonates secretion and decreased HCL secretion Formation of a protective coating of the ulcer beds Loading...780. Which one of the following drugs is effective only for the influenza A virus? None of these Oseltamivir A & B Rimantadine Zanamivir Loading...781. Which one of the following actions of epinephrine is blocked by prazosin? Tachycardia Bronchial dilation Pupil dilation High stroke volume Loading...782. Which one of the following is NOT a factor in Apgar Scoring System? Skull dimensions Heart rate Respiration Reflex irritability Loading...783. Which of the following agents most likely causes vasoconstriction? Histamine Bradykinin Nitric oxide Norepinephrine Loading...784. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Indanyl carbenicillin Ezetimibe Lamivudine Gemcitabine Capreomycin Loading...785. Which one of the following medications is used in cases of schizophrenia to treat involuntary movements caused by the use of antipsychotics such as haloperidol? Sertraline Lamotrigine Chlorpromazine Benztropine Loading...786. Which one of the following drugs causes teratogenic effect? Zanamavir Rimantadine Oseltamivir Ribavirin Amantadine Loading...787. A drug that inhibits the M2 protein ion channel and its ability to modulate intracellular PH? Acyclovir Rimantadine Zanamivir Ribavirin Loading...788. A 90-year-old man is hospitalized from falling and breaking his hip. He has been already in the hospital for 6 days when he developed a burning sensation upon urinating. An analysis of his urine shows plenty of gram positive cocci and leukocytosis. The attendant physician treats him with trimethoprim-sulfamethoxazole. However, the fever still persists. After 2 more days, the patient develops a diastolic murmur radiating to the axilla and a low-grade fever is still persisting. Out of the following, which would be the first line treatment for the cause of the possible infection? Piperacillin Vancomycin Gentamicin Ampicillin Loading...789. A 15-year-old male is brought to the emergency department for ataxia, hyperactivity, hallucinations, abusive language and nystagmus. Which of the following is most likely responsible for his condition? Phencyclidine (PCP) Barbiturates Amphetamines Cocaine Loading...790. A young female presents with areas of erythema and itching over the skin of her hands, arms and legs two hours after she ate nuts. Which of the following immunological reactions is the most likely responsible? Anaphylaxis Immune complex deposition Complement activity Cell mediated hypersensitivity Loading...791. A 19-year-old man is referred to the clinic for a positive purified protein derivative (PPD) test for tuberculosis. He moved to the United States from Egypt 2 years ago and has been in a good health. He has no history of fever, cough, weight loss or night sweats. He has no family history or contacts with tuberculosis. His physical examination is normal. His chest x-ray shows no cavitation or hilar adenopathy. What is the appropriate next step in management for this patient? Start treatment with multiple drug- antituberculosis therapy Repeat the PPD test and x-ray after 6 months Start treatment with isoniazid for 9 months Isolation and full antituberculous therapy for 6 months Loading...792. Which one of the following causes induction of cellular enzymes that interfere with viral protein synthesis? Ribavirin Interferon-alpha Amantadine Zanamavir Gancyclovir Loading...793. A 56-year-old man presents to the emergency room complaining of severe chest pain, nausea and excessive sweating for 30 minutes. ECG and laboratory tests confirm the diagnosis of acute myocardial infarction. What is the most likely reason of diaphoresis in this patient? Decreased sodium and water retention Elevated parathyroid hormone Parasympathetic stimulation Sympathetic stimulation Decreased peripheral resistance Loading...794. Which of the following is the most common cause of adverse drug reactions? Dosage discrepancy Allergic reaction Idiosyncrasy Non-compliance Loading...795. Which one of the following statements about dobutamine is incorrect? Increase myocardial cAMP Positive inotropic effect Avoid in acute heart failure Increase contractility Loading...796. A newborn presents with absence of the contents of left scrotal sac. There is no other abnormality. Which of the following is the most likely diagnosis? Undescended testis Hypopituitarism Agenesis Hypospadias Loading...797. Which of the following organisms is responsible for antibiotic-associated colitis? Clostridium botulinum Clostridium difficile Clostridium perfringens Clostridium tetani Loading...798. A 62 year-old man complains of fever and diminished consciousness for 2 days. He has been healthy all his life and he doesn’t take any medications. On examination, he responds inconsistently to commands. His temperature is 103 F, pulse 110/min and blood pressure is 80/56 mmHg. His physical examination is otherwise normal. There is no bleeding. Laboratory test are as follows: Hemoglobin: 12 g/dlukocyte count: 25,000 – 80% neutrophils Platelet count: 20,000 Hemophilia a Idiopathic thrombocytopenic purpura Thrombotic thrombocytopenic purpura Disseminated intravascular coagulation Hemophilia bat is the most likely diagnosis? Loading...799. Which one of the following studies measures heritability and influence of environmental factors? Cohort study Cross-sectional study Case-control study Adoption study Loading...800. A woman, tested genetically for glucose-6-phasphate dehydrogenase deficiency, is found to have only one defective X chromosome. She is married to a man with normal X chromosome. She is pregnant with a female fetus. Which of the following is most likely expected in her baby girl? The baby has 100% chance to clinically have the disease The baby has no chance to be a carrier The baby has 50% chance to clinically have the disease The baby has 50% chance to be a carrierPage 33 of 66 Loading...801. Which of the following drug is used as a cervical ripening agent to induce labor? Etodolac Celecoxib Ketorolac Dinoprostone Nubemetone Loading...802. Which one of the following enzymes catalyzes the transformation of testosterone into DHT? 5 α-reductase Cholesterol side chain cleavage enzyme (CYP11A1) Aromatase 17α-hydroxylase Loading...803. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Neostigmine Atropine Prazosin Succinylcholine Benztropine Loading...804. Histamine Receptor found on eosinophils and mast cells having a chemotactic function also found on neutrophils and CD⁴ T cells are following? H⁴ histamine receptor H¹ histamine receptor H² histamine receptor H³ histamine receptor H⁵ Histamine receptor Loading...805. The tracheal tube is originated from which of the following structures? Fourth pharyngeal arch Foregut Third pharyngeal arch Ductus arteriosus Loading...806. A 65-year-old man complains of lightheadedness when he gets off bed in the morning. He takes metoprolol and hydrochlorothiazide. Which of the following is the cause of his complaint? Vasovagal reflex Hypertension Aortic stenosis Antihypertensive therapy Loading...807. Which of the following is the mechanism of action of flumazenil in the treatment of lorazepam toxicity? Competitive inhibition at benzodiazepine receptors Noncompetitive inhibition of benzodiazepine receptors Stimulation of dopamine receptors Inhibition of alpha adrenoceptors Loading...808. A drug that belongs to proton pump inhibitor is one of the following? A & B Esomeprazole Sulbactam Rosiglitazone Ethacrynic Acid Loading...809. Fluconazole belongs to the class of following drugs? Antibiotics Antiviral Antiprotozoal Antifungal Antipyretic Loading...810. A 45-year-old woman working as a secretary visits her physician complaining of tingling and numbness in her hands. Upon conducting a physical examination, the doctor finds that the patient also has decreased sensation in all her fingers, except for the fifth digit. Keeping these in mind, which of the following muscles is usually weakened in patients suffering from this condition? Opponens pollicis Adductor pollicis Lumbricals Dorsal interossei Loading...811. A 37-year-old woman presents to the emergency room complaining of general tingling sensation all over her body and spasm of her right hand for 1 hour. Her spasm is worsening and she feels as her body becomes more rigid. She had undergone subtotal thyroidectomy 2 weeks ago and the incision is healed and clean. Blood tests reveal very low serum calcium level. What should be the immediate therapy to reverse her symptoms? Levothyroxine Parathyroid hormone Calcitonin Vitamin D Calcium gluconate Loading...812. Which one of the following features characterizes Crohn’s disease from ulcerative colitis? Perineal fissures and fistulas Bloody diarrhea Colectomy is curative Continuous disease beginning at rectum and extending without skipped areas Loading...813. A 28-year-old man has a minor injury as a result of motor car accident. He complains of severe pain due to a scratch on his scalp across the front hairline. Which one of these nerves is related to this pain? Vagus nerve Trigeminal nerve Orbital nerve Facial nerve Oculomotor nerve Loading...814. Low doses of one of the following drugs produce sedation, but at high doses it produces excitement? Scopolamine Phenylephrine Pirenzepine Physostigmine Atropine Loading...815. Which of the following leukocytes have nuclei of 3-5 lobes and azurophilic light-pink small granules in their cytoplasm? Neutrophils Plasma cells Monocytes Basophils Loading...816. What is the antidote to snake bites? Nalmefene Vitamin K A & B Antivenin Pralidoxime Loading...817. A patient with hyperthyroidism develops a cardiac arrhythmia, the most suitable drug to treat his arrhythmia would include: Bretylium Propranolol Digoxin Amiodarone Loading...818. Which one of the following tests is performed to determine if a fetus develops hemolytic disease of the newborn? Direct Coombs test Osmotic fragility test Hemoglobin electrophoresis Radioimmunoassay Loading...819. Abacavir belongs to the class of following drugs? Anti malaria Antibiotics Antiviral Antiprotozoal Antipyretic Loading...820. A 65 year-old woman presents to the emergency room for transient loss of consciousness. While she was walking with her husband today, she felt lightheaded and lost her consciousness for a few minutes then, she made a full recovery. On examination, her pulse is 86/min. and her blood pressure is 148/82. On auscultation, there is a systolic ejection murmur heard at the 2nd right intercostal space and radiates to the carotids. Lungs are clear bilaterally. What is the most likely diagnosis? Mitral regurgitation Aortic insufficiency Aortic stenosis Mitral stenosis Pulmonic stenosis Loading...821. Which one of the following parts of the heart is the major consumer of oxygen and requires the best blood supply? Left atrium Left ventricle Right ventricle Right atrium Loading...822. A 25-year-old man presents to his physician for his first annual physical examination. He moved to the city for a new job and he got health insurance so, he decided to do regular annual checks. His past medical, surgical and family histories are unremarkable. He does not smoke or drink alcohol. He does not take any recreational drugs. His physical examination and laboratory tests are normal. What is the recommended screening test for all patients at his age? Colonoscopy Prostate specific antigen (PSA) Depression screening test Erythrocyte sedimentation rate ECG stress test Loading...823. Which one of the following fetal structures transfer oxygenated blood from the umbilical vein to the inferior vena cava and becomes ligamentum venosum after birth? Umbilical artery Ductus venosus Ductus arteriosus Azygous vein Loading...824. A 24-year-old woman visits her physician for consultation about human papillomavirus (HPV) vaccine. She has been sexually active since she was a senior in high school with multiple partners. She had her last Pap smear last year and it was normal. On examination, there are multiple vaginal non-tender wart-like projections. What is the best advice concerning HPV vaccine to this patient? She already has HPV infection but she should take the vaccine for other strains of HPV HPV vaccine is essential to treat the current infection No need for the vaccine as long as Pap smear is normal She already has HPV infection so, no need for the vaccine She can only take the vaccine later after full recovery Loading...825. Receptors that produce the most rapid response: Cytokine receptors G-protein linked receptors Tyrosine-Kinase Receptors Intracellular Receptors Ion channel linked receptorsPage 34 of 66 Loading...826. Organophosphorus poisoning can be treated with which of the following agents? Atenolol Ipratropium bromide Physostigmine Atropine Loading...827. A 35-year-old man comes to the clinic complaining of myalgias and fever. Two weeks ago, he had experienced a brief, self-limited spell of diarrhea after going to a barbecue party. After that, there were no more symptoms and the patient remained asymptomatic. Yesterday evening, he developed fever of 103 F (39.4oC), severe muscle pain, and conjunctivitis. There is also generalized muscular soreness along with a diffuse maculopapular rash. Several minute hemorrhages can be seen under his fingernails. Complete blood count (CBC) performed at the time of admission shows white blood cell count of 15,000/mm3 with 30% eosinophils. Which one of these developmental forms is responsible for his infection? Encysted larvae Ovum Rhabditiform larvae Cyst Loading...828. Which of the following drug belongs to the Nonnucleoside reverse transcriptase inhibitor? Maraviroc Abacavir Indanyl carbenicillin Atazanavir Delavirdine Loading...829. A drug that belongs to thiazolidinediones is one of the following? A & B Sulbactam Rosiglitazone Ethacrynic Acid Cefazolin Loading...830. In case of transposition of the great arteries, the pulmonary artery arises from which one of the following parts of the heart? Left atrium Right atrium Left ventricle Right ventricle Loading...831. A study found that incidence of lung cancer in smokers is 230/100,000 and in non-smokers is 71/100,000. What is the relative risk for smokers? 71 230 2.3 3.2 Loading...832. A 30-year-old pregnant woman visits her obstetrician’s clinic at 10 weeks gestation. The patient has a history of type 1 diabetes and is worried that her condition may cause some complications in her pregnancy. From the list below, advise your patient that all of the following are a potential risk of type 1 diabetes in pregnancy EXCEPT which one? Fetal malformations Spontaneous abortions in the first trimester Having to undergo a cesarean section Preterm labor Loading...833. Cortisol is released from which part of the adrenal medulla? Zona fasciculate All of these Zona glomerulosa Zona reticularis A & B Loading...834. Which one of the following statements about the use of Celecoxib is wrong? Half-life of 11 hours Inhibition is irreversible Selective inhibitor of COX-2 Causes kidney toxicity Loading...835. Dizziness, tinnitus, blurred vision, and headache are linked with the following drug? Quinine Primaquine All of the above A & B Quinidine Loading...836. Autoantibodies to pancreatic islets Beta cells and insulin are found in the following types of Diabetes? A & C All of the above Type 2 Diabetes mellitus Type 1 Diabetes mellitus Latent autoimmune diabetes of the adults Loading...837. Hydralazine is used to treat one of the following disease? Viral infection Malaria High Blood pressure Diabetes Stomach Ulcer Loading...838. Which of the following medications is the most effective immunosuppressant in cases of organ transplantation? Vinblastine Cyclosporine Azathioprine Cyclophosphamide Loading...839. Griseofulvin belongs to the following drugs class? Antipyretic Antiprotozoal Antibiotics Antiviral Antifungal Loading...840. Misoprostol is an analog of the following type of prostaglandin? PGB PGE1 PGA PGI2 PGE Loading...841. Which one of the following types of necrosis is most likely associated with myocardial infarction? Liquefactive Coagulative Fibrinoid Caseous Loading...842. A patient with a history of diabetes presents with dark bronze skin pigmentation and multiple arthralgia. Which of the following would be detected in a joint aspirate? Copper Hemosiderin Negatively birefringent particles Monosodium urate crystals Loading...843. Release of which of the following chemical mediators results in pain in cases of acute inflammation? Complement C3b Serotonin Histamine Prostaglandin Loading...844. Which one of the following drugs is a thiazide diuretic drug? Chlorthalidone Amiloride Acetazolamide Bumetanide Loading...845. A 30-year-old man with a history of recurrent generalized tonic-clonic seizures visits his psychiatrist to refill his prescriptions. He complains of recent diplopia and ataxia. His doctor thinks that these new symptoms are related to one of his medications. Which of these drugs is most likely responsible for these new symptoms? Ethosuximide Carbamazepine Acetazolamide Clonazepam Gabapentin Loading...846. Which of the following statements is correct regarding the apex of the upright lung compared to its base? Alveoli are more compliant at the apex than at the base Alveoli are smaller at the apex than at the base Ventilation/perfusion ratio is lower at the apex than at the base Blood perfusion is lower at the apex than at the base Loading...847. Which one of the following blotting procedures is the best for studying mRNA levels? Southwestern blot Western blot Southern blot Northern blot Loading...848. Food allergies are typically causing which one of the following immunologic abnormalities? Cell-mediated hypersensitivity Immune-complex deposition Localized anaphylaxis Complement activation Loading...849. A 36-year-old man visits his physician complaining of chronic gastric pain for several years. Physical examination is unremarkable. Serology studies are positive for Helicobacter Pylori. Endoscopy reveals gastritis with no ulcers or tumors. Treatment starts with omeprazole, clarithromycin and metronidazole. What is the most appropriate noninvasive test to check for H. pylori eradication? Serum test for IgG antibodies against H. Pylori Examination and culture of gastric contents Rapid urease test Urea breath test Stool analysis and culture Loading...850. A patient presents with persistent dry cough and high potassium. Which of the following medications is associated with these side effects? Albuterol Captopril Furosemide DigoxinPage 35 of 66 Loading...851. A 74-year-old woman visits her physician complaining of a new onset of fatigue and temporal headache. She lost about 5-7 pounds over the last year. She also has morning stiffness for one hour accompanied by aching in the shoulders and hips. She noticed that her vision was deteriorating during the last year. Physical examination is unremarkable. Laboratory tests indicate high erythrocyte sedimentation rate. What is the most appropriate next step? Temporal artery biopsy Refer to a neurologist Carotid Doppler studies CT scan of the head Start prednisone Loading...852. About Nateglinide; All are true, except? release insulin Decrease insulin resistance Hypoglycemia less common than with Sulfonylureas decrease postprandial hypoglycemia Loading...853. Which one of the following is an anterior pituitary hormone? Somatostatin Fenofibrate Atorvastatin Corticotropin Torsemide Loading...854. Which of the following conditions is characterized by the presence of smooth, painless, wart-like lesions on genital organs? Secondary syphilis Chlamydia infection Gonococcal infection Candida infection Loading...855. A 60-year-old man complains of sudden onset of fever, jaundice, right upper abdominal pain and ascites. Liver biopsy shows areas of swelling and necrosis with neutrophilic infiltration. What is the diagnosis? Alcoholic hepatitis Budd-Chiari syndrome Acetaminophen toxicity Fatty liver Loading...856. Which of the following esophageal disorders is the most likely a complication of HIV infection? Candida esophagitis Esophageal varices Achalasia Adenocarcinoma Loading...857. Which of the following is Coumarin derivative Anticoagulant agent? Clopidogrel Heparin Abciximab Warfarin Ticlopidine Loading...858. A 79-year-old woman complaining of persistent cough presents to the clinic for chest x-ray. A small nodule is detected on the x-ray. Biopsy of the nodule reveals adenocarcinoma containing progesterone receptors. Her past history is significant for endometrial carcinoma treated 2 years ago. What is the most effective treatment for this patient? Radiotherapy Progestin therapy Lobectomy Cytotoxic agents Loading...859. In which one of the following parts of the GIT most of the ingested iron is absorbed? Descending colon Ileum Ascending colon Stomach Duodenum Loading...860. A 72-year-old man presents to the office for evaluation of new symptoms. He has a history of cancer and takes chemotherapeutic treatment. Now he complains of dyspnea and mild fatigue since last week. Examination reveals temperature of 98.3 F, pulse of 80/min, blood pressure of 140/86 and respiratory rate of 22/min. On chest auscultation, there are crackles on both lung bases with no wheezes. A chest x-ray shows bilateral diffuse interstitial markings. Which of the following agents is responsible for this patient’s new features? Bleomycin Cyclophosphamide Cisplatin Paclitaxel Etoposide Loading...861. Ozone toxicity leads to chest pain, cough, shortness of breath and sore throat. Sulfur dioxide toxicity is causing cough, runny nose and difficulty breathing due to swollen lungs. Nitrogen toxicity is very rare and is known as inert gas asphyxiation which is used as a suicide method. CT body screening Upper endoscopy Trial of proton pump inhibitor Barium swallow Esophageal manometry Loading...862. Which of the following findings is consistent with a case of right lung atelectasis? Trachea is not deviated (normal location) Trachea is deviated to the right Trachea is deviated to the left Loading...863. A patient complains of worsening diarrhea over the past three months. He has a history of recurrent urinary tract infection and joint pain affects numerous joints. A urine sample shows pneumaturia. Which of the following is the most likely cause of this patient’s symptoms? Ulcerative colitis Pseudomembranous colitis Enterovesical fistula Renal stones Loading...864. Erythema infectiosum (Fifth disease) is caused by which of the following organism? Parvovirus B19 Rubella virus Coxsackie A virus Paramyxovirus Loading...865. A drug that belongs to Loop Diuretics is one of the following? Bumetanide Cefazolin A & B Sulbactam Furosemide Loading...866. A cytokine that induces proliferation of antigen-primed T cells along with enhancing the activity of NK cells? Interleukin-2 (IL-2) Tissue necrosis factor-alpha Interferon-gamma Interleukin-1 (IL-1) Loading...867. During spermatogenesis, which type of cells enter meiosis 1 to from primary spermatocytes? Type A spermatocytes Primordial germ cells Type B spermatocytes Spermatids Loading...868. Which of the following causes pancreatitis? Azathioprine Didanosine All of the above L-asparaginase Exenatide Loading...869. Stimulation of hepatic microsomal cytochrome p450 enzymes can cause which one of the following? Increased intestinal absorption of certain drugs Decreased metabolism of certain drugs Enhancement of excretion of some drugs Increased metabolism of certain drugs Loading...870. Which one of the following medications binds tumor necrosis factor (TNF-α) and used in the treatment of rheumatoid arthritis? Paclitaxel Infliximab Methotrexate Trastuzumab Loading...871. Which of the following parts of the stomach has a dome-shaped appearance and lies superior to the lower end of esophagus? Fundus Antrum Body Pylorus Loading...872. Ca+ channel blockers belongs to the one of the following CLASS of Antiarrhythmic drugs? CLASS III CLASS II CLASS I CLASS IV Loading...873. Injury of the which of the following nerves results in loss of sensations of over the right scrotum and the medial side of the thigh? Ilioinguinal nerve Lateral cutaneous nerve Genitofemoral nerve Pudendal nerve Loading...874. Which one of the following drugs is often added to nasal decongestants? Norepinephrine Epinephrine Phenylephrine Albuterol Loading...875. Which of the following insects is the victor responsible for transmission of Rocky Mountain spotted fever? Mite Flea Louse TickPage 36 of 66 Loading...876. Which one of the following drugs has a beta effect (vasodilation) at low doses but when the dose is increased it causes vasoconstriction (Alpha effect) at high doses? Isoproterenol Clonidine Methoxamine Metaproterenol Epinephrine Loading...877. A 22-year-old man visits the clinic for evaluation of fever, headache and dry cough for 7 days. His medical history is unremarkable and he takes no medications. He had no previous similar episodes. On examination, temperature is 101.3 F, pulse is 88/min. and blood pressure is 100/60 mmHg. On auscultation, his lungs are clear bilaterally. X-ray shows diffuse infiltration in the lower lobes of both lungs. What is the most likely causative organism? Streptococci Mycoplasma Mycobacteria Rickettsia Fungi Loading...878. Which one of the following types of cells is involved in foreign body reaction? Neutrophil Plasma cell Eosinophil Giant cell Loading...879. Which of the following drugs is an ergosterol synthesis inhibitor? Ampicillin Acyclovir Ketoconazole Ritonavir Loading...880. A 2-year-old boy is brought to the emergency room by his mother. She tells you that her boy has been crying since she picked him up yesterday form the daycare. She thinks that he has abdominal pain. He vomited twice and he didn’t want to eat breakfast. There is no history of fever, rashes or any prior illnesses. On examination, there is a diffuse abdominal tenderness. Laboratory tests are significant for amylase of 1500 and lipase of 2500. What is the most likely etiology of this boy’s condition? Congenital annular pancreas Trauma Viral infection Gallstones Cystic fibrosis Loading...881. Which one of the following metals is the most likely cause of allergic contact dermatitis especially in females? Silver Gold Nickel Copper Loading...882. Following drug has a low therapeutic index? Ticlopidine Aspirin Clopidogrel Abciximab Digoxin Loading...883. