USMLE QUESTIONS BANK 2.0<<1234567891011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859606162636465666768697071727374757677787980818283848586878889909192939495969798991001011021031041051061071081091101111121131141151161171181191201211221231241251261271281291301311321331341351361371381391401411421431441451461471481491501511521531541551561571581591601611621631641651661671681691701711721731741751761771781791801811821831841851861871881891901911921931941951961971981992002012022032042052062072082092102112122132142152162172182192202212222232242252262272282292302312322332342352362372382392402412422432442452462472482492502512522532542552562572582592602612622632642652662672682692702712722732742752762772782792802812822832842852862872882892902912922932942952962972982993003013023033043053063073083093103113123133143153163173183193203213223233243253263273283293303313323333343353363373383393403413423433443453463473483493503513523533543553563573583593603613623633643653663673683693703713723733743753763773783793803813823833843853863873883893903913923933943953963973983994004014024034044054064074084094104114124134144154164174184194204214224234244254264274284294304314324334344354364374384394404414424434444454464474484494504514524534544554564574584594604614624634644654664674684694704714724734744754764774784794804814824834844854864874884894904914924934944954964974984995005015025035045055065075085095105115125135145155165175185195205215225235245255265275285295305315325335345355365375385395405415425435445455465475485495505515525535545555565575585595605615625635645655665675685695705715725735745755765775785795805815825835845855865875885895905915925935945955965975985996006016026036046056066076086096106116126136146156166176186196206216226236246256266276286296306316326336346356366376386396406416426436446456466476486496506516526536546556566576586596606616626636646656666676686696706716726736746756766776786796806816826836846856866876886896906916926936946956966976986997007017027037047057067077087097107117127137147157167177187197207217227237247257267277287297307317327337347357367377387397407417427437447457467477487497507517527537547557567577587597607617627637647657667677687697707717727737747757767777787797807817827837847857867877887897907917927937947957967977987998008018028038048058068078088098108118128138148158168178188198208218228238248258268278288298308318328338348358368378388398408418428438448458468478488498508518528538548558568578588598608618628638648658668678688698708718728738748758768778788798808818828838848858868878888898908918928938948958968978988999009019029039049059069079089099109119129139149159169179189199209219229239249259269279289299309319329339349359369379389399409419429439449459469479489499509519529539549559569579589599609619629639649659669679689699709719729739749759769779789799809819829839849859869879889899909919929939949959969979989991000100110021003100410051006100710081009101010111012101310141015101610171018101910201021102210231024102510261027102810291030103110321033103410351036103710381039104010411042104310441045104610471048104910501051105210531054105510561057105810591060106110621063106410651066106710681069107010711072107310741075107610771078107910801081108210831084108510861087108810891090109110921093109410951096109710981099110011011102110311041105110611071108110911101111111211131114111511161117111811191120112111221123112411251126112711281129113011311132113311341135113611371138113911401141114211431144114511461147114811491150115111521153115411551156115711581159116011611162116311641165116611671168116911701171117211731174117511761177117811791180118111821183118411851186118711881189119011911192119311941195119611971198119912001201120212031204120512061207120812091210121112121213121412151216121712181219122012211222122312241225122612271228122912301231123212331234123512361237123812391240124112421243124412451246124712481249125012511252125312541255125612571258125912601261126212631264126512661267126812691270127112721273127412751276127712781279128012811282128312841285128612871288128912901291129212931294129512961297129812991300130113021303130413051306130713081309131013111312131313141315131613171318131913201321132213231324132513261327132813291330133113321333133413351336133713381339134013411342134313441345134613471348134913501351135213531354135513561357135813591360136113621363136413651366136713681369137013711372137313741375137613771378137913801381138213831384138513861387138813891390139113921393139413951396139713981399140014011402140314041405140614071408140914101411141214131414141514161417141814191420142114221423142414251426142714281429143014311432143314341435143614371438143914401441144214431444144514461447144814491450145114521453145414551456145714581459146014611462146314641465146614671468146914701471147214731474147514761477147814791480148114821483148414851486148714881489149014911492149314941495149614971498149915001501150215031504150515061507150815091510151115121513151415151516151715181519152015211522152315241525152615271528152915301531153215331534153515361537153815391540154115421543154415451546154715481549155015511552155315541555155615571558155915601561156215631564156515661567156815691570157115721573157415751576157715781579158015811582158315841585158615871588158915901591159215931594159515961597159815991600160116021603160416051606160716081609161016111612161316141615161616171618161916201621162216231624162516261627162816291630163116321633163416351636163716381639164016411642>>Read moreGeneral Pediatric-related - MCQs 1-10Page 1 of 66 Loading...1. Which one of the following medications acts at the proximal tubule of the kidney? Spironolactone Furosemide Hydrochlorothiazide Acetazolamide Loading...2. 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? HPV vaccine is essential to treat the current infection No need for the vaccine as long as Pap smear is normal She can only take the vaccine later after full recovery She already has HPV infection but she should take the vaccine for other strains of HPV She already has HPV infection so, no need for the vaccineRead moreThe following represents an essential element to an effective quality council? Loading...3. 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. Trauma Congenital annular pancreas Viral infection Gallstones Cystic fibrosisat is the most likely etiology of this boy’s condition? Loading...4. Coagulation factor VIII is produced by which of the following cells? Endothelial cells Hepatic cells Splenic macrophages Juxtaglomerular cells Loading...5. Which one of the following drugs is a proton pump inhibitor drug? Rabeprazole Cimetidine Sucralfate Misoprostol Loading...6. Which of the following is a poor prognostic sign of acute pancreatitis a day after initiation of hydration and appropriate treatment? Random serum glucose of 70 mg/dL Blood urea nitrogen (BUN) rises 6 mg/dL Serum amylase of 900 IU/L Hematocrit drops by 4% Loading...7. If a new effective treatment for COVID-19 is initiated, which of the following will be the appropriate effect on incidence and prevalence? No change in both Incident decreases with no change in prevalence No change in incident and decreased prevalence Both incident and prevalence decrease Loading...8. Which of the following substances is elevated due to vitamin B12 deficiency? Homocysteine Hemosiderin Folic acid Cyanocobalamin Loading...9. Which of the following substances is the risk factor in developing mesothelioma? Lead Copper Silica Asbestos Loading...10. Which one of the following drugs belongs to drugs for hepatic viral infections? Ezetimibe Adefovir Indanyl carbenicillin Aluminium hydroxide Capreomycin Loading...11. Which of the following needs to be added to a breast-fed 9-week-old premature infant to improve pallor? Vitamin C Iron supplements Milk formula Orange juice Loading...12. Which one of the following drugs is a sodium channel blocker (Class I)? Procainamide Carvedilol Verapamil Amiodarone Loading...13. Which one of the following drugs form insoluble chelates that are not absorbed? A & B All of the above Pioglitazone & Calcium Levofloxacin & magnesium Rabeprazole & Sitaglipton Loading...14. Which one of the following tests is recommended in follow up for a patient receiving anti-tuberculous treatment (isoniazid and rifampin)? Blood glucose test Liver function tests Amylase and lipase tests Renal function tests Loading...15. Which of the following is the most abused drug for all ages in the United States? Cocaine Methamphetamine Marijuana Alcohol Loading...16. Drugs that show capacity-limited elimination have which of the following property? The elimination half-life(t½) remains constant A constant ratio of drug metabolites are formed as the administered dose increases As the administered dose increases the elimination half-life (t½) increases First-order elimination kinetics is followed by low and high doses both Loading...17. Megaloblastic anemia is caused by folic acid or Vitamin B12 deficiency. Which of these reactions is directly affected by vitamin B12 deficiency? Propionyl CoA >> methylmalonyl CoA Methylmalonyl CoA >> succinyl CoA Succinyl CoA >> fumarate Malonyl CoA >> palmitate Loading...18. Reversible neutropenia and thrombocytopenia is the adverse effect of following drug? Nystatin Amphotericin B Ketoconazole Flucytosine Loading...19. A drug that belongs to Loop Diuretics is one of the following? Sulbactam Cefazolin Furosemide A & B Bumetanide Loading...20. 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? Osteomyelitis Gout Rheumatoid arthritis Osteoarthritis Loading...21. What is the proper treatment of adrenal insufficiency? Fludrocortisone Adrenaline Prednisone Prednisone and fludrocortisone Loading...22. A patient is suffering from gouty arthritis along with hyperuricemia, which of the following drugs is indicated to give relief to this patient? Febuxostate Colchicine Allopurinol Probenecid Pegloticase Loading...23. Purple toe syndrome is caused by using the therapy of which drug? Cyclosporine Warfarin Digoxin Phenytoin Amikacin Loading...24. 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 breech presentation Previous CS is performed due to unknown cause Previous CS is performed due to prolonged second stage Loading...25. Which one of the following parts of the heart is the major consumer of oxygen and requires the best blood supply? Right ventricle Right atrium Left atrium Left ventriclePage 2 of 66 Loading...26. Which of the following drug contain the Carboxylic group, replaced with tetrazole ring in the structural formula? Irbesartan Valsratan Losartan Telmisartan Candesartan Loading...27. 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 thyroid stimulating hormone (TSH) Measurement of HbA1c Fasting serum glucose test Dexamethasone suppression test Assessment of insulin-like growth factor 1 (IGF-1) Loading...28. 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 Topical mupirocin Oral amoxicillin Loading...29. 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? Acute lymphatic leukemia Hairy cell leukemia Chronic myeloid leukemia Chronic lymphocytic leukemia Sezary syndrome Loading...30. Which of the following are the characteristics of Beck’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...31. Which one of the following actions of epinephrine is blocked by prazosin? Pupil dilation Tachycardia Bronchial dilation High stroke volume Loading...32. Risk of rupture of abdominal aortic aneurysm (AAA) is increased by all the following factors EXCEPT? Uncontrolled hypertension Male gender Increased aortic wall stress Smoking Loading...33. Which of the following drug is a Non-dihydropyridine antihypertensive drug? Amlodipine Carvedilol Bumetanide Diltiazem Nifedipine Loading...34. Which of the following is the most effective role of probenecid in treating gout? Probenecid decreases inflammation of affected joints Probenecid decreases production of uric acid Probenecid decreases secretion of uric acid Probenecid decreases reabsorption of uric acid Loading...35. Which of the following in the most likely cause of spontaneous abortion in the first trimester? Toxemia of pregnancy Maternal drug use Chromosomal abnormalities Congenital infection Loading...36. Dull, Persistent, and tightening is the characteristics of the following type of headache? Migraine Headache Cluster Headache Tension-Type Headache A & B Loading...37. Which of the following is the main reaction of hepatic cytochrome P-450 in metabolism? Methylation Binding with glucuronic acid Hydroxylation Binding with glutathione Loading...38. Which of these substances should be taken before consumption of milk in a patient who complains of abdominal pain and cramping after drinking milk? Aspirin Acetaminophen Niacin Lactase Loading...39. 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? Esophageal manometry Trial of a proton-pump inhibitor 24-hour pH monitoring Barium swallow Upper endoscopy Loading...40. 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? Nalidixic acid Tetracycline Metronidazole Trimethoprim Gentamycin Loading...41. Which of the following Diuretic drugs contain cyclic sulfonamide Except? Hydrochlorothiazide Indapamide Methylchlorothiazide Chlorothiazide Bendroflumethiazide Loading...42. Which one of the following drugs is a calcium channel blocker (Class IV)? Carvedilol Amiodarone Procainamide Verapamil Loading...43. Which of the following is the main role of colchicine in treating acute attack of gout? Reduction of gout symptoms and pain Increased uric acid excretion Inhibition of xanthine oxidase Decreased uric acid absorption Loading...44. Which one of the following drugs results in disulfiram- like action when it is accompanied with alcohol? Cefotetan Cimetidine Ampicillin Dipyridamole Loading...45. A drug that is used to treat HIV infections is one of the following? Atazanavir Niclosamide Etidronate Cladribine Praziquantel Loading...46. What is the mechanism of action of aminoglycosides? Inhibition of general metabolic pathways Blocking pathogens recognition of the host Disruption of ribosomal protein synthesis Disruption of cell wall hemostasis Loading...47. Anemia occurs in cases of multiple myeloma most likely results from which one of the following factors? Loss of blood due to gastrointestinal bleeding Infiltration of bone marrow with massive numbers of plasma cells Low production of hemopoietin Defective absorption of urine Loading...48. Which one of the following diuretics may elevate blood glucose level in some patients? Hydrochlorothiazide Triamterene Spironolactone Acetazolamide Loading...49. 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? Flutamide Pergolide Tadalafil Abiraterone Finasteride Loading...50. 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? Factitious hypoglycemia Pheochromocytoma Insulinoma Reactive hypoglycemiaPage 3 of 66 Loading...51. Which one of the following dermatologic disorders presents with a herald batch and a Christmas tree pattern? Pityriasis rosea Pemphigus vulgaris Bullous pemphigoid Psoriasis Loading...52. Which of the following insects is the victor responsible for transmission of Rocky Mountain spotted fever? Flea Louse Mite Tick Loading...53. Which of the following drug belongs to H2 histamine receptor blocker? Oxacillin Glimepiride Niacin Cefoxitin Nizatidine Loading...54. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Furosemide A & B Ethambutol Ibandronate Amphotericin B Loading...55. Counterregulatory hormone in diabetes that works against insulin include the following? Growth hormone All of the above Cortisol Catecholamines Glucagon Loading...56. Which of the following is the substance released from the parietal cells of the stomach? Gastrin Hydrochloric acid Pepsinogen Mucus Loading...57. Which one of the following statements about dobutamine is incorrect? Increase contractility Treat acute heart failure Positive inotropic effect Decrease myocardial cAMP Loading...58. Which one of the following medications enters the cell and acts on a cytoplasmic receptor? Propranolol Adrenaline Dexamethasone Insulin Loading...59. Which of the following is the enzyme responsible for conversion of testosterone into dihydrotestosterone (DHT)? 3-beta-hydroxylase Aromatase 5-alpha-reductase 17 alpha-hydroxylase Loading...60. Which one of the following drugs is tertiary amine antispasmodic? Dicyclomine Oxybutynin Biperiden Cyclopentolate Propantheline Loading...61. Which one of the following conditions is characterized by painless blisters on the back of the hands and hyperpigmentation of the face? Contact dermatitis Herpes zoster Porphyria cutanea tarda Dermatitis herpetiformis Loading...62. Which of the following drug is used as Mast Cell Stabilizers? Terbutaline Ipratropium Bromide Sodium Cromoglycate Salbutamol Montelukast Loading...63. Which of the following is the epithelial covering of vocal cords? Simple cuboidal Simple squamous Simple columnar Stratified squamous Loading...64. Which of the following medications is useful to distinguish nephrogenic from neurogenic diabetes insipidus? Desmopressin Acetazolamide Demeclocycline Hydrochlorothiazide Loading...65. Which one of the following conditions most likely shows lower than normal erythrocyte sedimentation rate (ESR)? Polycythemia Pregnancy Multiple myeloma Giant cell arteritis Loading...66. 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 Adduction of the hip joint Dorsiflexion of the ankle joint Flexion of the knee joint Extension of the knee joint Loading...67. Gray baby syndrome is the adverse effect of the following drug? Clindamycin Linezolid Chloramphenicol Quinupristin Loading...68. Which one of the following drugs is a prostaglandin that suppresses gastric acid secretion? Sucralfate Cimetidine Rabeprazole Misoprostol Loading...69. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefotaxime Cefadroxil Cefaclor Cefepime Loading...70. 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? Achalasia Lower esophageal ring Cancer esophagus Peptic esophageal stricture Diffuse esophageal spasm Loading...71. Deficiency of which of the following enzymes is associated with von Gierke’s disease? α-1,4-phosphorylase Hexosaminidase A Glucose-6-phosphatase Phosphofructokinase-1 Loading...72. Which of the following is the mechanism of action of pioglitazone in diabetic patients? Decreases insulin breakdown Increases glucose uptake in muscle cells Increases insulin release Increases glucose excretion Loading...73. 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 Pneumonia Lung cancer Asbestosis Sarcoidosis Loading...74. Antihyperlipidemic drugs which consist of open hydroxy acid lactone ring in the structural formula except? Atorvastatin Rosuvastatin Pravastatin Fluvastatin Simvastatin Loading...75. Acetazolamide and other carbonic anhydrase inhibitors act at which part of the kidney? Collecting duct Distal tubule Proximal tubule Descending loop of HenlePage 4 of 66 Loading...76. 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 50% chance to clinically have the disease The baby has no chance to be a carrier The baby has 100% chance to clinically have the disease The baby has 50% chance to be a carrier Loading...77. Carbonic anhydrase enzyme is present in the epithelial cells of one of the following part functional zones of the nephron? The collecting tubule and duct The descending loop of Henle The ascending loop of Henle The proximal convoluted tubules The distal convoluted tubules Loading...78. Which of the following is the mechanism of action of ursodiol to reduce the size of gallstones in the common bile duct? Relaxation of common bile duct Dissolving cholesterol form the stone Dissolving calcium from the stone Reducing bile synthesis Loading...79. 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? Papilledema Cardiomyopathy Bladder hemorrhage Hemolytic anemia Loading...80. 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? Hiatal hernia Femoral hernia Indirect inguinal hernia Direct inguinal hernia Loading...81. Long Acting Insulin is one of the following? Aspart Glargine Glulisine NPH Loading...82. Which of the following methods is the most likely to demonstrate spores? Acid-fast stain Malachite green stain India ink stain Gram stain Loading...83. Which of the following is NOT an adverse effect of aspirin? Renal problems Gastritis Tolerance Bleeding Loading...84. Which of the following is the most significant action of monoamine oxidase A? Metabolism of dopamine Metabolism of serotonin and dopamine Metabolism of norepinephrine, serotonin and tyramine Metabolism of serotonin and epinephrine Loading...85. Which of the following drug is a part of drugs for osteoporosis? Acetazolamide Calcitonin Furosemide A & B Rabeprazole Loading...86. Butoconazole belongs to the class of following drugs? Antipyretic Antibiotics Antifungal Antiviral Antiprotozoal Loading...87. Which one of the following drugs induce Dose Dumping syndrome? Amiodarone Digoxin Rifampin Erythromycin Ethanol Loading...88. Which of the following drug is Propionic acid derivative NSAID? Aspirin Diclofenac Piroxicam Mefenamic Acid Naproxen Loading...89. Taste and visual disturbance is the adverse effect of the following drug? Griseofulvin Miconazole Nystatin Terbinafine Loading...90. Aspirin has anti-platelet effect that lasts for the life of the platelet. What is the average life of a platelet? 2-4 days 120 days 24 hours 7-10 days Loading...91. 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 Restrain in bed and haloperidol administration Refer to psychiatry department Sleep enhancement protocol and family support as well as haloperidol administration Loading...92. A drug that causes REACTIVATION OF ACETYLCHOLINESTERASE? Neostigmine Echothiophate Tacrine Pralidoxime Loading...93. 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? Endothelial cells of the cornea Epithelial cells of the retina Epithelial cells of the ciliary body Epithelia cells of the cornea Loading...94. Aspirin is contraindicated in following disease? Peptic ulcer All of these Bleeding disorder Reye's syndrome A & B Loading...95. 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...96. 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? Digoxin Acetaminophen Mexalitine Amiodarone Loading...97. At low doses, one of the following drugs irreversible inhibit thromboxane production in platelets leading to a decrease in platelets aggregation? Ticlopidine A & B Clopidogrel Aspirin Loading...98. Which of the following substances is responsible for growth of the prostate at puberty? Progesterone Dihydrotestosterone Testosterone Estrogen Loading...99. 