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? A & B Furosemide Rabeprazole Ibandronate Isoniazid Loading...884. A 6-year-old girl is brought to her pediatrician by her mother for consultation. She said that her daughter is frequently bumping into chairs while walking or playing. On examination, she is found to have bitemporal hemianopia. CT scan shows calcification in the pituitary fossa. What is the most likely diagnosis of this condition? Choriocarcinoma Germinoma Teratoma Craniopharyngioma Gangliocytoma Loading...885. Which of the following locations is the most common for Koplik’s spots of measles? Buccal mucosa Hard palate Tongue Soft palate Loading...886. Which of the following management plans is recommended for a case of myocardial infarction with 70% main left stenosis? Percutaneous transluminal coronary angiography (PTCA) Coronary artery bypass graft (CABG) Percutaneous coronary intervention (PCI) Pharmacotherapy and observation Loading...887. Which one of the following lipid-lowering agents can cause skin flushing and pruritus? Atorvastatin Gemfibrozil Cholestyramine Niacin Loading...888. Which one of the following drugs decreases endogenous hepatic production of glucose? Pioglitazone Metformin Sitagliptin Acarbose Loading...889. Which of the following is the appropriate treatment of amoebic liver abscess? Surgical drainage Metronidazole Vancomycin Amikacin Amoxicillin Loading...890. A drug that act as laxative is one of the following? Furosemide Bumetanide Sodium phosphate Sulbactam A & B Loading...891. What are the 5 Ps of ischemia due to peripheral vascular disease? Pain-Pallor-Proteinuria-Paresthesia-Paralysis Pain-Pallor-Paralysis-Paresthesia-Poikilothermia Pain-Pallor-Paresthesia-Proteinuria-Poikilothermia Pain-Pallor-Paralysis-Polycythemia-Proteinuria Loading...892. Which one of the following effects is correlated to direct beta1-adrenoreceptor stimulation? Bradycardia Bronchodilation Vasoconstriction Tachycardia Loading...893. A baby is born with a protruding saclike lesion on the lower back. Examination reveals decreased sensations and reduction of tone and strength of both lower extremities. Which of the following is the most appropriate next step in management? Immediate lumber puncture Broad spectrum antibiotics to avoid meningitis Manual compression of the lesion Urgent surgical interference Loading...894. Which of the following agents should a patient take for a stuffy, runny nose? Albuterol Oxymetazoline Terbutaline Clonidine Metoprolol Loading...895. Nabumetone is a prodrug derived from which of the following class? Propionic acid derivative Acetic acid derivative Enolic acid derivative Fenamic acid derivative Salicylic Acid derivatives Loading...896. Which one of the following drugs is a neuromuscular blocker drug? Nicotine Neostigmine Benztropine Atropine Atracurium Loading...897. Two sisters, aged 40 and 45 years old, are brought to the emergency room presenting with severely dramatic pneumonia. When the lungs are examined, doctors are able to easily hear rales. The chest x-rays reveal that both sisters have bilateral and diffuse infiltrates. On taking down their history, it was observed that 2 weeks ago both sisters went hiking to a mountainous area where they explored a dusty cave. What would be the most likely causative agent of their condition? Blastomyces dermatitidis Histoplasma capsulatum Hemophilic influenzae Coxsackie A virus Loading...898. Which one of the following medical conditions is associated with an arthritis that resembles ankylosing spondylitis? Crohn’s disease Peptic ulcer Celiac disease Whipple disease Loading...899. Which one of the following drugs mediates histamine release from mast cells causing flushing? Griseofulvin Terbinafine Caspofungin Nystatin Loading...900. Lidocaine is an effective antiarrhythmic because of which of the following mechanisms? It prolongs QT interval It blocks alpha-receptors It suppresses excitability in ischemic areas of the heart It prolongs PR interval It block beta-receptorsPage 37 of 66 Loading...901. You receive a phone call from the nurse of a nursing home telling you that your patient refused to take her medications for the third day. She is 75 years old, competent and has disability of both lower limbs. What is your best response to the nurse’s concern? Tell the patient that if she doesn’t take her medications then, there is no need to take any future appointments Ask the patient for the reason of refusal and don’t force her to take her medications Call her family and address this issue with them to find the best way to solve this problem to avoid any blame if something happens to her Get help of the staff in the nursing home to force the patient to take her medications as you are responsible for any complications that could happen to her if she doesn’t take her medications. Loading...902. Which of these conditions is known as pulsus paradoxus? A fall of systolic blood pressure for more than 10 mmHg during inspiration A difference of 10/min between radial and femoral pulse A difference of 10/min between right and left radial pulse A difference in blood pressure for more than 10 mmHg between both arms Loading...903. Which of the following is the best treatment of genuine stress incontinence? Urethropexy Surgical repair Intermittent self-catheterization Anticholinergic Loading...904. A college student visits the clinic for pruritic maculopapular rash on abdomen, trunk, and palms of the hands and soles of the foot. Generalized lymphadenopathy and wart-like lesions are seen around anal area. Which of the following laboratory tests is the most useful for this patient? Chlamydia titer Venereal Disease Research Laboratory (VDRL) test Blood culture of gonococci Weil-Felix titer Loading...905. A 59-year-old man visits his physician for his yearly routine examination. He mentions that his exercise tolerance had been reduced over the last year. He also notes that he experiences shortness of breath and chest pain when he is ascending his home stairs although he lives on the second floor. He smokes 1-2 packs of cigarettes every day for 35 years. He drinks socially and uses recreational drugs occasionally. On examination, his vital signs are as follows: pulse 86/min, blood pressure 138/86 and his BMI is 30. His cardiac examination is unremarkable. He has family history of hypercholesterolemia and coronary disease. His laboratory tests show abnormal lipid profile (LDL Cholesterol: 230 mg/dL and HDL: 32 mg/dL). What is the most likely vascular pathology in this patient? Hyperplastic arteriosclerosis Medial calcific sclerosis Atherosclerosis Deep venous thrombosis Loading...906. A drug that effects the thyroid hormone is one of the following ? Sulbactam Bumetanide Triiodothyronine A & B Furosemide Loading...907. Atropine causes:? Only bradycardia Only tachycardia Bradycardia followed by tachycardia No effect on Heart Tachycardia followed by bradycardia Loading...908. A 50-year-old woman presents with palpitations and SOB. Her pulse is 140/min with irregular irregularity. Which of the following is the most likely finding in echocardiography? Dilated cardiomyopathy Mitral stenosis Left ventricular hypertrophy Right ventricular hypertrophy Loading...909. Dry or “sandy eyes” is seen after administration of large doses of which one of the following medications? Atropine Timolol Pilocarpine Carbacho Loading...910. Which one of the following cells secretes glycosaminoglycan and is found in the terminal and respiratory bronchioles? K cells Macrophages Clara cells Pneumocytes type Loading...911. A 17 year old girl is brought to the emergency room by her boyfriend complaining of severe and progressive abdominal pain. Physical examination and laboratory tests confirm a diagnosis of appendicitis. An emergent appendectomy is recommended. Who should sign the consent of surgery? Her regular physician Her father The ER physician Her boyfriend She does not need a consent Loading...912. Prophylaxis in HIV patients with TMP-SMX should be initiated at which of the following CD4 counts? Under 300 Under 100 Under 50 Under 200 Loading...913. A 32-year-old woman presents with a complaint of severe pain during menstruation. She is prescribed indomethacin. Which is the mechanism of action of this drug to reduce her pain? Interferes with the production of leukotrienes Stimulates the production of prostaglandin E2 Limits the production of histamine Inhibits the production of prostaglandin E2 Inhibits the production of Phospholipase A2 Loading...914. Which one of the following drugs is a Tetracycline? Cefepime Doxycycline Cefadroxil Cefdinir Loading...915. Heteroaryl acetic acid drug is following? Diclofenac Piroxicam Nabumetone Indomethacine Ibuprofen Loading...916. A 3-year- old boy is brought to the emergency room by his mother for vomiting and bloody diarrhea for 4 days. She also noticed low urinary output in the past 2 days. He had no similar attacks in the past and his medical and family histories are unremarkable. On examination, his vital signs are within normal limits, no signs of dehydration, no abdominal tenderness or organomegaly and no rashes or any skin manifestations of hemorrhage or internal disease. Laboratory tests reveal mild anemia, thrombocytopenia and abundant reticulocytes and schistocytes. Urinalysis reveals red blood cells with no casts. Kidney function tests reveal marked increase in serum urea and creatinine. Coagulation profile is normal. Stool Shiga toxin test is positive for Shiga toxin 2. Henoch-Schonlein purpura Idiopathic thrombocytopenic purpura Renal stonesat is the most likely diagnosis? Hemolytic uremic syndrome Thrombocytopenic thrombotic purpura Loading...917. A concerned mother has brought her 8-year old girl to the gynecology clinic because of enlarged breasts. Her daughter has been feeling depressed as her schoolmates make fun at her for her large breasts. There has no axillary or pubic hair. There is no history of menarche. Her voice did not change. Her examination is completely normal. What is the most likely diagnosis? Congenital adrenal hyperplasia Precocious puberty Androgen insensitivity syndrome Pituitary adenoma Isolated premature thelarche Loading...918. Which of the following medications is the drug of choice for motion sickness? Tolterodine Dicyclomine Scopolamine Benztropine Loading...919. A 30-year-old man tells you that when he carries a heavy lift, his muscle gives up all of a sudden. Which of the following actions is responsible for abrupt cessation of skeletal muscle contraction? Activation of muscle spindles Activation of Golgi tendon organs Lower blood supply to the muscle Activation of lower motor neuron Loading...920. Which one of the following drugs is used to treat asthma? Hydrochlorothiazide Ezetimibe Indanyl carbenicillin Repaglinide Ipratropium Loading...921. Which one of the following medications inhibits protein synthesis by binding to 50S subunit and preventing the formation of the initiation complex? Clindamycin Linezolid Azithromycin Minocycline Loading...922. Which of the following is NOT considered an indication for HIV testing? Semen donor Patients with symptoms of AIDS Recent positive test of a partner Homosexuality Loading...923. Your 8-year-old daughter wakes you up in the middle of the night complaining of severe coughing. You bring the child to the doctor the next day and upon examination, the following is revealed: noisy breathing on inspiration, flaring of the nostrils, marked retractions of the chest wall, and a severe barking cough. She has also developed an upper respiratory tract infection. What would be the best diagnosis for the patient? Viral croup Bronchiolitis Asthma Foreign body stuck in the main bronchus Loading...924. Which of the following is most likely characteristic of oral route of administration? It has the fastest onset of effect Absorption of the drug depends on the GIT function Most of oral medications reach the bloodstream through the liver It is the most appropriate route to interact with most of the emergencies Loading...925. A group of researchers investigate the effect of daily intake of baby aspirin on the development of coronary artery diseases. They are observing two groups of people divided according to intake of aspirin or not and how many develop CHD on each group. The results are listed on a chart. Which of the following is the correct measure to make an assumption? Specificity Relative risk Positive predictive value Odds ratioPage 38 of 66 Loading...926. Meissner’s plexus of nerves is located within which layer of the gastrointestinal tract? Submucosa Muscularis Externa Mucosa External layer Loading...927. Prolonged vomiting results in which one of the following findings? Metabolic alkalosis with hyperkalemia Metabolic alkalosis with hypokalemia Metabolic acidosis with hyperkalemia Metabolic acidosis with hypernatremia Loading...928. Which of the following drug resembles sex steroids and act at other receptors causing gynecomastia and menstrual irregularities at high doses? Bumetanide Acetazolamide Furosemide Triamterene Spironolactone Loading...929. A 60-year-old woman presents with severe tearing abdominal pain, nausea and dizziness. The patient is pale and lethargic with blood pressure of 80/50 and diffuse abdominal tenderness. There is no past history of similar episodes. What is the next step? Amylase and lipase levels Exploratory laparotomy Laparoscopy Ultrasound Loading...930. Which of the following substances is the risk factor in developing mesothelioma? Copper Lead Asbestos Silica Loading...931. Which of the following group is a compulsory part structural formula of Losartan? Phosphinic acid group Sulfahydril group Thiol group Carboxylate group Imidazole ring Loading...932. A 6-year-old girl is brought to her pediatrician by her mother for consultation. She said that her daughter is frequently bumping into chairs while walking or playing. On examination, she is found to have bitemporal hemianopia. CT scan shows calcification in the pituitary fossa. What is the most likely diagnosis of this condition? Teratoma Gangliocytoma Germinoma Choriocarcinoma Craniopharyngioma Loading...933. One of the following statements about the Parasympathetic neurons is wrong? Postganglionic fibers are long Preganglionic fibers arise from cranial nerves Originated from Efferent autonomic system Preganglionic neurons originated from the Sacral region Preganglionic fibers are long Loading...934. A 33-year-old man presents to his physician to discuss his plans for treatment of hyperthyroidism. One of the options is potassium perchlorate. What is the mechanism of action of potassium perchlorate as anti-thyroid? Blocking of coupling of iodotyrosines Inhibition of the release of thyroid hormone from the thyroid gland Competitive inhibition of iodide transport mechanism Blocking of peripheral deiodination of T3 and T4 Blocking of peroxidase catalyzed reactions Loading...935. Which one of the following procoagulant factors is produced by the epithelial cells? Prostacyclin Thromboxane A2 Fibrinogen von Willebrand’s factor (vWF) Loading...936. Which of the following is the most common cause of sudden death in patients with diabetes mellitus? Myocardial infarction Cerebral hemorrhage Hyperosmolar coma Gangrene Loading...937. Select Dihydropyridines Calcium channel blocker drug? Amiloride Diltiazam Acetazolamide Verapamil Nifedipine Loading...938. Bronchoconstriction results from stimulation of which one of the following receptor types? Beta-2- adrenergic receptors Alpha-1- adrenergic receptors M3 cholinergic receptors M2 cholinergic receptors Loading...939. A 37-year-old man visits his physician with complaints of sore throat, fever and muscle aches for 4 days. Throat swab is negative. His physician discussed with him the use of antibiotics in his case. The patient had read in an old magazine that one of the antibiotics is effective but the his physician explains that this antibiotic is highly nephrotoxic. Which one of these antibiotics is the most nephrotoxic? Rifampin Cloxacillin Ampicillin Amoxicillin Methicillin Loading...940. Measurement of the content of which one of the following could help to compare the collagen content of several tissues? Glycine Cysteine Proline Hydroxyproline Loading...941. A 20-year-old male athlete complains of pain and weakness of his right arm. He had a successful surgery on his knee last week. He has been walking with the aid of crutches since then. On examination, he is unable to extend his right arm at the elbow or the hand at the wrist. There is also a sensory deficit over the dorsolateral area of the right hand. Neurological examination is otherwise normal. Which nerve is most likely related to his symptoms? Axillary nerve Suprascapular nerve Radial nerve Median nerve Ulnar nerve Loading...942. A 54-year-old woman with a 6-year history of type 2 diabetes visits her physician for a regular examination. She was initially treated with oral hypoglycemic but her HbA1c had gotten worse so, her physician switched to insulin last year. Six-month ago, she had surgery in her wrist to release compression caused by carpal tunnel syndrome. Now, she complains of progressive increase in her feet size. Examination reveals coarse facial features with prominent supraorbital ridge. What is the most appropriate test to help reach the diagnosis of this case? Fasting serum glucose test Measurement of thyroid stimulating hormone (TSH) Dexamethasone suppression test Measurement of HbA1c Assessment of insulin-like growth factor 1 (IGF-1) Loading...943. A patient presents to the ER with a history of taking a large amount of acetaminophen tablets. Which of the following is the most appropriate next step of action? Administer N-acetylcysteine Blood transfusion Measure serum acetaminophen concentration Prepare for hemodialysis Loading...944. Which of the following is the most serious contraindication of electroconvulsive therapy? History of seizures Old age History of fracture Meningioma Loading...945. A 36 year-old man presents to the emergency room asking for removal of software implanted in his body by his neighbor. He tells you that his x-wife is hiring this neighbor to spy on him. For the last 6 years he has been hearing them talking about him and all details of his life. He lives alone and he does not have any friends. He has no kids and one sister who do not visit him anymore since he accused her of spying on him. His physical examination and laboratory studies are unremarkable. Drug test is negative. What is the most likely diagnosis? Major depressive disorder Schizophreniform disorder Bipolar disorder Schizophrenia Brief psychotic disorder Loading...946. A 35 year old man is brought to the ER by his coworker complaining of shortness of breath and dizziness. He was acting hysterical most of the day before he felt dizzy and needed help. They work at a plastic manufacture plant for seven years. What is the treatment needed to be given instantly? Atropine Flumazenil Activated charcoal Ethyl alcohol Sodium nitrite Loading...947. A 38 year old man is brought to the emergency room because of palpitation and shortness of breath for 4 hours. He travelled to Brazil two years ago on a business trip. He was bitten there by a fly and was treated by analgesics for a few weeks due to fever and headaches. On examination, heart rate is 150 with shifting of the apex to the left. Imaging studies and further investigations show cardiomyopathy. What is the organism most likely responsible for this condition? Streptococcus pyogenes Ascaris lumbricoides Trichophyton rubrum Trypanosoma cruzi Staphylococcus aureus Loading...948. A group of drugs bind to a receptor but do not produce any pharmacological effect is called: Agonist Partial agonist Antagonist Loading...949. Which of the following Diuretic drugs contain cyclic sulfonamide Except? Bendroflumethiazide Methylchlorothiazide Chlorothiazide Hydrochlorothiazide Indapamide Loading...950. A 35-year-old office worker complains of pain and numbness over the lateral side of the hand. It is worse at night and may awaken her from sleep. Examination reveals tingling over the median nerve distribution by compressing the opposing dorsal surface of the hand with the wrist flexed. Which of the following is the correct term of this test? Phalen test ELISA test Tinel test Coombs testPage 39 of 66 Loading...951. Which one of the following drugs is a Thiazide Diuretic? Indanyl carbenicillin Fenofibrate Ezetimibe Indapamide Atorvastatin Loading...952. Following drug is a phenylalanine derivative? Repaglinide Nateglinide Pioglitazone Metformin Loading...953. A 30-year-old man visits the clinic complaining of recurrent bouts of diarrhea accompanied with bloating over the past few years. He also reports that he has itchy vesicles around the extensor surfaces of his upper and lower extremities. The rest of clinical examination is normal. What is the skin condition most likely present in this patient? Shingles (herpes zoster) Rosacea Dermatitis herpetiformis Seborrheic keratosis Psoriasis Loading...954. Which one of the following statements correctly describes the inspiratory reserve volume? Volume of air that moves into the lung with each normal inspiration Volume of air that can still be inhaled in after a normal inspiration Volume of air that remains in the lung after a normal expiration Volume of air that present in the lung after maximal inspiration Loading...955. Achilles tendon xanthoma is most likely characteristic of which one of the following conditions? Pseudogout Familial hypercholesterolemia Diabetes mellitus Systemic lupus erythematosus Loading...956. A 46-year-old woman with a history of fibromyalgia presents to the clinic with a complaint of anxiety, frequent diarrhea and occasional palpitations. She also noticed an unexplained loss of weight and irregular menstrual periods over the last 3 months. What is the most likely laboratory investigation that could lead to a diagnosis in this case? Colonoscopy Cosyntropin stimulation test MRI of the brain CT scan of the head Serum Thyroid Stimulation Hormone (TSH) level Loading...957. A 65-year-old man is scheduled for a repair of an abdominal hernia. The patient has an abdominal hernia that can be reduced by pushing the contents of the abdomen back through the external ring. While performing the repair, the surgeon observes that the hernial sac is protruding from the superior abdominal wall to the inguinal ligament. It is also medial to the inferior epigastric vessels. After observing all these, what can be concluded about the type of a hernia the patient is suffering from? Femoral hernia Hiatal hernia Direct inguinal hernia Indirect inguinal hernia Loading...958. NucleoSide Reverse Transcriptase inhibitors(NRTIs) drug in Antiviral class? Acyclovir Zidovudine Nevirapine Saquinavir Amprenavir Loading...959. A 19-year-old man presents with syncope, dyspnea and chest pain with exercise. A crescendo-decrescendo murmur without carotid radiation is heard over the left sternal border. What is the most likely diagnosis? Mitral stenosis Hypertrophic cardiomyopathy Aortic stenosis Myocardial infarction Loading...960. Which of the following options is the adverse effect of Vancomycin? Chill's Phlebitis All of the above Fever Redman syndrome Loading...961. A) Atropine Flumazenil Dimercaprol Penicillamine Loading...962. Which one of the following parts of fallopian tube is the widest and the most common site for fertilization? Ampulla Isthmus Infundibulum Loading...963. A drug increase cAMP results in activation of protein kinase? Dobutamine Ticlopidine Tirofiban Aspirin Clopidogrel Loading...964. Which one of the following adverse effects of calcium channel blockers is wrong? Diarrhea Hypotension Fatigue Vertigo Loading...965. Following is the 2nd generation cephalosporin drug? Cefadroxil Cephalexin Cefaclor Cefepime Cefdinir Loading...966. A 22-year-old man presents to the clinic due to excessive urination. He goes to the restroom almost every 15 minutes. His physical examination is otherwise normal. Laboratory tests show Serum Na: 140 mEq/L Diabetes mellitus Diabetes insipidusat is the most likely diagnosis? Psychogenic polydipsiaine Na: 18 mEq/L Urine osmolality: 260 mOsm/kg after 4h fluid deprivation. Solute diuresis Urinary tract infection Loading...967. An 86-year-old female presented with a slate-gray pigmentation on the (butterfly) sun-exposed areas of the face with erythema and hyperpigmentation. There was no irritation, itching, ulceration, or discharge. Physical exam showed similar areas over both legs with atrophic skin, which the patient attributed to previous superficial wounds and bruises from falls. Examination showed no other pigmentation changes over the upper extremities, trunk, oral mucosa, sclera, or nail beds. Past medical history was significant for hypertension and atrial fibrillation. Which of the following drugs may be responsible? Sotalol Bretylium Amiodarone Quinidine Digoxin Loading...968. A 55-year-old man with a history of type 2 diabetes, hypertension and hypercholesterolemia presents for his routine examination. He is tall and obese. His vital signs are pulse 88/min, blood pressure 156/86 and oxygen saturation 98%. Which of the following is the most important action to reduce the risk of stroke in this patient? Weight loss Blood pressure control Blood glucose control Cholesterol reduction Loading...969. Which of the following is the classic electrocardiogram (ECG) finding in pericarditis? S-T segment elevation in anterior leads (V1-V4) Diffuse S-T segment elevation Sawtooth P waves S-T segment elevation in leads II. III and aVF Loading...970. Hemorrhagic cystitis may develop after the use of cyclophosphamide. Which one of the following drugs can reduce this risk? Infliximab Mensa Ampicillin Vitamin K Loading...971. Which of the following is the most accurate test for multiple myeloma? 24-hour urine calculation Urine electrophoresis Brain MRI Bone marrow biopsy Loading...972. Which one of the following statements about the use of Aspirin is wrong? Increases alveolar ventilation Repress the sensation of pain Inhibit inflammation Causes Interstitial nephritis Loading...973. Which of the following muscles are responsible for primary abduction of the arm at the shoulder joint? Supraspinatus and infraspinatus Coracobrachialis and deltoid Deltoid and infraspinatus Deltoid and supraspinatus Loading...974. One of the following statements is not right about the production of Acetylcholine? Acetylcholine rapidly hydrolyzed by Acetylcholinesterase Acetylcholine released by an increase in calcium level Uptake of choline is a rate-limiting step Acetylcholine is metabolized by COMT Neurotransmitter in vesicles are called varicosities Loading...975. Which of the following drug is commonly used for the Reactivation of inhibited Acetylcholine esterase? Edrophonium Bethanechol Pralidoxime Echothiophate CarbacholPage 40 of 66 Loading...976. An 80-year-old woman develops chest pain on second day after hysterectomy. Which of the following is the most likely diagnosis? Pulmonary infarction Myocardial infarction Right bundle branch block Acute pericarditis Loading...977. A 24-year old woman is diagnosed with vaginal trichomoniasis. She is prescribed metronidazole. She is breastfeeding her 3 month old boy. What is the appropriate advice for this patient concerning the use of metronidazole during breastfeeding? Stop breast feeding and replace it with formula for 3 months Stop breast feeding indefinitely Advise her to keep breastfeeding her child as there is no risk of the drug on breast feeding Stop metronidazole and choose another less effective drug as you weigh the benefits and the risks Advise her to use the pump to collect her breast milk every 24 hours right before she takes daily metronidazole Loading...978. Indapamide belongs to the one of the following class of diuretics? Thiazide Diuretic Potassium sparing diuretics Loop Diuretics Carbonic anhydrase inhibitors Loading...979. A 20-year-old male athlete complains of pain and weakness of his right arm. He had a successful surgery on his knee last week. He has been walking with the aid of crutches since then. On examination, he is unable to extend his right arm at the elbow or the hand at the wrist. There is also a sensory deficit over the dorsolateral area of the right hand. Neurological examination is otherwise normal. Which nerve is most likely related to his symptoms? Radial nerve Axillary nerve Median nerve Ulnar nerve Suprascapular nerve Loading...980. Which of the following drug belongs to H2 histamine receptor blocker? Cefoxitin Niacin Famotidine Glimepiride Oxacillin Loading...981. An 18 year-old man presents to the office for evaluation of multiple swellings in his neck. On examination, he has multiple large lymph nodes in his neck. Neurological examination reveals poor coordination on walking. Biopsy of lymph node is positive for lymphoma. He is diagnosed with ataxia-telangiectasia. What is the etiology of this disorder? Mutation in the NF1 gene on chromosome 17 Mutation in PKD1 on chromosome 16 Mutation in APC gene on chromosome 5 Deletion of VHL gene on chromosome 3 Defective DNA repair mechanisms Loading...982. A 10-year-old boy is brought to the emergency room by his mother due to a long active seizure. He was hospitalized two months ago for status epilepticus and was prescribed valproic acid. What is the first step of action? Intravenous injection of haloperidol Gastric lavage Intravenous fluids Electroencephalogram (EEG) Airway stabilization and 100% oxygen Loading...983. A patient comes to the emergency ward with recent organophosphorus compound poisoning. He will have all of the following signs & symptoms except: Increased lacrimation Bronchodilatation Diarrhea Increased salivation Muscle Weakness Loading...984. A 55-year-old woman presents to the emergency room for a cut wound on her hand. While she was cutting a piece of meat, she lost control of the knife resulting in a longitudinal wound in her hand. Bleeding stopped after a few minutes. Now she is concerned about tetanus vaccination. Records show that she received all the doses of tetanus-diphtheria (Td) and the last one was 4 years ago. What is the appropriate therapy for prophylaxis of tetanus in this patient? No further therapy Tetanus toxoid and tetanus immunoglobulin Tetanus toxoid Tetanus toxoid followed by tetanus immunoglobulin after 5 days Tetanus immunoglobulin Loading...985. Which one of the following drugs is the most effective in midazolam paradoxical reaction? Flumazenil Albuterol Adrenaline Protamine Loading...986. A 45-year-old woman is sent to the emergency room from a vision center after examining her eyes to get new glasses. While she was in the waiting room, she developed severe ocular pain in her right eye and she started seeing halos around light. Which of these agents most likely is the reason for this patient’s condition? Neomycin Pilocarpine Acetazolamide Timolol Atropine Loading...987. Which one of these conditions is most likely associated with peripheral lymphocytosis? Myocardial infarction Pyogenic bacterial infections Viral hepatitis Inflammatory bowel syndrome Loading...988. A 35-year-old unresponsive man is brought to the emergency room after an episode of agitation and confusion. He has a history of inadequately treated Graves’ disease. Physical examination reveals temperature of 102.5F. Blood pressure of 100/70 mm Hg, and pulse of 165 per minute. After stabilizing this patient, which of the following would be the best pharmacotherapy for treating his underlying condition? Iodine Levothyroxine Warfarin Propylthiouracil Dobutamine Loading...989. A 48 year-old man, who visited his daughter in London last week, complains of sudden severe pain and swelling in his right leg during his flight back to the USA. He is taken to the hospital and ultrasound is performed. It reveals femoral vein thrombosis. What is the most likely contributed to this finding? Daily aspirin Alcohol abuse Immobilization Hypothyroidism Hypertension Loading...990. During normal inspiration, the diaphragm: Contracts Relaxes Does not move Loading...991. Which one of the following effects is caused by administration of mecamylamine? Hypertension Pupillary constriction Tremors Tachycardia Loading...992. Which one of the following drugs is used to prevent acute mountain sickness? Chlorthalidone Furosemide Spironolactone Mannitol Acetazolamide Loading...993. Which of the following methods is the most likely to demonstrate spores? India ink stain Malachite green stain Gram stain Acid-fast stain Loading...994. Verapamil, a calcium channel antagonist: Decreases myocardial contractility Decreases intracellular K Increases conduction velocity Increases intracellular cAMP Increases reactivation of sodium channels Loading...995. A 43 year-old man presents to his physician with a complaint of progressive difficulty in swallowing solid food. He has a 10-year history of heartburn which increases with spicy food and relieves by antacids. He does not smoke or drink alcohol. His weight is the same since last visit six months ago. He is scheduled for endoscopy next week. What is the most likely initial diagnosis for this patient? Lower esophageal ring Diffuse esophageal spasm Achalasia Cancer esophagus Peptic esophageal stricture Loading...996. Which one of the following agents prolongs the duration of nerve block when combined with a local anesthetic? Isoproterenol Atropine Epinephrine Dobutamine Loading...997. Which one of the following medications should be taken on an empty stomach and at least one hour before meals? Propranolol Prednisone Aspirin Levothyroxine Loading...998. Amnestic syndrome due to thiamine deficiency is caused by lesions of which one of the following structures? Parietal lobe Cerebellum Limbic system Temporal lobe Loading...999. Alcohol is oxidized in the liver by which one of the following enzymes? Alcohol dehydrogenase Alcohol oxidase Alcohol decarboxylase Alcohol reductase Loading...1000. Torsades de pointes may occur after the use of which one of the following medications? Sotalol Lidocaine Propranolol RifampinPage 41 of 66 Loading...1001. A 78-year-old woman presents to the office with her daughter. Last week, she fell twice while she was walking with her daughter. She was not shaking or lost her consciousness and she got up in a minute. Her medical history is significant for hypertension and osteoarthritis. She takes Lisinopril daily and ibuprofen as needed. She also takes diphenhydramine to help her sleeping during the night. Her vital signs are within normal limits on sitting and standing. All her laboratory tests are within normal ranges. Her mini-mental status test is normal. What is the best explanation for this patient’s fallings? Side effect of one of her medications Old age Postural hypotension Alzheimer’s disease Osteoarthritis Loading...1002. An old patient with a history of a 2-week blunt trauma to his thigh develops an area of yellow-brown color at the site of injury. Which one of the following substances is responsible for this color? Lipofuscin Hemosiderin Melanin Bilirubin Loading...1003. A patient with a recent history of meningitis develops headache, blurred vision and cognitive decline. CT scan shows enlarged ventricles. Which of the following is most likely responsible for this condition? Impaired CSF resorption Destruction of the gray matter Obstruction of cerebral aqueduct Excessive CSF production Loading...1004. Loss of individual cells by fragmentation of nuclei and cytoplasm caused by a chemotherapeutic agent is produced through which one of the following mechanisms? Apoptosis Acute inflammation Mitochondrial poisoning Phagocytosis Loading...1005. A 49-year-old man who is recently diagnosed with hypertension and has a history of bronchial asthma and Raynaud syndrome visits his physician for initiation of his treatment plan. In selecting the appropriate antihypertensive drug, which of the following is the best treatment for this patient? Atenolol Diltiazem Captopril Metoprolol Verapamil Loading...1006. A drug causes accumulation of fat in the abdomen and the base of the neck on chronic administration? Lamivudine Ritonavir Zanamavir Vidarabine Amantadine Loading...1007. Which of the following group of medications prolongs GABA activity in the brain? Methamphetamines Alcohols Barbiturates Benzodiazepines Loading...1008. Which of the following is the earliest EKG sign of myocardial infarction? Inverted T-wave Pathological Q –wave Large peaked T-wave S-T elevation Loading...1009. Which of the following conditions is associated with the presence of non-inflammatory follicular papules (comedones)? Acne vulgaris Atopic dermatitis Bullous pemphigoid Pemphigus vulgaris Loading...1010. Which one of the following drugs belongs to inhibitors of viral coating? Nevirapine Amantadine Zidovudine Oseltamivir Acyclovir Loading...1011. What is the antidote of theophylline? Esmolol A & B All of the above Pralidoxime Activated charcoal Loading...1012. Amiodarone is considered one of which of the following classes of anti-arrhythmic drugs? Class III Class IV Class I Class II Loading...1013. A 55-year-old woman visits her physician to consult about hormone replacement therapy (HRT).Her physician discuss with her the pros and cons of using HRT. Which one of these benefits is gained by the use of HRT? HRT decrease the risk of hot flashes and vaginal dryness HRT decrease the risk of stroke HRT decrease the risk of breast cancer HRT decrease the risk of coronary artery disease HRT decrease the risk of deep venous thrombosis Loading...1014. A 30-year-old man is brought to the emergency room for alcohol intoxication. His blood alcohol level is 250 mg/dL. He refused to take any medications and insisted on leaving the hospital. What is the most appropriate response to this patient? We cannot release you before you become sober You have to sign consent to leave We will call the police if you don’t take treatment You can leave anytime if you want Loading...1015. Which of the following procedures is used in case of Barrett esophagus without dysplasia? Endoscopy and biopsy every 3 months Endoscopy and biopsy every 6 months Endoscopy and biopsy every 3 years Endoscopic eradication Loading...1016. Antihistamine agent with nonsedative effect from the chemical class of piperazine is the following? Hydroxyzine Cyproheptadine Promethazine Fexofenadine Cetirizine Loading...1017. Which of the following cellular pathological changes affects myocardial fibers in a case of irreversible myocardial infarction? Increased cytoplasmic sodium Karyorrhexis of the nuclei Depletion of myoglobin stores Decreased intracellular pH Loading...1018. Which one of the following gout treatments lowers serum uric acid? Colchicine Indomethacin Probenecid Allopurinol Loading...1019. Antihyperlipidemic drugs which consist of open hydroxy acid lactone ring in the structural formula except? Pravastatin Simvastatin Rosuvastatin Fluvastatin Atorvastatin Loading...1020. A 55 year-old man presents to the clinic because today he noticed that his left scrotum has suddenly gotten larger. He has no fever or pain. Examination reveals enlarged left scrotum with no tenderness or any signs of inflammation. There is a worm-like mass posterior to the left testicle. The mass illuminates and is not reducible on compression or when the patient lying down. What is the best next step in management? MRI of the pelvis Assurance and follow up in 2 weeks Refer to surgery for urgent reduction Urine culture Abdominal CT scan Loading...1021. A young man complains of syncope, dyspnea and chest pain after exercise. A crescendo-decrescendo systolic murmur is heard over the left sternal border without radiation. What is the most likely etiology? Hypertrophic cardiomyopathy Aortic dissection Aortic regurgitation Aortic stenosis Loading...1022. One of the following statements about the use of scopolamine is wrong? produce excitement at high doses Belladonna Alkaloid Shorter duration of action as compared to atropine in CNS Used for Motion sickness Short term memory blocker Loading...1023. Ceftriaxone belongs to the one of the following generation of the cephalosporin? 3rd generation 1st generation 4th generation 2nd generation Loading...1024. Which one of the following drugs decreases Glucose absorption? Metformin Rasagiline Miglitol Glipizide Loading...1025. A 45-year-old man who was diagnosed with malaria and received anti-malarial medication presents to the office with progressive fatigue and loss of appetite. He also mentions that he noticed that his urine has become dark lately. Urinalysis is positive for both bilirubin and urobilinogen. Blood studies show serum total bilirubin of 4.3 mg/dL, hemoglobin concentration of 8.5 g/dL and hematocrit of 30%. Which medication is used to treat this patient? Primaquine Chloroquine Doxycycline AtovaquonePage 42 of 66 Loading...1026. A drug that is used to treat leprosy is one of the following? Etidronate Furosemide Clofazimine A & B Magnesium hydroxide Loading...1027. Which of the following differentiates HIV virus from RNA tumor viruses? HIV virus contains 2 copies of RNA HIV virus has a cytolytic activity HIV virus is a retrovirus HIV virus contains the pol gene Loading...1028. Extrapyramidal side effects develop after the use of haloperidol due to its effect on which of the following receptors? Alpha-adrenergic receptors Nicotinic receptors Muscarinic receptors Dopamine receptors Loading...1029. The binding of a drug to plasma proteins will tend to: Decrease half-life. Increase its rate of biotransformation. Increase its pharmacological activity Decrease its rate of glomerular filtration. Increase its concentration in the plasma. Loading...1030. If a new effective treatment for COVID-19 is initiated, which of the following will be the appropriate effect on incidence and prevalence? Incident decreases with no change in prevalence Both incident and prevalence decrease No change in both No change in incident and decreased prevalence Loading...1031. Which one of the following autoantibodies is associated with Goodpasture syndrome? Anti-Ach receptor Anti-basement membrane Anti-histone Anti-centromere Loading...1032. Which of the following medications is most likely prescribed in cases of asthma associated with chronic environmental allergies? Oral fexofenadine Albuterol inhaler Oral montelukast Fluticasone nasal spray Loading...1033. Which of the following drugs are highly bound to albumin? Ibuprofen Digoxin All of the above Warfarin A & B Loading...1034. A 78 year-old patient is admitted to the hospital for treatment of pneumonia. On the third day, the nurse noticed that his heart rate is 150/min. and blood pressure is 116/86 mmHg. The patient is stable with no chest pain or shortness of breath. His ECG shows saw tooth pattern with no other abnormalities. What is the most appropriate next step of management of this patient? Start heparin Refer to a cardiologist Perform electric cardioversion Order cardiac enzymes Start metoprolol Loading...1035. Which of the following drugs is used to inhibit viral neuraminidase? Naftifine Zanamivir Ibandronate Acyclovir Capecitabine Loading...1036. Which one of the following drugs is a Meglitinide drug? Indanyl carbenicillin Hydrochlorothiazide Ezetimibe Nateglinide Fenofibrate Loading...1037. Which one of the following drugs is a prostaglandin that suppresses gastric acid secretion? Sucralfate Cimetidine Rabeprazole Misoprostol Loading...1038. Which of the following is the most common complication of diverticulosis? Obstruction Bleeding Perforation Diverticulitis Loading...1039. Which one of the following is most likely normal in duodenal ulcer? Pepsin secretion Response of gastrin to food Parietal cell mass Fasting serum gastrin Loading...1040. What is the genetic abnormality related to Cri-du-chat-syndrome? Deletion of phenylalanine in position 508 Trisomy 18 Deletion of short arm of chromosome 5 Mutations of the fibrillin gene on chromosome 15 Loading...1041. Mechanism of action of Abciximab is following? Inhibit ADP mediation Decrease Calcium levels Inhibit COX-2 Inhibit glycoprotein receptors Inhibit COX-1 Loading...1042. A 43-year old cashier visits her physician with a complaint of severe pain for 3 months and a new onset of itching in her right leg. Examination reveals multiple varicosities on the medial side the right thigh and leg and an erythematous patch on the medial side of the knee. What is the most common precipitating factor for this condition? Excessive sweating Strenuous exercise Prolonged standing Alcohol intake Prolonged exposure to the sun Loading...1043. Which of the following drugs are carboxylate derivatives of ACEIs except? Lisinopril Quinapril Fosinopril Ramipril Enalapril Loading...1044. Which of the following beta blockers has the longest duration of action? Nadolol Metoprolol Propranolol Sotalol Loading...1045. A 57-year-old man with a history of bleeding per rectum visits his physician to discuss the results of his recent CT colpography test. The test was positive for the presence of a colorectal polyp. The sensitivity and specificity of this test to detect a colorectal polyp is 75% and 90% respectively. What is the probability that this patient indeed has a colorectal polyp? 84% 86% 90% 92% 88% Loading...1046. In high doses, Aspirin lacks anti-platelet activity by which of the following phenomena Stimulates leukotrienes Inhibits leukotrienes Inhibits prostacyclins Stimulates prostacyclins Stimulates thromboxanes Loading...1047. Which of the following drug is used as Mast Cell Stabilizers? Montelukast Terbutaline Sodium Cromoglycate Salbutamol Ipratropium Bromide Loading...1048. Which one of the following drugs is a inhibitors of the P-GP (glycoprotein) efflux pumps? Linezolid A & B Amiodarone All of the above Digoxin Loading...1049. If a dose of the following drug is not properly adjusted it accumulates in neonates that interfere with the function of mitochondrial ribosomes? Amikacin Clindamycin Erythromycin Chloramphenicol Loading...1050. Which of the following drug belongs to Sulfonylureas? Urae Cefoxitin Niacin Oxacillin GlyburidePage 43 of 66 Loading...1051. Cinchonism is a possible side effect of which one of the following drugs? Metoclopramide Enflurane Isoniazid Quinidine Loading...1052. Intermediate Acting Insulin is one of the following? Detemir Glargine Lispro NPH (neutral Protamine hagedorn) Loading...1053. A disease in which blood vessels become inflamed and this inflammation leads to restriction of blood flow to organs and tissues also sometimes permanently damage organs is called? Ductus arteriosus Steven-johnson syndrome Hypotrichosis Churg Strauss syndrome Reye syndrome Loading...1054. Amylin hormone is released from one of the following cells? Pancreatic Alpha cells juxtaglomerular cells Pancreatic Beta cells Pancreatic Delta cells Loading...1055. Pins and needles and numbness is the adverse effect of the following drug? Ethambutol Nystatin Isoniazid Streptomycin Loading...1056. 37-year-old previously healthy man is brought to the emergency room for dizziness, chest pain and A palpitations. Cardiac chemistry panel is normal. ECG shows a sloping upstroke of the QRS complex. What is the treatment of choice of this condition? Verapamil Metoprolol Digoxin Atropine Procainamide Loading...1057. Absorption of levodopa-carbidopa is reduced when taken with meals rich in which of the following nutrients? Carbohydrate Fat Protein Loading...1058. Thrombocytopenic purpura (TTP) is the adverse effect of the following drug? Clopidogrel Ticlopidine Abciximab Both A & B All of the above Loading...1059. A 57-year-old man with a history of bleeding per rectum visits his physician to discuss the results of his recent CT colpography test. The test was positive for the presence of a colorectal polyp. The sensitivity and specificity of this test to detect a colorectal polyp is 75% and 90% respectively. What is the probability that this patient indeed has a colorectal polyp? 90% 84% 92% 86% 88% Loading...1060. Which one of the following antihypertensive medications is appropriate to use for an asthmatic patient? Timolol Metoprolol Propranolol Labetalol Loading...1061. Which type of hypersensitivity reaction develops from Mycobacterium tuberculosis? Type IV Type II Type I Type III Loading...1062. Which of the following is the most likely finding on a biopsy of a case of chronic bronchitis? Non-caseating granuloma Interstitial fibrosis Caseating granuloma Abundant mucus with plugging of the bronchioles Loading...1063. Which of the following is the most effective role of probenecid in treating gout? Probenecid decreases production of uric acid Probenecid decreases secretion of uric acid Probenecid decreases inflammation of affected joints Probenecid decreases reabsorption of uric acid Loading...1064. A 43-year-old man presents to your clinic for a follow up after colon biopsy taken last week. He has a history of constipation and blood in stools for 6 months. Biopsy reveals colon cancer. After you told him the bad news, he looked down and told you that constipation was not that bad. He seeks more investigations because he does not think that he has cancer. What is the emotional stage experienced by this patient at this time? Denial Depression Anger Acceptance Bargaining Loading...1065. A drug that is used to treat HIV infections is one of the following? Cladribine Tenofovir Etidronate Praziquantel Niclosamide Loading...1066. Which one of the following statements about the digoxin is incorrect? Indicated for diastolic HF 36 hours half-life Low therapeutic index Increase contractility None of these Loading...1067. Which of the following medications increases cardiac output in pulmonary edema following myocardial infarction? Dobutamine Verapamil Lisinopril Metoprolol Loading...1068. A 32-year-old man visits his physician for a follow up after receiving a punch to the right side of his face. He complains of difficulty to chew food on the right side. Examination reveals possible injury to muscles of mastication. Muscles of mastication are derived form which of these structures? Branchial Arch 4 Branchial Arch 1 Branchial Arch 2 Branchial Arch 3 Branchial Arch 5 Loading...1069. A 53-year-old man visits his physician with a complaint of erectile dysfunction. He is married for 20 years and they have two kids. He had never complained of his sexual performance until last month when he found out that he could not induce a full erection. He has no major health conditions and does not take any medications. He smokes one pack of cigarettes daily for 25 years. He does not drink alcohol or takes recreational drugs. What is the most likely etiology for this patient’s condition? Trauma Endocrine Pure psychogenic Infection Vascular Loading...1070. A 24-year-old man with a history of HIV infection develops pallor and increasing fatigue. Laboratory tests confirm the diagnosis of acute lymphoblastic leukemia. Which one of these chemotherapeutic agents is used for this patient without causing further damage to his immune system? Cisplatin Chlorambucil Procarbazine Ifosfamide Vincristine Loading...1071. Which of the following drugs appears unchanged in the urine? Oseltamivir A & B Zanamivir All of the above Amantadine Loading...1072. Which one of the following viruses is responsible for the development of viral myocarditis? Mumps virus Adenovirus Coxsackie B virus Rhinovirus Loading...1073. A 70-year-old man is brought to the doctor having a sudden onset of severe lower back pain. Upon conducting a physical examination of the patient, severe kyphosis is revealed. An x-ray of the back shows a compression fracture in the lumbar area of a vertebral body. This is followed by marked thinning of the bones as well. Laboratory tests measuring serum calcium, alkaline phosphatase, phosphorus, and parathyroid hormone levels, all come back within the normal range. What is the most likely reason behind the bone changes in the patient? Osteopetrosis Osteoporosis Osteomalacia Osteitis fibrosa cystica Loading...1074. Injury of the C8 and T1 at the lower portion of the brachial plexus most likely affects which one of the following nerves? Radial nerve Ulnar nerve Median nerve Axillary nerve Loading...1075. A 34-year old woman delivered a girl at her 37-week gestational age through a normal delivery two hours ago. Examination of the newborn girl reveals pink skin, red reflex in both eyes, high arched palate, webbed neck, swollen hands and feet and widely spaced nipples. Heart and lungs auscultation is unremarkable except for a systolic murmur below the left scapula. Which of the following congenital heart diseases is most likely found in this patient? Tetralogy of Fallot Coarctation of the aorta Atrial septal defect Transposition of great vessels Ventricular septal defectPage 44 of 66 Loading...1076. A patient with a history of lower leg fracture presents with severe pain, paresthesia, pallor, poikilothermia, pulselessness and paralysis of the affected leg. Which of the following is the immediate treatment of this case? Referral to orthopedics Send home and observation Intravenous broad-spectrum antibiotics Fasciotomy and tissue perfusion Loading...1077. A 62-year-old woman visits her physician for a routine physical examination. She has a long history of lower back pain and she takes ibuprofen as needed. She also takes levothyroxine for hypothyroidism. She exercises daily for 30 minutes and follows a regular diet. On examination, her pulse is 45/min. Holter monitor reveals a regular pulse ranging from 40-80 pulse/min. Her thyroid-stimulating hormone is within normal limits. What is the best management for this patient at this point? Reassurance and follow up visits Pacemaker implantation Perform exercise stress test Repeat Holter monitor examination Refer to a cardiologist Loading...1078. Which one of the following anti-Parkinsonism medications should be avoided in patients with glaucoma? Bromocriptine Trihexyphenidyl Selegiline Levodopa Loading...1079. A 400 mg dose of a drug was administered and 200 mg of it was eliminated after two hours. Which of the following is the amount of drug left after six hours if the drug follows first-order elimination kinetics? 25 mg 0 mg 50 mg 75 mg Loading...1080. A 54-year-old woman with a history of hypothyroidism, hypertension, depression and joint pains develops fatigue, facial rash, headaches, dizziness, confusion, diarrhea and personality changes. She takes levothyroxine, hydralazine, amitriptyline and ibuprofen. Which of these drugs is most likely responsible for this patient new symptom? Ibuprofen Hydralazine Amitriptyline Levothyroxine Loading...1081. Which of the following characterized by painless blisters on the back of the hands with friable surrounding skin and hyperpigmentation of the face? Dermatitis herpetiformis Porphyria cutanea tarda Herpes Zoster Contact dermatitis Loading...1082. Indirectly acting reversible cholinergic agonist drug? Echothiophate Pilocarpine Acetylcholine Tacrine Loading...1083. Which one of the following local anesthetics can NOT be given parenterally due to its physicochemical properties? Procaine Benzocaine Etidocaine Mepivacaine Loading...1084. Which one of the following proteins surrounds the nuclear envelope? Vimentin Actin Tropomyosin Enkephalin Loading...1085. A 1-year-old boy with a diagnosis of stable small ventricular septal defect is scheduled for a dental procedure. Which of the following medications should be administered prior to this procedure? No medication Azithromycin Ampicillin Amoxicillin Loading...1086. As physicians, we need to know some definitions in Genetics, which are related directly to our practice and guide us to diagnose and treat many genetic disorders. These items include genome, genotype, phenotype, genetic code, gene expression, etc. Which one of the following choices describes the definition of a phenotype? DNA structure that determines the expression of a trait An observable physical or biochemical trait on an organism Physical location of a trait on a DNA molecule Genetic history of an organism Loading...1087. Which of the following medications inhibits folic acid synthesis through its effect on dihydropteroate synthetase enzyme? Trimethoprim Pyrimethamine Methotrexate Sulfonamides Loading...1088. Which of the following conditions is an indication for interferon gamma? Glomerulonephritis Chronic myeloblastic leukemia Chronic granulomatous disease Hepatitis A Loading...1089. Which of the following indicates the probability that a person who has a positive test result actually has the disease? Attributable risk Positive predictive value Sensitivity Specificity Loading...1090. As physicians, we need to know some definitions in Genetics, which are related directly to our practice and guide us to diagnose and treat many genetic disorders. These items include genome, genotype, phenotype, genetic code, gene expression, etc. Which one of the following choices describes the definition of a phenotype? Physical location of a trait on a DNA molecule An observable physical or biochemical trait on an organism Genetic history of an organism DNA structure that determines the expression of a trait Loading...1091. Which of the following is the initial treatment of asymptomatic aortic stenosis? Furosemide Valve replacement Hydrochlorothiazide Balloon valvuloplasty Loading...1092. Which of the following is the most effective treatment of a case of an old man with benign prostatic hypertrophy (BPH)? Propranolol Finasteride Doxazosin and finasteride Doxazosin Loading...1093. Which of the following factors most likely affects the result of a study due to awareness of study subjects that they are being studied? Berkson’s bias Hawthorne effect Pygmalion effect Recall bias Loading...1094. Which of the following is the best next step for a suspicious malignant melanoma? Shave biopsy Excision with a safety margin Observation Excisional biopsy Loading...1095. Which of the following tests is the most accurate for diagnosis of herpes encephalitis? Serological studies for herpes PCR of CSF MRI of the brain Viral culture of CSF Loading...1096. Which one of the following drugs works through inhibition of acetyl-cholinesterase enzyme and used in myasthenia gravis? Atropine Noradrenaline Neostigmine Montelukast Loading...1097. Mechanism of action of Ticlopidine is following? Inhibit COX-2 Inhibit glycoprotein receptors Decrease Calcium levels Inhibit ADP mediation Inhibit COX-1 Loading...1098. Which of the following screening tests should be recommended for a patient taking olanzapine for schizophrenia? Hemolysis