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? Destruction of the gray matter Impaired CSF resorption Excessive CSF production Obstruction of cerebral aqueduct Loading...100. Which of the following drug belongs to Osmotic Diuretic? Urea A & B Ampicillin Furosemide MannitolPage 5 of 66 Loading...101. Achilles tendon xanthoma is most likely characteristic of which one of the following conditions? Pseudogout Familial hypercholesterolemia Systemic lupus erythematosus Diabetes mellitus Loading...102. 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? CT scan of the head MRI of the brain Serum Thyroid Stimulation Hormone (TSH) level Colonoscopy Cosyntropin stimulation test Loading...103. 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...104. The binding of a drug to plasma proteins will tend to: Increase its concentration in the plasma. Increase its rate of biotransformation. Decrease its rate of glomerular filtration. Increase its pharmacological activity Decrease half-life. Loading...105. Which one of the following drugs is a natural penicillin with a property of high acid stability than other naturally occurring penicillin? Penicillin V Penicillin G Methicillin Amoxicillin Loading...106. 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? Kallmann’s syndrome Androgen insensitivity disorder Early pregnancy Kartagener’s syndrome Turner’s syndrome Loading...107. Lidocaine is an effective antiarrhythmic because of which of the following mechanisms? It prolongs PR interval It block beta-receptors It prolongs QT interval It blocks alpha-receptors It suppresses excitability in ischemic areas of the heart Loading...108. 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 Brain biopsy Head CT scan Loading...109. What is the most common injury resulting from wearing a heavy backpack for a long time? Rotator cuff injury Costoclavicular syndrome Shoulder dislocation Frozen shoulder Loading...110. Which of the following medications is used in opioid overdose? Flumazenil Norepinephrine Naloxone Phencyclidine Loading...111. Following drug causes Systemic acidosis by binding with cations in antacid? Sodium polystyrene sulfonate Alendronate Sevelamer A & B Metamucil Loading...112. 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 Advise her to use the pump to collect her breast milk every 24 hours right before she takes daily metronidazole 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 Loading...113. Which of the following types of receptors are associated with the slowest response time? G-protein coupled receptors Transmembrane enzyme receptors Steroid receptors Ion channel receptors Loading...114. When a intravascular clot started floating in the blood termed as one of the following option? Embolus All of above Thrombus Coagulation Loading...115. 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? Alcohol abuse Type II diabetes Atherosclerosis Familial hypercholesterolemia Loading...116. Naloxone is the treatment of choice of which one of the following toxicities? Citalopram overdose Amitriptyline toxicity Methylphenidate overdose Hydrocodone toxicity Loading...117. Drug-to-drug interaction based on absorption, transformation, distribution and excretion is considered which one of the following types of interaction? Chemical interaction Pharmaceutical interaction Pharmacokinetic interaction Pharmacodynamic interaction Loading...118. If a dose of the following drug is not properly adjusted it accumulates in neonates that interfere with the function of mitochondrial ribosomes? Erythromycin Amikacin Clindamycin Chloramphenicol Loading...119. Which one of these apoproteins is associated with chylomicrons? Apo C-II Apo A Apo E Apo B-48 Apo D Loading...120. Which of the following hormone belongs to the posterior pituitary? Furosemide Somatrem Urofollitropin Oxytocin A & B Loading...121. 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? 75 mg 25 mg 0 mg 50 mg Loading...122. Clopidogrel belongs to which of the following class of antiplatelet agents? Glycoproteins inhibitors Theinopyridines Polyamines Dipyridamole Fabric acid derivatives Loading...123. 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? Stiff neck Hypotension Neuropsychiatric disturbances Polyphagia Loading...124. A drug is used in severe alcohol poisoning is the following drug? Fomepizole Calcium Gluconate Amyl Nitrate DIGIBIND Loading...125. 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? Pericarditis Aortic dissection Hypertrophic cardiomyopathy Myocardial infarctionPage 6 of 66 Loading...126. 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 Tourette syndrome Huntington disease Epilepsy Loading...127. Ketorolac is derived from which of the following class? Acetic acid derivative Propionic acid derivative Salicylic Acid derivatives Fenamic acid derivative Enolic acid derivative Loading...128. 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? Pyelonephritis Necrotizing pancreatitis Appendicitis Acute cholecystitis Loading...129. 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 External iliac Inferior epigastric Loading...130. 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? Creutzfeldt-Jakob disease Drug-induced tremors Huntington’s disease Tourette’s syndrome Parkinson’s disease Loading...131. Which one of the following disorders is accompanied by blue sclera? Neurofibromatosis type 2 Systemic lupus erythematosus Osteogenesis imperfecta Duchenne muscular dystrophy Loading...132. Which of the following is a characteristic finding in isopropanol poisoning? Elevated anion gap Ketosis without acidosis Blindness due to ocular accumulation Elevated serum BUN and creatinine Loading...133. Reflex bradycardia caused by alpha-1-agonists is blocked by which of the following medications? Atropine Adrenaline Metoprolol Phenylephrine Loading...134. Which of the following histamine H1 antagonists is identified for its serotonin-blocking effect? Desloratadine Loratadine Cyproheptadine Fexofenadine Loading...135. 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 Daily aspirin Hypothyroidism Hypertension Immobilization Loading...136. Which one of the following medications act as bacteriostatic by inhibiting bacterial dihydrofolate reductase? Dapsone Trimethoprim Sulfamethoxazole Ciprofloxacin Loading...137. Alkylating agents are associated with bone marrow depression and for this reason they are inappropriate for this patient. Replication of a chromosome Deletion of a gene on the affected chromosome Missing of a chromosome Presence of an extra chromosome Duplication of a gene on the affected chromosome Loading...138. Which of the following medications increases cardiac output in pulmonary edema following myocardial infarction? Dobutamine Lisinopril Metoprolol Verapamil Loading...139. One of the following statements about the use of succinylcholine is wrong? prolonged apnea in patients deficient in cholinesterase Act like Acetylcholine to depolarize junction Malignant hyperthermia with halothane Resistance to plasma cholinesterase causes Hyperkalemia Loading...140. Which one of these drugs is more beneficial to treat hypertension in diabetic patients? Furosemide Enalapril Verapamil Amlodipine Loading...141. 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 vivax Babesia microti Plasmodium falciparum Plasmodium malariae Loading...142. Which of the following is the most sensitive test for myocardial infarction? Troponin-1 Lactose dehydrogenase (LDH) Troponin-C Creatine kinase myocardial fraction (CK-MB) Loading...143. Which of the following medications is considered irreversible alpha receptor antagonist? Labetalol Phenoxybenzamine Tolazoline Prazosin Loading...144. 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? Gentamicin Vancomycin Amoxicillin Ampicillin Azithromycin Loading...145. 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 Trigeminal nerve Facial nerve Oculomotor nerve Loading...146. Erythema infectiosum (Fifth disease) is caused by which of the following organism? Rubella virus Coxsackie A virus Parvovirus B19 Paramyxovirus Loading...147. Which one of the following drugs is most likely to cause severe bone marrow depression? Tacrolimus Sirolimus Prednisone Cyclosporine Loading...148. 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 Manual compression of the lesion Urgent surgical interference Broad spectrum antibiotics to avoid meningitis Loading...149. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Rifamycins Rabeprazole Ibandronate A & B Furosemide Loading...150. Which one of the following drugs may cause parkinsonism-like adverse effect? Quetiapine Olanzapine Haloperidol ClozapinePage 7 of 66 Loading...151. Which one of the following local anesthetics that causes local vasoconstriction and may leads to hypertension? Tetracaine Lidocaine Etidocaine Cocaine Loading...152. Amphotericin B belongs to the class of following drugs? Antifungal Antipyretic Antiviral Antibiotics Antiprotozoal Loading...153. Which one of the following differentiates exudate from transudate? High specific gravity Low protein content Few leukocytes High osmotic pressure Loading...154. Which one of the following antihypertensive medications is NOT safe in pregnancy? Labetalol Methyldopa Lisinopril Nifedipine Loading...155. Which of the following is a major complication of central retinal veins occlusion? Retinal detachment Glaucoma Lens subluxation Cataract Loading...156. Acute decrease in response to a drug after initial or repeated intake is known as which of the following drug interactions? Permissive Additive Synergetic Tachyphylactic Loading...157. Which of the following locations is the site of action of furosemide to inhibit sodium reabsorption? Collecting tubules Descending limb of loop of Henle Distal convoluted tubules Ascending limb of loop of Henle Loading...158. Which of the following is the percentage of thymine in a DsDNA if it contains 20% guanine? 30% 50% 20% 40% Loading...159. 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...160. Which of the following is characteristic of Hodgkin lymphoma and differentiates it from non-Hodgkin lymphoma? Affects mostly old age Peripheral nodes are most likely involved Reed-Sternberg cells Associated with HIV and autoimmune disease Loading...161. Oxytocin is an agent used to increase uterine contractions during labor and also control postpartum bleeding and hemorrhage has the following adverse effects except? Hyponatremia Bradycardia Phlebitis Uterine Hypertonicity Neonatal jaundice Loading...162. Which one of these medication groups is contraindicated in a patient with narrow-angle glaucoma? Diuretics Muscarinic-receptor antagonists Cholinomimetics Beta blockers Loading...163. 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? Vitiligo Melasma Benign lentigo Freckles Loading...164. Which of the following is the main role of hydroxyurea in treatment of sickle cell anemia? Decrease levels of HbF in red blood cells Decrease oxygen affinity to HbS Increase ability of HbS to bind 2.3-bisphosphoglycerate Increase levels of HbF in red blood cells Loading...165. Which one of the following glucocorticoids can cause sodium and water retention? Cortisol Betamethasone Triamcinolone Dexamethasone Loading...166. In cases of atrial septal defect (ASD), foramen ovale is formed by incomplete development of which one of the following structures? Septum primum Ostium secundum Ostium primum Septum secundum Loading...167. 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 Metaproterenol Clonidine Epinephrine Methoxamine Loading...168. Which one of the following viruses most likely causes aplastic crisis in sickle cell disease? Rotavirus Herpes simplex virus Parvovirus B19 Hepatitis C virus Loading...169. Which of the following conditions could be a serious side effect of sumatriptan? Cutaneous flushing Torsades de pointes Dilated cardiomyopathy Coronary vasospasm Loading...170. Heparin acts by binding to which of the following substances to achieve its anticoagulant activity? Prothrombin Antithrombin III Factor VIII Factor V Loading...171. Echothiophate, which is used mainly for ophthalmic actions inhibits: DOPA decarboxylase Acetylcholinesterase Catechol-O-methyltransferase (COMT) Tyrosine hydroxylase Monoamine Oxidase Loading...172. 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? Ampicillin Ceftazidime Vancomycin Amphotericin B Acyclovir Loading...173. Which of the following conditions is characterized by the presence of periventricular calcified densities on brain imaging? Cytomegalovirus infection Huntington’s disease Down syndrome Toxoplasmosis Loading...174. Chronic use of which of the following drugs may increase the toxicity of acetaminophen? Cimetidine Ketoconazole Verapamil Ethanol Loading...175. Which of the following markers identifies B lymphocytes in a blood sample treated with different fluorescent-labeled antibodies? CD8 CD19 CD4 CD3Page 8 of 66 Loading...176. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Ibandronate A & B Isoniazid Rabeprazole Furosemide Loading...177. Organophosphorus poisoning can be treated with which of the following agents? Atropine Atenolol Physostigmine Ipratropium bromide Loading...178. 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? Stabilize the patient Ultrasound examination of the pelvis Admit the patient Digital pelvic examination Loading...179. Which one of the following drugs is the most effective in improvement of ascites? Digoxin Lisinopril Hydrochlorothiazide Spironolactone Loading...180. 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? Metastases Osteomalacia Acute osteomyelitis Osteoporosis Loading...181. Which one of the following correctly describes nicotinic Ach receptors? G-protein–coupled receptors Ligand-gated Na+/K+ channels Enzyme-linked receptors Loading...182. Which one of the following conditions is characterized by joint space narrowing and osteophyte formation while bone density appears normal? Osteoarthritis Gout Pseudogout Rheumatoid arthritis Loading...183. 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 followed by tetanus immunoglobulin after 5 days No further therapy Tetanus immunoglobulin Tetanus toxoid Tetanus toxoid and tetanus immunoglobulin Loading...184. Which of the following drug is a part of proton pump inhibitors? Furosemide Rabeprazole Acetazolamide A & B Mannitol Loading...185. Which one of the following drugs causes cyanide toxicity? Nicardipine Clonidine Sodium nitroprusside Minoxidil Loading...186. 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 Physical location of a trait on a DNA molecule An observable physical or biochemical trait on an organism Genetic history of an organism Loading...187. Which of the following differentiates physiologic jaundice from pathologic 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 Bilirubin peaks at higher levels (> 15 mg/dL) in physiologic jaundice Loading...188. Which of the following is the target LDL in a patient with diabetes? 100-130 Less than 70 70-100 More than 130 Loading...189. Which one of the following parts of lymph nodes has T lymphocyte as the predominate cell? Paracortex Germinal center Medulla Cortex Loading...190. 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? Fomepizole Neostigmine Nalaxone Flumazenil Physostigmine Loading...191. Which of the following group is a compulsory part structural formula of Losartan? Carboxylate group Phosphinic acid group Sulfahydril group Imidazole ring Thiol group Loading...192. The antimuscarinic drug used for motion sickness as well as for blockage of short-term memory? Physostigmine Pirenzepine Phenylephrine Atropine Scopolamine Loading...193. A hypoglycemic drug that decreases insulin resistance by binding with peroxisome proliferator-activated receptor gamma (PPAR-gamma) in muscles, fat, and liver? Pioglitazone Glyburide Metformin Sitagliptin Loading...194. 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? Trigeminal nerve Vagus nerve Facial nerve Oculomotor nerve Orbital nerve Loading...195. Which one of the following statements about dobutamine is incorrect? Increase myocardial cAMP Positive inotropic effect Avoid in acute heart failure Increase contractility Loading...196. Which of the following conditions most likely be presented with primary amenorrhea? Pregnancy Pituitary adenoma Turner syndrome Loading...197. Which of the following is the main action of carbidopa when it is used in combination with levodopa in the management of Parkinsonism? It inhibits the conversion of levodopa to dopamine peripherally It reduced levodopa side effects such as hypotension It increases the permeability of blood-brain barrier to levodopa It increases the absorption of levodopa Loading...198. Which one of the following statements about the functions of histamine is incorrect? Cause itching and pain increase peripheral resistance Stimulate gastric acid secretion Constriction of bronchioles Loading...199. Which of these medications is the most appropriate treatment of malignant hyperthermia? Acetaminophen Indomethacin Dantrolene Ibuprofen Loading...200. Which one of the following drugs is a Alpha Glucosidase inhibitors? Indanyl carbenicillin Repaglinide Hydrochlorothiazide Ezetimibe AcarbosePage 9 of 66 Loading...201. Which of the following drugs is used to inhibit viral neuraminidase? Capecitabine Zanamivir Naftifine Acyclovir Ibandronate Loading...202. Which of the following is the role of infliximab in the management of rheumatoid arthritis? It is a TNF-alpha receptor agonist It neutralizes the activity of TNF-alpha by binding to soluble forms of it It is a TNF-alpha receptor antagonist Inhibition of dihydrofolate reductase Loading...203. A drug causes Blockage of the M2 protein ion channel and it's ability to modulate intracellular PH? Amantadine Vidarabine Lamivudine Zanamavir Acyclovir Loading...204. The binding of a drug to plasma proteins will tend to: Decrease its rate of glomerular filtration. Increase its concentration in the plasma. Increase its pharmacological activity Increase its rate of biotransformation. Decrease half-life. Loading...205. Which one of the following local anesthetics can NOT be given parenterally due to its physicochemical properties? Etidocaine Procaine Mepivacaine Benzocaine Loading...206. Which one of the following agents is used to eradicate the organism's (Phthisis pubis) extraerythrocytic phase? Primaquine Chloroguanide Pyrimethamine Quinacrine Chloroquine Loading...207. Which of the following drug is used as a cervical ripening agent to induce labor? Celecoxib Etodolac Ketorolac Dinoprostone Nubemetone Loading...208. Mechanism of action of repaglinide? GLP-1 agonist Insulin sensitiser DPP-IV inhibitor A-glucosidase inhibitor Insulin secretagogue Loading...209. 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 Heroin Morphine Cocaine Loading...210. Which one of the following statements about the use of Alpha-methyldopa is incorrect? Alpha² agonist activity Reduce peripheral resistance Cardiac output is decreased Causes Sedation and drowsiness Loading...211. 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 Hydroxyzine Diphenhydramine Ranitidine Promethazine Loading...212. Which of the following drugs are protein synthesis inhibitor? Linezolid Tetracyclin All of the above Erythromycin Gentamicin Loading...213. Which of the following medications prevents cholesterol absorption at small intestine brush border? Fenofibrate Ezetimibe Niacin Colestipol Loading...214. Erythromycin belongs to the class of following drugs? Antibiotics Anti-malaria Antiviral Antiprotozoal Antipyretic Loading...215. Which of the following drugs is used after chemotherapy to increase the leukocyte count if it drops? Prednisone Dexamethasone Filgrastim Interleukin-2 Loading...216. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Aluminium hydroxide Ezetimibe Nizatidine Indanyl carbenicillin Ethionamide Loading...217. 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? Transference Acting out Displacement Projection Countertransference Loading...218. Which of the following are the major sites for heme synthesis? Bone marrow and kidney Kidney and liver Bone marrow and spleen Bone marrow and liver Kidney and spleen Loading...219. Which one of the following disease is caused by bite of infected ticks? Lyme disease Mycoplasma Pneumonia Cholera Rocky mountain spotted fever Loading...220. Mechanism of action of Abciximab is following? Inhibit glycoprotein receptors Inhibit COX-2 Inhibit ADP mediation Inhibit COX-1 Decrease Calcium levels Loading...221. Which one of the following drugs is a 4th generation Cephalosporin? Cefaclor Cefadroxil Cefdinir Cefepime Loading...222. Following drug consists of an aromatic derivative ring in the structural formula? Atorvastatin Simvastatin Pravastatin Colestipol Lovastatin Loading...223. Autoantibodies to pancreatic islets Beta cells and insulin are found in the following types of Diabetes? Type 1 Diabetes mellitus All of the above Latent autoimmune diabetes of the adults A & C Type 2 Diabetes mellitus Loading...224. Which one of the following is most likely normal in duodenal ulcer? Fasting serum gastrin Parietal cell mass Response of gastrin to food Pepsin secretion Loading...225. Which one of these drugs is associated with aplastic anemia? Penicillin Chloramphenicol Metronidazole NitrofurantoinPage 10 of 66 Loading...226. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Indanyl carbenicillin Ezetimibe Capreomycin Lamivudine 6-thioguanine Loading...227. 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...228. Which one of the following substances is released by sympathetic postganglionic neurons which innervate renal vascular smooth muscle? Dopamine Norepinephrine Epinephrine Acetyl choline Loading...229. EXPLANATION: It is positive in this patient. Tinel sign is reproduction of pain by tapping or percussion on the medial nerve. Erythrocyte sedimentation rate (SER) Anti-cyclic citrullinated peptide Cervical spine x-ray Rheumatoid factor Loading...230. Which of the following substances is used in mercury poisoning? Flumazenil Fomepizole Methylene blue Succimer Loading...231. Which of the following findings is consistent with a case of right lung atelectasis? Trachea is deviated to the left Trachea is deviated to the right Trachea is not deviated (normal location) Loading...232. Which of the following is most likely characteristic of oral route of administration? It is the most appropriate route to interact with most of the emergencies Absorption of the drug depends on the GIT function Most of oral medications reach the bloodstream through the liver It has the fastest onset of effect Loading...233. Which one of the following conditions is associated with Acanthosis Nigricans? Diabetes insipidus Diabetes mellitus Hemochromatosis Amyloidosis Loading...234. 