Hemochromatosis Cancer Diabetes Loading...1099. The anterior pituitary is derived from which of the following structures? Neurohypophysis Rathke’s pouch Infundibulum Third pharyngeal arch Loading...1100. Which one of the following antibiotics is the most appropriate treatment of chancroid, a bacterial infection caused by Haemophilus ducreyi? Ciprofloxacin Vancomycin Ampicillin CeftriaxonePage 45 of 66 Loading...1101. Which statement about the use of pilocarpine is wrong? relaxation of Ciliary muscles Used for Xerostomia Used for Sjögren syndrome Produce rapid miosis Lack of selectivity Loading...1102. Phenylephrine has the least affinity for following adrenoceptors type? α2 Receptors α1 & B1 Receptors α1 Receptors All of these Both A & B Loading...1103. Which one of these drugs is associated with aplastic anemia? Metronidazole Chloramphenicol Penicillin Nitrofurantoin Loading...1104. Which of the following amino acids is a non essential? Asparagine Histidine Glutamic acid Aspartic acid Alanine Loading...1105. Which one of the following contraceptive methods is contraindicated in women with a history of deep venous thrombosis (DVT)? Combined oral contraceptive Intrauterine contraceptive device (IUD) Norplant Depo-Provera injections Loading...1106. Antimuscarinic agent is following? Nicotine Tacrine Atropine Physostigmine Acetylcholine Loading...1107. Which of the following drug has Ocular effects like mydriasis and fixed far vision? Phentolamine Neostigmine Phenylephrine Timolol Mecamylamine Loading...1108. Which one of the following indicates drug resistance? Response to a drug decreases after repeated use Induction of liver metabolism No or minimum effect on a microorganism due to genetic mutation Altered effect of the drug when used with another drug Loading...1109. A 5-year-old girl with a mass in her neck is brought to the clinic for an evaluation. Her mother says that this mass appeared 6 months ago and is increasing in size. There is no pain or discomfort. On examination, the mass is in the midline, inferior to the hyoid bone. Laboratory tests reveal normal thyroid panel. Surgery is recommended after a CT scan is performed. What is the most likely diagnosis? Lipoma Branchial cleft cyst Dermoid cyst Ectopic thyroid gland Thyroglossal duct cyst Loading...1110. Reye syndrome causes brain and liver damage in children with viral infections like chickenpox and flu. this disease is linked with the following drug? Mefenamic acid None of these Aspirin Acetaminophen Ketorolac Loading...1111. Cholestatic Jaundice is the adverse effect of the following drug? Cefepime Chloramphenicol Erythromycin Clindamycin Loading...1112. An indirect-acting adrenergic agonist is following? A & B Clonidine Amphetamine Acetylcholine Albuterol Loading...1113. A young adult complains of fever, sore throat and lymphadenopathy for 5 days. Examination reveals bilateral enlarged tender cervical lymph nodes and enlarged spleen. Which of the following organisms is most likely responsible for this patient’s condition? Epstein-Barr virus Cytomegalovirus Human papillomavirus Human immunodeficiency virus (HIV) Loading...1114. A 24-year-old man with a history of AIDS is currently managed by antiretroviral therapy (HAART) containing a protease-inhibitor, a nucleoside reverse transcriptase inhibitor and a non-nucleoside reverse transcriptase inhibitor. Which one of these drugs is a nucleoside reverse transcriptase inhibitor? Etravirine Efavirenz Indinavir Zidovudine Saquinavir Loading...1115. Which one of the following types of drug interactions occurs when aspirin is given with acetaminophen? Permissive Tachyphylactic Additive Synergistic Loading...1116. Which of the following substances increases absorption of iron in the intestine? Cyanocobalamin Ascorbic acid Riboflavin Folic acid Loading...1117. A 28-year-old woman visits her physician complaining of fatigue, palpitations, loss of weight, diarrhea and irritability for 4 months. She is also intolerant to hot weather. She does not smoke or drink coffee or alcohol. Her vital signs are within normal limits except for rapid regular pulse. She has fine tremors and her skin is warm and moist. Her thyroid gland is asymmetrically enlarged and lobulated. Laboratory tests show: Thyroid stimulating hormone (TSH) 0.02 mu/ml and T4 28 mu/dLr physician discusses advantages and disadvantages of all treatment options with the patient. What is the most important disadvantage of radioactive iodine therapy? Acute renal failure Anemia and agranulocytosis Leukemia Ablation of the gland and future hypothyroidism Repeated doses due to repeated failures Loading...1118. Ingestion of which of the following products may cause hypertensive crisis in patients taking MAO inhibitors? Vitamin D and calcium Gluten-rich food Carbohydrates such as starch Tyramine-rich food Loading...1119. A 26-year-old man complains of cough, night fever, loss of weight, anorexia and night sweats for six weeks presents to his physician. Physical examination reveals vital signs within normal limits except for slight fever. Chest x-ray shows a small cavity in the right middle lobe and enlarged bronchopulmonary lymph nodes. Blood analysis reveals lymphocytosis and his sputum is positive for acid-fast bacilli. A treatment plan is discussed with the patient and he starts taking his medications.ich of these drugs acts by inhibition of formation of mycolic acid? Ethambutol Streptomycin Rifampin Isoniazid Pyrazinamide Loading...1120. A 2-year-old boy is brought to the emergency room by his mother. She tells you that her boy has been crying since she picked him up yesterday form the daycare. She thinks that he has abdominal pain. He vomited twice and he didn’t want to eat breakfast. There is no history of fever, rashes or any prior illnesses. On examination, there is a diffuse abdominal tenderness. Laboratory tests are significant for amylase of 1500 and lipase of 2500. Cystic fibrosisat is the most likely etiology of this boy’s condition? Congenital annular pancreas Gallstones Trauma Viral infection Loading...1121. A 2-month-old child is brought to the clinic by his parents with a complaint of failure to thrive. During an examination, the baby suffers a seizure. Test of stat serum chemistries indicates hyperlipidemia, severe hypoglycemia, ketosis, and lactic acidosis. Hepatomegaly is also confirmed by both physical examination and CT scan. Which of the following conditions is the child suffering from based on these findings? Von Gierke disease Gaucher disease Niemann-Pick disease Pompe disease Loading...1122. A drug inhibit the human gonadal and adrenal steroids synthesis along with fungistatic property? Caspofungin Nystatin Flucytosine Ketoconazole Loading...1123. Which test of the following is used to evaluate acute exacerbation of asthma? Pulse oximetry Chest x-ray Pulmonary function tests Complete blood count Loading...1124. A study is conducted to evaluate the action of a new oral antidiabetic drug in patients with new onset type II diabetes. All patients involved in the study are informed that they would be treated with a new oral antidiabetic drug. They are divided into three groups and each group would be treated with a different dose. Drug assessment is determined based on testing serum glucose and HgA1C regularly throughout the study. Which of the following best describes this type of study? Randomized controlled trial Single blind clinical trial Double blind clinical trial Case-control study Cross sectional study Loading...1125. A 37-year-old woman complains of watery diarrhea, abdominal cramps and periodic facial flushing for the last six months. Examination reveals bilateral wheezing and slightly enlarged liver. Urine analysis shows high levels of 5-hydroxyindoleacetic acid (5-HIAA). Multiple tumors are detected by a CT scan. What is the most likely primary site of these tumors? Colon Small Intestine Esophagus StomachPage 46 of 66 Loading...1126. A 24-year-old woman visits her physician for consultation about human papillomavirus (HPV) vaccine. She has been sexually active since she was a senior in high school with multiple partners. She had her last Pap smear last year and it was normal. On examination, there are multiple vaginal non-tender wart-like projections. What is the best advice concerning HPV vaccine to this patient? She can only take the vaccine later after full recovery She already has HPV infection so, no need for the vaccine She already has HPV infection but she should take the vaccine for other strains of HPV No need for the vaccine as long as Pap smear is normal HPV vaccine is essential to treat the current infection Loading...1127. Which one of the following drugs is associated with elevated liver function test results? Ethambutol Isoniazid Rifampin Capreomycin Loading...1128. Concurrent therapy of digitalis with the following drugs enhance the potential for cardiotoxicity? Amiodarone All of the above Quinidine Erythromycin Tetracycline Loading...1129. What is the most common cause of chronic chest pain? Musculoskeletal Gastrointestinal Cardiac Malignant Loading...1130. Which of the following receptors is inhibited by ondansetron to treat nausea following chemotherapy? Dopamine receptors Serotonin 5-HT receptors Nicotinic receptors Muscarinic receptors Loading...1131. A 68-year-old man presents to the emergency room complaining of multiple episodes of fainting since he woke up today. His fainting mainly occurs when he stands up. He has a history of coronary artery disease, diabetes, high cholesterol and hypertension. He takes atenolol, metformin, lovastatin and lisinopril. On physical examination, his blood pressure is 120/75, pulse is 55/min. and irregular, heart sounds are normal and lungs are clear on auscultation. ECG shows dropped beat after progressive lengthening of the PR interval. What is the most likely initial diagnosis? Atrial fibrillation Mobitz type II second degree AV block Third degree atrioventricular block Mobitz type I (Wenckebach) second degree AV block Atrial flutter Loading...1132. Administration of clopidogrel with aspirin is an example of which of the following drug interactions? Tachyphylactic Synergistic Permissive Additive Loading...1133. Autoantibodies to pancreatic islets Beta cells and insulin are found in one of the following types of Diabetes? Type 2 Diabetes mellitus Type 1 Diabetes mellitus Pseudo hypoglycemia Gestational Diabetes mellitus Loading...1134. Amylin analog is one of the following? Levothyroxine A & B Furosemide Pramlintide Bumetanide Loading...1135. The drug that produces dilation of the pupil (mydriasis) for 6 hours is one of the following drugs? Physostigmine Cyclopentolate Tropicamide Ipratropium Atropine Loading...1136. Which of the following explains the higher incidence of sickle cell disease in African Americans more than other races? Natural selection Genetic drift Increased mutation rate Increased gene flow Loading...1137. A 24-year-old man presents to the clinic with a complaint of grey-colored penile discharge and burning micturition for 2 days. His medical, surgical and family histories are unremarkable. Examination reveals a purulent discharge that can be seen by squeezing his penis. Penile swab shows Gram-negative diplococci within neutrophils. What is the most appropriate treatment? IV ceftriaxone IM ampicillin IV penicillin Oral doxycycline IV ceftriaxone and oral doxycycline Loading...1138. Which of the following is the mechanism of action of metoclopramide? Nicotinic receptor antagonist α-Adrenoceptor antagonist Serotonin reuptake reuptake inhibitor (SSRI) Dopamine D2-receptor antagonist Loading...1139. Which one of the following agent is a insulin? Desmopressin Detemir Atorvastatin Torsemide Somatostatin Loading...1140. Bones of calvarium and facial bones are formed by which one of the following types of ossification? Membranous ossification Endochondral ossification Loading...1141. Which one of the following anti-hypertensive medications is contraindicated in pregnancy? Labetalol Ramipril Nifedipine Methyldopa Loading...1142. Which statement about the Actions of the incretin hormone Glucagon-like peptide-1 is wrong? Decrease Beta cells growth Suppress appetite Inhibit inappropriate Glucagon secretion Increase Glucose-dependent insulin secretion Loading...1143. Which of the following drugs is used to inhibit viral neuraminidase? Capecitabine Acyclovir Ibandronate Oseltamivir Naftifine Loading...1144. A 40-year-old man with a long history of intravenous drug addiction presents to the emergency room complaining of fever, anorexia, malaise, shortness of breath, cough and chest pain for 2 days. On physical examination, temperature is 102.7 F, Pulse is 110/min. and blood pressure is 110/66. Irregular erythematous nodules are seen on his hands and feet. Which of the following is most likely valvular lesion associated with this infection? Aortic valve stenosis Pulmonic valve stenosis Mitral valve regurgitation Mitral valve stenosis Tricuspid valve regurgitation Loading...1145. A 62-year-old man who has a history of various drug overdose incidents presents to the emergency room after administration of a high dose of aspirin. Which set of these findings characterizes this condition? Metabolic alkalosis and respiratory acidosis Metabolic acidosis and respiratory alkalosis Metabolic acidosis and respiratory acidosis Metabolic alkalosis and respiratory alkalosis Loading...1146. Which of the following correctly describes unstable angina? Angina occurs at rest Angina following strenuous exercise Angina relieved by rest Loading...1147. A 35 year-old woman presents with troubled vision and severe pain in her left eye. She has been diagnosed with shingles on the left side of her face and the cornea of her left eye. Which of these nerves is the most likely affected in this patient? Optic nerve Facial nerve Trigeminal nerve Oculomotor nerve Loading...1148. Which of the following tests would most likely indicates the etiology of vitamin B12 deficiency anemia? Osmotic fragility test Coomb’s test Schilling test Complete blood count (CBC) Loading...1149. Which of the following medications acts to prevent cholesterol absorption at small intestine brush border? Gemfibrozil Colestipol Ezetimibe Cholestyramine Loading...1150. An 18-year-old male complains of nausea and slight icterus for 2 weeks. Medical, surgical and family histories are unremarkable. Physical examination reveals slight jaundice and tenderness on the right upper side of the abdomen. Laboratory findings include positive IgM anti-HAV and marked elevation of ALT and AST levels. What is the appropriate management of this patient at this time? Supportive treatment Acyclovir HBV vaccine Interferon alfa FamciclovirPage 47 of 66 Loading...1151. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Rabeprazole Ibandronate Rifamycins Furosemide A & B Loading...1152. Which of the following esophageal disorders is the most likely a complication of HIV infection? Candida esophagitis Achalasia Esophageal varices Adenocarcinoma Loading...1153. Which of the following characteristics differentiates cephalohematoma from caput succedaneum in newborn? Cephalohematoma crosses suture lines Cephalohematoma disappears in the first few days Cephalohematoma does not cross suture lines Cephalohematoma will never calcify Loading...1154. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefepime Cefaclor Ceftazidine Cefadroxil Loading...1155. A 40-year-old woman complains of fatigue, headache and generalized pain for 9 months. She presented to the clinic several times and had multiple negative workups. Her pain started as localized to her head, neck and shoulder but now it is generalized. On physical examination, there are multiple points of tenderness on bony prominences. What is the most likely prognosis of this condition? Full recovery with radiation and chemotherapy Full recovery with specific medical therapy Slow progression to permanent disability Symptomatic improvement with supportive therapy Full recovery with multiple surgeries Loading...1156. A 58-year-old man presents to the clinic with sudden weakness of his right arm. He also complains of progressive difficulty breathing on exertion, palpitations and a low grade fever during the last month. Examination reveals elevated jugular venous pressure, a loud S1 and mid-diastolic rumbling murmur hard on fifth intercostal space. Transesophageal echocardiography (TEE) confirms the diagnosis. What is the most likely diagnosis? Vegetative valvular lesions Left ventricular wall aneurysm Atrial myxoma Atrial thrombus Loading...1157. Which one of the following analgesics inhibits COX in CNS and can be used safely for pregnant women? Acetylsalicylic acid Ibuprofen Naproxen Acetaminophen Loading...1158. A scientific researcher is classifying some drugs according to their actions on different receptors. One of these drugs binds to its receptor without producing any action. Agonist Antagonist Inverse agonistis drug should be classified as what? Partial agonist Loading...1159. The effect of two medications is greater than the sum of their individual effects explains which of the following drug interactions? Additive Permissive Tachyphylaxis Synergistic Loading...1160. Which of the following needs to be added to a breast-fed 9-week-old premature infant to improve pallor? Iron supplements Vitamin C Orange juice Milk formula Loading...1161. Amphotericin B exerts its anti-fungal effect by which of the following mechanisms? Inhibition of fungal protein synthesis Alteration of cell membrane permeability Inhibition of DNA synthesis Inhibition of fungal cell wall synthesis Inhibition of cell wall synthesis Loading...1162. A 50 year-old man presents to the clinic with a long history of heartburn after eating, exaggerated when he is lying down and lessened when he takes antacids. Endoscopy reveals a large irregular, erythematous area in the lower esophagus. Esophageal motility studies reveal dysfunction of the lower esophageal sphincter (LES). Which of the following most likely leads to increase in the resting pressure of LES? Chocolate Fat Caffeine Alcohol Protein Loading...1163. A 34 year old woman visits her physician with a complaint of severe headache for two months. She took several kinds of analgesics with no significant improvement. Her headache is worse in the morning and improved by doing day activities. Imaging studies and laboratory tests confirm the diagnosis of pituitary adenoma. Which of the following is the most likely effect of this tumor on vision? Homonymous hemianopsia Binasal hemianopsia Superior hemianopsia Bitemporal hemianopsia Loading...1164. Which of the following is the main complication of sickle cell disease? Autosplenectomy Cerebral hemorrhage Hepatic failure Renal failure Loading...1165. A newly born infant is found to have a deformity on the iris. Eye exam reveals keyhole-shaped defect of the iris. Which of the following terms describes this defect? Anisocoria Heterochromia iridis Aniridia Coloboma Loading...1166. Which of the following drug belongs to H2 histamine receptor blocker? Niacin Oxacillin Glimepiride Cimetidine Cefoxitin Loading...1167. A 16 year old woman is brought to the emergency room by her mother following a seizure. She is 30 week pregnant with twins. Her mother told you that her daughter was eating lunch and when she stood up she fell on the floor and started shaking. She never had any seizures before. During last week, she complained of headache and swelling of her face. She missed her last two obstetrician’s appointments. On Examination, she is unresponsive and difficult to arouse. Her blood pressure is 210/120. There is edema of her face and both hands. Fetal heart rate is 140/min. Outpatient treatment and recommend regular visits to the clinic Hospitalization and observation until delivery at term Hospitalization and treatment with antihypertensive and epileptic drugs and wait until delivery at term Hospitalization and induction of laborat is the next step of management of this patient? Loading...1168. A 9-month-child who was delivered after premature labor and is feeding on cow milk and orange juice. What is the predicted deficiency? IronVitamin D Vitamin C Calcium Loading...1169. A drug causes Blockage of the M2 protein ion channel and it's ability to modulate intracellular PH? Vidarabine Lamivudine Zanamavir Amantadine Acyclovir Loading...1170. A 23 year-old woman presents to the emergency room with severe lower right abdominal pain for the last six hours. She had intermittent lower abdominal pain for three days but never been severe like this time. Her last menstrual period was three months ago and before that she had regular 28 day periods. On physical examination, her vital signs are within normal limits and she has a local tenderness on the lower abdomen with no rebound. On pelvic examination, there is a tender small-sized mass felt in the right vaginal fornix. What is the most likely diagnosis? Ectopic pregnancy Endometriosis Pelvic abscess Acute appendicitis Ovarian cyst Loading...1171. Which one of the following tests is diagnostic for acromegaly? Fasting blood glucose level Serum insulin-like growth factor-1 (IGF-1) Serum cortisol level Serum growth hormone level Loading...1172. Which one of the following factors stimulates the renal secretion of renin? Decreased pressure in the afferent glomerular arterioles Increased pressure in the afferent glomerular arterioles Decreased serum sodium ion concentration Increased chloride ion concentration in the renal distal tubules Loading...1173. A 60-year-old man visits the clinic due to profuse watery diarrhea and left lower abdominal colicky pain for the last 6 hours. Upon taking history, the patient claims that he is taking broad spectrum antibiotics for acute bronchitis. Which is the most likely causative organism for the patient’s new symptoms? Clostridium Septicum Clostridium histolyticum Clostridium butyricum Clostridium botulinum Clostridium difficile Loading...1174. Which of the following drugs improves skeletal muscle spasm by acting inside the muscle cell? Tubocurarine Dantrolene Diazepam Botulinum toxin Loading...1175. A 48-year-old man complains of acute pain in his right big toe. He has a history of gout and takes treatment for it. Recently, he was diagnosed with hypertension and started treatment 2 weeks ago. Which one of these drugs is most likely responsible for his recent complaint? Metoprolol Captopril Verapamil HydrochlorothiazidePage 48 of 66 Loading...1176. Pancreatic exocrine secretions empty into the duodenum through which one of the following? Duct of Wirsung Common bile duct Duct of Santorini Accessory pancreatic duct Loading...1177. Which one of the following medications acts at the proximal tubule of the kidney? Furosemide Hydrochlorothiazide Spironolactone Acetazolamide Loading...1178. A drug that is used for Hypotrichosis of the eyelashes? Dinoprostone Bimatoprost Treprostinil Epoprostenol Carboprost Loading...1179. Which of the following is the main step in treating alcoholic liver disease? Naltrexone Abstinence Baclofen Disulfiram Loading...1180. A drug that inhibits the fungal squalene epoxidase thus decreasing the synthesis of ergosterol? Nystatin Terbinafine Griseofulvin Itraconazole Loading...1181. Which of the following is an epithelial tumor with a “stuck-on” appearance? Basal cell carcinoma Squamous cell carcinoma Actinic keratosis Seborrheic keratosis Loading...1182. Which one of the following conditions is most likely affects the lungs of a patient with Parkinsonism? Embolism Atherosclerosis Thrombosis Arteriosclerosis Loading...1183. During normal inspiration, the diaphragm: Does not move Contracts Relaxes Loading...1184. A 22-year-old woman presents to the clinic for a recurrent urinary tract infection. She is prescribed trimethoprim/sulfamethoxazole. What is the mechanism of action of this antimicrobial drug? Inactivation of bacterial toxins Inhibition of bacterial protein synthesis Inhibition of mycolic acid synthesis Inhibition of bacterial wall synthesis Inhibition of folic acid synthesis Loading...1185. Regulation of which of the following regions is mostly dependent on extrinsic nerves? Upper esophagus Lower esophagus Large intestine Small intestine Loading...1186. Beta-Blocker drug is following? Atropine Metoprolol Atracurium Mecamylamine Tacrine Loading...1187. Bicornuate uterus results from failure of the fusion of which of the following structures? Mesonephric ducts Urogenital sinus Paramesonephric ducts Nephrogenic ridges Loading...1188. Which one of the following is a fat-soluble vitamin? Riboflavin Ascorbic acid Retinoid Thiamine Loading...1189. In case of constrictive pericarditis, examination reveals increased jugular venous pressure with inspiration. Which of the following is considered positive in this patient? Kussmaul sign S3 gallop Raynaud’s phenomenon Hepatojugular reflux Loading...1190. A thiophene-containing agent that blocks the synthesis of leukotrienes by inhibiting 5_ lipoxygenase is the following? Acetaminophen Zafirlukast Montelukast Zileuton Loading...1191. Which of the following is a major complication of central retinal veins occlusion? Retinal detachment Cataract Lens subluxation Glaucoma Loading...1192. A crescendo-decrescendo murmur is heard during systole at the second right intercostal space and radiates to the carotid artery. Which one of the following findings is most likely seen on the chest X-ray? Right ventricular hypertrophy Boot-shaped heart Enlarged cardiac shadow in both directions Left ventricular hypertrophy Loading...1193. Which one of the following drugs belongs to H2 histamine receptor blocker? Nizatidine Ezetimibe Torsemide Atorvastatin Indanyl carbenicillin Loading...1194. Which one of the following neoplasms is the most likely related to HIV infection? Kaposi sarcoma Myelocytic leukemia Hodgkin’s lymphoma Burkitt’s lymphoma Loading...1195. A 12-year-old girl is brought to the emergency room with her parents. Consent form the parents is needed to proceed with the treatment. The parents speak Spanish and very little English. What is the best next step of action? Find any Spanish-speaking person in the clinic to interpret the instructions Speak to the boy to find out if he speaks English, and if he does, explain the instructions to him. Use electronic interpreting device to translate the instructions Try your best to explain the treatment plan to them Loading...1196. Which of the following are the most likely effects of beta blockers on the end-diastolic volume (EDV) and the ejection time (ET)? EDV increases and ET decreases EDV decreases and ET increases Both of them decrease Both of them increase Loading...1197. Which of the following drug prevents bacterial protein synthesis by binding to the 30s ribosomal subunit macrolides tetracyclin penicillin lincosamine Loading...1198. A 37-year-old woman presents to the office for a consultation about family planning. She is married for 11 years and she has never had any extra-marital relationships. They have been tested negative for HIV infection. She hopes to become pregnant and to stop using condoms. She had normal Pap smears for the past 18 years. The last Pap smear was 1 year ago. When does she need to have her next Pap smear? in 1 year in 3 years in 6 months in 2 years During this visit Loading...1199. A drug that effects the thyroid hormone is one of the following? Thyroxine Bumetanide Furosemide Sulbactam A & B Loading...1200. A drug that belongs to thiazolidinediones is one of the following? Pioglitazone A & B Sulbactam Ethacrynic Acid CefazolinPage 49 of 66 Loading...1201. Which of the following is the most likely mechanism of action of hydralazine in treating cardiovascular disorders? Sympathetic antagonism Decreased cardiac preload Parasympathetic stimulation Relaxation of arterial smooth muscle Loading...1202. A 46 year-old man underwent a kidney transplantation last week due to chronic renal failure. The surgery was successful and the transplanted kidney started to produce urine during the operation. Today, his urine examination shows high creatinine and low urinary output. He has no pain or fever. A biopsy taken from the transplanted kidney shows cellular infiltrate . Which of these cells is responsible for this patient’s recent condition? Fibrocytes T-helper cells B Lymphocytes