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 EKG Check carboxyhemoglobin level Obtain MRI of the brain Obtain CT scan of the head Loading...235. Which of the following local anesthetics causes vasoconstriction and may lead to an increase of blood pressure? Lidocaine Benzocaine Cocaine Tetracaine Loading...236. Which of the following drugs should NOT be initiated in case of acute decompensated heart failure? Lisinopril Metoprolol Potassium supplements Digoxin Loading...237. 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. Hospitalization and induction of labor Outpatient treatment and recommend regular visits to the clinicat is the next step of management of this patient? Hospitalization and treatment with antihypertensive and epileptic drugs and wait until delivery at term Hospitalization and observation until delivery at term Loading...238. Which of the following pathological terms describes the disordered, non-neoplastic cell growth? Neoplasia Dysplasia Metaplasia Anaplasia Loading...239. 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? Trypanosoma cruzi Treponema pallidum Toxoplasma gondii Herpes simplex virus Togavirus Loading...240. Which one of the following drugs acts mainly by blocking the synthesis of leukotrienes? Cromolyn Montelukast Ipratropium Zileuton Loading...241. Which of the following is the mechanism of action of ciprofloxacin? Inhibits bacterial protein synthesis through binding with 30 S Interferes with bacterial metabolic production Interferes with bacterial cell wall synthesis Inhibits DNA gyrase and relaxation of DNA Loading...242. 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 regurgitation Pulmonic valve stenosis Tricuspid valve regurgitation Mitral valve stenosis Aortic valve stenosis Loading...243. Niemann-Pick disease is characterized by deficiency of which one of the following enzymes? Arylsulfatase Beta-glucosidase Sphingomyelinase Alpha-glucosidase Loading...244. Which one of the following hypertensive drug is poisonous when given orally? Hydralazine Minoxidil Sodium nitroprusside Fenoldopam Loading...245. Which one of the following drugs is a Inducer of the P-GP (glycoprotein) efflux pumps? Digoxin Amiodarone Rifampin Erythromycin All of the above Loading...246. Which one of the following medications is used for cases of Parkinson’s disease and influenza type A? Bromocriptine Amantadine Benztropine Ribavirin Loading...247. Which of the following characterizes intravenous (IV) route of administration? Undergo first pass metabolism Maximum bioavailability Efficacy is affected by liver disorders Rabidly excreted Loading...248. Albumin quantitatively a primary protein in serum is synthesized by? Brain Kidney Lungs Intestine Liver Loading...249. A fenamic acid derivative of Nonsteroidal anti-inflammatory drugs also called? Acetic acid Oxicam N-arylanthranilic acids Propionic acid Salicylates Loading...250. Which of the following types of necrosis occurs in abscesses and brain infarcts? Fibrinoid necrosis Coagulative necrosis Caseous necrosis Liquefaction necrosisPage 11 of 66 Loading...251. 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? Repeat the PPD test and x-ray after 6 months Start treatment with isoniazid for 9 months Start treatment with multiple drug- antituberculosis therapy Isolation and full antituberculous therapy for 6 months Loading...252. Which one of the following medications is the best recommended for induction of medical abortion? Ergotamine Mifepristone Estrogen Progesterone Loading...253. 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? Regression Projection Reaction formation Repression Splitting Loading...254. 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? Hospitalization and intravenous antibiotics Outpatient wide spectrum antibiotics and schedule a visit after 3 days Collect blood and urine samples for culture Schedule MRI of the abdomen and pelvis Schedule Intravenous pyelogram Loading...255. Which one of the following valve abnormalities is related to intravenous drug abuse? Aortic regurgitation Mitral stenosis Aortic stenosis Tricuspid regurgitation Loading...256. 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? Refer to a cardiologist Start heparin Perform electric cardioversion Start metoprolol Order cardiac enzymes Loading...257. Which one of the following procoagulant factors is produced by the epithelial cells? Fibrinogen Prostacyclin von Willebrand’s factor (vWF) Thromboxane A2 Loading...258. Cefaclor belongs to one of the following generations of the cephalosporin? 4th generation 1st generation 3rd generation 2nd generation Loading...259. Heteroaryl acetic acid drug is following? Diclofenac Nabumetone Ibuprofen Piroxicam Indomethacine Loading...260. 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? Clopidogrel Sodium nitroprusside Calcium gluconate Labetalol Heparin Loading...261. 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? Blood glucose Serum creatinine Urinary sodium Alanine aminotransferase (ALT) Loading...262. 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? Lymphoproliferative disease Kaposi’s sarcoma of the palate Torus palatinus Palatal abscess Malignant melanoma of the palate Loading...263. A drug that belongs to proton pump inhibitor is one of the following? Esomeprazole Ethacrynic Acid A & B Rosiglitazone Sulbactam Loading...264. Which one of the following conditions is NOT a common cause of vitamin B12 deficiency? Gastric bypass Diet deficiency of vitamin B12 Malabsorption syndrome Intrinsic factor deficiency Loading...265. Which of the following is the currently drug of choice for the treatment of cutaneous anthrax? Azithromycin Penicillin Gentamicin Ciprofloxacin Loading...266. A single injection of leuprolide was given to a man 2 weeks ago. Which of the following changes could be revealed today? Increased testosterone production Increased FSH receptors Increased LH receptors Decreased testosterone production Loading...267. Which of the following hormone belongs to the posterior pituitary? Urofollitropin Desmopressin Furosemide Somatrem A & B Loading...268. 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 Gaucher disease Pompe disease Loading...269. Aztreonam belongs to the one of the following class? Carbapenems Monobactams Penicillins Cephalosporin Loading...270. Which of the following findings distinguishes chronic renal failure from acute renal failure? High serum sodium History of elevated BUN History of elevated serum creatinine High serum calcium Loading...271. Which of the following are the characteristics of Virchow’s triad? Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) Stasis, hypercoagulability and endothelial damage Hypotension, distant heart sounds and jugular vein distention (JVD) Loading...272. Androgen is released from which part of the adrenal medulla? All of these A & B Zona glomerulosa Zona reticularis Zona fasciculate Loading...273. Which statement is true regarding action of lung surfactant? It lowers surface tension and decreases compliance It affects more large alveoli than sma alveoli It elevates surface tension forces and decreases compliance It lowers surface tension and increases compliance Loading...274. 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 2 Branchial Arch 4 Branchial Arch 3 Branchial Arch 1 Branchial Arch 5 Loading...275. During spermatogenesis, which type of cells enter meiosis 1 to from primary spermatocytes? Spermatids Type B spermatocytes Primordial germ cells Type A spermatocytesPage 12 of 66 Loading...276. Which of the following side effects occurs with both tricyclic antidepressants and phenothiazines? Weight loss Orthostatic hypotension Excessive salivation Seizures Loading...277. Which of the following is the most common primary disturbance of acid-base balance in pregnant women? Respiratory acidosis Respiratory alkalosis Metabolic alkalosis Metabolic acidosis Loading...278. Which one of the following antiretroviral drugs is a protease inhibitor? Ritonavir Etravirine Tenofovir Lamivudine Zidovudine Loading...279. Acyclovir belongs to one of the following classes of drugs? Antibiotics Antiprotozoal Antifungal Antipyretic Antiviral Loading...280. Which one of the following drugs is a inhibitors of the P-GP (glycoprotein) efflux pumps? All of the above A & B Linezolid Amiodarone Digoxin Loading...281. 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 Subcutaneous Sublingual Oral Intravenous Loading...282. Which one of the following drugs is a Thiazide Diuretic? Atorvastatin Fenofibrate Metolazone Indanyl carbenicillin Ezetimibe Loading...283. 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 B3 (Niacin) Vitamin A (Retinol) Vitamin D (Cholecalciferol) Vitamin C (Ascorbic Acid) Vitamin B6 (Pyridoxine) Loading...284. Which of the following is the mechanism of action of metoclopramide? α-Adrenoceptor antagonist Dopamine D2-receptor antagonist Nicotinic receptor antagonist Serotonin reuptake reuptake inhibitor (SSRI) Loading...285. Which one of the following glucocorticoids is a short acting? A & B Amiloride Hydrocortisone Betamethasone Prednisone Loading...286. 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? Acute hepatitis Pancreatic cancer Gall bladder stones Hemolytic anemia Loading...287. Which one of the following antihypertensive medications is directly acting vasodilator? Labetalol Clonidine Nifedipine Enalapril Loading...288. Which of the following side effects is most likely associated to spironolactone? Hyperglycemia Hypercalcemia Metabolic alkalosis Hyperkalemia Loading...289. 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? Bipolar disorder Major depressive disorder Brief psychotic disorder Schizophreniform disorder Schizophrenia Loading...290. Which one of the following statements about the use of Leflunomide is incorrect? Inhibit Dihydroorotate dehydrogenase Reduce pain & inflammation Immunomodulatory agent Can't be used as monotherapy Loading...291. 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? Serology for infectious mononucleosis Throat swab and culture Admit to the intensive care unit Ultrasonography of the neck Prescribe broad spectrum antibiotic Loading...292. 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%? Supplemental oxygen at night Daily oral prednisone Continuous supplemental oxygen Albuterol inhaler as needed Loading...293. 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? Ethyl alcohol Atropine Activated charcoal Sodium nitrite Flumazenil Loading...294. 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 Glucose provides energy for NaCl to increase gastric emptiness It reduces bowel contractions and consequently improves diarrhea Loading...295. Which statement about the Actions of the incretin hormone Glucagon-like peptide-1 is wrong? Suppress appetite Inhibit inappropriate Glucagon secretion Decrease Beta cells growth Increase Glucose-dependent insulin secretion Loading...296. 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 Normochromic normocytic anemia Microcytic anemia Coagulation disorder Macrocytic anemia with neurological signs Loading...297. Indirectly acting reversible cholinergic agonist drug? Echothiophate Tacrine Pilocarpine Acetylcholine Loading...298. 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. Trial of proton pump inhibitor Barium swallow Esophageal manometry Upper endoscopy CT body screening Loading...299. 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? Blood transfusion Prepare for hemodialysis Administer N-acetylcysteine Measure serum acetaminophen concentration Loading...300. 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? Hypoglossus muscle Palatoglossus muscle Styloglossus muscle Genioglossus musclePage 13 of 66 Loading...301. Which of the following statements is true about innate immunity? Resistance persists through generations Its main components are T cells, B cells and circulating antibodies Its main secreted proteins are immunoglobulins Highly specific and refined over time Loading...302. 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? MRI of the brain Further investigations including liver function test Arrange nursing and supportive assistance Begin anti-depressive medication Discontinue atenolol Loading...303. 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? Promethazine Cyproheptadine Carbinoxamine Triplodine Loratadine Loading...304. 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? Iliococcygeus Coccygeus Pubococcygeus Loading...305. 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 Hemosiderin Bilirubin Melanin Loading...306. 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? Lorazepam Midazolam Buspirone Trazodone Promethazine Loading...307. Which one of the following treatment most likely prevents meningeal leukemia in a young boy diagnosed with acute lymphoblastic leukemia? Intrathecal methotrexate Radiotherapy Cyclophosphamide High dose of cortisone Loading...308. Which one of these drugs can lead to weight gain and constipation? Clozapine Pimozide Bromocriptine Ziprasidone Loading...309. Which of the following joint conditions is characterized by narrowing of joint space and formation of osteophytes? Pseudo-gout Rheumatoid arthritis Osteoarthriti Gouty arthritis Loading...310. 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 Head CT scan MRI of the brain Brain biopsy Loading...311. 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? Meningioma Multiple sclerosis Transient ischemic attack Conversion disorder Loading...312. 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...313. Which one of the following drugs is associated the most to tardive dyskinesia after use for years? Risperidone Olanzapine Aripiprazole Chlorpromazine Loading...314. 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? Start treatment after obtaining a written consent from his wife Start treatment immediately Seek guardianship through the court Refer the patient for psychiatric evaluation Schedule another appointment for the patient only to be sure of his own decision Loading...315. 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? Contrast enema IV hydration and antibiotics MRI of the abdomen Refer to surgery for bowel resection Colonoscopy Loading...316. 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 Vaginal examination Transabdominal ultrasonography Loading...317. Which one of the following fractures is incomplete and involving the cortex of only one side of the bone? Torus fracture Nursemaid’s elbow Greenstick fracture Osgood-Schlatter disease Loading...318. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Ethambutol Furosemide Caspofungin A & B Ibandronate Loading...319. Which one of the following is the wrong statement about the use of Acetylcholine as a neurotransmitter? Neurotransmitter of parasympathetic nerves In preganglionic fibers terminated at the adrenal medulla Rapidly inactivated by cholinesterase Neurotransmitter of somatic nerves Acetylcholine has a positive chronotropic effect Loading...320. 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? Septic shock Acute myocardial infarction Left bundle branch block Pericardial effusion Hypertrophic cardiomyopathy Loading...321. Vertebral artery arises from which one of the following arteries? Internal carotid artery Subclavian artery Common carotid artery External carotid artery Loading...322. Which of the following is the best initial management of esophageal candidiasis in an HIV patient? Intravenous amphotericin Oral fluconazole Upper endoscopy Oral nystatin Loading...323. 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 Ampicillin Gentamicin Vancomycin Loading...324. A patient with hyperthyroidism develops a cardiac arrhythmia, the most suitable drug to treat his arrhythmia would include: Digoxin Propranolol Amiodarone Bretylium Loading...325. A drug that belongs to DPP-IV inhibitors is one of the following? Sulbactam Sitagliptin Rosiglitazone Ethacrynic Acid A & BPage 14 of 66 Loading...326. Varicella zoster vaccine is not recommended if an elderly patient already developed shingles. True False Loading...327. Which one of the following is a fatal complication of multiple long bone fractures in a young age? Thromboembolism Fat embolism Pericardial effusion Deep venous thrombosis Loading...328. 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? Staphylococcus aureus Pneumonitis aeruginosa Streptococcus viridans Bacillus anthracis Loading...329. Retention of sodium and water is decreased by using one of the following drugs? Diltiazem Enalapril Acetaminophen Methyldopa Loading...330. Which one of the following substances induces the closure of patent ductus arteriosus? Ibuprofen Prostaglandin E Estradiol Indomethacin Loading...331. Primitive spermatogenic germ cells are located in which one of the following sites? Seminal vesicles Vas deferens Seminiferous tubules Interstitium of the testes Loading...332. 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? Physiological Chemical Competitive Irreversible Loading...333. 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? Langerhans cell histiocytosis Squamous cell carcinoma Mycosis fungoides Malignant melanoma Basal cell carcinoma Loading...334. 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? Drug-induced tubular obstruction Blocking of efferent arteriole vasoconstriction Increased glomerular filtration rate (GFR) Renal interstitial nephritis Increase absorption of water in the proximal convoluted tubules Loading...335. Following are the 17 alpha-Hydroxyprogesterone derivatives Having a pregnane nucleus in the structural formula? Hydroxyzine Promethazine Cyproheptadine Fexofenadine Cetirizine Loading...336. Which of the following explains the higher incidence of sickle cell disease in African Americans more than other races? Increased gene flow Natural selection Genetic drift Increased mutation rate Loading...337. Autoantibodies to pancreatic islets Beta cells and insulin are found in one of the following types of Diabetes? Type 1 Diabetes mellitus Gestational Diabetes mellitus Type 2 Diabetes mellitus Pseudo hypoglycemia Loading...338. 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? Tetralogy of Fallot Tracheoesophageal fistula Pyloric stenosis Tracheomalacia Imperforate anus Loading...339. Which of the following agents most likely causes vasoconstriction? Histamine Bradykinin Norepinephrine Nitric oxide Loading...340. 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? Infection Trauma Pure psychogenic Vascular Endocrine Loading...341. A 30-year-old female after thyroidectomy needs replacement therapy. The preferred thyroid preparation for maintenance replacement therapy is which of the following drugs? Protirelin Liothyronine Desiccated thyroid Liotrix Levothyroxine Loading...342. Which of the following drugs is neuraminidase inhibitor drug? Zanamivir Naftifine Capecitabine Miconazole Ibandronate Loading...343. Beta-Blocker drug is following? Atropine Mecamylamine Metoprolol Tacrine Atracurium Loading...344. Which one of the following drugs is a Thiazide Diuretic? Fenofibrate Indanyl carbenicillin Chlorthalidone Atorvastatin Ezetimibe Loading...345. Incretin mimetic is one of the following? Bumetanide A & B Furosemide Pramlintide Exenatide Loading...346. Which of the following drug belongs to the Oxazolidinone class of Antibiotics? Linezolid Sulbactam Ciprofloxacin Erythromycin Oxytetracycline Loading...347. 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 Median nerve Ulnar nerve Suprascapular nerve Radial nerve Loading...348. Proliferation of endometrial glands results from stimulation by which one of the following hormones? Progesterone Androgen Estrogen Follicle stimulating hormone Loading...349. Which of the following conditions may occur as a result of a long umbilical cord? Nuchal cord Placenta previa Amnion nodosum Abruptio placenta Loading...350. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Benztropine Acetylcholine Tamsulosin Succinylcholine AtropinePage 15 of 66 Loading...351. 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? Chronic hypertension High cholesterol Alcohol Smoking Lyme disease Loading...352. Which of the following drug belongs to the Nonnucleoside reverse transcriptase inhibitor? Abacavir Atazanavir Maraviroc Delavirdine Indanyl carbenicillin Loading...353. Low doses of one of the following drugs produce sedation, but at high doses it produces excitement? Atropine Pirenzepine Scopolamine Phenylephrine Physostigmine Loading...354. What is the most common cause of epididymitis in males older than 35 years of age? Chlamydia Gonococci Streptococci E Coli Loading...355. 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? Conversion disorder Transient ischemic attack Multiple sclerosis Meningioma Loading...356. Maraviroc belongs to the class of following drugs? Antiprotozoal Antifungal Anti malaria Antiviral Antipyretic Loading...357. 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 Negative stool analysis Family history of inflammatory bowel syndrome Having first attack in his twenties History of diarrhea and weight loss Loading...358. 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 Bilirubin Melanin Hemosiderin Loading...359. A toddler swallowed a coin. Which of the following is the most common site of impaction of this coin? Ileocecal junction Esophagus Transverse colon Stomach Loading...360. What is the mechanism of action of finasteride? Stimulation of the posterior lobe of pituitary gland Gonadotropin-releasing hormone analog Inhibition of 5-alpha-reductase Inhibition of testosterone negative feedback Loading...361. 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? Medial calcific sclerosis Deep venous thrombosis Hyperplastic arteriosclerosis Atherosclerosis Loading...362. 