Cytotoxic T cells Plasma cells Loading...1203. Mitochondria are NOT found in which of the following organisms? Fungi Viruses Yeasts Protozoa Loading...1204. A 57 year-old man presents to the ER complaining of sudden dizziness and heart racing for 2 hours. He is a CEO of a big corporation and those symptoms started during a stressful meeting. At first, he felt irregular heartbeats and ignored it but he felt dizzy soon after and his staff drove him to the ER. There is no chest pain, shortness of breath or loss of consciousness. His vital signs are temp 97.8 F, Pulse 138/min and irregular, blood pressure 107/60 and oxygen saturation is 96% on room air. His ECG shows irregular irregularity with absence of P waves. What is the appropriate treatment to improve his symptoms in this current situation? Aspirin Heparin Refer to cardiologist Cardioversion Metoprolol Loading...1205. Which statement is true regarding action of lung surfactant? It affects more large alveoli than sma alveoli It lowers surface tension and decreases compliance It lowers surface tension and increases compliance It elevates surface tension forces and decreases compliance Loading...1206. Which of the following pathological signs is the first visible one in atheroma formation? Calcification Fatty streak Thrombus Hemorrhage Loading...1207. A 16-year-old high school student presents to the office with her mother for consultation. Her mother admits that her daughter is sad because she broke up with her friend recently. Yesterday, she tried to cut her wrist but her brother screamed and they stopped her. The girl does not make eye contact and her head is bent down through the interview. She tells the doctor that she does not want to live anymore. She refuses to answer any question and declined physical examination. What is the most appropriate next step of management for this patient? Advise family that it is a normal reaction and keep an eye on her Refer to the psychiatric clinic next day Prescribe antidepressant and follow up in a week Admit to the hospital Refer to the social worker Loading...1208. A pregnant female presents on her third trimester with painless, bright bleeding without uterine contractions. It stopped after about one hour. Examination of the fetus reveals no distress. Which of the following is the most appropriate next step? Hospitalization and observation until labor Immediate delivery Transabdominal ultrasonography Vaginal examination Loading...1209. A 26-year-old pregnant woman visits her primary care physician for routine examination. Her examination is normal. Her blood group is O, Rh-negative. Administration of which of the following should prevent the development of related fetal complications? Wide spectrum antibiotics Rh (D) immune globulin Ferrous sulfate Folic acid derivatives Loading...1210. What is the most common cause of epididymitis in males older than 35 years of age? Streptococci E Coli Gonococci Chlamydia Loading...1211. A CT scan of the chest shows a focal, wedge-shaped area of hemorrhage in a segment of the lung. Which of the following is the most likely cause of this finding? Atherosclerosis Thrombosis Embolism Arteriosclerosis Loading...1212. A 56 year old man is taken to the emergency room after having grand mal seizure during a staff meeting. He has no history of seizure but he complains lately of recurrent headaches on the morning and decrease in intensity later in the day. Laboratory investigations and imaging studies are performed. Which of these tests will confirm the diagnosis of glioblastoma multiform? CSF analysis MRI of the brain Head CT scan Brain biopsy Loading...1213. Which one of the following is the adverse effect of Heparin? Hypersensitivity Bleeding Thrombocytopenia All of the above Osteoporosis Loading...1214. Which one of the following tests is recommended in follow up for a patient receiving anti-tuberculous treatment (isoniazid and rifampin)? Blood glucose test Renal function tests Liver function tests Amylase and lipase tests Loading...1215. A 26-year-old man presents to the clinic with a complaint of recurrent episodes of bloating, flatulence and diarrhea following eating dairy products. He mentions that he does not experience these symptoms if he does not drink milk or if he is fasting. What is the most likely cause of diarrhea in this patient? Inflammatory Osmotic Psychogenic Secretory Loading...1216. Which of the following drugs is the initial therapy for Alzheimer disease? Carbachol Donepezil Pilocarpine Methacholine Loading...1217. Which one of the following diuretics may elevate blood glucose level in some patients? Acetazolamide Spironolactone Triamterene Hydrochlorothiazide Loading...1218. A 24-year-old woman visits her physician for treatment of anxiety. She requests to change her current medication because it is sedative. Which one of these drugs has the minimum sedative effect? Midazolam Promethazine Lorazepam Buspirone Trazodone Loading...1219. A patient presents with wrist pain at night. It affects his palm, thumb, index and radial half of his ring finger. Flexion of the wrist reproduces the pain. Which of the following is the name of this sign? Wonder sign Chandler sign Tinel sign Phalen sign Loading...1220. Which of the following is the most common cause of congestive heart failure associated with systolic impairment in the United States? Atherosclerosis Alcohol Rheumatic heart disease Diabetes Loading...1221. Onychomycoses is the fungal infection of one of the following? Nails Hair Teeth Skin Loading...1222. A scientific researcher is classifying some drugs according to their actions on different receptors. One of these drugs binds to its receptor without producing any action. Inverse agonist Antagonistis drug should be classified as what? Agonist Partial agonist Loading...1223. A 21-year-old pregnant woman visits her physician for a prenatal visit. Ultrasonography shows neural tube defects. The patient was not compliant with her medications. Assuming that the condition is caused by deficiency of a certain nutrient, which one of these abnormalities would be seen as well? Macrocytic anemia with neurological signs Macrocytic anemia Microcytic anemia Coagulation disorder Normochromic normocytic anemia Loading...1224. Heteroaryl acetic acid drug is following? Nabumetone Tolmetin Indomethacine Ibuprofen Piroxicam Loading...1225. A 65-year-old farmer presents to the clinic for evaluation of a long time lesion on his forehead. During an examination for life insurance, the nurse noticed it and advised him to go to the clinic for evaluation. The lesion is 1.5 in diameter, tan and nodular with an adherent greasy scale. Microscopically, it shows atypical keratinocytes invading the dermis and presence of intercellular bridges between the tumor cells. What is the most likely diagnosis? Basal cell carcinoma Mycosis fungoides Langerhans cell histiocytosis Squamous cell carcinoma Malignant melanomaPage 50 of 66 Loading...1226. Which of the following is the mechanism of action of digoxin to increase cardiac contractility? Inhibition of phosphodiesterase Inhibition of Na/K ATPase Inhibition of Na/Ca ATPase Inhibition of K/Ca ATPase Loading...1227. Which of the following groups of drugs are useful for night terrors and sleepwalking? Alcohols Benzodiazepines Barbiturates Tricyclic anti-depressants Loading...1228. A drug that act as laxative is one of the following? Bumetanide Lactulose Sulbactam A & B Furosemide Loading...1229. A drugs decrease the migration of granulocytes into the effected area Also Block cell division by binding to mitotic spindles? Colchicine Allopurinol Probenecid Sulindac Loading...1230. Prazosin blocks which of the following actions of epinephrine? Bronchodilation High stroke volume Mydriasis Tachycardia Loading...1231. Gluconeogenesis is a metabolic process in which glucose is generated from non-carbohydrate carbon substrates. Which one of the following substrates does NOT share its carbon in glucose skeleton but rather contributes as an energy source for gluconeogenesis? Oxaloacetate Alpha-ketoglutarate Fumarate Acetyl CoA Succinyl CoA Loading...1232. Which of the following characteristics is correct if the drug is highly tissue-bound? Low volume of distribution High metabolic rate Low plasma concentration Low drug dilution Loading...1233. A 9-month-old boy is brought to the pediatrician for persistent cough, poor weight gain, and several bouts of pneumonitis. Upon taking history from his mother, she mentions that her boy had been also having foul-smelling and very large stools for a few months. Which of the following diagnostic techniques will help to provide the correct diagnosis of this condition? CT of the chest Sweat chloride test TB skin test Serum immunoglobulins Loading...1234. Which of the following is a serious complication of ergotamine? Headache Prolonged vasospasm Hypotension Depression Loading...1235. Which of the following medications may cause acute cholestatic hepatitis? Erythromycin Acarbose Colchicine Metformin Loading...1236. Which one of the following drugs prevents the release of Renin and increase in heart rate from sympathetic stimulation? Dobutamine Enalapril Metoprolol Digoxin Loading...1237. Which of the following statements is true about innate immunity? Highly specific and refined over time Its main components are T cells, B cells and circulating antibodies Resistance persists through generations Its main secreted proteins are immunoglobulins Loading...1238. The antimuscarinic drug used for motion sickness as well as for blockage of short-term memory? Phenylephrine Scopolamine Pirenzepine Physostigmine Atropine Loading...1239. A patient comes with constipation, incontinence, and a fall in blood pressure. He is being treated for cardiac arrhythmias. Which drug is most likely related to these complaints? Amiodarone Verapamil Quinidine Propranolol Loading...1240. Which one of the following glucocorticoids is short acting? Betamethasone Prednisone A & B Cortisone Amiloride Loading...1241. Which of the following types of rashes characterizes Lyme disease? Erythema marginatum Erythema multiform Erythematous maculopapular rash Erythema migrans Loading...1242. Echothiophate, which is used mainly for ophthalmic actions inhibits: Catechol-O-methyltransferase (COMT) Acetylcholinesterase Tyrosine hydroxylase DOPA decarboxylase Monoamine Oxidase Loading...1243. A 62-year-old man presents to the clinic with rashes all over his body and painful joints. Last month, he was diagnosed with arrhythmia. He is taking one medication for it. Laboratory tests reveal anti-histone antibodies. Which of the following drugs is most likely responsible for this condition? Metoprolol Hydralazine Propranolol Sotalol Verapamil Loading...1244. A 55 year-old man presents to his physician complaining of sinusitis, chest pain and productive cough for 2 weeks. His sputum is mixed with blood. He also has pain and swelling of hands and feet for 3 months. On examination, he has synovitis of proximal interphalangeal joints of both hands. His laboratory tests reveal anemia, elevated ESR, elevated creatinine and positive c-ANCA. Urinalysis shows red blood casts and proteinuria. Chest x-ray shows multiple nodules in both lungs. What is the most likely diagnosis? Miliary tuberculosis Acute glomerulonephritis Rheumatoid arthritis Wegener granulomatosis Systemic lupus erythematosus Loading...1245. A 19-year-old woman presents with nausea and vomiting. Her last menstrual period was 6 weeks ago. Which of the following is the best next step in management? Beta-HCG Urinalysis Complete blood count Serum electrolytes Loading...1246. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? A & B Miconazole Ethambutol Ibandronate Flucytosine Loading...1247. Which one of the following substances induces the closure of patent ductus arteriosus? Ibuprofen Indomethacin Prostaglandin E Estradiol Loading...1248. Which one of the following macrolide drugs has a half-life of >40 hours? Telithromycin Azithromycin Clarithromycin Erythromycin Loading...1249. Which one of the following drugs causes inhibition of viral neuraminidase? Oseltamivir A & C Zanamivir Ribavirin Amantadine A & B Loading...1250. A middle aged woman is evaluated for gait problems. On examination, her ability to touch her nose while her eyes closed fails and so, touching the heel of one toe to the toe of the other. Which of the following locations is the most likely affected? Ankle and elbow joints Cerebellum Parietal lobe Frontal lobePage 51 of 66 Loading...1251. In which one of the following locations a mural thrombus commonly occurs following myocardial infarction? Left atrium Left ventricle Right atrium Right ventricle Thoracic aorta Loading...1252. A 27-year-old man complains of 2-week history of watery diarrhea and 5 lb. weight loss. He had no similar episodes in the past, did not travel recently, did not eat out or take antibiotics. He quit smoking last month after 1 PPD for 5 years. His family history is significant of some relatives who are diagnosed with inflammatory bowel syndrome. His examination reveals diffuse mild abdominal tenderness and hyperactive bowel sounds. Stool analysis is negative for blood and ova. What is in the history and/or examination could support the diagnosis of ulcerative colitis rather than Crohn’s disease in this patient? Smoking cessation History of diarrhea and weight loss Negative stool analysis Having first attack in his twenties Family history of inflammatory bowel syndrome Loading...1253. Which of the following are the characteristics of Dressler’s syndrome? Stasis, hypercoagulability and endothelial damage Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) Hypotension, distant heart sounds and jugular vein distention (JVD) Loading...1254. Which of the following drugs is most likely protective against the toxicity of doxorubicin? Dexrazoxane Mensa Vitamin C Leucovorin Loading...1255. Which of the following proteins in the serum transport drugs? Organic anion polypeptides Alpha-1 acid glycoprotein A & B Albumin All of the above Loading...1256. A 25-year-old man is brought by police for screaming and attaching neighbors. His temperature is 102.4 F, his respiratory rate is 30/min, his pulse is 110/min, his blood pressure is 170/90 and his pupils are dilated. He suddenly becomes unresponsive and requires resuscitation. Which of the following substances is most likely was taken? Ethanol Morphine Heroin Cocaine Loading...1257. Deficiency of which of the following enzymes is associated with von Gierke’s disease? Phosphofructokinase-1 Hexosaminidase A Glucose-6-phosphatase α-1,4-phosphorylase Loading...1258. Which one of the following medications causes black stools? Buspirone Iron Ampicillin Propranolol Loading...1259. A 2-month-old child is brought to the clinic by his parents with a complaint of failure to thrive. During an examination, the baby suffers a seizure. Test of stat serum chemistries indicates hyperlipidemia, severe hypoglycemia, ketosis, and lactic acidosis. Hepatomegaly is also confirmed by both physical examination and CT scan. Which of the following conditions is the child suffering from based on these findings? Niemann-Pick disease Von Gierke disease Pompe disease Gaucher disease Loading...1260. Which of the following conditions could be a serious side effect of sumatriptan? Cutaneous flushing Dilated cardiomyopathy Coronary vasospasm Torsades de pointes Loading...1261. Which of the following is the most frequent and irreversible side effect of typical anti-psychotics? Akathisia Tardive dyskinesia Anxiety Dystonia Loading...1262. A 17-year-old male student presents to the clinic with episodes of starring with lip smacking. He reports that he became unresponsive when he has these episodes. These episodes last for 1-2 minutes and he feels confused when he retains his consciousness. General, neurological examinations and EEG are normal. What is the most likely diagnosis? Simple focal seizure Myoclonic seizure Tonic-clonic seizure Complex focal seizure Absence seizure Loading...1263. Which of the following drug belongs to lincosamide antibiotics? Clindamycin Linezolid Sulbactam Ciprofloxacin Oxytetracycline Loading...1264. Risk of rupture of abdominal aortic aneurysm (AAA) is increased by all the following factors EXCEPT? Smoking Male gender Uncontrolled hypertension Increased aortic wall stress Loading...1265. Which of the following benefits is achieved as a result of adding progesterone to estrogen in HRT? Decrease the effect of estrogen on the breast Decrease the occurrence of endometrial cancer Decrease bone resorption Increase the effect of estrogen on the heart Loading...1266. A 54 year old man visits his physician for evaluation of low back pain. He has a history of lung cancer and he receives a combination of radiation and chemotherapy. His back pain started 3 months ago and now he complains of numbness and tingling in his lower limbs. What is the most likely cause of this patient’s back pain? Paraneoplastic disease Primary osteosarcoma Muscular spasm of paravertebral muscles Metastases to the vertebral column Loading...1267. Which of the following medications is considered irreversible alpha receptor antagonist? Prazosin Tolazoline Phenoxybenzamine Labetalol Loading...1268. Stimulation of muscarinic receptors by pilocarpine is competitively inhibited by which of the following medications? Pralidoxime Edrophonium Physostigmine Atropine Loading...1269. What is the most common cause of hypertension in young women? Rheumatic heart disease Atherosclerosis Oral contraceptive pills Cardiomyopathy Loading...1270. Which of the following conditions is most likely caused by over-secretion of growth hormone in adults (acromegaly)? Gastric adenocarcinoma Hypothyroidism Malignant melanoma Carpal tunnel syndrome Loading...1271. In a case of Barrett esophagus, the normal tissue of the distal part of the esophagus is transferred into which of the following type of tissues? Keratinized squamous epithelium Ciliated columnar epithelium Non-ciliated columnar epithelium Non-keratinized squamous epithelium Loading...1272. A 78 year-old patient is admitted to the hospital for treatment of pneumonia. On the third day, the nurse noticed that his heart rate is 150/min. and blood pressure is 116/86 mmHg. The patient is stable with no chest pain or shortness of breath. His ECG shows saw tooth pattern with no other abnormalities. What is the most appropriate next step of management of this patient? Start heparin Order cardiac enzymes Refer to a cardiologist Perform electric cardioversion Start metoprolol Loading...1273. Outpatient prophylaxis of superior ventricular tachycardia (SVT) is best accomplished by which of the following medications? Procainamide Adenosine Diltiazem Lidocaine Loading...1274. Which of the following drug belongs to Osmotic Diuretic? Urae Oxacillin Ampicillin Cefoxitin Niacin Loading...1275. A 20-year old female student represents with a 1-week history of nausea, vomiting and anorexia. She returned 2-weeks ago from a trip to Guatemala. On physical examination, her temperature was 100.3 F, clear chest and she has mild jaundice and a palpable tender liver. Her CBC was normal and her liver function tests are as follows: Serum total bilirubin 3.1 mg/dL. Serum aspartate aminotransferase 1100. Serum alanine aminotransferase 1900. Serum alkaline phosphatase 112. What is the most likely lab test to confirm your diagnosis? IgM antibody to hepatitis A virus Antibody to hepatitis B surface antigen DNA for Epstein-Burr virus Serum anti-mitochondrial antibodies Antibody to hepatitis C virusPage 52 of 66 Loading...1276. A 51-year-old man is brought to the emergency room because of severe abdominal pain which is radiating to his back. Today, the patient had many episodes of vomiting. He is an alcoholic, drinking daily but he does not smoke or take any recreational drugs. On physical examination, the patient is lying down in the fetal position and appearing to be ill and febrile. There is also an area of bluish periumbilical discoloration on the skin of his abdomen. However, there is no flank discoloration. There are also reduced bowel sounds and he is having severe mid epigastric tenderness upon palpitation. The rectal examination is normal. What is your primary diagnosis? Necrotizing pancreatitis Appendicitis Pyelonephritis Acute cholecystitis Loading...1277. A 45-year-old man is rushed to the emergency room having severe headaches and recurrent fever started 1 week ago, a week after he came back from a trip to Africa. Physical examination reveals high fever and splenomegaly. Brain imaging reveals signs of cerebral involvement. Which of these following parasites is likely causing the patient’s symptoms? Plasmodium malariae Plasmodium falciparum Plasmodium vivax Babesia microti Loading...1278. A person who is a bus driver suffering from seasonal allergy. To relieve his seasonal allergy which drug is the drug of choice for this bus driver? Triplodine Cyproheptadine Promethazine Loratadine Carbinoxamine Loading...1279. Which form of dosage has a high rate of bioavailability? Syrup Tablet Control released drugs Suspension Capsules Loading...1280. A 22-year-old man visits the clinic for evaluation of fever, headache and dry cough for 7 days. His medical history is unremarkable and he takes no medications. He had no previous similar episodes. On examination, temperature is 101.3 F, pulse is 88/min. and blood pressure is 100/60 mmHg. On auscultation, his lungs are clear bilaterally. X-ray shows diffuse infiltration in the lower lobes of both lungs. What is the most likely causative organism? Mycobacteria Streptococci Fungi Mycoplasma Rickettsia Loading...1281. A 22-year- old man presents to the emergency room complaining of sudden onset of shortness of breath and palpitation for 2 hours. He had similar episodes in the past which resolved by breath holding. His past medical, surgical and family histories are unremarkable. He takes no medication. ECG reveals supraventricular tachycardia. Carotid massage on the right side fails to subside this attack. What is the most likely next step in management? IV lidocaine Try carotid massage on the left side IV procainamide IV adenosine IV succinylcholine Loading...1282. Histamine Receptor found on the mucus layer causing the production of gastric acid secretion is the following? H⁴ histamine receptor H⁵ Histamine receptor H³ histamine receptor H² histamine receptor H¹ histamine receptor Loading...1283. A 3-month-old girl is brought to the clinic due to weakness and pallor for one week. History claims that she was born after premature delivery. She is normal in development and growth. She is breastfed and her immunizations are up to date. What is the most appropriate treatment? Vitamin C supplement Iron supplement Vitamin D supplement Milk formula instead of breastfeeding Loading...1284. Rapid Acting Insulin is one of the following? Glulisine Glargine NPH Regular Loading...1285. Which one of the following anti-arrhythmic drugs may lead the development of torsade de pointes at therapeutic doses? Adenosine Lidocaine Propranolol Quinidine Loading...1286. Which one of the following reactions occurs between five days and three months after transplant? Chronic rejection Delayed rejection Hyperacute rejection Acute rejection Loading...1287. Which of the following is the main reaction of hepatic cytochrome P-450 in metabolism? Binding with glucuronic acid Hydroxylation Methylation Binding with glutathione Loading...1288. Sensations to the external auditory meatus is innervated by which of the following nerves? Auriculotemporal nerve Facial nerve Vagus nerve Great auricular nerve Loading...1289. Which of these medications is the most appropriate treatment of malignant hyperthermia? Dantrolene Acetaminophen Ibuprofen Indomethacin Loading...1290. Blockage of ɑ1 and ɑ2 adrenergic receptors on the arteriolar beds lead to following? Reduce peripheral resistance Increase renin secretion Increase peripheral resistance None Increase renin secretion Loading...1291. A 23-year-old man who takes anti-mycobacterial therapy for pulmonary tuberculosis presents to the clinic because of recent visual disturbance and pain with movement of his left eye. On examination, there is tenderness to the pressure of the left eye and a blind spot at the center of vision. Fundus examination reveals pale optic disc. What is the most likely etiology of this patient’s visual symptoms? A side effect of isoniazid A side effect of ethambutol A side effect of rifampin A side effect of pyrazinamideAs a complication of tuberculosis Loading...1292. A 1-day old full term baby of a 23-year old mother who was delivered yesterday by normal vaginal delivery is coughing, choking and ejecting the formula from his nose and mouth. He also turns blue during feeding. What is the primary diagnosis of this boy? Imperforate anus Pyloric stenosis Tetralogy of Fallot Tracheomalacia Tracheoesophageal fistula Loading...1293. Which one of the following drugs may cause parkinsonism-like adverse effect? Olanzapine Quetiapine Haloperidol Clozapine Loading...1294. Elevation of which one of the following substances in blood occurs due to reduced renal blood flow? Renin Ammonia Calcium Cholesterol Loading...1295. A drug that Increases the cell permeability allowing more Flucytosine to penetrate the cell? Nystatin Caspofungin Amphotericin B Ketoconazole Loading...1296. Intramuscular vitamin B12 should be prescribed after gastrectomy. Which of the following gastric cells is responsible for this replacement treatment? G cells Chief cells Goblet cells Parietal cells Loading...1297. Which one of the following is the best treatment of trigeminal neuralgia? Methylphenidate Fluoxetine Carbamazepine Riboflavin Loading...1298. A 34 year-old man with one week history of sore throat presents today for fever, hoarseness, difficulty breathing and drooling. On physical examination, his temperature is 102.3f and has inspiratory stridor. What is the most preferred next action for this patient? Admit to the intensive care unit Throat swab and culture Prescribe broad spectrum antibiotic Serology for infectious mononucleosis Ultrasonography of the neck Loading...1299. Which of the following organisms is responsible for the development of oral hairy leukoplakia in HIV patients? Candida albicans Epstein-Barr virus Human papilloma virus Bartonella henselae Loading...1300. CLASS II drugs of the Antiarrhythmic drugs interfere with one of the following options? Ca+ channel blockers Na+ channel blockers Beta adrenoceptors Blockers K+ channel blockersPage 53 of 66 Loading...1301. Which of these medications is the drug of choice in treatment of severe digitalis intoxication? Propranolol Calcitonin Bupropion Immune Fab Loading...1302. A disease that is characterized by the movement of gastric contents from the stomach into the esophagus? Dyspepsia GERD A & B Peptic Ulcer disease Loading...1303. Cardiac glycosides are used in the treatment of congestive heart failure and atrial fibrillation. Given the differences between the cardiac glycosides in their length of action and organs of major excretion, the correct statement concerning the use of digitoxin is: digitoxin has a much higher incidence of toxicity in patients with renal disease gastrointestinal absorption of digitoxin is incomplete and highly variable within patients digitoxin is only available as an oral preparation digitoxin is excreted primarily unchanged in the kidney with a half-life of about 24 hours digitoxin is highly protein-bound in the serum Loading...1304. A 12-year-old girl visits her physician for follow up after treatment with methotrexate for acute lymphoblastic leukemia. Stool analysis reveals blood in stool. Her platelet count is very low. Which of these substances should be administered immediately? Leucovorin Penicillamine Deferoxamine Amitriptyline AVitamin K Loading...1305. A 42-year-old man complains of rash and itching. He has no fever, headache or myalgia. On examination, there is maculopapular rash on the abdomen, palms of the hands and soles of the foot. There are also hypertrophic wart-like lesions around the anal area. Cervical, occipital and inguinal lymph nodes are enlarged. CBC shows marked increase in lymphocytes. What is the most appropriate laboratory test to confirm his diagnosis? Nucleic acid amplification