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? Transposition of the great arteries Atrial septal defect Patent ductus arteriosus Tetralogy of Fallot Ventricular septal defect Loading...363. Which of the following is the most accurate test for multiple myeloma? Brain MRI Urine electrophoresis 24-hour urine calculation Bone marrow biopsy Loading...364. Which one of the following statements about the digoxin is incorrect? None of these Low therapeutic index 36 hours half-life Indicated for diastolic HF Increase contractility Loading...365. Which one of the following types of cells myelinates axons of neurons of CNS? Astrocytes Microglia Schwann cells Oligodendroglia Loading...366. Which of the following medications is a non-drowsy anti-allergic medication? Diphenhydramine Cetirizine Loratadine Chlorpheniramine Loading...367. 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 Aortic stenosis Myocardial infarction Hypertrophic cardiomyopathy Loading...368. Which of the following defense mechanisms is most likely associated with paranoia? Undoing Splitting Superego lacunae Projection Loading...369. 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 Electrocardiogram (ECG) Echocardiography MRI of the chest Loading...370. Unilateral or bilateral sweating is the symptom of one of the following types of headache? Cluster Headache Migraine Headache Tension-Type Headache A & B Loading...371. Which type of bias is reflected when individuals with severe disease are uncovered because they die first? Measurement bias Confounding bias Selection bias Late-look bias Loading...372. 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 is excreted primarily unchanged in the kidney with a half-life of about 24 hours digitoxin is only available as an oral preparation gastrointestinal absorption of digitoxin is incomplete and highly variable within patients digitoxin has a much higher incidence of toxicity in patients with renal disease digitoxin is highly protein-bound in the serum Loading...373. 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 Gaucher disease Von Gierke disease Pompe disease Loading...374. An empty scrotal sac is found upon examination of a newborn male. Which of the following is the most likely abnormality? Hypogonadism Venous atresia Agenesis Undescended testis Loading...375. In which of the following Diuretic, cyclic sulfonamide is replaced by an Amide? Bendroflumethiazide Chlorthalidone Chlorothiazide Hydrochlorothiazide MethylchlorothiazidePage 16 of 66 Loading...376. 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 Tissue plasminogen activator (tPA) Ticlopidine Loading...377. Which one of the following conditions is a long term complication of cystic fibrosis? Adenocarcinoma of the lung Pneumothorax Bronchiectasis Emphysema Loading...378. Which of the following drug are indandione derivative oral anticoagulants? Heparin Phenindione Phytonadione Menadione Dicumarol Loading...379. Which one of the following drugs works through inhibition of acetyl-cholinesterase enzyme and used in myasthenia gravis? Neostigmine Atropine Montelukast Noradrenaline Loading...380. Which statement about the use of pilocarpine is wrong? Produce rapid miosis Lack of selectivity relaxation of Ciliary muscles Used for Xerostomia Used for Sjögren syndrome Loading...381. Which one of the following gastrointestinal conditions is NOT associated with blood in stools? Diverticulosis Irritable bowel syndrome Ulcerative colitis Cancer colon Loading...382. The only type of insulin that should be given intravenously is one of the following? A & B Regular Lispro Detemir Glargine Loading...383. Which of the following cells of the ovary secretes inhibin, follistatin and activin? Surface epithelial cells Granulosa cells Theca externa cells Theca interna cells Loading...384. Which of the following organisms is responsible for the development of oral hairy leukoplakia in HIV patients? Candida albicans Epstein-Barr virus Bartonella henselae Human papilloma virus Loading...385. Intermediate Acting Insulin is one of the following? NPH (neutral Protamine hagedorn) Detemir Glargine Lispro Loading...386. When a blood clot adhere to vessel wall this is called as one of the following? Coagulation All of the above Embolus Thrombus Loading...387. 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 Refer to cardiologist Heparin Metoprolol Aspirin Loading...388. Which of the following medications is the drug of choice for motion sickness? Scopolamine Tolterodine Dicyclomine Benztropine Loading...389. Which one of the following drugs is used to treat copper toxicity? Atropine Penicillamine Aminocaproic acid Protamine Loading...390. Which one of the following conditions is characterized by high blood pressure, hypokalemia and elevated renal potassium? Fanconi syndrome Waardenburg syndrome Liddle syndrome Tay-sachs disease Loading...391. Which one of the following drugs belongs to Antidiarreals? Aluminium hydroxide Indanyl carbenicillin Nizatidine Ezetimibe Atorvastatin Loading...392. 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? Rickettsia Fungi Mycobacteria Streptococci Mycoplasma Loading...393. Which of the following is the main mechanism of action of methylergonovine in treating postpartum hemorrhage? Strong vasoconstriction Blocking sympathetic stimulation Forceful contraction of myometrium Instant blood coagulation Loading...394. Which one of the following drugs is commonly contributing to hypokalemia? Verapamil Lisinopril Furosemide Spironolactone Loading...395. Which of the following drug contain the Sulfahydril group in the structural formula? Quinapril Ramipril Captopril Lisinopril Enalapril Loading...396. 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? Homophilus influenzae Candida albicans Moraxella catarrhalis Pseudomonas aeruginosa Streptococcus pneumoniae Loading...397. Which one of the following is characteristic of Chlamydia? Obligate intracellular Facultative intracellular Anaerobic bacteria Gram-negative diplococci Loading...398. A drug used in severe DIGITALIS toxicity is the following drug? Amyl Nitrate DIGIBIND Calcium Gluconate Fomepizole Loading...399. 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? Duodenal atresia Meckel’s diverticulum Esophageal atresia Pyloric stenosis Loading...400. Ranitidine is used to treat one of the following diseases? Diabetes Blood pressure Malaria Stomach Ulcer Viral infectionPage 17 of 66 Loading...401. Which of the following is responsible for the wrinkled appearance of the scrotum? Pampiniform plexus Thickened keratinized epithelium Dartos fascia Tunica albuginea Loading...402. Rocky mountain spotted fever is caused by following? Clostridium tetani Chlamydia trachomatis Spirochetes Rickettsia Rickettsii Loading...403. 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? Limits the production of histamine Inhibits the production of prostaglandin E2 Stimulates the production of prostaglandin E2 Interferes with the production of leukotrienes Inhibits the production of Phospholipase A2 Loading...404. Which one of the following amines is permanently charged? Secondary Tertiary Quaternary Primary Loading...405. Bulging of anterior fontanelle is considered after examination of which one of the following anatomic landmarks? Lambda Bregma Sagittal suture Pterion Loading...406. During normal inspiration, the diaphragm: Does not move Relaxes Contracts Loading...407. Which one of the following drugs has a relatively lowest potential to induce drowsiness? Acrivastine Fexofenadine Loratadine Cetirizine Loading...408. 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? Tay-Sachs disease Niemann-Pick disease Fabry’s disease Gaucher’s disease Loading...409. Indirect acting irreversible cholinergic agonist drug? Tacrine Echothiophate Neostigmine Pilocarpine Loading...410. A direct-acting adrenergic agonist is following? A & B Clonidine Albuterol Acetylcholine Amphetamine Loading...411. Which of the following muscles are responsible for primary abduction of the arm at the shoulder joint? Deltoid and supraspinatus Supraspinatus and infraspinatus Deltoid and infraspinatus Coracobrachialis and deltoid Loading...412. Which of the following is the mode of inheritance of cystic fibrosis? X-linked dominant X-linked recessive Autosomal dominant Autosomal recessive Loading...413. Which of the following signs of infective endocarditis appears as small, tender nodules on the finger and toe pads? Splinter hemorrhages Osler nodes Janeway lesions Roth’s spots Loading...414. 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? Patent processus vaginalis Defective closure of tunica vaginalis Undescended testis Defect in the inguinal canal Defect in the pelvic floor Loading...415. 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...416. 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? Male pseudohermaphrodite True hermaphrodite Female pseudohermaphrodite Turner’s syndrome Loading...417. Duration of action of nitroprusside is following? 15 to 30 minutes 30 minutes 3 to 6 hours 1 to 2 minutes Loading...418. Control of diabetes is most likely determined by which one of the following laboratory tests? Fasting blood glucose Random blood glucose Urinary glucose content Hemoglobin A1C Loading...419. A drug that is a part of Macrolide is following? Cefepime Azithromycin Cefdinir Cefaclor Loading...420. 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? Folic acid deficiency anemia Iron deficiency anemia Vitamin B12 deficiency Aplastic anemia Loading...421. 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/Lat is the most likely diagnosis? Psychogenic polydipsia Diabetes insipidus Solute diuresisine Na: 18 mEq/L Urine osmolality: 260 mOsm/kg after 4h fluid deprivation. Urinary tract infection Diabetes mellitus Loading...422. Tazobactam belongs to the one of the following class? Monobactams Carbapenems Cephalosporin Penicillins Beta lactamase inhibitor Loading...423. 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 succinylcholine IV procainamide IV adenosine Try carotid massage on the left side IV lidocaine Loading...424. Liposomal preparation of one of the following drugs decreases the risk of nephrotoxicity? Ethambutol Nystatin Isoniazid Amphotericin B Loading...425. A drug that inhibits the fungal squalene epoxidase thus decreasing the synthesis of ergosterol? Itraconazole Terbinafine Nystatin GriseofulvinPage 18 of 66 Loading...426. Which one of the following maneuvers is recommended to deliver the baby arms in breech delivery? Mauriceau-Smellie-Veit maneuver Lovest maneuver Prague maneuver Pinard maneuver Loading...427. 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? Normal reaction Chronic rejection Hyperacute rejection Acute rejection Acute pyelonephritis Loading...428. Administration of spironolactone and furosemide leads to which of the following? Reduce magnesium loss Reduce potassium loss Increase potassium loss Reduce sodium loss Loading...429. Which of the following regions of the brain is most likely affected in patients with Huntington’s disease? Temporal lobe Caudate nucleus Anterior frontal lobe Substantia nigra Loading...430. Which one of the following naturally occurring penicillins has a higher minimum bactericidal concentration and can't be used for bacteremia? Penicillin G Penicillin V Methicillin Amoxicillin Loading...431. 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 Suprascapular nerve Ulnar nerve Median nerve Loading...432. Which of the following is considered a limiting adverse effect of ACE inhibitors? Hyperkalemia Hyponatremia Acidosis Hypokalemia Loading...433. Which of the following receptors are membrane receptors (not intracellular)? Receptors for steroids Receptors for vitamin D The nicotinic receptors for acetylcholine Receptors for thyroid hormones Loading...434. Which of the following is the most common cause of congestive heart failure associated with systolic impairment in the United States? Alcohol Atherosclerosis Rheumatic heart disease Diabetes Loading...435. 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 It reduces bowel contractions and consequently improves diarrhea Glucose provides energy for NaCl to increase gastric emptiness Cotransport of glucose and NaCl across the intestinal membrane facilitates absorption of water and Na. Loading...436. Which of the following is the classic electrocardiogram (ECG) finding in atrial flutter? S-T segment elevation in anterior leads (V1-V4) Sawtooth P waves Diffuse S-T segment elevation S-T segment elevation in leads II. III and aVF Loading...437. Which one of the following types of cells is programmed to destroy cells the fail to display MHC class 1 antigen properly? Natural killer cells CD8 lymphocyte B lymphocyte CD4 lymphocyte Loading...438. Decreased production of which type of collagen may result in osteogenesis imperfecta? Type III Type IV Type II Type I Loading...439. Stimulation of muscarinic receptors by pilocarpine is competitively inhibited by which of the following medications? Atropine Pralidoxime Edrophonium Physostigmine Loading...440. 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...441. A drug that effects the thyroid hormone is one of the following? Bumetanide Thyroxine A & B Sulbactam Furosemide Loading...442. Which of the following correctly describes unstable angina? Angina relieved by rest Angina occurs at rest Angina following strenuous exercise Loading...443. Which one of the following statements about the use of Celecoxib is wrong? Causes kidney toxicity Selective inhibitor of COX-2 Half-life of 11 hours Inhibition is irreversible Loading...444. 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? Vancomycin Ampicillin and gentamicin Ampicillin Ceftazidime Ceftazidime and gentamicin Loading...445. Which one of the following drugs is a potassium channel blocker (Class III)? Amiodarone Carvedilol Verapamil Procainamide Loading...446. Which one of the following conditions most likely shows lower than normal erythrocyte sedimentation rate (ESR)? Multiple myeloma Giant cell arteritis Polycythemia Pregnancy Loading...447. Which of the following is the appropriate treatment of a moderate case of acne vulgaris? Benzyl peroxide Topical antibiotic Oral isotretinoin Oral antibiotic and topical therapy Loading...448. Conversion of ethanol to acetate will result in increase production of which of the following? Oxaloacetate NADH Pyruvate NAD Loading...449. Which one of the following indicates drug resistance? No or minimum effect on a microorganism due to genetic mutation Induction of liver metabolism Altered effect of the drug when used with another drug Response to a drug decreases after repeated use Loading...450. Which one of the following drugs is a calcium channel blocker (Class IV)? Verapamil Amiodarone Procainamide CarvedilolPage 19 of 66 Loading...451. Which one of the following drugs is effective only for the influenza A virus? Zanamivir A & B Rimantadine None of these Oseltamivir Loading...452. 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 metoprolol Order cardiac enzymes Perform electric cardioversion Refer to a cardiologist Start heparin Loading...453. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Ethambutol Ibandronate A & B Furosemide Fluconazole Loading...454. Which one of the following cells is derived from monocytes and lying within the alveoli? Macrophages Pneumocytes type II Pneumocytes type I Clara cells K cells Loading...455. 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...456. 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? Parathyroid hormone Calcitonin Vitamin D Levothyroxine Calcium gluconate Loading...457. Gingival hyperplasia, granulocytopenia and facial hirsutism are possible side effects of which one of the following medications? Phenytoin Phenobarbital Valproic acid Carbamazepine Loading...458. 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? Diltiazem Metoprolol Atenolol Verapamil Captopril Loading...459. Which of the following is the main step in treating alcoholic liver disease? Abstinence Baclofen Disulfiram Naltrexone Loading...460. 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? Refer to a rheumatologist Electromyography X-ray of lumbar spine Complete bed rest with ibuprofen for 3 days HLA-B27 testing Loading...461. 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? Riboflavin deficiency Thiamine deficiency Folic acid deficiency Niacin deficiency Vitamin B12 deficiency Loading...462. Which one of the following medications causes black stools? Iron Ampicillin Buspirone Propranolol Loading...463. A patient presents with persistent dry cough and high potassium. Which of the following medications is associated with these side effects? Albuterol Captopril Digoxin Furosemide Loading...464. Which one of the following studies measures heritability and influence of environmental factors? Adoption study Cohort study Case-control study Cross-sectional study Loading...465. Which of the following agents reduce the blood levels of certain drugs through its action on hepatic P450 system? Kava St. John’s wart Guava juice Grapefruit juice Loading...466. In which one of the following locations a mural thrombus commonly occurs following myocardial infarction? Left ventricle Thoracic aorta Left atrium Right ventricle Right atrium Loading...467. A patient becomes tetanic because of a recent thyroidectomy. Rapid Reversal of this problem can be done by giving the patient? PTH Calcitonin Plicamycin (mithramycin) Calcium gluconate (CaG) Vitamin D Loading...468. A patient with acute appendicitis complains of abdominal pain. Which of the following chemical mediators are responsible for this pain? Prostaglandin and bradykinin Histamine and serotonin Tumor necrosis factor and IgG Leukotriene and interlukin-1 Loading...469. Amylin consecrated with insulin has the following actions except? Decrease postprandial glucagon secretion Delayed gastric emptying time Suppress appetite Increase beta-cell growth Loading...470. 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 followed by tetanus immunoglobulin after 5 days Tetanus toxoid and tetanus immunoglobulin No further therapy Tetanus immunoglobulin Tetanus toxoid Loading...471. Which of the following leads to toxic reactions when a drug is taken repeatedly? Absorption disorder Tolerance Tachyphylaxis Cumulative action Loading...472. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Lamivudine Gemcitabine Ezetimibe Capreomycin Indanyl carbenicillin Loading...473. Terbinafine is a drug of choice for treating dermatophytoses, it's blood levels are Increased by following drug? Cimetidine Nystatin Caspofungin Rifampin Loading...474. Which of the following hormone belongs to the posterior pituitary? Urofollitropin A & B Furosemide Vasopressin Somatrem Loading...475. Which of the following drugs is used to inhibit viral neuraminidase? Ibandronate Oseltamivir Capecitabine Acyclovir NaftifinePage 20 of 66 Loading...476. Which of the following hormone belongs to the oral diabetic agent? Acarbose A & B Furosemide Somatrem Oxytocin Loading...477. Which one of the following antibiotics is the empiric treatment of cellulitis in a diabetic patient? Neomycin Vancomycin Imipenem Amoxicillin Loading...478. Which of the following management plans is recommended for a case of myocardial infarction with 70% main left stenosis? Percutaneous transluminal coronary angiography (PTCA) Percutaneous coronary intervention (PCI) Pharmacotherapy and observation Coronary artery bypass graft (CABG) Loading...479. 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? Rosacea Seborrheic keratosis Shingles (herpes zoster) Psoriasis Dermatitis herpetiformis Loading...480. Amylin hormone is released from one of the following cells? Pancreatic Delta cells Pancreatic Beta cells Pancreatic Alpha cells juxtaglomerular cells Loading...481. A 35-year-old man complains of pain and swelling in the sacro-coccygeal region. Which of the following is the most likely diagnosis? Pilonidal abscess Liposarcoma Perianal abscess Suppurative hidradenitis Loading...482. Which one of these drugs reverses both muscarinic and nicotinic effects of organophosphorus compounds by restoring cholinesterase? Atropine Physostigmine Pralidoxime Atracurium Loading...483. Which of the following is the classic electrocardiogram (ECG) finding in pericarditis? Diffuse S-T segment elevation Sawtooth P waves S-T segment elevation in leads II. III and aVF S-T segment elevation in anterior leads (V1-V4) Loading...484. 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 Frozen shoulder Shoulder dystocia Rotator cuff tear Loading...485. Sjögren syndrome is characterized by a dry mouth and lack of tears. what is the recommended drug for this syndrome? Tropicamide Cyclopentolate Atropine Pilocarpine Bethanechol Loading...486. 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 Cancer thyroid Radioactive induced thyrotoxicosisat is the most likely diagnosis? Loading...487. 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...488. Which one of the following oral anti-diabetic drugs is associated with lactic acidosis? Metformin Pioglitazone Glipizide Nateglinide Loading...489. Which one of the following drugs is a thiazide diuretic drug? Chlorthalidone Amiloride Bumetanide Acetazolamide Loading...490. Which of the following is the first line therapy for gastroparesis in patients with diabetes? Metoclopramide Omeprazole Cimetidine Ondansetron Loading...491. 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 Achalasia Peptic esophageal stricture Diffuse esophageal spasm Cancer esophagus Loading...492. Which of the following differentiates HIV virus from RNA tumor viruses? HIV virus is a retrovirus HIV virus contains the pol gene HIV virus contains 2 copies of RNA HIV virus has a cytolytic activity Loading...493. Which of the following placental sites of insertion most likely predispose to an inverted uterus? Lower Posterior Fundal Anterior Loading...494. Which one of the following statements of tetracycline is wrong? Deposition in bones and teeth Avoid in Pregnancy Causes GIT disturbance Bind with 50S ribosomal subunit Loading...495. One of the OATPs (Organic anion transporting polypeptides) drugs transporters OATP4C1 has a mainly limited distribution to the following? Liver Heart Skin Stomach Kidney Loading...496. 