test for chlamydia Biopsy of the anal lesions Stool and urine analysis Serology for Human papilloma virus VDRL for syphilis Loading...1306. Which of the following drug is Cholinergic agonist used for diagnosis of myasthenia gravis as well as an antidote for tubocurarine? Atropine Piruterol Tyramine Atracurium Edrophonium Loading...1307. Which one of the following substances is used to differentiate between central and nephrogenic diabetes insipidus? Cosyntropin Dexamethasone Cortisol Desmopressin Loading...1308. A 31-year-old pregnant woman presents to her physician on her second trimester for a prenatal checkup. She works at a big farm. She has no concerns except for some mild swellings on her neck. On physical examination, her vital signs are within normal limits. She has mild cervical lymphadenopathy. She is prescribed an oral antibiotic but she is noncompliant. Her child is delivered with hydrocephalus and intracranial calcifications. Which organism is the most likely responsible? Treponema pallidum Toxoplasma gondii Herpes simplex virus Togavirus Trypanosoma cruzi Loading...1309. A 57 year-old man presents to the ER complaining of sudden dizziness and heart racing for 2 hours. He is a CEO of a big corporation and those symptoms started during a stressful meeting. At first, he felt irregular heartbeats and ignored it but he felt dizzy soon after and his staff drove him to the ER. There is no chest pain, shortness of breath or loss of consciousness. His vital signs are temp 97.8 F, Pulse 138/min and irregular, blood pressure 107/60 and oxygen saturation is 96% on room air. His ECG shows irregular irregularity with absence of P waves. What is the appropriate treatment to improve his symptoms in this current situation? Cardioversion Heparin Metoprolol Aspirin Refer to cardiologist Loading...1310. Which one of the following conditions most likely shows lower than normal erythrocyte sedimentation rate (ESR)? Polycythemia Pregnancy Multiple myeloma Giant cell arteritis Loading...1311. What is the correct match regarding the genetic transmission of the following diseases? Hypophosphatemic rickets- X-link recessive Duchenne muscular dystrophy- X-link dominant Leber hereditary optic neuropathy- Mitochondrial inheritance Huntington’s disease- Autosomal recessive Loading...1312. A 14-year-old student is brought to the emergency room complaining of severe abdominal pain. Diagnostic tests reveal high serum levels of δ-aminolevulinate and porphobilinogen and low level of uroporphyrinogen I synthetase in urine. Given the above test results, which of the following symptoms would be presented in this case? Polyphagia Stiff neck Neuropsychiatric disturbances Hypotension Loading...1313. Which one of the following drugs is a Meglitinide drug? Indanyl carbenicillin Ezetimibe Fenofibrate Repaglinide Hydrochlorothiazide Loading...1314. Which one of the following drugs is a proton pump inhibitor drug? Cimetidine Sucralfate Rabeprazole Misoprostol Loading...1315. Which of the following statements is true about live attenuated vaccine? No booster is needed for live attenuated vaccines It is mainly used for immunocompromised patients They only induce humoral immunity Close contacts of influenza patients can be safely vaccinated with live attenuated vaccine Loading...1316. Which one of the following valve abnormalities is related to intravenous drug abuse? Aortic stenosis Tricuspid regurgitation Mitral stenosis Aortic regurgitation Loading...1317. Following statements about the use of Metformin in wrong? Discontinued in women with a SCr> 1.4 Cause Vit. B12 depletion Don't use in alcoholic patients Cause renal impairment Loading...1318. Which one of the following disease is caused by bite of infected ticks? Rocky mountain spotted fever Mycoplasma Pneumonia Lyme disease Cholera Loading...1319. Which of the following is the main site of action of HMG-CoA reductase inhibitors? Liver Blood Kidney GI tract Loading...1320. Which of the following is a contraindication of use of benzodiazepines in anxiety disorder? Smoking Sleep apnea Seizures Diabetes mellitus Loading...1321. A 1-year-old girl is brought to the pediatrician by her parents due to poor growth and skeletal abnormalities. Laboratory investigations show microcytic anemia and higher concentration of hemoglobin A2. Which is the most likely diagnosis? Iron deficiency β-thalassemia Lead poisoning Sickle cell anemia Loading...1322. An autopsy of an adult shows enormous cardiomyopathy, high level of cardiac deposition of glycosphingolipids and restricted cardiocytes. Which of the following lipid storage disease is most likely the correct diagnosis? Fabry’s disease Gaucher’s disease Tay-Sachs disease Niemann-Pick disease Loading...1323. Which of the following is/are the most likely biopsy features seen in Celiac disease? Lymphoid aggregates with granulomas Lack of ganglion cells Crypt abscesses with excess neutrophils Flattening of villi with excess lymphocytes Loading...1324. Consumption of which of the following products most likely reduces the risk for coronary heart disease in susceptible patients? Sugar-free snacks Saturated fat Beef products Fish oils Loading...1325. Which of the following drugs acts directly on dopamine receptors to improve the effects of Parkinson’s disease? Carbidopa Amantadine Selegiline BromocriptinePage 54 of 66 Loading...1326. What is the antidote of Verapamil? Atropine Both C & D can be used Calcium Pyridostigmine Epinephrine Loading...1327. Which one of the following drugs is associated the most to tardive dyskinesia after use for years? Aripiprazole Chlorpromazine Olanzapine Risperidone Loading...1328. An 82 year-old woman who underwent right knee replacement yesterday develops new symptoms. Right after surgery, she was agitated, awake all night and refused to eat or take postoperative medications. Today she is still agitated and not oriented to time and place. What is the most appropriate management at this point? Diphenhydramine to enhance sleeping Restrain in bed and lorazepam administration Sleep enhancement protocol and family support as well as haloperidol administration Refer to psychiatry department Restrain in bed and haloperidol administration Loading...1329. Which of the following is Sulphamoyl Derivative diuretic drug? Ethacrynic Acid Bumetanide Hydrochlorothiazide Chlorthalidone Metolazone Loading...1330. A drug used in severe DIGITALIS toxicity is the following drug? DIGIBIND Calcium Gluconate Amyl Nitrate Fomepizole Loading...1331. A 64 year-old woman complains of continuous chest pain for 20 minutes. It started suddenly during a stressful meeting. Her pain is dull, aching in nature and 9/10 in severity. She had several episodes of chest pain in the past that starting after exertion and resolving by rest. She was diagnosed with type 2 diabetes and hypertension 8 years ago. Her pulse is 98/min., regular and blood pressure is 160/100. ECG shows T inversion in leads II, III and AVF. Cardiac enzymes are negative. Echocardiography shows no wall motion abnormalities and ejection fraction of 65%. What is the most appropriate immediate treatment of this patient? Cardiac catheterization Tissue plasminogen activator (tPA) Ibuprofen Coronary angioplasty Enoxaparin Loading...1332. Which one of the following statements about the use of Labetalol is incorrect? Doesn't cause reflex tachycardia 3-6 hours duration of action Used as I.V infusion in emergency Selective Beta-1 blocker Loading...1333. A 68 year-old man with a long history of poorly controlled diabetes presents to his physician complaining of pain and drainage in his left ear. His vital signs are within normal limits. The pinna of his left ear is tender. The external meatus is swollen and covered with purulent drainage. What is the most likely organism responsible for his condition? Streptococcus pneumoniae Candida albicans Pseudomonas aeruginosa Haemophilus influenzae Moraxella catarrhalis Loading...1334. Carbonic anhydrase enzyme is present in the epithelial cells of one of the following part functional zones of the nephron? The descending loop of Henle The ascending loop of Henle The distal convoluted tubules The proximal convoluted tubules The collecting tubule and duct Loading...1335. Blanching and sloughing of skin is the adverse effect of one of the following Direct acting adrenergic agonists? Epinephrine Dobutamine Dopamine Isoproterenol Norepinephrine Loading...1336. A 23-year-old man visits his physician for routine examination. He has a history of HIV infection for 3 months and he is compliant with his medications. He is concerned about developing AIDS. Which of the following is the most useful test to address his concern? HIV p24 antigen CD4 lymphocyte count HIV antibody test HIV RT PCR Loading...1337. Beta-Blocker drug is following? Atropine Tamsulosin Succinylcholine Acetylcholine Esmolol Loading...1338. Which one of the following is the most common cause of microcytic hypochromic anemia in a patient diagnosed with progressive renal failure? Frequent hematuria Iron deficiency anemia Erythropoietin deficiency Blood loss Loading...1339. The functions of insulin include the following except one? increase breakdown of fat to Ketone bodies Cellular Uptake of plasma glucose Uptake of Amino acids into a cell inhibit the production of glucose from the liver Loading...1340. Mechanism of action of Aspirin is following? Inhibit COX-1 Inhibit COX-2 Inhibit ADP mediation Inhibit glycoprotein receptors Decrease Calcium levels Loading...1341. Which one of the following drugs is a natural penicillin with a property of high acid stability than other naturally occurring penicillin? Amoxicillin Penicillin G Methicillin Penicillin V Loading...1342. Which one of the following drugs belongs to drugs for hepatic viral infections? Aluminium hydroxide Indanyl carbenicillin Ezetimibe Capreomycin Entecavir Loading...1343. A 45 year-old man presents with progressive burning epigastric pain. He smokes and drinks alcohol socially. Physical examination, laboratory tests and imaging studies confirm the diagnosis of peptic ulcer. He is prescribed omeprazole. What is the effect of this medication that improves this condition? Neutralization of gastric acid Anti-cholinergic effect Inhibition of H+/K+ ATPase pump Forming a layer to protect gastric mucosa Blocking of H2 receptor Loading...1344. Which of the following is the drug of choice of anaphylactic shock? Diphenhydramine Dopamine Adrenaline Phenylephrine Loading...1345. Chemotherapeutic agents use may result in the loss of individual neoplastic cells through which of the following mechanisms? Apoptosis Acute inflammation Phagocytosis Coagulative necrosis Loading...1346. Which of the following conditions is characterized by the presence of periventricular calcified densities on brain imaging? Huntington’s disease Toxoplasmosis Cytomegalovirus infection Down syndrome Loading...1347. Paget disease of bone is characterized by which one of the following features? Decrease osteoclastic activity Increase osteoblastic activity only Increase osteoclastic activity only Increase both osteoblastic and osteoclastic activity Loading...1348. Which of the following medications is selectively used in NSAID-induced gastric ulcer? Cimetidine Misoprostol Famotidine Bismuth Loading...1349. Administration of which one of the following medications can lead to the development of hemolytic anemia? Verapamil Hydralazine Propranolol Quinidine Loading...1350. EXPLANATION: It is positive in this patient. Tinel sign is reproduction of pain by tapping or percussion on the medial nerve. Cervical spine x-ray Anti-cyclic citrullinated peptide Rheumatoid factor Erythrocyte sedimentation rate (SER)Page 55 of 66 Loading...1351. Which of the following conditions may occur as a result of a long umbilical cord? Placenta previa Abruptio placenta Nuchal cord Amnion nodosum Loading...1352. Failure of degeneration of the urachus may lead to which of the following defects? Renal agenesis Polycystic kidney disease Bladder adenocarcinoma Bladder exstrophy Loading...1353. Which one of the following local anesthetics that causes local vasoconstriction and may leads to hypertension? Cocaine Tetracaine Lidocaine Etidocaine Loading...1354. Which of the following side effects is most likely associated to spironolactone? Metabolic alkalosis Hyperglycemia Hypercalcemia Hyperkalemia Loading...1355. Which of the following are the major sites for heme synthesis? Bone marrow and liver Kidney and spleen Bone marrow and kidney Bone marrow and spleen Kidney and liver Loading...1356. Which one of the following macrolide drugs has a short half-life of 2 hours? Azithromycin Erythromycin Clarithromycin Telithromycin Loading...1357. Which of the following conditions most likely be presented with primary amenorrhea? Pregnancy Turner syndrome Pituitary adenoma Loading...1358. A 27 year-old woman presents to the clinic complaining of fatigue and constipation. She also notes recent cold intolerance and dry skin. Her obstetric history is significant for a full term vaginal delivery 6 months ago. Her past medical history is unremarkable except for fine tremors and mild palpitations 3 months ago that resolved spontaneously. On examination, her temperature is 97.3 F, her pulse is 54/min, her blood pressure is 120/80 and her thyroid gland is enlarged and not tender. Her thyroid panel shows low T4 and elevated TSH. What is the most likely effective treatment of this condition? Surgery and life-long levothyroxine Begin radioactive iodine Life-long levothyroxine Supportive treatment until it resolves Begin methimazole therapy Loading...1359. Which one of the following parts of the cell is the site of steroid synthesis? Peroxisome Rough endoplasmic reticulum Golgi apparatus Smooth endoplasmic reticulum Loading...1360. When you suggested to a mother to vaccinate her child with MMR on scheduled basis, she refused for religious belief. What is the most appropriate nest step? Obtain a court order Explain to her with documentation the benefits and risks of immunization Report her to health authorities Proceed with immunization Loading...1361. Which of the following substances is responsible for growth of the prostate at puberty? Dihydrotestosterone Estrogen Progesterone Testosterone Loading...1362. A 2-week-old boy is brought for persistent vomiting of non-bilious material after feeding. The boy is lysergic and dehydrated. Examination reveals presence of an olive-sized mass in the epigastric area moving with peristalsis. What is the most likely diagnosis? Esophageal atresia Duodenal atresia Meckel’s diverticulum Pyloric stenosis Loading...1363. Which one of the following antipsychotics has higher affinity to both dopamine and serotonin receptors? Thioridazine Haloperidol Fluphenazine Clozapine Loading...1364. Which of the following locations is the most common site of mural thrombus following myocardial infarction? Left ventricle Right ventricle Aorta Right atrium Loading...1365. The therapeutic indication of Clomiphene drug specifically is to treat the following disease? Thromboembolic disease Treat osteoporosis Fluid retention Induce ovulation Estrogen-dependent Breast Cancer Loading...1366. A 12-year-old boy frequently experiences severe asthmatic attacks and becomes cyanotic, dyspneic, and agitated. Which of the following agents would be most likely used to prevent these attacks? Epinephrine Scopolamine Atropine Cromolyn sodium Loading...1367. Which of the following drug is the Antidote of Isoniazid? Amyl Nitrate Digibind Pyridoxine N-acetyl-cysteine Loading...1368. Which one of the following neurologic drugs can cause diplopia, thickened gums and hirsutism? Phenobarbital Carbamazepine Phenytoin Valproic acid Loading...1369. Which of the following correctly describes permissive drug interaction? Presence of drug A is required for full effect of drug B Effect of drug A and drug B is equal to the sum of their individual effectsich of the following drugs is the effective treatment of benzodiazepines toxicity? Decrease in response of a drug after repeated administration Effect of drug A and drug B is greater than the sum of their individual effects Loading...1370. Which one of the following amines is permanently charged? Secondary Tertiary Quaternary Primary Loading...1371. Which one of the following parts of the cell is the site of steroid synthesis? Rough endoplasmic reticulum Smooth endoplasmic reticulum Peroxisome Golgi apparatus Loading...1372. The effect of medications on parasympathetic function declines slowly in which one of the following organs? Glands Smooth muscles Eye Heart Loading...1373. Which one of the following drugs is a Substrate of the P-GP (glycoprotein) efflux pumps? All of the above Erythromycin Digoxin Amiodarone A & B Loading...1374. Which one of the following is a fatal complication of multiple long bone fractures in a young age? Deep venous thrombosis Pericardial effusion Thromboembolism Fat embolism Loading...1375. Which of the following is the most significant action of monoamine oxidase A? Metabolism of norepinephrine, serotonin and tyramine Metabolism of dopamine Metabolism of serotonin and epinephrine Metabolism of serotonin and dopaminePage 56 of 66 Loading...1376. A toddler swallowed a coin. Which of the following is the most common site of impaction of this coin? Ileocecal junction Transverse colon Stomach Esophagus Loading...1377. A 69-year-old man presents to the clinic with his wife for evaluation of his memory problem. His wife tells you that her husband has begun to forget recent events insidiously since last year. He forgets recent conversations and recent appointments. He is no longer able to manage his checkbook and daily budget as he used to do. He has no history of general medical condition and he only takes baby aspirin daily. His examination is normal. Mini mental status examination reveals prominent memory loss. MRI shows a few areas of cerebral atrophy. Which of the following is the most likely diagnosis? Lewy body dementia Vascular dementia Old age dementia Creutzfeldt-Jakob disease Alzheimer’s disease Loading...1378. A 2-year old girl is presented with rectal bleeding. Her mom noticed blood in her BM yesterday and was worried about it and she decided to go to your clinic to examine her daughter. There is mild pain, not related to meals. No nausea or vomiting. The girl is healthy and her routine physical examination 2 months ago was normal. You perform a biopsy and the histopathology of the affected part shows mixed gastric and intestinal tissues. Which of the following is the most likely diagnosis? Diverticulitis Appendicitis Intussusception Volvulus Meckel’s diverticulum Loading...1379. Which of the following is the currently drug of choice for the treatment of cutaneous anthrax? Azithromycin Gentamicin Ciprofloxacin Penicillin Loading...1380. Which of the following markers identifies B lymphocytes in a blood sample treated with different fluorescent-labeled antibodies? CD8 CD3 CD4 CD19 Loading...1381. A 39-year-old woman presents with an inflamed ulcer on the sole of her foot not healed for 2 months. Peripheral sensations are reduced bilaterally. Elevation of which of the following laboratory tests most likely explains this condition? Urinary sodium Alanine aminotransferase (ALT) Serum creatinine Blood glucose Loading...1382. A 58-year-old woman is brought to the emergency room complaining of lightheadedness for 4 hours. She has diarrhea with loose stool for 2 days. She explains her symptoms as flu and she drinks lots of water as her neighbor advised her to avoid dehydration. Her physician told her that she should take combined solution of sodium chloride (NaCl) and glucose to prevent dehydration. What is the mechanism of action of this mixture to improve dehydration? Glucose provides energy for NaCl to increase gastric emptiness The mixture helps to increase secretion of water and Na through the large intestine It reduces bowel contractions and consequently improves diarrhea Cotransport of glucose and NaCl across the intestinal membrane facilitates absorption of water Loading...1383. The gland responsible for secretion of prolactin is derived from which of the following structures? Neurohypophysis Primordial follicle Infundibulum Rathke’s pouch Loading...1384. Which of the following medications may cause acquired angioedema within days to weeks after starting it? Benazepril Propranolol Aspirin Clopidogrel Loading...1385. Which of the following should be added to premature infants of breast-feeding mothers after 2 month of age? Vitamin C Iron Zink Copper Loading...1386. A 62-year-old woman is noted to have open-angle glaucoma. She inadvertently applies excessive pilocarpine to her eyes. This may result in which of the following? Mydriasis Bronchial smooth muscle dilation Dilation of blood vessels Decreased gastrointestinal motility Constipation Loading...1387. A 58-year-old woman was hospitalized for 10 days after cholecystectomy. Today, examination reveals swelling and tenderness of her right leg. Diagnosis of femoral vein thrombosis is confirmed. Which of the following is the precipitating factor most likely contributes to this condition? Surgical complication Immobilization Effect of medications Septicemia Loading...1388. Which one of the following types of cells is programmed to destroy cells the fail to display MHC class 1 antigen properly? CD4 lymphocyte Natural killer cells CD8 lymphocyte B lymphocyte Loading...1389. Which of the following anticoagulant medications works by binding to thrombin and inhibiting it? Hirudin Warfarin Heparin Ticlopidine Loading...1390. Proliferation of endometrial glands results from stimulation by which one of the following hormones? Androgen Progesterone Estrogen Follicle stimulating hormone Loading...1391. Which one of the following medications inhibits cell wall synthesis of bacteria? Erythromycinotein Synthesis Inhibitors: Aminoglycosides, Tetracyclines, Spectinomycin, Erythromycin, Lincomycin, Clindamycin and Chloramphenicol. Clindamycin Carbapenem Aminoglycoside. Loading...1392. A drug that is more effective in combination with itraconazole to treat chromoblastomycosis? Nystatin Griseofulvin Amphotericin B Flucytosine Loading...1393. Which one of the following naturally occurring penicillins has a higher minimum bactericidal concentration and can't be used for bacteremia? Penicillin G Methicillin Penicillin V Amoxicillin Loading...1394. A drugs inhibit the urate-anion exchanger in the proximal tubules that mediates urate reabsorption? Probenecid Allopurinol Sulindac Colchicine Loading...1395. A patient comes to a rural hospital one hour after he experienced excruciating chest pain. After workup, you diagnose his case as myocardial infarction. The nearest hospital is 2-hour away. What is the best next step? Transfer to the nearest hospital Consult a cardiologist Administer thrombolytic now Loading...1396. During development, hypothalamus arises from which one of the following structures? Telencephalon Mesencephalon Metencephalon Diencephalon Loading...1397. Which one of the following drugs is effective against prolactin-secreting tumors? Bromocriptine Prazosin Adrenaline Chlorpromazine Loading...1398. Which of the following is the most common cause of nasal obstruction and bleeding in adolescents? Nasal cancer Papilloma Nasal polyps Angiofibroma Loading...1399. A 21 year old college student was playing basketball with his friends when he fell on his outstretched right hand with the palm down. He stood up and continued playing. After 2 days, he felt swelling and tenderness of his right palm without any deformity. On examination, there is tenderness to deep palpation on the snuff box of this right hand. What is the most likely diagnosis of this patient? First metacarpal bone fracture Scaphoid fracture Colles fracture Tear of opponens pollicis Loading...1400. Which of the following anti-retroviral treatments is a non-competitive reverse transcriptase inhibitor? Zidovudine Nevirapine Didanosine SaquinavirPage 57 of 66 Loading...1401. Which of the following is the most common primary disturbance of acid-base balance in pregnant women? Metabolic acidosis Respiratory acidosis Metabolic alkalosis Respiratory alkalosis Loading...1402. A 43-year-old man visits his physician concerned about finding traces of bright red blood on toilet paper after he wipes. His stool has normal color and not mixed with blood. His medical and surgical histories are unremarkable. He has no family history of colon cancer. What is the most appropriate next step in management? Colonoscopy Anoscopy Sigmoidoscopy Fecal occult blood test Barium enema Loading...1403. Which of the following is the mechanism of action of the main drug used for the treatment of high LDL cholesterol? Inhibition of HMG-CoA reductase Decreased synthesis of LDL receptors Inhibition of cholesterol uptake by the liver Breakdown of adipose tissues Loading...1404. Long Acting Insulin is one of the following? Glulisine NPH Glargine Aspart Loading...1405. A 24 year old medical student visits her physician for a refill of her treatment of depression. She is prescribed imipramine, a tricyclic antidepressant. During discussion of the treatment, her physician mentions that this drug undergoes first pass hepatic metabolism. The prescribed drug is most likely administered by which route? Intramuscular Oral Subcutaneous Sublingual Intravenous Loading...1406. A 73-year old man is brought to the emergency room for dizziness and nystagmus. Examination reveals loss of sensation on the left side of his face and the right side of his body. He has hoarseness of voice and drooping of his right eyelid. The right side of the face is drier than the left side. He is referred for CT scan on his head. What is the site of lesion responsible for hoarseness of this patient? Lateral spinothalamic tract Inferior cerebellar peduncle Nucleus Ambiguus Spinal nucleus of fifth cranial nerve Loading...1407. Which one of the following medications inhibits fibrinolysis? Lepirudin Heparin Aminocaproic acid Rifampin Loading...1408. A 2-year-old boy originally from Egypt is diagnosed with anemia after he took antibiotics for the treatment of otitis media. He has two brothers and one sister. One of his brothers was diagnosed with anemia when he was two years old. His parents were given a list of food and drugs that could be associated with this type of anemia. What is the mode of inheritance of this condition? Autosomal recessive Multifactorial Mitochondrial Autosomal dominant X-linked recessive Loading...1409. Drug distribution into tissues depends mostly on which of the following? Binding to plasma protein Rate of absorption Tissue receptors Interaction with other drugs Loading...1410. A 55 year-old man underwent internal fixation of fractured femur after a motorcar accident and massive bleeding 24 hours ago. He was stable after the surgery and his urine output was normal after he received intravenous fluids. Now he complains of substernal chest pain and shortness of breath. On examination, His temperature is 98.8 F, Pulse is 110/min, blood pressure is 160/100 mmHg and his respiratory rate is 24/min. There is no jugular vein distention. His extremities have established pulses bilaterally and good perfusion. Auscultation reveals harsh systolic murmur across the precordium and crackles on both lung bases. ECG shows sinus tachycardia with delayed precordial transition and no other changes. Laboratory tests including cardiac enzymes are all normal. What is the most likely diagnosis? Hypertrophic cardiomyopathy Septic shock Pericardial effusion Acute myocardial infarction Left bundle branch block Loading...1411. A 56-year-old man with a history of type 2 diabetes presents to his physician for a follow up. He complains of recurrent hypoglycemic reactions to his medications. Which of these medications is most likely responsible for this patient’s hypoglycemic reactions? Glucagon Acarbose Metformin Rosiglitazone Glyburide Loading...1412. One of the following statements is false about the functions of epinephrine? Bronchodilation Strengthen the contractility of the myocardium Increase in systolic blood pressure Hyperglycemic effect Increased blood supply to the kidney Loading...1413. Disease prevalence can be measured by which one of the following studies? Cross-sectional study Adoption study