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 theophylline Interaction of ciprofloxacin to ipratropium bromide Interaction of ciprofloxacin to Lisinopril Interaction of ciprofloxacin to albuterol Interaction of ciprofloxacin to oxygen Loading...497. A young woman presents with chronic diarrhea found to have rectovaginal fistula. Which of the following is most likely her diagnosis? Ulcerative colitis Crohn’s disease Ischemic colitis Celiac disease Loading...498. Which of the following drug is a PGF2-Alpha analog? Treprostinil Dinoprostone Epoprostenol Carboprost Misoprostol Loading...499. Which one of the following drugs is used for subcutaneous and systemic mycoses? Butoconazole Griseofulvin Itraconazole Econazole Loading...500. Which one of the following drugs causes teratogenic effect? Oseltamivir Ribavirin Zanamavir Amantadine RimantadinePage 21 of 66 Loading...501. Which one of the following drugs is a Proteas inhibitor? Maraviroc Abacavir Indanyl carbenicillin Atazanavir Delavirdine Loading...502. Which of the following drug is belong to the dihydropyridines class of antihypertension? Amiloride Verapamil Losartan Amlodipine Diltiazem Loading...503. Which of the following is the active form of vitamin D? 1-dihydroxycholecalciferol 25-hydroxycholecalciferol 1,25-dihydroxycholecalciferol Cholecalciferol Loading...504. 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? Left bundle branch block (LBBB) Hypertrophic cardiomyopathy Pericardial effusion Septic shock Acute myocardial infarction Loading...505. Which one of the following drugs belongs to 3st generation Cephalosporins? Cefadroxil Cefdinir Cefepime Cefaclor Loading...506. Loss of individual cells by fragmentation of nuclei and cytoplasm caused by a chemotherapeutic agent is produced through which one of the following mechanisms? Mitochondrial poisoning Apoptosis Acute inflammation Phagocytosis Loading...507. 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 a non-selective beta-blocker while labetalol is a beta1 blocker Atenolol is a beta 2 blocker while labetalol is a beta1 blocker Atenolol is both beta and alpha-blocker while labetalol is a beta-blocker only Atenolol is a beta1 blocker while labetalol is both alpha and beta-blocker Atenolol is a beta1 blocker while labetalol is a beta 2 blocker Loading...508. Which of the following is the most dangerous adverse effect of chronic alcohol abuse? Live cirrhosis Cutaneous vasodilation Impaired judgment Respiratory depression Loading...509. Which one of the following statements about the functions of ACE inhibitors is wrong? Increase level of bradykinin Decrease output of the sympathetic nervous system Increase vasodilation of vascular smooth muscle Increase retention of sodium and water Loading...510. A drug that act as laxative is one of the following? Sulbactam Furosemide Bumetanide A & B Sodium phosphate Loading...511. 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? Gentamicin Ampicillin Piperacillin Vancomycin Loading...512. 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 coronary artery disease HRT decrease the risk of stroke HRT decrease the risk of hot flashes and vaginal dryness HRT decrease the risk of deep venous thrombosis HRT decrease the risk of breast cancer Loading...513. The pericardial cavity is a space lies between which of the following structures? Epicardium and myocardium Parietal serous pericardium and visceral serous pericardium Parietal fibrous pericardium and visceral fibrous pericardium Epicardium and pericardium Loading...514. Which one of the following medical conditions is associated with an arthritis that resembles ankylosing spondylitis? Crohn’s disease Whipple disease Celiac disease Peptic ulcer Loading...515. Miconazole belongs to the following type of drugs class? Antiviral Anti malaria Antifungal Antibiotics Antipyretic Loading...516. One of the following statements about the sympathetic neurons is wrong? Preganglionic neurons originated from Lumber Originated from Efferent autonomic system Preganglionic neurons are Long Postganglionic neurons innervate tissues Preganglionic neurons originated from thoracic Loading...517. 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? Middle meningeal artery Cavernous sinus Inferior cerebral artery Superior cerebellar artery Loading...518. 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 Start prednisone Carotid Doppler studies CT scan of the head Loading...519. 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? Digoxin Furosemide Atenolol Epinephrine Albuterol Loading...520. Which of the following is the mechanism of action of benzodiazepines in the treatment of insomnia? Dopamine receptor agonist Alpha adrenergic antagonist Binds to GABA receptors Binds to serotonin receptors Loading...521. Polyuria is an adverse effect of which of the following drug? Conivaptan Desmopressin Oxytocin Vasopressin Loading...522. Which one of the following oral hypoglycemic drugs is the initial therapy for patients with type 2 diabetes? Acarbose Glyburide Metformin Repaglinide Loading...523. 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? Progesterone deficiency Estrogen deficiency Testosterone deficiency Thyroid hormone deficiency Loading...524. 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? Aortic stenosis Mitral stenosis Tricuspid regurgitation Mitral valve prolapse Dilated cardiomyopathy Loading...525. Which one of the following drugs is the first line medication in transplant immunopharmacology? Methotrexate Cyclosporine Sulfasalazine ThalidomidePage 22 of 66 Loading...526. 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 Arteriosclerosis Embolism Loading...527. Pins and needles and numbness is the adverse effect of the following drug? Streptomycin Nystatin Ethambutol Isoniazid Loading...528. 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? Begin methimazole therapy Surgery and life-long levothyroxine Begin radioactive iodine Supportive treatment until it resolves Life-long levothyroxine Loading...529. Receptors have a high sensitivity for which of the following drug? Norepinephrine Isoproterenol Epinephrine All of these A & B Loading...530. 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? Ovarian cancer Endometrial cancer Lung cancer Liver cirrhosis Cervical cancer Loading...531. 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? Cerebellum Ankle and elbow joints Parietal lobe Frontal lobe Loading...532. Which of the following drug belongs to potassium sparing Diuretics? Amiloride Urea Acetazolamide Furosemide A & B Loading...533. Which one of the following glucocorticoids is long acting? Betamethasone A & B Prednisone Cortisone Amiloride Loading...534. Which of the following statements correctly describe the lag time of a drug? Time from administration of the drug to appearance in blood 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 reaching minimal effect concentration Loading...535. Measurement of the content of which one of the following could help to compare the collagen content of several tissues? Proline Hydroxyproline Cysteine Glycine Loading...536. What is the mechanism of action of zileuton? Inhibition of cytokine production Inhibition of muscarinic receptor action Inhibition of calcium (Ca2+) channel activity Inhibition of mediator release Inhibition of leukotriene production Loading...537. Which one of the following drugs is a microtubule inhibitor chemotherapeutic drug? Vincristine Dactinomycin Busulfan Methotrexate Loading...538. Prophylaxis in HIV patients with TMP-SMX should be initiated at which of the following CD4 counts? Under 50 Under 100 Under 300 Under 200 Loading...539. Zalcitabine belongs to the class of following drugs? Antiprotozoal Antiviral Anti malaria Antipyretic Antifungal Loading...540. Which of the following is the most common complication of diverticulosis? Diverticulitis Obstruction Bleeding Perforation Loading...541. The therapeutic indication of Tamoxifen Drug specifically is to treat one of the following diseases? Thromboembolic disease Treat osteoporosis Estrogen-dependent Breast Cancer Fluid retention Induce ovulation Loading...542. Which of the following is the mechanism of action of metoprolol in angina? Increases central venous pressure Increases peripheral resistance Reduces requirement of the heart for oxygen Reduces production of epinephrine Loading...543. A drugs interfere with metabolism of azathioprine requiring a reduction in dosage? Probenecid Sulfinpyrazone Colchicine Allopurinol Loading...544. Prolonged use of which one of the following diuretics can lead to hyperkalemia and gynecomastia? Furosemide Acetazolamide Spironolactone Hydrochlorothiazide Loading...545. The therapeutic indication of Clomiphene drug specifically is to treat the following disease? Thromboembolic disease Estrogen-dependent Breast Cancer Fluid retention Induce ovulation Treat osteoporosis Loading...546. Gynecomastia is the adverse effect of the following drug? Griseofulvin Fluconazole Flucytosine Ketoconazole Loading...547. 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? Pulmonic stenosis Mitral regurgitation Aortic stenosis Mitral stenosis Aortic insufficiency Loading...548. Which drug belongs to the Quinoline methanol antimalarial class? Mefloquine Quinine Quinidine Chloroquine Pyrimethamine Loading...549. A drug that belongs to Loop Diuretics is one of the following? Sulbactam Ethacrynic Acid A & B Cefazolin Doripenem Loading...550. Thyroid hormone can cause which one of the following effects? Lowers blood cholesterol Lowers oxygen consumption Hypoglycemia Lowers body temperaturePage 23 of 66 Loading...551. Absorption of levodopa-carbidopa is reduced when taken with meals rich in which of the following nutrients? Carbohydrate Fat Protein Loading...552. 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/dl Thrombotic thrombocytopenic purpura Idiopathic thrombocytopenic purpura Hemophilia aukocyte count: 25,000 – 80% neutrophils Platelet count: 20,000 Hemophilia bat is the most likely diagnosis? Disseminated intravascular coagulation Loading...553. 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 Alzheimer’s disease Vascular dementia Creutzfeldt-Jakob disease Lewy body dementia Loading...554. 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? CREST syndrome Mallory-Weiss syndrome Staphylococcal food poisoning Bulimia nervosa NSAID-induced esophagitis Loading...555. Which of the following is the most serious contraindication of electroconvulsive therapy? Old age History of seizures Meningioma History of fracture Loading...556. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Pyrazinamide A & B Ibandronate Rabeprazole Furosemide Loading...557. 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? Kwashiorkor Pellagra Marasmus Scurvy Loading...558. Which one of the following anti-arrhythmic drugs may lead the development of torsade de pointes at therapeutic doses? Propranolol Adenosine Lidocaine Quinidine Loading...559. Which of the following drug is a derivative of Propionic acid? Diflunisal Etodolac Piroxicam Mefenamic Acid ketorolac Loading...560. Which one of the following conditions characterized by hemolytic episodes caused by increased erythrocyte sensitivity to complement lytic actions? Glucose-6-phosphate dehydrogenase deficiency anemia Hereditary spherocytosis Paroxysmal nocturnal hemoglobinuria Sickle cell anemia Loading...561. 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? C7 and C8 C6 and C7 C8 and T1 C5 and C6 Loading...562. What is the correct match regarding the genetic transmission of the following diseases? Leber hereditary optic neuropathy- Mitochondrial inheritance Duchenne muscular dystrophy- X-link dominant Huntington’s disease- Autosomal recessive Hypophosphatemic rickets- X-link recessive Loading...563. Which one of the following drugs is a Meglitinide drug? Indanyl carbenicillin Fenofibrate Ezetimibe Hydrochlorothiazide Repaglinide Loading...564. Which of the following is the mechanism of action of cromolyn for asthmatic patients? Inhibits COX 2 Blocks adenosine receptors in bronchial smooth muscle Inhibits phosphodiesterase Prevents degradation of mast cells Loading...565. 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 ventricle Left ventricle Right atrium Loading...566. Which of the following medications is most likely prescribed in cases of asthma associated with chronic environmental allergies? Oral fexofenadine Oral montelukast Albuterol inhaler Fluticasone nasal spray Loading...567. Estrogen is the female hormone due to which female sex organs and secondary sexual characteristics developed. Estrogen has the following adverse effects except? Endometrial cancer Thromboembolic disease Paresthesia Fluid retention Hepatic Adenoma Loading...568. Which of the following medications reduces the effectiveness of oral contraceptives? Omeprazole Carbamazepineich of the following medications is the best treatment of absence seizures? Ketoconazole Ritonavir Loading...569. Which one the following parts of the large intestine is extraperitoneal? Sigmoid colon Descending colon Cecum Transverse colon Loading...570. Which of the following drugs causes Rhabdomyolysis as an adverse effect? Simvastatin Dronedarone Digoxin Amikacin Warfarin Loading...571. 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 3.2 2.3 Loading...572. Which of the following locations is the most common site of mural thrombus following myocardial infarction? Right ventricle Right atrium Aorta Left ventricle Loading...573. Which one of the following is a anterior pituitary hormone? Torsemide Fenofibrate Desmopressin Urofollitropin Atorvastatin Loading...574. Which one of the following drugs is used to treat asthma? Hydrochlorothiazide Ezetimibe Ipratropium Indanyl carbenicillin Repaglinide Loading...575. Which one of the following reactions occurs between five days and three months after transplant? Acute rejection Delayed rejection Hyperacute rejection Chronic rejectionPage 24 of 66 Loading...576. 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? Borderline personality disorder Obsessive compulsive disorder Antisocial personality disorder Conduct disorder Histrionic personality disorder Loading...577. Which one of the following drugs binds with dietary phosphate & prevents its absorption? Calcitonin Sevelamer Rabeprazole Furosemide Acetazolamide Loading...578. 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 heparin Start low molecular weight heparin and warfarin Loading...579. Which of the following is considered an indication of first-generation histamine H1-receptor blockers? Peptic ulcer Allergy Apoplexy Cough Loading...580. A thiophene-containing agent that blocks the synthesis of leukotrienes by inhibiting 5_ lipoxygenase is the following? Montelukast Zafirlukast Acetaminophen Zileuton Loading...581. Which one of the following drugs belongs to alkylating agent? Gemcitabine Indanyl carbenicillin Dacarbazine Capreomycin Lamivudine Loading...582. 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? Ewing sarcoma Osteoporosis Osteosarcoma Metastatic adenocarcinoma Loading...583. Which one of the following drugs increase survival in patients with MI? Furosemide Atenolol Verapamil Digoxin Loading...584. 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 Forming a layer to protect gastric mucosa Inhibition of H+/K+ ATPase pump Blocking of H2 receptor Loading...585. Which one of the following drugs is the most effective in midazolam paradoxical reaction? Protamine Albuterol Adrenaline Flumazenil Loading...586. A) Bupropion Haloperidol Methylphenidate Ethosuximide Loading...587. Which one of the following is the adverse effect of ACE inhibitors? Skin rashes All of the above Dry cough A & B hypokalaemia Loading...588. Which of the following is the most important risk factor for coronary artery disease? High LDL cholesterol Obesity High total cholesterol Low HDL cholesterol Loading...589. Which of the following is the mechanism of action of the main drug used for the treatment of high LDL cholesterol? Inhibition of cholesterol uptake by the liver Decreased synthesis of LDL receptors Breakdown of adipose tissues Inhibition of HMG-CoA reductase Loading...590. The gland responsible for secretion of prolactin is derived from which of the following structures? Neurohypophysis Primordial follicle Rathke’s pouch Infundibulum Loading...591. 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? Alcohol Phencyclidine Cocaine Lysergic acid diethylamide Loading...592. 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 Barium enema Fecal occult blood test Anoscopy Sigmoidoscopy Loading...593. Which of the following is higher in athletics than in non-athletics in resting conditions? Stroke volume Heart rate Oxygen consumption Cardiac output Loading...594. Which one of the following enzymes catalyzes the transformation of testosterone into DHT? Aromatase 5 α-reductase 17α-hydroxylase Cholesterol side chain cleavage enzyme (CYP11A1) Loading...595. Para-aminophenol derivative drug is the following? Mefenamic acid Meloxicam None of these Celecoxib Acetaminophen Loading...596. 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 Interferon alfa Acyclovir HBV vaccine Famciclovir Loading...597. 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? Agranulocytosis Hepatic toxicity Thrombocytopenia Hearing loss Loading...598. 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? Lead poisoning Iron deficiency β-thalassemia Sickle cell anemia Loading...599. Which one of the following drugs is used to treat constipation? Metamucil Sevelamer Sodium polystyrene sulfonate A & B Alendronate Loading...600. Which one of the following stain is most likely relevant to diagnose Cryptococcus neoformans? Giemsa stain Silver stain India ink stain Ziehl-Neelsen stainPage 25 of 66 Loading...601. During development, hypothalamus arises from which one of the following structures? Metencephalon Telencephalon Mesencephalon Diencephalon Loading...602. Which of the following differentiates Dubin-Johnson syndrome from Rotor syndrome? Black pigmentation of the liver Conjugated hyperbilirubinemia Level of liver enzymes Mode of inheritance Loading...603. Which of the following chemotherapeutic agents is specific for the M phase of the cell cycle? Vincristine Mechlorethamine Cytarabine Hydroxyurea Daunorubicin Loading...604. Which of the following drugs is used for respiratory virus infections? Miconazole Naftifine Capecitabine Oseltamivir Ibandronate Loading...605. Immune-related problem is one of the following? Fever Aids Headache High Blood pressure Loading...606. 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? Propylthiouracil Levothyroxine Dobutamine Warfarin Iodine Loading...607. 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 Ovarian cyst Acute appendicitis Pelvic abscess Endometriosis Loading...608. Which of the following statements is correct regarding the apex of the upright lung compared to its base? Blood perfusion is lower at the apex than at the base Ventilation/perfusion ratio is lower at the apex than at the base Alveoli are more compliant at the apex than at the base Alveoli are smaller at the apex than at the base Loading...609. 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? Blood glucose control Blood pressure control Cholesterol reduction Weight loss Loading...610. 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? Acetazolamide Clonazepam Ethosuximide Gabapentin Carbamazepine Loading...611. Which of these medications is the drug of choice in treatment of severe digitalis intoxication? Propranolol Immune Fab Calcitonin Bupropion Loading...612. Which of the following beta blockers has the longest duration of action? Metoprolol Nadolol Sotalol Propranolol Loading...613. 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? Streptococcus pneumonia Cryptococcus neoformans Toxoplasma gondii Aspergillus fumigatus Loading...614. A drug that elevate bronchial smooth muscle cAMP leading to decreased intracellular calcium and prompt bronchodilation. Clonidine Phenylephrine Epinephrine Dipivefrin Albuterol Loading...615. 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? Blood samples and intravenous antibiotics MRI of the pelvis Observation and waiting for the results of blood culture CT scans of the abdomen and pelvis Oral ampicillin and gentamicin Loading...616. 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? Azygous vein Ductus arteriosus Ductus venosus Umbilical artery Loading...617. 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? Pulmonic valve stenosis Mitral valve stenosis Mitral valve regurgitation Aortic valve stenosis Tricuspid valve regurgitation Loading...618. Which of the following drugs appears unchanged in the urine? Amantadine Zanamivir A & B All of the above Oseltamivir Loading...619. Directly acting cholinergic agonist drug? Acetylcholine A & B Tacrine Echothiophate Pilocarpine Loading...620. Antihistamine agent with nonsedative effect from the chemical class of piperazine is the following? Fexofenadine Promethazine Cyproheptadine Cetirizine Hydroxyzine Loading...621. Which of the following physiological changes is expected in a person comping on a mountain at an altitude of 4500 meters? Increased renal excretion of H ion Decreased erythropoietin production Decreased 2,3-diphosphoglycerate Decreased arterial Pco2 Loading...622. 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? Use electronic interpreting device to translate the instructions Speak to the boy to find out if he speaks English, and if he does, explain the instructions to him. Try your best to explain the treatment plan to them Find any Spanish-speaking person in the clinic to interpret the instructions Loading...623. Canal of Schlemm is located at which one of the following junctions? Cornea and sclera Cornea and iris Ciliary body and iris Cornea and ciliary body Loading...624. 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? Atropine Digoxin Metoprolol Verapamil Procainamide Loading...625. Which of the following drug is a part of drugs for osteoporosis? Acetazolamide Alendronate A & B Furosemide RabeprazolePage 26 of 66 Loading...626. 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? Liver Retina Skeletal muscles Small intestine Brain Loading...627. Which of the following drug belongs to the Nonnucleoside reverse transcriptase inhibitor? Abacavir Indanyl carbenicillin Atazanavir Maraviroc Efavirenz Loading...628. Which of the following are side effects of Aspirin? Urticaria Bronchoconstriction Metabolic acidosis All of the above Peptic ulcer diseased Loading...629. Which of the following proteins in the serum transport drugs? A & B Albumin All of the above Organic anion polypeptides Alpha-1 acid glycoprotein Loading...630. Which of the following drug belongs to Osmotic Diuretic? Cefoxitin Urae Oxacillin Niacin Ampicillin Loading...631. 