Case-control study Cohort study Loading...1414. Which of the following conditions should be screened at the age of 50? Lung cancer Colon cancer Adrenal insufficiency Prostate cancer Loading...1415. Epinephrine acts to dilate bronchial smooth muscle through which one of the following receptors? Beta-1-adrenoreceptors Alpha-1-adrenoreceptors Beta-2-adrenoreceptors Alpha-2-adrenoreceptors Loading...1416. Which of the following statements correctly describes the relative risk of a study? Risk of developing disease in the exposed group divided by risk in the unexposed group The difference in risk between exposed and unexposed groups Odds that the group with a disease was exposed to a risk factor divided by odds that the group without the disease was exposed The proportion of risk reduction attributable to the intervention as compared to a control Loading...1417. Which of the following drug is a derivative of Enolic acid? Etodolac Mefenamic Acid Piroxicam ketorolac Diflunisal Loading...1418. What is the most appropriate treatment of organophosphate poisoning? Pralidoxime Hexamethonium Pyridostigmine Morphine Loading...1419. Which of the following drug contain the Sulfahydril group in the structural formula? Enalapril Lisinopril Quinapril Ramipril Captopril Loading...1420. Which one of the following is a anterior pituitary hormone? Desmopressin Torsemide Somatostatin Fenofibrate Atorvastatin Loading...1421. Which of the following is the checkpoint in cell development that is affected by ionizing radiation? G0/G1 G1/S G2/M S/G2 Loading...1422. Which of the following is the most common cause of acute mesenteric ischemia? Mesenteric vein thrombosis Embolism Vascular autoimmune disease Abdominal aortic aneurysm Loading...1423. A 52-year-old alcoholic man complains of painful lesions on his tongue and inside his mouth. He also has hyper-pigmented scales on his face and both hands. He is weak, forgetful and suffers of burning sensation in several parts of his body. He mentions that he has diarrhea for the last two months. Deficiency of which of these vitamins is responsible for this patient’s condition? Folic acid Vitamin D Vitamin B3 (niacin) Vitamin C Vitamin A Loading...1424. An 18 year-old student visits her physician for a routine physical examination. She has no complaints. Physical examination is unremarkable except for a mid-systolic click followed by a late systolic murmur heard at the lower left sternal border and apex. The murmur duration increases in standing and shortens with squatting. Electrocardiogram (ECG) shows no abnormalities. Which of the following is the most likely diagnosis of this condition? Tricuspid regurgitation Dilated cardiomyopathy Aortic stenosis Mitral valve prolapse Mitral stenosis Loading...1425. Which one of the following is a anterior pituitary hormone? Atorvastatin Urofollitropin Torsemide Desmopressin FenofibratePage 58 of 66 Loading...1426. A drug that belongs to Loop Diuretics is one of the following? A & B Sulbactam Cefazolin Ethacrynic Acid Doripenem Loading...1427. Which of the following drug are Nonsteroidal antiestrogens? Estrogen Estradiol Estradiol acetate Exemestane Tamoxifen Loading...1428. Directly acting cholinergic agonist drug? Echothiophate Tacrine Pilocarpine Acetylcholine A & B Loading...1429. One of the following statements about the sympathetic neurons is wrong? Originated from Efferent autonomic system Preganglionic neurons originated from Lumber Preganglionic neurons originated from thoracic Postganglionic neurons innervate tissues Preganglionic neurons are Long Loading...1430. A 24 year old medical student visits her physician for a refill of her treatment of depression. She is prescribed imipramine, a tricyclic antidepressant. During discussion of the treatment, her physician mentions that this drug undergoes first pass hepatic metabolism. The prescribed drug is most likely administered by which route?ugs administered by intramuscular, intravenous, subcutaneous and sublingual routes reach the blood stream first before they are metabolized by liver enzymes. Intramuscular Oral Intravenous Sublingual Loading...1431. Which of the following types of necrosis occurs in abscesses and brain infarcts? Liquefaction necrosis Caseous necrosis Fibrinoid necrosis Coagulative necrosis Loading...1432. A drug that act as laxative is one of the following? Furosemide A & B Bumetanide Sulbactam Magnesium hydroxide Loading...1433. Which of the following drug is Leukotriene Antagonist? Salbutamol Sodium Cromoglycate Ipratropium Bromide Terbutaline Montelukast Loading...1434. A cytokine that enhances the activity of NK cells and attracts neutrophils and macrophages? Interferon gamma Tissue necrosis factor-alpha Interleukin-2 Interleukin-1 Loading...1435. Gray baby syndrome is the adverse effect of the following drug? Clindamycin Chloramphenicol Linezolid Quinupristin Loading...1436. Mechanism of action of repaglinide? Insulin sensitiser DPP-IV inhibitor GLP-1 agonist Insulin secretagogue A-glucosidase inhibitor Loading...1437. Which one of the following medications inhibits protein synthesis by binding to 50S subunit and preventing the formation of the initiation complex? Linezolid Azithromycin Clindamycin Minocycline Loading...1438. Which of the following conditions is considered a physiological change for normal pregnancy? Decreased respiratory tidal volume Decreased blood volume Decreased GI tone and motility Decreased body weight Loading...1439. Which of the following substances is used in mercury poisoning? Methylene blue Succimer Flumazenil Fomepizole Loading...1440. Albumin quantitatively a primary protein in serum is synthesized by? Lungs Intestine Kidney Liver Brain Loading...1441. A 12-year-old boy with a history of cystic fibrosis develops dyspnea, cough and fever. His temperature is 103.1 F, his pulse is 120/min and his oxygen saturation is 85%. Lung examination reveals bilateral rhonchi. What is the appropriate antibiotic treatment? Ceftazidime Ampicillin Ceftazidime and gentamicin Vancomycin Ampicillin and gentamicin Loading...1442. Which one of the following antibacterial drugs is a protein synthesis inhibitor drug? Cefuroxime Chloramphenicol Aztreonam Vancomycin Loading...1443. Thrombosis of the appendicular artery is significant due to compression by inflammatory edema. This artery arises directly from which of the following arteries? Right colic artery Superior mesenteric artery Inferior mesenteric artery Ileocolic artery Loading...1444. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Capecitabine Naftifine Miconazole Ibandronate Voriconazole Loading...1445. Which one of the following medications has a significant alpha-adrenergic blocking activity? Chlorpromazine Clozapine Risperidone Haloperidol Loading...1446. A 70-year-old man develops chest pain 2 days after hip replacement. Which is the most likely diagnosis? Myocardial infarction Cor pulmonale Bundle branch block Pulmonary embolism Loading...1447. The vitreous chamber of the eye is located between which of the following structures of the eye? The cornea and the retina The lens and the retina The iris and the lens The cornea and the iris Loading...1448. Acute decrease in response to a drug after initial or repeated intake is known as which of the following drug interactions? Additive Tachyphylactic Synergetic Permissive Loading...1449. Which one of the following drugs causes a non-productive cough? Somatostatin Atorvastatin Captopril Torsemide Desmopressin Loading...1450. Which of the following is the next step to investigate oliguria in a catheterized patient? Measure urine specific gravity Measure serum creatinine Start intravenous fluids Irrigate the catheterPage 59 of 66 Loading...1451. Which one of the following structures provides the majority of noradrenergic innervation to the cerebral cortex? Substantia nigra Locus coeruleus Raphe nucleus Caudate nucleus Loading...1452. Which drug belongs to the Quinoline methanol antimalarial class? Quinidine Pyrimethamine Chloroquine Mefloquine Quinine Loading...1453. Which one of the following statements about the use of Fenoldopam is wrong? Increase renal perfusion Useful in Glaucoma Lowers blood pressure Dopamine-1 receptor agonist Loading...1454. Serotonin Receptor linked with nausea and emesis? 5HT³ 5HT4 5HT5 5HT² 5HT¹ Loading...1455. A 68-year-old woman presents to her physician with a complaint of urinary incontinence. She is a nursing home resident and her staff tells you that the patient feels desire to void but she cannot hold it to the restroom. She has no pain, dysuria or hematuria. She has a long history of hypertension and she takes metoprolol and hydrochlorothiazide. Which of the following is the most appropriate first step of management? Refer to a urologist Discontinue metoprolol Try timed voiding Prescribe tolterodine therapy Discontinue hydrochlorothiazide Loading...1456. Which one of the following agents is used to eradicate the organism's (Phthisis pubis) extraerythrocytic phase? Quinacrine Pyrimethamine Chloroguanide Chloroquine Primaquine Loading...1457. Which one of the following medications inhibits HMG-CoA reductase? Aspirin Simvastatin Tacrolimus Digoxin Loading...1458. Aminoglycosides inhibit protein synthesis through targeting which of the following? 30S ribosomal subunits RNA polymerase Peptidoglycan units mRNA Loading...1459. Immune-related problem is one of the following? Fever Aids Headache High Blood pressure Loading...1460. Which one of the following drugs is a sodium channel blocker (Class I)? Amiodarone Carvedilol Procainamide Verapamil Loading...1461. Which one of the following drugs is a Thiazide Diuretic? Fenofibrate Ezetimibe Atorvastatin Chlorthalidone Indanyl carbenicillin Loading...1462. Which of the following drugs is neuraminidase inhibitor drug? Miconazole Zanamivir Ibandronate Naftifine Capecitabine Loading...1463. An old man complains of progressive back pain and joints pain for 10 years. There is enlargement in distal interphalangeal joints, osteophytes on the vertebral bodies and sclerosis with narrowing of multiple joint spaces. What is your diagnosis? Rheumatoid arthritis Gout Osteoarthritis Osteomyelitis Loading...1464. Which one of the following can be found in sickle cell disease? Bite cells Spherocytes Schistocytes Howell-Jolly bodies Loading...1465. A 40-year-old man with a long history of intravenous drug addiction presents to the emergency room complaining of fever, anorexia, malaise, shortness of breath, cough and chest pain for 2 days. On physical examination, temperature is 102.7 F, Pulse is 110/min. and blood pressure is 110/66. Irregular erythematous nodules are seen on his hands and feet. Which of the following is most likely valvular lesion associated with this infection? Mitral valve stenosis Aortic valve stenosis Tricuspid valve regurgitation Pulmonic valve stenosis Mitral valve regurgitation Loading...1466. Which of the following is characteristic of Hodgkin lymphoma and differentiates it from non-Hodgkin lymphoma? Peripheral nodes are most likely involved Affects mostly old age Reed-Sternberg cells Associated with HIV and autoimmune disease Loading...1467. A) Bupropion Ethosuximide Methylphenidate Haloperidol Loading...1468. Which one of the following drugs belongs to alkylating agent? Indanyl carbenicillin Lamivudine Dacarbazine Gemcitabine Capreomycin Loading...1469. Which of the following drug is a derivative of Fenamic acid? Diflunisal Piroxicam Etodolac ketorolac Mefenamic Acid Loading...1470. Which of the following substances is elevated due to vitamin B12 deficiency? Cyanocobalamin Homocysteine Hemosiderin Folic acid Loading...1471. Which one of the following inhibit the excretion of Indomethacin, naproxen, and ketoprofen? Allopurinol Sulfinpyrazone Probenecid Colchicine Loading...1472. A 29 year-old man presents to his physician complaining of fatigue and lethargy for the past 3 days after he came back from a hiking trip in Northern California. During the trip, he noticed a rash on his left arm. The rash was smaller but now it’s expanding in size. On examination, the rash looks round with central clearing. What is the most likely organism involved in this condition? Meningococci Treponema pallidum Rickettsia prowazekii Staphylococcus aureus Borrelia burgdorferi Loading...1473. Which of the following drug belongs to Sulfonylureas? Cefoxitin Urae Oxacillin Niacin Glimepiride Loading...1474. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Capreomycin Ezetimibe Lamivudine Capecitabine Indanyl carbenicillin Loading...1475. A 30-year-old man presents to the emergency room with excruciating chest pain and shortness of breath for an hour. Past, surgical and familial histories are unremarkable except that his father died of heart attack at the age of 32. Imaging studies and laboratory tests confirm the diagnosis of myocardial infarction. What is the most likely precipitation factor contributing to his condition? Atherosclerosis Familial hypercholesterolemia Type II diabetes Alcohol abusePage 60 of 66 Loading...1476. Which of the following is the enzyme responsible for conversion of testosterone into dihydrotestosterone (DHT)? 3-beta-hydroxylase 5-alpha-reductase 17 alpha-hydroxylase Aromatase Loading...1477. Which of the following drug is a derivative of salicylic acid? Mefenamic Acid Piroxicam Etodolac Diflunisal ketorolac Loading...1478. A 56- year-old man visits his physician complaining of lower back pain for 1 week. He was moving to a new house and carrying a lot of furniture during the last 2 weeks. He does not remember any injury or trauma to his back. His pain is not radiating, improving by rest and ibuprofen and worsening by movement. Medical, surgical and family histories are unremarkable. On examination, vital signs are within normal limits. There is a diffuse tenderness over the lumbar area. Neurological examination is normal. Laboratory tests are normal. What is the most appropriate next step of management for this patient? Complete bed rest with ibuprofen for 3 days X-ray of lumbar spine Electromyography HLA-B27 testing Refer to a rheumatologist Loading...1479. - - - disease is inherited disorder of copper metabolism characterized by reduced serum copper & increased cincentration of copper in brain & viscera wilsons disorder restless legs syndrome parkinsons disorder Gout Loading...1480. Injury of which of the following nerves caused loss of sensation of the palmar surface of the lateral three and half digits and the lateral part of the palm? Axillary nerve Median nerve Ulnar nerve Radial nerve Loading...1481. A 32-year-old man with a history of HIV infection presents to the clinic complaining of fecal urgency and bloody diarrhea. The patient was diagnosed with pneumocystis jiroveci pneumonia 6 months ago. Which of these organisms is the most likely involved in this condition? cytomegalovirus Giardia lamblia Entamoeba histolytica Clostridium difficile Loading...1482. An 80 mg dose of a drug was administered to a patient. 40 mg was eliminated during the first hour. This drug follows first-order elimination kinetics. Which of the following is the amount of the drug remains 3 hours after administration? None 20 mg 10 mg 30 mg Loading...1483. Which one of the following arteries is most likely affected in a case of expressive aphasia? Anterior cerebral Vertebral Middle cerebral Posterior cerebral Loading...1484. A 77-year-old man presents to the emergency room with a complaint of retention of urine. Carbachol is administered to stimulate bladder emptying. Which of the following is a prominent side effect of carbachol? Dilation of the pupils Delirium Dry skin Excessive salivation Tachycardia Loading...1485. What is the most appropriate next step in management of a patient complaining of symptoms of GERD? Omeprazole Ranitidine Barium swallow Endoscopy Loading...1486. Coagulation factor VIII is produced by which of the following cells? Hepatic cells Juxtaglomerular cells Splenic macrophages Endothelial cells Loading...1487. Which one of the following statements about the use of the metformin is incorrect? Decrease intestinal absorption of glucose Promote glucose uptake Promote insulin secretion Inhibit hepatic glucose output Potential for lactic acidosis Loading...1488. A middle aged male represents with an edematous circular skin lesion of black eschar. Which of the following bacteria is the most likely the causative organism of this condition? Bacillus anthracis Streptococcus viridans Staphylococcus aureus Pneumonitis aeruginosa Loading...1489. A 57-year-old man with a long history of type 2 diabetes visits the clinic for follow up. He takes metformin, aspirin and pravastatin. His blood pressure was high in the last 2 visits. He made lifestyle changes in the form of diet and exercise but they did not help in lowering his blood pressure. His BMI is 25% and his blood pressure today is 150/92 mmHg. What is the most appropriate treatment for this patient’s hypertension? Minoxidil 30 mg daily Continue lifestyle modification for 3 months Lisinopril 10 mg daily Metoprolol 25 mg daily Hydralazine 50 mg daily Loading...1490. A disease characterized as recurrent and persistent abdominal discomfort and abdominal pain? Dyspepsia GERD Peptic Ulcer disease A & B Loading...1491. Which of the following hormone belongs to the oral diabetic agent? Oxytocin A & B Somatrem Furosemide Glimepiride Loading...1492. Which of the following is the most common complication of otitis media? Drum perforation Hearing loss Meningitis Brain abscess Loading...1493. A fenamic acid derivative of Nonsteroidal anti-inflammatory drugs also called? N-arylanthranilic acids Oxicam Propionic acid Salicylates Acetic acid Loading...1494. An athletic girl presents with amenorrhea for 3 weeks. Pregnancy test is negative and her vital signs are within normal limits. Which is the most likely cause of this amenorrhea? Testosterone deficiency Estrogen deficiency Progesterone deficiency Thyroid hormone deficiency Loading...1495. Which of the following is a major complication of central retinal veins occlusion? Cataract Retinal detachment Glaucoma Lens subluxation Loading...1496. Which of the following leads to toxic reactions when a drug is taken repeatedly? Absorption disorder Cumulative action Tolerance Tachyphylaxis Loading...1497. Which of the following substances lines the vesicles that involved in LDL uptake by hepatocytes? Chylomicrons Laminin Clathrin Transferrin Loading...1498. Secretion of which one of the following hormones is decreased due to renal failure? Thyroxin Erythropoietin Insulin Glucagon Loading...1499. Indirect acting irreversible cholinergic agonist drug? Tacrine Pilocarpine Echothiophate Neostigmine Loading...1500. Which one of the following dermatologic disorders presents with a herald batch and a Christmas tree pattern? Psoriasis Bullous pemphigoid Pityriasis rosea Pemphigus vulgarisPage 61 of 66 Loading...1501. Which one of the following drugs is a calcium channel blocker (Class IV)? Amiodarone Procainamide Verapamil Carvedilol Loading...1502. Which of the following medications is a non-drowsy anti-allergic medication? Loratadine Diphenhydramine Cetirizine Chlorpheniramine Loading...1503. A college student presents to the emergency room with burns involving about 10% of his body surface and localized to his upper chest and right arm. His vital signs are within normal limits. The lesions are painful, erythematous and swollen. Application of pressure produces blanching and is painful. Which of the following is the best next step in management? Admission to hospital Cleaning, dressing and analgesics Surgical debridement and grafting Broad spectrum antibiotics Loading...1504. A patient presents with vomiting, diarrhea and abdominal cramps a few hours after a picnic. Which is the causative organism? Clostridium difficile E-coli Staphylococcus aureus Streptococcus pyogenes Loading...1505. A 62-year-old woman with a history of type 2 diabetes complains of nausea and bloating for the last three months. Gastric emptying studies confirm the diagnosis of diabetic gastroparesis. What is the first line therapy for this patient? Clindamycin Omeprazole Sodium bicarbonate Metoclopramide Ondansetron Loading...1506. Androgen is released from which part of the adrenal medulla? Zona fasciculate Zona reticularis All of these Zona glomerulosa A & B Loading...1507. Which one of the following drugs is a calcium channel blocker (Class IV)? Amiodarone Procainamide Verapamil Carvedilol Loading...1508. A 65 year-old farmer presents to your clinic complaining of shortness of breath for 6 months. Last 2 weeks he noticed that he has to get up several times during the night to be able to breath. He proudly tells you that he had never visited a doctor before although he smokes and drinks every night. On physical examination, there is displaced point of his maximum impulse, rales over both lungs and enlarged liver. Echo shows both right and left ventricular dilation and EF 30%. Laboratory test are normal except high bilirubin, AST 245 and ALT 180. What is the initial cause of this patient presentation? High cholesterol Chronic hypertension Alcohol Smoking Lyme disease Loading...1509. Which of the following is the main action of carbidopa when it is used in combination with levodopa in the management of Parkinsonism? It reduced levodopa side effects such as hypotension It inhibits the conversion of levodopa to dopamine peripherally It increases the absorption of levodopa It increases the permeability of blood-brain barrier to levodopa Loading...1510. Which of the following is most likely associated with normal vaginal pregnancy after a previous cesarean section (CS)? Previous CS is performed due to arrest of cervical dilation Previous CS is performed due to prolonged second stage Previous CS is performed due to breech presentation Previous CS is performed due to unknown cause Loading...1511. Which of the following drugs causes peripheral edema? Labetalol A & B Oxytocin Somatrem Amlodipine Loading...1512. Epinephrine acts on which one of the following receptors to constrict vascular smooth muscle? β2-Adrenoceptors α2-Adrenoceptors α1-Adrenoceptors β1-Adrenoceptors Loading...1513. Which one of the following antibiotics is the empiric treatment of cellulitis in a diabetic patient? Imipenem Neomycin Vancomycin Amoxicillin Loading...1514. Ketorolac is derived from which of the following class? Fenamic acid derivative Acetic acid derivative Propionic acid derivative Enolic acid derivative Salicylic Acid derivatives Loading...1515. A 45-year-old woman visits her physician with a complaint of pain and fatigue in her wrist and hand for 6 weeks. MRI confirms the diagnosis of carpal tunnel syndrome. What is the structure that forms the anterior wall of the carpal tunnel? Extensor retinaculum Skin Superficial fascia Palmer aponeurosis Flexor retinaculum Loading...1516. Which one of the following statements about the use of Diclofenac is incorrect? Accumulate in synovial fluid Excrete out by the kidney Also used for ankylosis spondylitis Less potent than Naproxen Loading...1517. Which of the following is the appropriate treatment of a moderate case of acne vulgaris? Oral isotretinoin Benzyl peroxide Oral antibiotic and topical therapy Topical antibiotic Loading...1518. A young boy presents with multiple skin lesions for more than a year. He is sensitive to sun and biopsies of some of his lesions show squamous cell carcinoma. Which of the following mutations is most likely present in this condition? Nonsense mutation Thymidine dimers Missense mutation Point mutation Loading...1519. An 80-year-old man is diagnosed with severe atherosclerosis. He has been a heavy smoker for 62 years and also has a long history of hypercholesterolemia. Atherosclerotic occlusion of which of these arteries will cause insufficient perfusion of the urinary bladder? Internal iliac Lateral sacral Inferior epigastric External iliac Loading...1520. Which of the following is the role of infliximab in the management of rheumatoid arthritis? It is a TNF-alpha receptor antagonist It is a TNF-alpha receptor agonist It neutralizes the activity of TNF-alpha by binding to soluble forms of it Inhibition of dihydrofolate reductase Loading...1521. Which one of the following drugs is used for subcutaneous and systemic mycoses? Butoconazole Griseofulvin Econazole Itraconazole Loading...1522. An obese 46-year-old man presents to the clinic with complaints of weakness, fatigue and tingling and numbness of his hands and feet. He rarely exercises and he eats almost daily in fast food restaurants. Laboratory tests show fasting blood glucose of 156 mg/dL. He is advised to improve his lifestyle and follow up in 2 weeks. On the next visit, the level of blood glucose is 164 mg/dL. Which of these drugs improves his condition without affecting insulin secretion? Carbetamide Metformin Tolazamide Glyclopyramide Glipizide Loading...1523. Counterregulatory hormone in diabetes that works against insulin include the following? Cortisol Growth hormone All of the above Catecholamines Glucagon Loading...1524. Drug-to-drug interaction based on absorption, transformation, distribution and excretion is considered which one of the following types of interaction? Pharmacodynamic interaction Chemical interaction Pharmaceutical interaction Pharmacokinetic interaction Loading...1525. Which of the following type of virus causes chickenpox? A & B Cytomegalovirus Herpesvirus Orthomyxoviruses Varicella zosterPage 62 of 66 Loading...1526. A drug induces rapid depolarization of the membrane inhibiting the intracellular synthesis of DNA, RNA, and protein? Daptomycin Vancomycin Aztreonam Imipenem Loading...1527. Which of the following enzymes is markedly elevated in primary biliary cirrhosis? Alanine aminotransferase (ALT) Acid phosphatase Aspartate aminotransferase (AST) Alkaline phosphatase Loading...1528. Which one of the following glucocorticoids can cause sodium and water retention? Betamethasone Cortisol Triamcinolone Dexamethasone Loading...1529. Unilateral or bilateral sweating is the symptom of one of the following types of headache? Tension-Type Headache Cluster Headache A & B Migraine Headache Loading...1530. A 24-year-old woman visits her physician for consultation about human papillomavirus (HPV) vaccine. She has been sexually active since she was a senior in high school with multiple partners. She had her last Pap smear last year and it was normal. On examination, there are multiple vaginal non-tender wart-like projections. What is the best advice concerning HPV vaccine to this patient? She can only take the vaccine later after full recovery She already has HPV infection so, no need for the vaccine No need for the vaccine as long as Pap smear is normal She already has HPV infection but she should take the vaccine for other strains of HPV HPV vaccine is essential to treat the current infection Loading...1531. A 55-year-old woman presents to the emergency room for a cut wound on her hand. While she was cutting a piece of meat, she lost control of the knife resulting in a longitudinal wound in her hand. Bleeding stopped after a few minutes. Now she is concerned about tetanus vaccination. Records show that she received all the doses of tetanus-diphtheria (Td) and the last one was 4 years ago. What is the appropriate therapy for prophylaxis of tetanus in this patient? Tetanus toxoid and tetanus immunoglobulin Tetanus immunoglobulin Tetanus toxoid followed by tetanus immunoglobulin after 5 days Tetanus toxoid No further therapy Loading...1532. Autonomic nervous system is the part of? Central nervous system Spinal cord Brain Peripheral nervous system Somatic nervous system Loading...1533. Which of the following chemotherapeutic agents is specific for the M phase of the cell cycle? Vincristine Mechlorethamine Daunorubicin Hydroxyurea Cytarabine Loading...1534. Which of the following correctly describes pleiotropy? One gene contributes to multiple phenotypic effects Not all individuals with mutant genotype show the same mutant phenotype Increased severity of a disease in succeeding generations Phenotype is always the same among individuals having the same genotype Loading...1535. A 16-year-old high school student presents to the office with her mother for consultation. Her mother admits that her daughter is sad because she broke up with her friend