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 Ileocolic artery Inferior mesenteric artery Superior mesenteric artery Loading...632. Which one of the following drugs is Quaternary compound antispasmodic? Oxybutynin Propantheline Biperiden Dicyclomine Cyclopentolate Loading...633. A drug that inhibits xanthine oxidase through the formation of a stable complex with xanthine oxidase is the following? Pegloticase Allopurinol Probenecid Colchicine Febuxostate Loading...634. A drug is more effective when combined with Flucytosine to treat candidiasis or cryptococcosis? Amphotericin B Itraconazole Caspofungin Griseofulvin Loading...635. 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? Abdominal CT scan MRI of the pelvis Urine culture Refer to surgery for urgent reduction Assurance and follow up in 2 weeks Loading...636. Uric acid excretion is Increased by using one of the following options? All of the above A & B Allopurinol Sulfinpyrazone Probenecid Loading...637. Which of the following anticoagulant medications works by binding to thrombin and inhibiting it? Heparin Warfarin Hirudin Ticlopidine Loading...638. The mechanism of action of etidronate disodium is most likely related to Excretion unchanged in the urine Inhibition of the formation of hydroxyapatite crystals Inhibition of both normal and abnormal bone resorptions An unusual form of phosphorus (P) Hyperphosphatemia Loading...639. Which of the following explains the reason for the formation of atheroma at the bifurcations of arteries such as aorta and carotid? Hypoxemia Endothelial dysfunction Cholesterol breakdown Regular blood flow Loading...640. Which of the following is the most frequent and irreversible side effect of typical anti-psychotics? Akathisia Dystonia Anxiety Tardive dyskinesia Loading...641. Which one of the following agent is a insulin? Desmopressin Somatostatin Torsemide Atorvastatin Detemir Loading...642. Which of the following is the leading cause of blindness in the USA? Glaucoma Diabetic retinopathy Cataract Macular degeneration Loading...643. Which of the following cellular pathological changes affects myocardial fibers in a case of irreversible myocardial infarction? Decreased intracellular pH Increased cytoplasmic sodium Karyorrhexis of the nuclei Depletion of myoglobin stores Loading...644. A drug that belongs to Loop Diuretics is one of the following? Doripenem A & B Cefazolin Furosemide Sulbactam Loading...645. 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 Paclitaxel Etoposide Cisplatin Loading...646. Which of the following is the best immediate treatment for unresponsive patient with diabetic ketoacidosis? Insulin and glucose Observation and hospitalization Bicarbonate Metformin Loading...647. Which one of the following drugs is a loop Diuretics drug? Chlorthalidone Bumetanide Amiloride Acetazolamide Loading...648. Amantadine belongs to the class of following drugs? Antipyretic Antibiotics Antiprotozoal Anti malaria Antiviral Loading...649. 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? Morphine Carbamazepine Nortriptyline Ibuprofen Loading...650. Which of the following antibiotics is the most appropriate one to treat a case of Legionella pneumonia? Erythromycin Metronidazole Clindamycin VancomycinPage 27 of 66 Loading...651. Which one of the following drugs is a selective Beta-2 adrenergic long-acting bronchodilator? Terbutaline Pirbuterol Metaproterenol Albuterol Formoterol Loading...652. Which one of the following cholinomimetic agents is used in the challenge test for diagnosis of asthma? Carbachol Pilocarpine Methacholine Bethanechol Loading...653. Which one of the following drugs is associated with peripheral neuropathy? Ethambutol Rifampin Isoniazid Capreomycin Loading...654. 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? Cytomegalovirus Human immunodeficiency virus (HIV) Human papillomavirus Epstein-Barr virus Loading...655. 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? Serum immunoglobulins CT of the chest TB skin test Sweat chloride test Loading...656. Concurrent therapy of digitalis with the following drugs enhance the potential for cardiotoxicity? Tetracycline Quinidine Amiodarone All of the above Erythromycin Loading...657. 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?As a complication of tuberculosis A side effect of rifampin A side effect of isoniazid A side effect of ethambutol A side effect of pyrazinamide Loading...658. CLASS II drugs of the Antiarrhythmic drugs interfere with one of the following options? Ca+ channel blockers K+ channel blockers Beta adrenoceptors Blockers Na+ channel blockers Loading...659. Bronchoconstriction results from stimulation of which one of the following receptor types? M2 cholinergic receptors M3 cholinergic receptors Alpha-1- adrenergic receptors Beta-2- adrenergic receptors Loading...660. The structural formula of the following drugs contains the Biphenyl methyl group except? Olmesartan Valsartan Eprosartan Candesartan Losartan Loading...661. 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 Metoprolol Cardioversion Heparin Refer to cardiologist Loading...662. 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...663. Mechanism of action of Aspirin is following? Inhibit glycoprotein receptors Decrease Calcium levels Inhibit COX-1 Inhibit ADP mediation Inhibit COX-2 Loading...664. Which of the following is the common cause of secondary dyslipidemia? Diabetes mellitus Apo C-II deficiency Familial hypercholesterolemia Familial combined hyperlipidemia Loading...665. Which one of the following statements about the use of Labetalol is incorrect? 3-6 hours duration of action Doesn't cause reflex tachycardia Selective Beta-1 blocker Used as I.V infusion in emergency Loading...666. Which of the following drug contain sulfonamide structure in the structural formula? Meloxicam None of these Celecoxib Mefenamic acid Acetaminophen Loading...667. Which one of the following conditions is most likely affects the lungs of a patient with Parkinsonism? Atherosclerosis Embolism Arteriosclerosis Thrombosis Loading...668. Ceftriaxone belongs to the one of the following generation of the cephalosporin? 1st generation 3rd generation 2nd generation 4th generation Loading...669. Which of the following is characteristic of Alzheimer’s disease? Neurofibrillary tangles Nuclear atypia Negri bodies Lewy bodies Loading...670. 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...671. 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 Hypoxanthine-guanine phosphoribosyltransferase (HGPRT) Myoadenylate deaminase Loading...672. Red man syndrome is caused by lincosamine penicilin vancomycin cephalosporin Loading...673. Which of the following statements about the use of aminoglycoside is wrong? Accumulate in endolymph and perilymph Causes ototoxicity Bind to 50S subunit cross the placental barrier Accumulate in renal cortex Loading...674. Which of the following drug has Ocular effects like mydriasis and fixed far vision? Phentolamine Timolol Mecamylamine Phenylephrine Neostigmine Loading...675. Which of the following is the most common etiology of type II diabetes? Insulin receptor deficiency Low insulin production Increased hepatic glycogen breakdown Altered hormone-receptor complexPage 28 of 66 Loading...676. Which of the following is the effect of digoxin on a case of heart failure? Decreased stroke volume and vagal activity Rapid conduction through AV node Increased stroke volume and cardiac output Increased sympathetic tone and decreased vagal activity Loading...677. Which of the following antibiotics is the most appropriate treatment of mycoplasma pneumonia? Doxycycline Gentamicin Ampicillin Azithromycin Loading...678. 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? Coombs test Tinel test ELISA test Phalen test Loading...679. 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 Lobectomy Cytotoxic agents Progestin therapy Loading...680. A drug that effects the thyroid hormone is one of the following ? Bumetanide A & B Furosemide Levothyroxine Sulbactam Loading...681. Failure of degeneration of the urachus may lead to which of the following defects? Bladder adenocarcinoma Polycystic kidney disease Renal agenesis Bladder exstrophy Loading...682. Which one of the following is the best treatment of trigeminal neuralgia? Methylphenidate Fluoxetine Carbamazepine Riboflavin Loading...683. Which of the following drugs is the initial therapy for Alzheimer disease? Pilocarpine Methacholine Donepezil Carbachol Loading...684. Which one of the following medications binds tumor necrosis factor (TNF-α) and used in the treatment of rheumatoid arthritis? Methotrexate Infliximab Paclitaxel Trastuzumab Loading...685. 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? Electroencephalogram (EEG) Gastric lavage Intravenous injection of haloperidol Airway stabilization and 100% oxygen Intravenous fluids Loading...686. 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 myocardium Injury to the lung tissue Injury to the right bronchus Injury to the esophagus Loading...687. 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...688. What is the best first step of action for a case of posterior myocardial infarction? Metoprolol 60 mg administration Tissue plasminogen activator Stress test Aspirin 325 mg administration Loading...689. Administration of which one of the following substances most likely reverses the course of Wernicke-Korsakoff syndrome? Riboflavin Niacin Vitamin K Thiamine Loading...690. Which one of the following results of Tensilon test confirms the diagnosis myasthenia gravis Rapid amelioration of symptoms Slow and gradual amelioration of symptoms No effect Exaggeration of weakness Loading...691. Which of the following controls the secretion of thyrotropin? Concentration of thyrotropin in the pituitary gland Concentration of iodine in the thyroid gland Concentration of thyroid hormones in the thyroid gland Concentration of thyroid hormones in the blood Loading...692. 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? Right ventricular hypertrophy Dilated cardiomyopathy Left ventricular hypertrophy Mitral stenosis Loading...693. Which one of the following drugs blocks dopamine uptake transporter? Alcohol Nicotine Marijuana Cocaine Loading...694. Prazosin blocks which of the following actions of epinephrine? Mydriasis Tachycardia High stroke volume Bronchodilation Loading...695. Ibuprofen belongs to one of the following class? Propionic acid Acetic acid derivative Fenamates Oxicam derivative Loading...696. Which one of the following lipid-lowering agents can cause skin flushing and pruritus? Gemfibrozil Atorvastatin Cholestyramine Niacin Loading...697. 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 Abdominal ultrasound Esophagostomy Barium studies Loading...698. 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? Acetaminophen Hydrocodone Vitamin C Aspirin Loading...699. 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. Partial agonist Inverse agonistis drug should be classified as what? Agonist Antagonist Loading...700. Which one of the following drugs is a Tetracycline? Minocycline Cefdinir Cefepime CefadroxilPage 29 of 66 Loading...701. Which of the following drug is a derivative of N- arylanthranilic acid? Etodolac Mefenamic Acid Diflunisal ketorolac Piroxicam Loading...702. Which of the following is the most likely cause of death in cases of overdose of hypnotics? Status epilepticus Cerebral edema Depression of the medullary respiratory center Hypothermia Loading...703. A 15-year-old boy is diagnosed with “Walking pneumonia”. Which of the following is the most effective treatment of this condition? Tetracycline Azithromycin Ampicillin Vancomycin Loading...704. 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? Propranolol Metoprolol Verapamil Hydralazine Sotalol Loading...705. Which one of the following enzyme deficiencies is related to Tay-Sachs disease? Sphingomyelinase deficiency Glucocerebrosidase deficiency Arylsulfatase A deficiency Hexosaminidase A deficiency Loading...706. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Indanyl carbenicillin Nizatidine Aluminium hydroxide Ezetimibe Macrolides Loading...707. Which one of the following symptoms is most likely found in Parkinson’s disease? Visual hallucinations Intention tremors Chorea Cogwheel rigidity Loading...708. Which one of the following macrolide drugs has a short half-life of 2 hours? Erythromycin Azithromycin Telithromycin Clarithromycin Loading...709. Which one of the following is the most common cause of ruptured aortic aneurysm? History of intravenous drug use Cardiomyopathy Hypertension Atherosclerosis Loading...710. Imidazoline derivative drug with Alpha2 adrenoceptors effect? Dipivefrin Clonidine Phentolamine Albuterol Loading...711. Which one of the following drugs is a more effective drug and drug of choice for fungal infection with a shorter duration of therapy? Griseofulvin Terbinafine Delavirdine Itraconazole Loading...712. Which one of the following tests is performed to determine if a fetus develops hemolytic disease of the newborn? Radioimmunoassay Osmotic fragility test Hemoglobin electrophoresis Direct Coombs test Loading...713. Which of these medications is contraindicated in a case of cardiogenic shock? Intravenous fluids Metoprolol Dopamine Norepinephrine Loading...714. Which of the following drug is Cholinergic agonist used for diagnosis of myasthenia gravis as well as an antidote for tubocurarine? Tyramine Edrophonium Atracurium Atropine Piruterol Loading...715. 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? Uterohypophysis Neurohyperphysis Adenohyperphysis Neurohypophysis Adenohypophysis Loading...716. 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? Saquinavir Zidovudine Etravirine Efavirenz Indinavir Loading...717. The cough associated with Captopril is most likely associated with? Release of histamine Increase in bradykinin levels Stimulation of adenosine receptors in the lungs Decrease in the metabolism of acetylcholine Direct airway irritation Loading...718. Which one of the following drugs is the most fatal in suicidal overdose? Imipramine Phenelzine Bupropion Citalopram Loading...719. Which of the following options is the adverse effect of Vancomycin? Phlebitis Chill's All of the above Fever Redman syndrome Loading...720. Cimetidine is used to treat one of the following diseases? Blood pressure Diabetes Viral infection Malaria Stomach Ulcer Loading...721. Which one of the following defines the drug efficacy? The dose of a drug needed to produce a maximal effect The capacity a drug to affect a condition irrespective of the dose The impact of the drug on a wide range of patients The minimal amount of drug administered that leads to toxicity Loading...722. Which of the following is the next step to investigate oliguria in a catheterized patient? Irrigate the catheter Measure urine specific gravity Measure serum creatinine Start intravenous fluids Loading...723. 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? X-linked recessive Autosomal dominant Mitochondrial Autosomal recessive Multifactorial Loading...724. 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 unionized form ionized form glucuronidated form quaternary charge Loading...725. 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? von Willebrand disease Hemophilia A Disseminated intravascular coagulopathy Vitamin K deficiencyPage 30 of 66 Loading...726. Which of the following drug is a derivative of Enolic acid? Diflunisal ketorolac Etodolac Mefenamic Acid Piroxicam Loading...727. Which one of the following joints is the only articulation between the upper limb and the trunk? Acromioclavicular joint Glenohumeral joint Coracoclavicular joint Sternoclavicular joint Loading...728. Hypertriglyceridemia and hypercholesterolemia are the adverse effects of following drugs? Protease inhibitors Integrase inhibitors Entry inhibitors Nucleoside analogs Loading...729. Which one of the following drugs belongs to H2 histamine receptor blocker? Nizatidine Torsemide Ezetimibe Atorvastatin Indanyl carbenicillin Loading...730. 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? Asthma Foreign body stuck in the main bronchus Viral croup Bronchiolitis Loading...731. 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? Escherichia coli Streptococcus viridans Staphylococcus aureus Campylobacter Loading...732. 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? Diffuse axonal injury Epidural hematoma Subdural hematoma Cerebral contusion Loading...733. Which of the following drug is a part of proton pump inhibitors? Acetazolamide A & B Mannitol Pantoprazole Furosemide Loading...734. The effect of two medications is greater than the sum of their individual effects explains which of the following drug interactions? Synergistic Tachyphylaxis Permissive Additive Loading...735. 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 Trichophyton rubrum Trypanosoma cruzi Ascaris lumbricoides Staphylococcus aureus Loading...736. Which one of the following drugs belongs to Antidiarreals? Nizatidine Ezetimibe Indanyl carbenicillin Methyl cellulose Atorvastatin Loading...737. Which one of the following analgesics inhibits COX in CNS and can be used safely for pregnant women? Ibuprofen Acetaminophen Naproxen Acetylsalicylic acid Loading...738. 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 Cystic fibrosis Viral infection Gallstones Trauma Loading...739. Which of the following is the most likely cause of decreased visual acuity in pregnancy? Thickening of the cornea Retinal detachment Optic nerve degeneration Macular degeneration Loading...740. 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 Osmotic fragility test Schilling test Metabisulfite test Coomb’s test Loading...741. Which of the following is the mechanism of action of selegiline in treating Parkinson’s disease? Blocks catechol-O-methyltransferase (COMT) Precursor of dopamine Agonist at dopamine receptors Inhibition of MAO type B to reserve dopamine Loading...742. Which of these conditions is known as pulsus paradoxus? A difference of 10/min between radial and femoral pulse A fall of systolic blood pressure for more than 10 mmHg during inspiration 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...743. Which one of the following proteins surrounds the nuclear envelope? Vimentin Actin Tropomyosin Enkephalin Loading...744. Which of the following drugs causes peripheral edema? A & B Somatrem Amlodipine Oxytocin Labetalol Loading...745. A drug that act as laxative is one of the following? Furosemide Sulbactam Bumetanide A & B Castor oil Loading...746. Which one of the following drugs has a synergistic effect with Flucytosine? Griseofulvin Amphotericin B Caspofungin Nystatin Loading...747. 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 Churg Strauss syndrome Reye syndrome Hypotrichosis Steven-johnson syndrome Loading...748. 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: Heart attack Alcohol toxicityctose dehydrogenase 267 U/L What is the most likely diagnosis of this patient condition? Stroke Alcohol withdrawal Loading...749. Which one of the following drugs is a beta blocker (Class II)? Carvedilol Amiodarone Verapamil Procainamide Loading...750. 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? Normal arterial O2 partial pressure Normal respiratory function tests Normal arterial CO2 partial pressure Decreased pulmonary artery pressure Increased pulmonary venous pressurePage 31 of 66 Loading...751. 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? Sexual dysfunction Constipation Diarrhea Hyperglycemia Loading...752. 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 7.05, bicarbonate 15, Pco2 30 and Po2 90 pH 7.00, bicarbonate 15, Pco2 60 and Po2 90 pH 7.50, bicarbonate 24, Pco2 40 and Po2 90 pH 7.47, bicarbonate 15, Pco2 30 and Po2 90 pH 7.60, bicarbonate 24, Pco2 60 and Po2 90 Loading...753. Which one of the following nicotinic antagonist drugs has the ability to lower blood pressure, a vasodilator? Succinylcholine Tubocurarine Trimethaphan Ipratropium Loading...754. Which of the following medications inhibits folic acid synthesis through its effect on dihydropteroate synthetase enzyme? Pyrimethamine Methotrexate Trimethoprim Sulfonamides Loading...755. Which of the following receptors is the most likely affected in patients with diabetes mellitus? End-bulbs of Krause Meissner’s corpuscle Pacinian corpuscle Ruffini’s end organ Loading...756. Which one of the following anti-Parkinsonism medications should be avoided in patients with glaucoma? Bromocriptine Trihexyphenidyl Selegiline Levodopa Loading...757. Emotions, judgments and motor aspects of speech are controlled by which one of the following lobes of the brain? Temporal Occipital Frontal Parietal Loading...758. 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? Hormonal treatment Surgical removal of the cyst Termination of pregnancy Assurance and follow up on next visits Wide spectrum antibiotics to prevent infection Loading...759. Which of the following benefits is achieved as a result of adding progesterone to estrogen in HRT? Decrease bone resorption Increase the effect of estrogen on the heart Decrease the effect of estrogen on the breast Decrease the occurrence of endometrial cancer Loading...760. A drug that blocks the glycoprotein GP IIb/IIIa receptors of platelets? Dipyridamole Aspirin Tirofiban Ticlopidine Clopidogrel Loading...761. Which one of the following antibiotics is the most appropriate treatment of chancroid, a bacterial infection caused by Haemophilus ducreyi? Ceftriaxone Ampicillin Vancomycin Ciprofloxacin Loading...762. Amphotericin B exerts its anti-fungal effect by which of the following mechanisms? Inhibition of DNA synthesis Inhibition of fungal cell wall synthesis Alteration of cell membrane permeability Inhibition of cell wall synthesis Inhibition of fungal protein synthesis Loading...763. Which one of the following autoantibodies is associated with Goodpasture syndrome? Anti-basement membrane Anti-centromere Anti-Ach receptor Anti-histone Loading...764. 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 Postural hypotension Old age Alzheimer’s disease Osteoarthritis Loading...765. 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? Obstructive jaundice Pancreatic cancer Hemolysis Gallstones Hepatocellular disease Loading...766. In high doses, Aspirin lacks anti-platelet activity by which of the following phenomena Stimulates thromboxanes Inhibits leukotrienes Stimulates prostacyclins Stimulates leukotrienes Inhibits prostacyclins Loading...767. Gonadotropin-releasing hormones are synthesized by which of the following nuclei of the hypothalamus? Ventromedial nuclei Arcuate nuclei Anterior nuclei Dorsomedial nuclei Loading...768. Cinchonism is a possible side effect of which one of the following drugs? Quinidine Enflurane Metoclopramide Isoniazid Loading...769. Which one of the following drugs is worst for causing gastric irritation? Diclofenac Acetaminophen Aspirin Sulindac Misoprostol Loading...770. The effect of medications on parasympathetic function declines slowly in which one of the following organs? Glands Smooth muscles Eye Heart Loading...771. 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 Acute myocardial infarction Pulmonary embolism Rupture of abdominal aortic aneurysm Loading...772. 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? Borderline personality disorder Histrionic personality disorder Conduct disorder Obsessive compulsive disorder Antisocial personality disorder Loading...773. A drug that inhibits the M2 protein ion channel and its ability to modulate intracellular PH? Acyclovir Zanamivir Ribavirin Rimantadine Loading...774. Which of the following is a serious complication of ergotamine? Depression Hypotension Headache Prolonged vasospasm Loading...775. 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? Laparoscopy Exploratory laparotomy Amylase and lipase levels UltrasoundPage 32 of 66 Loading...776. Which one of the following is an antimuscarinic agent? Pralidoxime Scopolamine Neostigmine Echothiophate Tacrine Loading...777. Abacavir belongs to the class of following drugs? Anti malaria Antiviral Antipyretic Antiprotozoal Antibiotics Loading...778. Which of the following drugs are carboxylate derivatives of ACEIs except? Enalapril Quinapril Ramipril Lisinopril Fosinopril Loading...779. Which one of the following conditions is the most common cause of aortic stenosis in the the elderly patients? Rheumatic fever Subacute bacterial endocarditis Calcification of the aortic valve Bicuspid aorta Loading...780. Which one of the following fungistatic drugs has a half-life of 30 hours? Voriconazole Ketoconazole Fluconazole Posaconazole Loading...781. Which of the following is the reason that nitroglycerin is given sublingually? It diminishes the odds of developing methemoglobinemia It has less reflex tachycardia than other routes It avoids first pass metabolism It improves patient compliance Loading...782. At which of these vertebral levels does the trachea bifurcate? Seventh cervical Fourth thoracic First thoracic Sixth thoracic Loading...783. Which one of the following effects is caused by administration of mecamylamine? Tachycardia Hypertension Tremors Pupillary constriction Loading...784. The functions of insulin include the following except one? increase breakdown of fat to Ketone bodies inhibit the production of glucose from the liver Cellular Uptake of plasma glucose Uptake of Amino acids into a cell Loading...785. Which one of the following drugs is 2nd generation flouroquinolone? Ciprofloxacin Levofloxacin Nalidixic acid Moxifloxacin Loading...786. Which one of the following tests can be used to distinguish between Folic acid and vitamin B12 deficiencies? Serum homocysteine level Serum cystathionine level Serum methionine level Serum methylmalonate level Loading...787. Gonadotropin-releasing hormones are synthesized by which of the following nuclei of the hypothalamus? Ventromedial nuclei Arcuate nuclei Dorsomedial nuclei Anterior nuclei Loading...788. Which one of the following drugs is contraindicated in a case of osteoporosis? Calcium oxalate Prednisone Albuterol Simvastatin Loading...789. Which of the following is considered a dynamic stabilizer of the glenohumeral joint? Subscapularis muscle Glenoid fossa Coracohumeral ligament Inferior glenohumeral ligament Loading...790. In which one of the following parts of the GIT most of the ingested iron is absorbed? Ileum Ascending colon Duodenum Descending colon Stomach Loading...791. In an acute attack of gout, Indomethacin is preferred over Colchicine because of which characteristic? More likely to reduce inflammation Less likely to cause acute renal failure More likely to prevent further acute attacks Less likely to cause GI bleeding Less likely to cause diarrhea Loading...792. 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 Lisinopril Atenolol Furosemide Loading...793. Which one of the following drugs causes inhibition of viral neuraminidase? A & B A & C Amantadine Zanamivir Oseltamivir Ribavirin Loading...794. Mitochondria are NOT found in which of the following organisms? Protozoa Yeasts Viruses Fungi Loading...795. Fluconazole belongs to the class of following drugs? Antiviral Antiprotozoal Antifungal Antibiotics Antipyretic Loading...796. 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? Pancreatitis Diverticulitis Gastroenteritis Intestinal obstruction Loading...797. 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? Acetaminophen toxicity Alcoholic hepatitis Fatty liver Budd-Chiari syndrome Loading...798. Which of the following is the correct statement about the difference between a strain and a sprain? Strain affects muscles or ligaments while sprain affects tendons 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 Loading...799. Which one of the following may precipitate to an acute porphyria attack? High carbohydrate diet Low carbohydrate diet Mediterranean diet Vegetarian diet Loading...800. Heteroaryl acetic acid drug is following? Piroxicam Ibuprofen Tolmetin Indomethacine NabumetonePage 33 of 66 Loading...801. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Neostigmine Benztropine Succinylcholine Atropine Prazosin Loading...802. Which one of the following drugs belongs to 1st generation Cephalosporins? A & B Cefdinir All of the above Cefazolin Cefadroxil Loading...803. Which of the following factors directly stimulates the release of antidiuretic hormone (ADH)? Increased blood volume Increased extracellular fluid osmolality Decreased temperature Decreased extracellular fluid osmolality Loading...804. 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? Osmotic Psychogenic Inflammatory Secretory Loading...805. Meissner’s plexus of nerves is located within which layer of the gastrointestinal tract? Muscularis Externa External layer Submucosa Mucosa Loading...806. Which form of dosage has a high rate of bioavailability? Syrup Control released drugs Capsules Tablet Suspension Loading...807. 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? Chloroquine Atovaquone Primaquine Doxycycline Loading...808. 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 acidosis and respiratory acidosis Metabolic acidosis and respiratory alkalosis Metabolic alkalosis and respiratory acidosis Metabolic alkalosis and respiratory alkalosis Loading...809. 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? German measles Smallpox Chicken pox Mumps Measles Loading...810. 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 Pregnancy Metastatic carcinoma Prolactinoma Loading...811. 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? Beta-naphthylamine is directly carcinogenic to human bladder Detoxification of beta-naphthylamine by glucuronic acid conjugation. Human urinary glucuronidase splits beta-naphthylamine into glucuronic acid and a toxic metabolite. Metabolism of beta-naphthylamine by human cytochrome 450 system in the liver Loading...812. Which one of the following is the most common cause of microcytic hypochromic anemia in a patient diagnosed with progressive renal failure? Blood loss Iron deficiency anemia Frequent hematuria Erythropoietin deficiency Loading...813. Which of the following is the most common cancer of the lower third of esophagus in non-alcoholic, non-smoker patients? Adenocarcinoma Melanoma Squamous cell carcinoma Sarcoma Loading...814. Prostaglandin is derived from prostanoic acid, prostanoic acid contains 20 carbon fatty acids, how many carbons rings in the structural formula of prostanoic acid? 3 carbon ring 4 carbon ring 5 carbon ring 6 carbon ring 2 carbon ring Loading...815. Which one of the following anti-depressants is most likely effective in bulimia nervosa? Amitriptyline Imipramine Tranylcypromine Fluoxetine Loading...816. 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...817. 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? Circumflex artery Posterior interventricular artery Right coronary artery Anterior interventricular artery Left coronary artery Loading...818. 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? Histoplasma capsulatum Coxsackie A virus Hemophilic influenzae Blastomyces dermatitidis Loading...819. Which of the following drugs has the least CNS side effects? Amantadine Zidovudine Rimantadine Ganciclovir Acyclovir Loading...820. Which of the following types of rashes characterizes Lyme disease? Erythema marginatum Erythematous maculopapular rash Erythema migrans Erythema multiform Loading...821. 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 Febrile lymphadenopathy with rah Blindness and pulseless upper extremities Loading...822. Foci of hemorrhage and necrosis in which of the following parts of the brain is characteristic of Wernicke’s encephalopathy? Basal ganglia Anterior pituitary Mamillary bodies Posterior pituitary Loading...823. Which of the following drug is Non-NucleoSide Reverse Transcriptase inhibitors(NNRTIs)? Amprenavir Acyclovir Nevirapine Saquinavir Zidovudine Loading...824. Griseofulvin belongs to the following drugs class? Antifungal Antiprotozoal Antiviral Antibiotics Antipyretic Loading...825. Following is the 2nd generation cephalosporin drug? Cefdinir Cephalexin Cefaclor Cefepime CefadroxilPage 34 of 66 Loading...826. A drug that is a part of Aminoglycosides is following? Tobramycin Cefdinir Cefepime Cefaclor Loading...827. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Phenoxybenzamine Metoprolol Mecamylamine Tacrine Atracurium Loading...828. Which of the following tests would most likely indicates the etiology of vitamin B12 deficiency anemia? Coomb’s test Complete blood count (CBC) Schilling test Osmotic fragility test Loading...829. 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? Inferior mesenteric artery Abdominal aorta Celiac trunk Superior mesenteric artery Loading...830. 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? Lidocaine Propranolol Amiodarone Adenosine Verapamil Loading...831. Which one of the following drugs is a neuromuscular blocker drug? Neostigmine Benztropine Pancuronium Mecamylamine Atropine Loading...832. 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? Palmer aponeurosis Superficial fascia Extensor retinaculum Flexor retinaculum Skin Loading...833. Which of the following is the most common cause of sudden death in patients with diabetes mellitus? Cerebral hemorrhage Myocardial infarction Gangrene Hyperosmolar coma Loading...834. Epinephrine acts on which one of the following receptors to constrict vascular smooth muscle? α2-Adrenoceptors α1-Adrenoceptors β1-Adrenoceptors β2-Adrenoceptors Loading...835. 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? Androgen insensitivity syndrome Pituitary adenoma Isolated premature thelarche Precocious puberty Congenital adrenal hyperplasia Loading...836. Ethacrynic acid belongs to one of the following classes of diuretics? Thiazide Diuretic Potassium-sparing diuretics Loop Diuretics Carbonic anhydrase inhibitors Loading...837. 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? Amitriptyline Levothyroxine Ibuprofen Hydralazine Loading...838. Which of the following explains the benefit of lactulose in hepatic encephalopathy? Lactulose decreases stress of the liver to produce glucose Lactulose antagonize the action of ammonia on hepatic cells Lactulose converts to lactic acid by intestinal bacteria which decreases ammonia Lactulose removes circulating toxins from the blood Loading...839. Rapid Acting Insulin is one of the following? Glulisine Regular Glargine NPH Loading...840. Which of the following group of medications prolongs GABA activity in the brain? Methamphetamines Benzodiazepines Barbiturates Alcohols Loading...841. Disease prevalence can be measured by which one of the following studies? Cross-sectional study Case-control study Adoption study Cohort study Loading...842. Which of the following conditions is considered a physiological change for normal pregnancy? Decreased respiratory tidal volume Decreased GI tone and motility Decreased blood volume Decreased body weight Loading...843. Onychomycoses is the fungal infection of one of the following? Hair Skin Nails Teeth Loading...844. 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? Thinning of hair Gastrointestinal toxicity Nausea Myelosuppression Gonadal toxicity Loading...845. 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? Right middle lobar bronchus Left superior lobar bronchus Left middle lobar bronchus Right superior lobar bronchus Loading...846. Bones of calvarium and facial bones are formed by which one of the following types of ossification? Endochondral ossification Membranous ossification Loading...847. Which one of the following drugs reverses the effects of heparin? Chloroquine Warfarin Protamine Epinephrine Loading...848. Nelfinavir belongs to the class of following drugs? Anti-malaria Antiprotozoal Antiviral Antibiotics Antipyretic Loading...849. 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...850. 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? Acetyl CoA Alpha-ketoglutarate Oxaloacetate Fumarate Succinyl CoAPage 35 of 66 Loading...851. 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 APC gene on chromosome 5 Mutation in PKD1 on chromosome 16 Deletion of VHL gene on chromosome 3 Mutation in the NF1 gene on chromosome 17 Defective DNA repair mechanisms Loading...852. Which of the following laboratory tests could be slightly increased in Gilbert’s syndrome? Bilirubin, direct Triglyceride Bilirubin, indirect Haptoglobin Loading...853. Which one of the following cells secretes glycosaminoglycans and found in the in the terminal and respiratory bronchioles? K cells Macrophages Pneumocytes type II Pneumocytes type I Clara cells Loading...854. 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...855. Which one of the following inhibit the excretion of Indomethacin, naproxen, and ketoprofen? Allopurinol Probenecid Colchicine Sulfinpyrazone Loading...856. Histamine Receptor found on eosinophils and mast cells having a chemotactic function also found on neutrophils and CD⁴ T cells are following? H³ histamine receptor H⁵ Histamine receptor H² histamine receptor H⁴ histamine receptor H¹ histamine receptor Loading...857. Consumption of which of the following products most likely reduces the risk for coronary heart disease in susceptible patients? Beef products Saturated fat Fish oils Sugar-free snacks Loading...858. 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 Increased production of cAMP Decreased production of cAMP Deficiency in the brush border enzymes Increased motility of the small intestine Loading...859. Which one of the following gout treatments lowers serum uric acid? Colchicine Probenecid Allopurinol Indomethacin Loading...860. Administration of which one of the following can increase the excretion of a weak acid i.e. Aspirin toxicity? A neutral salt A weak base A strong acid A weak acid Loading...861. A drug that is used to treat leprosy is one of the following? A & B Clofazimine Furosemide Etidronate Magnesium hydroxide Loading...862. Which of the following drugs should NOT be initiated in case of acute decompensated heart failure? Digoxin Metoprolol Lisinopril Potassium supplements Loading...863. Which of the following characterizes syndrome of inappropriate antidiuretic hormone secretion? Euvolemic hyponatremia with continued Na excretion Serum osmolality is greater than urine osmolality Recommended treatment is desmopressin acetate and hydration Hyperosmotic volume contraction Loading...864. Which of the following drug is Antiprogestrin? Metformin Acarbose Sitagliptin Pioglitazoneich one of the following drugs Increases Glucose-dependent insulin release and decreases secretion of glucagon? Bicalutamide Loading...865. Which one of the following anti-hypertensive medications is contraindicated in pregnancy? Ramipril Methyldopa Labetalol Nifedipine Loading...866. Which type of hypersensitivity reaction develops from Mycobacterium tuberculosis? Type IV Type I Type II Type III Loading...867. Which one of the following arteries is most likely affected in a case of expressive aphasia? Anterior cerebral Vertebral Posterior cerebral Middle cerebral Loading...868. 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 peroxidase catalyzed reactions Blocking of coupling of iodotyrosines Blocking of peripheral deiodination of T3 and T4 Inhibition of the release of thyroid hormone from the thyroid gland Competitive inhibition of iodide transport mechanism Loading...869. All of the following drugs have anti-inflammatory effects except? Naproxen Acetaminophen Piroxicam ketorolac Mefenamic acid Loading...870. 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...871. 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? Aspirin Coronary angiography Echocardiography Thallium stress test Loading...872. 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? Fluconazole Caspofungin Amphotericin B Metronidazole Loading...873. Which of the following conditions is characterized by the presence of smooth, painless, wart-like lesions on genital organs? Chlamydia infection Candida infection Gonococcal infection Secondary syphilis Loading...874. 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? 86% 92% 90% 84% 88% Loading...875. Which one of the following statements correctly describes the inspiratory reserve volume? Volume of air that remains in the lung after a normal expiration Volume of air that present in the lung after maximal inspiration Volume of air that moves into the lung with each normal inspiration Volume of air that can still be inhaled in after a normal inspirationPage 36 of 66 Loading...876. Deficiency of the enzyme argininosuccinate in urea cycle leads to the accumulation of which one of the following? Argininosuccinate Arginine Citrulline Ornithine Loading...877. 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? Acarbose Glucagon Glyburide Rosiglitazone Metformin Loading...878. Which of the following is the checkpoint in cell development that is affected by ionizing radiation? G2/M G0/G1 S/G2 G1/S Loading...879. 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? What side effects did you experience? Do you understand the benefits of taking this medication on time? I am afraid, you have to take this antibiotic otherwise, you will have more complications of the condition. Why don’t you like to take this medication? Loading...880. Which one of the following statements about the Digoxin is wrong? Positive Inotropic drug Has a half-life of 36 hours None of these A cardiac glycosides Inhibit Na+/K+ exchange Loading...881. Food allergies are typically causing which one of the following immunologic abnormalities? Localized anaphylaxis Cell-mediated hypersensitivity Immune-complex deposition Complement activation Loading...882. Which of the following types of sensations is carried to the thalamus by the anterolateral tracts after crossing the spinal cord? Crude touch Vibrations Position Fine touch Loading...883. Blockage of ɑ1 and ɑ2 adrenergic receptors on the arteriolar beds lead to following? Reduce peripheral resistance Increase peripheral resistance None Increase renin secretion Increase renin secretion Loading...884. Which of the following drugs is used for respiratory virus infections? Capecitabine Zanamivir Naftifine Miconazole Ibandronate Loading...885. 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? Total anomalous pulmonary venous return Truncus arteriosus Tricuspid atresia Tetralogy of Fallot Transposition of the great arteries Loading...886. Thrombocytopenic purpura (TTP) is the adverse effect of the following drug? All of the above Clopidogrel Ticlopidine Abciximab Both A & B Loading...887. 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 peripheral resistance Decreased sodium and water retention Parasympathetic stimulation Sympathetic stimulation Elevated parathyroid hormone Loading...888. Which of the following statements about ACh release and deactivation is true? 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 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 Loading...889. M1 Receptors are primarily located in: Exocrine glands, vessels (smooth muscles & endothelium) Myocardium, smooth muscles Cerebral cortex, Sympathetic ganglia, myenteric ganglia Postganglionic neurons Skeletal muscle neuromuscular endplates Loading...890. Which one of the following drugs belongs to 3rd generation Cephalosporins? Ceftibuten Cefaclor Cefepime Cefadroxil Loading...891. Which one of the following is the most common etiology of abdominal aortic aneurysm in the United States? Cystic medial necrosis Atherosclerosis Rheumatic heart disease Turner syndrome Loading...892. Which one of the following drugs is a neuromuscular blocker drug? Benztropine Succinylcholine Atropine Mecamylamine Neostigmine Loading...893. The sympathomimetic which may promote diuresis by a direct effect on the kidney is: dobutamine norepinephrine epinephrine dopamine Isoproterenol Loading...894. Which one of the following drugs is a Thiazide Diuretic? Ezetimibe Fenofibrate Hydrochlorothiazide Atorvastatin Indanyl carbenicillin Loading...895. Which one of the following drugs is 4th generation cephalosporin drug? Cefepime Cefuroxime Cefixime Cefadroxil Loading...896. 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. Ethambutol Streptomycin Isoniazid Pyrazinamide Rifampinich of these drugs acts by inhibition of formation of mycolic acid? Loading...897. 