recently. Yesterday, she tried to cut her wrist but her brother screamed and they stopped her. The girl does not make eye contact and her head is bent down through the interview. She tells the doctor that she does not want to live anymore. She refuses to answer any question and declined physical examination. What is the most appropriate next step of management for this patient? Prescribe antidepressant and follow up in a week Advise family that it is a normal reaction and keep an eye on her Refer to the social worker Refer to the psychiatric clinic next day Admit to the hospital Loading...1536. A 65-year-old man is scheduled for a repair of an abdominal hernia. The patient has an abdominal hernia that can be reduced by pushing the contents of the abdomen back through the external ring. While performing the repair, the surgeon observes that the hernial sac is protruding from the superior abdominal wall to the inguinal ligament. It is also medial to the inferior epigastric vessels. After observing all these, what can be concluded about the type of a hernia the patient is suffering from? Direct inguinal hernia Indirect inguinal hernia Hiatal hernia Femoral hernia Loading...1537. One of the OATPs (Organic anion transporting polypeptides) drugs transporters OATP4C1 has a mainly limited distribution to the following? Kidney Liver Stomach Skin Heart Loading...1538. Which of the following is the main mechanism of action of methylergonovine in treating postpartum hemorrhage? Instant blood coagulation Strong vasoconstriction Forceful contraction of myometrium Blocking sympathetic stimulation Loading...1539. A 70-year-old woman, having had an appendectomy 25 years ago, is brought to the emergency room with severe abdominal pain. The patient describes the pain as being crampy and colicky. She also says that the pain seems to increase and then improve on its own. She has already vomited 10 times since the pain started in the morning. She has also not had a bowel movement since last 2 days or passed flatus in last couple of days. Physical examination shows that the abdomen is distended slightly. Auscultation of the abdomen shows peristaltic rushes and high-pitched bowel sounds. Tympanic abdomen is revealed during percussion. The patient is also diffusely tender with palpitation but there is no rebound tenderness. Rectal examination also shows an absence of stool. What would be the likely diagnosis? Intestinal obstruction Diverticulitis Pancreatitis Gastroenteritis Loading...1540. Which one of the following statements about the functions of histamine is incorrect? increase peripheral resistance Cause itching and pain Constriction of bronchioles Stimulate gastric acid secretion Loading...1541. Which of the following effects is caused by alcohol intake? Increased body temperature Increased body heat loss No effect on body temperature or body heat loss Decreased body heat loss Loading...1542. A 4-year-old boy is brought to his physician by his mother. She is worried and tells you that her son is weak and not growing properly. He chews his fingers and lips constantly and seems to enjoy it. On examination, there is marked loss of tissues on his fingers and lips. His serum and urine levels of uric acid are both high. What is the most likely diagnosis of this condition? Hurler syndrome Galactosemia Gaucher disease Tay-sachs disease Lesch-Nyhan syndrome Loading...1543. During newspaper delivery, a boy walked into the Out Patient Department (OPD) with a history of having palpitations since morning. His pulse and heart rate were difficult to count. He was immediately shifted to the Intensive Care Unit (ICU) and an urgent electrocardiogram (ECG) was taken which showed narrow complex tachycardia with a heart rate of 194 per min and absence of P waves. His blood pressure was 100/73 mmHg. He was comfortable at rest with no distress and not in cardiac failure. Carotid sinus massage was tried, which failed to convert Supraventricular Tachycardia. He was diagnosed with paroxysmal supraventricular tachycardia. Which of the following drugs would you think is the drug of the first choice in this situation? Amiodarone Verapamil Lidocaine Adenosine Propranolol Loading...1544. Na+ channel blockers belongs to the one of the following CLASS of Antiarrhythmic drugs? CLASS IV CLASS I CLASS II CLASS III Loading...1545. Carbonic anhydrase enzyme is present in the epithelial cells of one of the following part functional zones of the nephron? The distal convoluted tubules The collecting tubule and duct The proximal convoluted tubules The ascending loop of Henle The descending loop of Henle Loading...1546. Which one of the following types of cell secretions involves exocytosis? Holocrine secretion Apocrine secretion Merocrine secretion Loading...1547. Which of the following is the mechanism of action of ciprofloxacin? Interferes with bacterial cell wall synthesis Inhibits bacterial protein synthesis through binding with 30 S Interferes with bacterial metabolic production Inhibits DNA gyrase and relaxation of DNA Loading...1548. A week old female presents for her first checkup. Examination reveals jaundice and splenomegaly. Laboratory investigations show: Total bilirubin level: 27 mg/dL Direct bilirubin: 0.6 mg/dL Hgb: 10.1 g/dL Reticulocytes: 6% A blood smear shows burr cells and spherocytosis. Which of these tests will be positive in this patient? Acid hemolysis test Coomb’s test Schilling test Metabisulfite test Osmotic fragility test Loading...1549. Which one of the following conditions is characterized by high blood pressure, hypokalemia and elevated renal potassium? Fanconi syndrome Tay-sachs disease Waardenburg syndrome Liddle syndrome Loading...1550. An anticancer agent 6-mercaptopurine metabolism disturbed by following drug due to which dose is reduced? Allopurinol Sulfinpyrazone Probenecid ColchicinePage 63 of 66 Loading...1551. Which of the following is higher in athletics than in non-athletics in resting conditions? Oxygen consumption Stroke volume Heart rate Cardiac output Loading...1552. A drug that is a part of Macrolide is following? Azithromycin Cefepime Cefaclor Cefdinir Loading...1553. A patient with acute appendicitis complains of abdominal pain. Which of the following chemical mediators are responsible for this pain? Histamine and serotonin Leukotriene and interlukin-1 Prostaglandin and bradykinin Tumor necrosis factor and IgG Loading...1554. Para-aminophenol derivative drug is the following? Meloxicam Celecoxib Acetaminophen Mefenamic acid None of these Loading...1555. Which of the following is the best therapy for essential tremors? Haloperidol Physiotherapy Propranolol Metoclopramide Loading...1556. Which one of the following complications is the common cause of death in acromegaly? Renal failure Hepatic failure Heart failure Splenic infarction Loading...1557. Which one of the following fungistatic drugs has a half-life of 30 hours? Voriconazole Ketoconazole Posaconazole Fluconazole Loading...1558. A 32-year-old woman who is recently divorced visits her physician for visual disturbances. The patient complains of trouble vision for 3 days. On examination, tunnel vision is detected along with marked weakness of planter flexion although the patient can walk on her tiptoes without any complaint. All laboratory tests and imaging studies are normal. What is the most likely diagnosis of this patient? Multiple sclerosis Transient ischemic attack Meningioma Conversion disorder Loading...1559. A drug that belongs to Loop Diuretics is one of the following? Sulbactam Doripenem Cefazolin A & B Bumetanide Loading...1560. Which one of the following is the main mechanism of absorption of most drugs in the gastrointestinal tract (GIT)? Passive diffusion Endocytosis and exocytosis Facilitated transport Pinocytosis Loading...1561. Which one of the following drugs is a Tetracycline? Demeclocycline Cefadroxil Cefepime Cefdinir Loading...1562. A 40-year-old man who works in a manufacture of explosives presents to the clinic for a routine physical examination. Medical history reveals that the patient experiences episodes of headache and palpitation every Monday. Physical examination, laboratory tests and ECG show normal results. The patient questions if the chemicals related to his job could be responsible for his symptoms. Which is the appropriate response for this question? Yes. They are related to withdrawal of chemical and may lead to massive heart attack Yes. They are related to exposure to a chemical and may lead to renal failure No. They are not related to exposure because the symptoms occur on Monday after weekend No. They are not related to exposure because they are episodic Loading...1563. A 19-year-old man with a history of immunodeficiency disease develops fever. Prophylactic measures including some medications are initiated. A few days later, the patient develops acute renal failure. Which of these drugs is most likely responsible? Ciprofloxacin Acyclovir Nystatin Ampicillin Amphotericin B Loading...1564. A patient requires quinidine to treat his atrial arrhythmia, which of the following drugs should be administered prior to it to prevent the deleterious effects? Acetaminophen Mexalitine Amiodarone Digoxin Loading...1565. A 48 year-old man, who visited his daughter in London last week, complains of sudden severe pain and swelling in his right leg during his flight back to the USA. He is taken to the hospital and ultrasound is performed. It reveals femoral vein thrombosis. What is the most likely contributed to this finding? Alcohol abuse Immobilization Hypertension Hypothyroidism Daily aspirin Loading...1566. Which one of the following glucocorticoids is long acting? Cortisone Amiloride Betamethasone A & B Prednisone Loading...1567. A 57 year-old man presents to the ER complaining of sudden dizziness and heart racing for 2 hours. He is a CEO of a big corporation and those symptoms started during a stressful meeting. At first, he felt irregular heartbeats and ignored it but he felt dizzy soon after and his staff drove him to the ER. There is NO chest pain, shortness of breath or loss of consciousness. His vital signs are temp 97.8 F, Pulse 138/min and irregular, blood pressure 107/60 and oxygen saturation is 96% on room air. His ECG shows irregular irregularity with absence of P waves. What is the appropriate treatment to improve his symptoms in this current situation? Cardioversion Metoprolol Aspirin Heparin Refer to cardiologist Loading...1568. Which one of the following is the effect of metoprolol on cardiac ejection time? Increased Decreased No effect Loading...1569. Which of the following autoantibodies is associated with diffuse scleroderma? Anti-DNA topoisomerase 1 Anti-SSA Anti-SSB Anti-histone Loading...1570. Which one of the following statements about the functions of ACE inhibitors is wrong? Increase level of bradykinin Increase vasodilation of vascular smooth muscle Decrease output of the sympathetic nervous system Increase retention of sodium and water Loading...1571. Which of the following drug belongs to Carbonic anhydrase inhibitors? Mannitol A & B Acetazolamide Furosemide Urea Loading...1572. Which one of the following drugs associated with nephrotoxicity? Rifampin Isoniazid Capreomycin Ethambutol Loading...1573. Aspirin is contraindicated in following disease? Reye's syndrome Bleeding disorder All of these Peptic ulcer A & B Loading...1574. Which type of bias is reflected when individuals with severe disease are uncovered because they die first? Selection bias Late-look bias Measurement bias Confounding bias Loading...1575. A patient presents with painless scrotal mass and increased thyroid panel. Which of the following markers would be elevated in this patient? Alpha-fetoprotein Human chorionic gonadotropin Follicle stimulating hormone Lactate dehydrogenasePage 64 of 66 Loading...1576. Amylin consecrated with insulin has the following actions except? Decrease postprandial glucagon secretion Delayed gastric emptying time Suppress appetite Increase beta-cell growth Loading...1577. Imidazoline derivative drug with Alpha2 adrenoceptors effect? Clonidine Albuterol Phentolamine Dipivefrin Loading...1578. A 29-year-old man underwent bone marrow transplantation two weeks ago. Yesterday he developed diarrhea with occult blood and rashes all over his face, hands and feet. Examination reveals jaundice and maculopapular rashes on his face, palms and soles. What are the most likely cells activated in this case? Host B-lymphocytes Donor T-lymphocytes Host T-lymphocytes Donor B-lymphocytes Loading...1579. A young man complains of daytime sleeping, cataplexy and sleep paralysis. Which of the following is the best treatment? Zolpidem Hydroxyzine Modafinil Diazepam Loading...1580. Which one of the following drugs is used to treat helminthic infections for cestodes? Albendazole Thiabendazole Ivermectin Mebendazole Praziquantel Loading...1581. Which of the following groups are found in the structural formula of Angiotensin-converting enzyme inhibitors Except? Phosphinic acid group Thiol group Sulfahydril group Imidazole ring Carboxylate group Loading...1582. A 30 year-old woman with a history of Grave’s disease presents to her physician for a routine evaluation. She was treated 2 years ago with radioactive iodine. Three months later, she was prescribed levothyroxine 0.125 mg. On her last evaluation, six months ago, her doctor lowered her dose to 0.088 mg due to decrease of TSH level. Today, her lab tests show increase in T4 and T3 and very low TSH and positive TSH receptor antibodies. Ectopic thyroid tissue Incomplete ablation of thyroid gland Hashimoto’s disease Radioactive induced thyrotoxicosis Cancer thyroidat is the most likely diagnosis? Loading...1583. Control of diabetes is most likely determined by which one of the following laboratory tests? Urinary glucose content Fasting blood glucose Random blood glucose Hemoglobin A1C Loading...1584. Which one of the following glucocorticoids is long acting? A & B Prednisolone Amiloride Cortisone Dexamethasone Loading...1585. Which one of the following is the class of aliskiren? Direct renin inhibitor Corticotropin Interior pituitary hormone Angiotensin receptor blocker ACE inhibitor Loading...1586. A middle-aged woman presents with stabbing chest pain radiates to the back. She has a history of Marfan syndrome and poorly controlled hypertension. What is your diagnosis? Myocardial infarction Pericarditis Aortic dissection Hypertrophic cardiomyopathy Loading...1587. Which of the following prostaglandin type also called prostacyclin? PGE PGB PGA PGE1 PGI2 Loading...1588. A 40-year-old woman complains of swelling in her neck. Examination reveals a small, non-tender nodule in her thyroid. Which of the following is the best next step of action? Ultrasound of the thyroid Fine needle aspiration T4 and TSH levels Excisional biopsy Loading...1589. Aldosterone is released from which part of the adrenal medulla? Zona glomerulosa A & B Zona reticularis All of these Zona fasciculate Loading...1590. Which of the following locations is the site of action of furosemide to inhibit sodium reabsorption? Collecting tubules Descending limb of loop of Henle Ascending limb of loop of Henle Distal convoluted tubules Loading...1591. Which of the following agents reduce the blood levels of certain drugs through its action on hepatic P450 system? Guava juice Kava Grapefruit juice St. John’s wart Loading...1592. Which of the following drug can disrupt the enteric coating by increasing the Gastric PH? Oxacillin Sitagliptin Omeprazole Cefoxitin Glimepiride Loading...1593. Which one of the following drugs is used to treat asthma? Montelukast Ezetimibe Indanyl carbenicillin Repaglinide Hydrochlorothiazide Loading...1594. A 74-year-old man presents to the clinic with a complaint of palpitation and lightheadedness. Image studies revealed blockage of the artery to the SA node. This artery arises from which of these arteries? Left coronary artery Right coronary artery Circumflex artery Posterior interventricular artery Anterior interventricular artery Loading...1595. A severe reaction to medicine which causes skin blisters and peels off outside of the body but also could make blisters inside the human body and make it hard to eat anything, this disease is known as? Steven-johnson syndrome Atherosclerosis Hypotrichosis Ductus arteriosus Reye syndrome Loading...1596. A 12-year old child is brought to his psychiatrist for an evaluation of abnormal behavior. His teachers contacted his parents several times because he always cheats and lies at school. He also shoots family dog with his BB gun although he gets in trouble doing that. He has no remorse on hitting other kids and has no concern about others’ feelings. Which of the following is the most likely diagnosis? Bipolar disorder Schizophrenia Conduct disorder Attention-deficit hyperactivity disorder (ADHD) Loading...1597. Which of these substances should be taken before consumption of milk in a patient who complains of abdominal pain and cramping after drinking milk? Lactase Aspirin Acetaminophen Niacin Loading...1598. Purple toe syndrome is caused by using the therapy of which drug? Warfarin Amikacin Phenytoin Digoxin Cyclosporine Loading...1599. Miconazole belongs to the following type of drugs class? Antiviral Antibiotics Antipyretic Anti malaria Antifungal Loading...1600. Peripheral resistance is linked with one of the following issues? Fever Aids Blood pressure HeadachePage 65 of 66 Loading...1601. An old patient presents with multiple tumors on the liver. Which of the following is the most common site of the primary tumor? Lung Kidney Colon Breast Loading...1602. A young woman presents with chronic diarrhea found to have rectovaginal fistula. Which of the following is most likely her diagnosis? Celiac disease Ischemic colitis Crohn’s disease Ulcerative colitis Loading...1603. Researchers perform a study on foot ulcers caused by diabetes. They collect patients of foot ulcers and divided them into a group of patients with diabetes and another group of non-diabetic patients. The researchers compute the rate of foot ulcers in diabetic patients versus non-diabetic patients. This study is considered: Double-blind study Longitudinal study Cohort study Cross-sectional study Case-control study Loading...1604. Which of the following drug belongs to Osmotic Diuretic? Urea Furosemide A & B Ampicillin Mannitol Loading...1605. A young man complains of little finger numbness and difficulty gripping things. Which of the following is the affected nerve root? Cervical 7 Cervical 6 Cervical 8 Cervical 5 Loading...1606. A 21-year-old medical student with a history of asthma presents to the clinic for medication refill. He discussed with his physician the pros and cons of treatment with theophylline. One of the disadvantages of using theophylline is low toxic threshold. Which of these drugs is used to treat theophylline toxicity? Atenolol Albuterol Furosemide Epinephrine Digoxin Loading...1607. Which of the following drugs has the least CNS side effects? Rimantadine Ganciclovir Amantadine Acyclovir Zidovudine Loading...1608. Which of the following drug is a derivative of N- arylanthranilic acid? Piroxicam ketorolac Etodolac Diflunisal Mefenamic Acid Loading...1609. Interferon alpha is indicated for the treatment of which one of the following conditions? Kidney transplantation Bullous pemphigoid Hepatitis C virus infection Rheumatoid arthritis Loading...1610. Which of the following drug is Antiprogestrin? Sitagliptin Metformin Acarboseich one of the following drugs Increases Glucose-dependent insulin release and decreases secretion of glucagon? Pioglitazone Bicalutamide Loading...1611. A 30-year-old man visits the clinic complaining of recurrent bouts of diarrhea accompanied with bloating over the past few years. He also reports that he has itchy vesicles around the extensor surfaces of his upper and lower extremities. The rest of clinical examination is normal. What is the skin condition most likely present in this patient? Seborrheic keratosis Psoriasis Dermatitis herpetiformis Rosacea Shingles (herpes zoster) Loading...1612. Which one of the following cells lines the alveoli and secretes the surfactant? Pneumocytes type I K cells Clara cells Macrophages Pneumocytes type II Loading...1613. Which of the following is the mechanism of action of zileuton for asthma? Inhibition of Phospholipase A Stimulation of beta-2 receptors Inhibition of 5-lipoxygenase Inhibition of phosphodiesterase Loading...1614. Mullerian-inhibitory factor plays a major rule in development of the male reproductive system. Which type of cells secrets it? Leydig cells Sertoli cells Loading...1615. ADP-mediated platelets aggregation is inhibited by? Aspirin Dipyridamole Tirofiban Ticlopidine Abciximab Loading...1616. A 28-year-old man is brought by his father to the emergency room with flaccid coma for 15 minutes. His father mentions that his son had seizures on a regular basis. This time, he lost his consciousness, fell to the ground and his body started jerking for about 3 minutes. While talking to his father, the patient becomes conscious, confused and complains of headache. Which of the following medications is the initial treatment for this condition? Felbamate Topiramate Phenytoin Ethosuximide Loading...1617. Which one of the following conditions is a long term complication of cystic fibrosis? Adenocarcinoma of the lung Pneumothorax Bronchiectasis Emphysema Loading...1618. A 72-year-old woman presents to her physician complaining of abdominal pain and frequent episodes of burning micturition. After physical examination and laboratory tests, she is diagnosed with urinary tract infection. She is prescribed gentamicin in addition to other medications. What is the most likely complication attributed to this antibiotic? Thrombocytopenia Agranulocytosis Hepatic toxicity Hearing loss Loading...1619. Which of the following tests is the most accurate one to confirm the diagnosis of achalasia? Upper endoscopy Manometry Barium esophagram Chest-x-ray Loading...1620. A 72-year-old man presents to his physician for a follow up after a stroke. The physician pays more attention for the care of this patient, as he reminds the physician of his father who passed away 3 years ago after having a stroke. This is an example of which one of these mechanisms? Projection Transference Acting out Countertransference Displacement Loading...1621. Which one of the following enzymes is associated with Lyesh-Nyhan syndrome? Xanthine oxidase Adenosine deaminase Ribonucleotide reductase Hypoxanthine-guanine phosphoribosyl transferase Loading...1622. A 27-year-old pregnant woman in her sixth week presents for her first prenatal visit. Ultrasound confirms fetal cardiac activity and length consistent with 6 weeks of pregnancy. It also shows a simple cyst measures 4-cm on the left ovary. What is the best next step of management? Surgical removal of the cyst Hormonal treatment Assurance and follow up on next visits Termination of pregnancy Wide spectrum antibiotics to prevent infection Loading...1623. Which of the following drug is Propionic acid derivative NSAID? Piroxicam Diclofenac Naproxen Aspirin Mefenamic Acid Loading...1624. A 23-year-old man with a history of Marfan syndrome presents to the ER complaining of sharp pain on the upper back. He is admitted to intensive care unit (ICU) for the risk of aortic dissection. Which of the following proteins are responsible for the probable development of abdominal aortic aneurysm (AAA) in this patient? Myosin and actin Fibrillin and elastin Fibrin and actin Myosin and fibrin Loading...1625. A 5-year-old boy is brought to the ER by his mother. He has fever, cough, lethargy, headache and neck pain. On examination, his temperature is 103.2 F, his neck is rigid and tender and Kernig sign is positive. CSF is clear and significant for glucose 60 mg/dL, protein 80 mg/dL, no bacteria or pus cells and lymphocytes count is 70%. What is the most likely causative organism? Streptococcus Bovis Staphylococcus Aureus Neisseria Meningitidis Streptococcus Pneumonia EchovirusPage 66 of 66 Loading...1626. Which one of the following drugs is a selective beta-1 agonist? Amrinone Digoxin Dobutamine Dopamine Loading...1627. Following drugs should be avoided in patients with heart failure? Diuretic ACE inhibitors B-blocker CCBs Inotropic drugs Loading...1628. A 35 woman undergoes a hysterectomy. A section of one of her fallopian tubes is shown on this picture. What is your diagnosis? Ectopic pregnancy Chronic salpingitis Papillary carcinoma Endometriosis Loading...1629. Nelfinavir belongs to the class of following drugs? Anti-malaria Antipyretic Antiviral Antibiotics Antiprotozoal Loading...1630. Which of the following is the major indication of ondansetron in patients receiving chemotherapy? GERD Nausea and vomiting Headache Hair loss Loading...1631. Which of the following findings distinguishes chronic renal failure from acute renal failure? History of elevated BUN High serum calcium High serum sodium History of elevated serum creatinine Loading...1632. As physicians, we need to know some definitions in Genetics, which are related directly to our practice and guide us to diagnose and treat many genetic disorders. These items include genome, genotype, phenotype, genetic code, gene expression, etc. Which one of the following choices describes the definition of a phenotype? Genetic constitution of an organism DNA structure that determines the expression of a trait Physical location of a trait on a DNA molecule An observable physical or biochemical trait on an organism Loading...1633. Which of the following joint conditions is characterized by narrowing of joint space and formation of osteophytes? Osteoarthriti Rheumatoid arthritis Gouty arthritis Pseudo-gout Loading...1634. 5-FdUMP a false nucleotide inhibits thymidylate synthetase decreasing thymidylic acid(an essential DNA component) is MOA of following drug? Ketoconazole Amphotericin B Nystatin Flucytosine Loading...1635. What is the best treatment of gastroparesis in a diabetic patient? Gastric resection Vagotomy Omeprazole Metoclopramide Loading...1636. Which one of the following intravenous anesthesia has antiemetic action? Fentanyl Thiopental Propofol Ketamine Loading...1637. Which one of the following drugs is the most effective for nausea and vomiting of pregnancy? Cimetidine Loratadine Meclizine Ondansetron Loading...1638. A 21 year-old college student complains of the appearance of yellowish coloration on her sclera. She mentions that she had been dizzy and weak for the last 3 days but did not feel any pain or fever and no change in stool color. Abdominal examination reveals normal bowel sounds and no tenderness or organomegaly. Laboratory tests show normal levels of liver enzymes and serum bilirubin. Which is the most likely initial diagnosis? Pancreatic cancer Obstructive jaundice Hemolysis Hepatocellular disease Gallstones Loading...1639. A 70-year-old man with a history of paraplegia develops sudden pleuritic chest pain. A chest CT scan shows a hemorrhagic wedge-shaped pleural based area localized in the right lower lobe. Which of the following is the most likely cause of this lesion? Inflammation Thrombosis Atherosclerosis Embolism Loading...1640. Which of the following is an indandione analog Anticoagulant agent? Heparin Abciximab Anisindione Clopidogrel Warfarin Loading...1641. Which one of the following types of cells myelinates axons of neurons of CNS? Schwann cells Astrocytes Microglia Oligodendroglia Loading...1642. Which of the following in the mode of inheritance of glucose-6-phosphate dehydrogenase deficiency? Autosomal dominant X-linked dominant Autosomal recessive X-linked recessive Loading... By Medical Tactics|2022-03-01T16:03:08+00:00March 1, 2022|Question Banks|0 CommentsShare This Story, Choose Your Platform!FacebookXRedditLinkedInWhatsAppTelegramTumblrPinterestVkXingEmail About the Author: Medical Tactics Related PostsPharmacology Questions Bank 1.0 Pharmacology Questions Bank 1.0 Easy Biology MCQs Gallery Easy Biology MCQs Easy Medical MCQs Gallery Easy Medical MCQs Medical Questions & Answers Gallery Medical Questions & Answers Leave A Comment Cancel replyComment Save my name, email, and website in this browser for the next time I comment.
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