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? Gallstones Pancreatic cancer Obstructive jaundice Hemolysis Hepatocellular disease Loading...898. Which of the following is a contraindication of use of benzodiazepines in anxiety disorder? Sleep apnea Diabetes mellitus Seizures Smoking Loading...899. Which one of the following medications can be used safely in cases of lack of liver function? Clonazepam Midazolam Diazepam Lorazepam Loading...900. Cephalexin belongs to the class of following drugs? Antipyretic Antiviral Antibiotics Anti malaria AntiprotozoalPage 37 of 66 Loading...901. Which of the following agents should a patient take for a stuffy, runny nose? Albuterol Clonidine Terbutaline Oxymetazoline Metoprolol Loading...902. Which of the following is not a feature of Tetralogy of Fallot? Right ventricular hypertrophy Atrial septal defect Overriding aorta Pulmonary stenosis Loading...903. Select Dihydropyridines Calcium channel blocker drug? Diltiazam Acetazolamide Nifedipine Amiloride Verapamil Loading...904. 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 toxoid Neither tetanus toxoid or antitoxin Tetanus antitoxin Loading...905. Which one of the following is the class of aliskiren? Corticotropin Angiotensin receptor blocker Direct renin inhibitor ACE inhibitor Interior pituitary hormone Loading...906. 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? Digoxin Quinidine Bretylium Amiodarone Sotalol Loading...907. Na+ channel blockers belongs to the one of the following CLASS of Antiarrhythmic drugs? CLASS II CLASS I CLASS III CLASS IV Loading...908. 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? Metoclopramide Diazepam Citalopram Fluoxetine Donepezil Loading...909. Which of the following is the nonessential amino acid? Alanine Lycine Methionine Histidine Leucine Loading...910. Which one of the following types of necrosis is most likely associated with myocardial infarction? Fibrinoid Coagulative Caseous Liquefactive Loading...911. Which one of the following local anesthesia is mainly used for regional nerve block? Tetracaine Cocaine Bupivacaine Dibucaine Loading...912. 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? Ectopic thyroid gland Dermoid cyst Lipoma Thyroglossal duct cyst Branchial cleft cyst Loading...913. Interferon alpha is indicated for the treatment of which one of the following conditions? Rheumatoid arthritis Kidney transplantation Hepatitis C virus infection Bullous pemphigoid Loading...914. 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? Gall bladder stones Hemolytic anemia Acute hepatitis Pancreatic cancer Loading...915. 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...916. Aminoglycosides inhibit protein synthesis through targeting which of the following? RNA polymerase mRNA Peptidoglycan units 30S ribosomal subunits Loading...917. Which one of the following drugs associated with nephrotoxicity? Capreomycin Ethambutol Rifampin Isoniazid Loading...918. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefepime Cefaclor Ceftazidine Cefadroxil Loading...919. 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...920. A disease characterized as recurrent and persistent abdominal discomfort and abdominal pain? A & B Peptic Ulcer disease GERD Dyspepsia Loading...921. Which one of the following substances is used to differentiate between central and nephrogenic diabetes insipidus? Cosyntropin Desmopressin Dexamethasone Cortisol Loading...922. Which of the following statements is true about live attenuated vaccine? They only induce humoral immunity It is mainly used for immunocompromised patients Close contacts of influenza patients can be safely vaccinated with live attenuated vaccine No booster is needed for live attenuated vaccines Loading...923. Which of the following drug belongs to lincosamide antibiotics? Ciprofloxacin Sulbactam Clindamycin Linezolid Oxytetracycline Loading...924. Histamine Receptor found on the mucus layer causing the production of gastric acid secretion is the following? H² histamine receptor H³ histamine receptor H⁵ Histamine receptor H¹ histamine receptor H⁴ histamine receptor Loading...925. A drug inhibit the human gonadal and adrenal steroids synthesis along with fungistatic property? Nystatin Ketoconazole Flucytosine CaspofunginPage 38 of 66 Loading...926. Which of the following are the primary vessels responsible for the regulation of blood pressure? Veins Capillaries Arteries Venuses Arterioles Loading...927. 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? Chloramphenicol Tetracycline Erythromycin Cephalexin Ampicillin Loading...928. Which one of the following complications is the common cause of death in acromegaly? Renal failure Hepatic failure Heart failure Splenic infarction Loading...929. 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? II III VI I Loading...930. 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 Timolol Acetazolamide Pilocarpine Atropine Loading...931. Which of the following is most likely to occur with carbonic anhydrase inhibitors? Acidic urine Alkalosis Hyperuricemia Hyperkalemia Hyperchloremia Loading...932. A drug that belongs to thiazolidinediones is one of the following? A & B Sulbactam Ethacrynic Acid Cefazolin Rosiglitazone Loading...933. 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 Mefenamic acid Ketorolac Naproxen Acetaminophen Loading...934. 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? Muscular spasm of paravertebral muscles Paraneoplastic disease Metastases to the vertebral column Primary osteosarcoma Loading...935. 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? Scabies Pemphigus vulgaris Cicatricial pemphigoid Dermatitis herpetiformis Bullous pemphigoid Loading...936. 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? Induction of labor Send her home and follow up the next scheduled visit Blood type and Rh testing Cesarean section Loading...937. Laboratory tests for a patient are as follows: Plasma creatinine concentration is 0.8 mg/dLine creatinine concentration is 80 mg/dL Urine volume is 1 ml/min 300 ml/min 100 ml/min 50 ml/minich of the following is the creatinine clearance? 200 ml/min Loading...938. 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 Clostridium difficile Giardia lamblia Entamoeba histolytica Loading...939. 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 butyricum Clostridium botulinum Clostridium difficile Clostridium histolyticum Loading...940. Which one of the following is the effect of metoprolol on cardiac ejection time? Decreased Increased No effect Loading...941. An enolic acid derivative of Nonsteroidal anti-inflammatory drugs also called? N-arylanthranilic acids Salicylates Oxicam derivative Acetic acid Propionic acid Loading...942. 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? Consult a cardiologist Administer thrombolytic now Transfer to the nearest hospital Loading...943. Which of the following should be added to premature infants of breast-feeding mothers after 2 month of age? Vitamin C Zink Copper Iron Loading...944. Which one of the following drugs is associated with optic neuritis? Capreomycin Ethambutol Isoniazid Rifampin Loading...945. Which one of the following is the adverse effect of Heparin? Bleeding All of the above Hypersensitivity Thrombocytopenia Osteoporosis Loading...946. One of the following statements is not right about the production of Acetylcholine? Acetylcholine released by an increase in calcium level Acetylcholine is metabolized by COMT Neurotransmitter in vesicles are called varicosities Acetylcholine rapidly hydrolyzed by Acetylcholinesterase Uptake of choline is a rate-limiting step Loading...947. Which one of the following medications increases the threshold for angina? Metoprolol Digoxin Benazepril Furosemide Loading...948. What is the most common cause of abdominal aortic aneurysm? Post-operative Atherosclerosis Complication of coronary artery disease Post-inflammatory Loading...949. 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 so, no need for the vaccine 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 but she should take the vaccine for other strains of HPV She can only take the vaccine later after full recovery Loading...950. 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 Renal stones Pseudomembranous colitis Enterovesical fistulaPage 39 of 66 Loading...951. Which one of the following drugs is used to treat helminthic infections for cestodes? Ivermectin Praziquantel Albendazole Mebendazole Thiabendazole Loading...952. A group of drugs bind to a receptor but do not produce any pharmacological effect is called: Antagonist Partial agonist Agonist Loading...953. 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 Amoxicillin Cloxacillin Methicillin Ampicillin Loading...954. Which of the following is the coagulation parameter affected by warfarin? Bleeding time Partial thromboplastin time (PTT) Prothrombin time (PT) Loading...955. Ca+ channel blockers belongs to the one of the following CLASS of Antiarrhythmic drugs? CLASS II CLASS I CLASS III CLASS IV Loading...956. Which one of the following nerves would be likely affected if a stab injury is established to the lower brachial plexus (C8-T1)? Radial nerve Axillary nerve Musculocutaneous nerve Ulnar nerve Loading...957. 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 Craniopharyngioma Choriocarcinoma Germinoma Gangliocytoma Loading...958. 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 Beta adrenergic antagonist Ganglion blocker Direct smooth muscle vasodilator Alpha adrenergic antagonist Loading...959. Which of the following virus infections mostly develops chronic hepatitis? Hepatitis B Hepatitis C Hepatitis A Loading...960. The following drug is a peripheral dopamine-1 receptor agonist? Minoxidil Alpha-Methyldopa Hydralazine Fenoldopam Loading...961. A 70-year-old man develops chest pain 2 days after hip replacement. Which is the most likely diagnosis? Cor pulmonale Myocardial infarction Pulmonary embolism Bundle branch block Loading...962. Alendronate is effective in which one of the following conditions? Spinal cord lesions Hyperthyroidism Osteoporosis Hypoparathyroidism Loading...963. Which of the following is the most common cause of nasal obstruction and bleeding in adolescents? Papilloma Nasal polyps Nasal cancer Angiofibroma Loading...964. Which of the following drug are coumarin derivative oral anticoagulants? Dicumarol Heparin Phytonadione Phenindione Menadione Loading...965. Which one of the following medications inhibits cell wall synthesis of bacteria? Erythromycin Aminoglycoside. Carbapenem Clindamycinotein Synthesis Inhibitors: Aminoglycosides, Tetracyclines, Spectinomycin, Erythromycin, Lincomycin, Clindamycin and Chloramphenicol. Loading...966. Which of the following is the earliest EKG sign of myocardial infarction? Pathological Q –wave S-T elevation Inverted T-wave Large peaked T-wave Loading...967. Which of the following is/are the most likely biopsy features seen in Celiac disease? Lymphoid aggregates with granulomas Lack of ganglion cells Flattening of villi with excess lymphocytes Crypt abscesses with excess neutrophils Loading...968. 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 Assurance and follow up in 3 months Start warfarin Start aspirin Start heparin Loading...969. Aldosterone production is reduced by using one of the following drugs? Lisinopril Diltiazem Aspirin Erythromycin Loading...970. Which of the following type of virus causes chickenpox? Orthomyxoviruses Cytomegalovirus A & B Herpesvirus Varicella zoster Loading...971. A drug that blocks the viral membrane matrix protein M2 and its ability to modulate intracellular PH? Zanamivir Acyclovir Oseltamivir Ribavirin Rimantadine Loading...972. Action of incretin hormone GLP-1 is following except? Increase glucose-dependent insulin secretion Inhibit inappropriate glucagon secretion Enhance appetite slow gastric emptying Increase beta-cell growth Loading...973. Which of the following drug belongs to H2 histamine receptor blocker? Glimepiride Cimetidine Oxacillin Cefoxitin Niacin Loading...974. Propranolol is used to treat one of the following diseases? High Blood pressure Stomach Ulcer Viral infection Malaria Diabetes Loading...975. 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? Atherosclerosis Hyperplastic arteriosclerosis Medical calcific sclerosisPage 40 of 66 Loading...976. 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 Echovirus Neisseria Meningitidis Streptococcus Pneumonia Staphylococcus Aureus Loading...977. Which one of the following medications inhibits fibrinolysis? Lepirudin Aminocaproic acid Rifampin Heparin Loading...978. Which of the following statements is true about warfarin? Liver is the main site of action of warfarin Toxicity of warfarin is treated by protamine sulfate Warfarin is monitored by PTT Warfarin acts by activation of antithrombin Loading...979. N-Substitutions of the catecholamine pharmacophore with isopropyl groups or aryl-alkyl groups improve the selectivity of which receptor? Alpha Receptor Dopaminergic receptor Muscarinic Receptor Beta Receptor Neuromuscular Activity Loading...980. Insulin dependent Diabetes mellitus? Type 2. Diabetic mellitus Gestational Diabetes mellitus Type 1 diabetes Mellitus A & D Pseudo hypoglycemia Loading...981. 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 host T-lymphocytes Development of liver failure Activation of the donor B-lymphocytes Activation of the donor T -lymphocytes Loading...982. Which of the following is the LEAST factor can lead to urinary tract infection? Pregnancy Prolonged tetracycline therapy Urinary tract obstruction Diabetes mellitus Loading...983. Bicornuate uterus results from failure of the fusion of which of the following structures? Paramesonephric ducts Urogenital sinus Nephrogenic ridges Mesonephric ducts Loading...984. Which of the following drug prevents bacterial protein synthesis by binding to the 30s ribosomal subunit lincosamine tetracyclin macrolides penicillin Loading...985. Which one of the following tests is diagnostic for acromegaly? Serum insulin-like growth factor-1 (IGF-1) Serum cortisol level Serum growth hormone level Fasting blood glucose level Loading...986. 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? Rickettsia prowazekii Staphylococcus aureus Borrelia burgdorferi Treponema pallidum Meningococci Loading...987. Which one of the following parts of fallopian tube is the widest and the most common site for fertilization? Isthmus Infundibulum Ampulla Loading...988. Which one of the following anticonvulsant drugs in used only in the treatment of absence seizures? Ethosuximide Carbamazepine Lorazepam Levetiracetam Loading...989. Indinavir belongs to the class of following drugs? Antipyretic Antibiotics Antiprotozoal Antiviral Anti malaria Loading...990. Which one of the following cephalosporins belongs to the third generation? Cefixime Cefoxitin Cefaclor Ceftin Loading...991. 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 Tinel sign Chandler sign Phalen sign Loading...992. Receptors that produce the most rapid response: Ion channel linked receptors G-protein linked receptors Tyrosine-Kinase Receptors Intracellular Receptors Cytokine receptors Loading...993. Chemotherapeutic agents use may result in the loss of individual neoplastic cells through which of the following mechanisms? Coagulative necrosis Acute inflammation Phagocytosis Apoptosis Loading...994. Naphthalene ring containing Antihyperlipidemic drug in the structural formula is the following? Rosuvastatin Simvastatin Fluvastatin Colestipol Atorvastatin Loading...995. 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 2 years in 3 years During this visit in 6 months Loading...996. What is the most common cause of chronic chest pain? Cardiac Musculoskeletal Gastrointestinal Malignant Loading...997. 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? Creutzfeldt-Jakob disease Old age dementia Vascular dementia Alzheimer’s disease Lewy body dementia Loading...998. 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 Metoprolol 25 mg daily Lisinopril 10 mg daily Hydralazine 50 mg daily Continue lifestyle modification for 3 months Loading...999. 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? Varicella DTaP MMR Oral polio vaccine Loading...1000. 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/dl Disseminated intravascular coagulationukocyte count: 25,000 – 80% neutrophils Platelet count: 20,000 Idiopathic thrombocytopenic purpura Hemophilia aat is the most likely diagnosis? Hemophilia b Thrombotic thrombocytopenic purpuraPage 41 of 66 Loading...1001. Which of the following is the most common cause of death in an old patient with uncontrolled diabetes? Hyperosmolar coma Pulmonary embolism Myocardial infarction Cerebral hemorrhage Loading...1002. Which one of the following macrolide drugs has a half-life of >40 hours? Clarithromycin Azithromycin Erythromycin Telithromycin Loading...1003. 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? Amniotic fluid embolism Pre-eclampsia Abruptio placenta Placenta previa Loading...1004. Which one of the following agents prolongs the duration of nerve block when combined with a local anesthetic? Dobutamine Atropine Isoproterenol Epinephrine Loading...1005. Sensations to the external auditory meatus is innervated by which of the following nerves? Facial nerve Vagus nerve Great auricular nerve Auriculotemporal nerve Loading...1006. Which of the following drug belongs to Carbonic anhydrase inhibitors? A & B Mannitol Acetazolamide Urea Furosemide Loading...1007. 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? Intussusception Volvulus Appendicitis Meckel’s diverticulum Diverticulitis Loading...1008. Which of the following drug are Nonsteroidal antiestrogens? Estradiol acetate Exemestane Estrogen Estradiol Tamoxifen Loading...1009. Misoprostol is an analog of the following type of prostaglandin? PGE PGB PGA PGE1 PGI2 Loading...1010. 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? Refer to the psychiatric clinic next day Admit to the hospital Prescribe antidepressant and follow up in a week Refer to the social worker Advise family that it is a normal reaction and keep an eye on her Loading...1011. 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? Heparin Streptokinase Dipyridamole Aspirin Warfarin Loading...1012. Which one of the following cell markers is unique for NK cells? CD56 CD14 CD40 CD16 Loading...1013. Which of the following is calculated by dividing the incidence rate of a disease in exposed by the incident rate of unexposed? Positive predictive value Odds ratio Attributable risk Relative risk Loading...1014. 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? Dermatitis herpetiformis Rosacea Shingles (herpes zoster) Seborrheic keratosis Psoriasis Loading...1015. Which of the following prostaglandin type also called prostacyclin? PGA PGI2 PGE PGB PGE1 Loading...1016. Intramuscular vitamin B12 should be prescribed after gastrectomy. Which of the following gastric cells is responsible for this replacement treatment? Goblet cells Parietal cells G cells Chief cells Loading...1017. 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? Aortic regurgitation Hypertrophic cardiomyopathy Aortic dissection Aortic stenosis Loading...1018. 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? C0-trimoxazole Rifampin Ciprofloxacin Chloramphenicol Loading...1019. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Aluminium hydroxide Indanyl carbenicillin Cycloserine Nizatidine Ezetimibe Loading...1020. Ganglion blocker drug is following? Atracurium Neostigmine Benztropine Mecamylamine Atropine Loading...1021. 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? Tay-sachs disease Hurler syndrome Lesch-Nyhan syndrome Galactosemia Gaucher disease Loading...1022. 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? IV calcium gluconate IV dobutamine IV fluids stat IV heparin Sublingual glyceryl nitrate (GTN) Loading...1023. 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 T-lymphocytes Host B-lymphocytes Donor T-lymphocytes Donor B-lymphocytes Loading...1024. Deferoxamine is an antidote used for toxicity of the following? Calcium bicarbonate Atropine Isoniazid Iron Loading...1025. 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? Spinal nucleus of fifth cranial nerve Inferior cerebellar peduncle Lateral spinothalamic tract Nucleus AmbiguusPage 42 of 66 Loading...1026. 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? Atropine Cromolyn sodium Epinephrine Scopolamine Loading...1027. A certain drug has a high serum protein binding. Which of the following is increased as a result of injecting this drug? Drug interaction Renal excretion Distribution of the drug Liver metabolism Loading...1028. Regulation of which of the following regions is mostly dependent on extrinsic nerves? Small intestine Upper esophagus Lower esophagus Large intestine Loading...1029. A drug that inhibit the guanosine triphosphate formation thus preventing viral mRNA capping and RNA dependent RNA polymerase blockage? Ribavirin Amantadine Oseltamivir All of the above Both A & B Loading...1030. What is the meaning of Dose Dumping phenomenon? High dose of IV drugs Excess release of control released drugs Excess release of gastric acid Excess release of Insulin Excess release of glucose Loading...1031. Which one of the following drugs belongs to H2 histamine receptor blocker? Ezetimibe Indanyl carbenicillin Torsemide Atorvastatin Ranitidine Loading...1032. What is the most common cause of hypertension in young women? Oral contraceptive pills Atherosclerosis Cardiomyopathy Rheumatic heart disease Loading...1033. Immune related problem is one of the following? High Blood pressure Fever Headache Aids Loading...1034. 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? Strenuous exercise Alcohol intake Prolonged standing Prolonged exposure to the sun Excessive sweating Loading...1035. Which of the following drugs acts directly on dopamine receptors to improve the effects of Parkinson’s disease? Carbidopa Amantadine Bromocriptine Selegiline Loading...1036. Which one of the following drugs is often added to nasal decongestants? Norepinephrine Albuterol Phenylephrine Epinephrine Loading...1037. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Capreomycin Nizatidine Indanyl carbenicillin Ezetimibe Aluminium hydroxide Loading...1038. Which one of the following drugs inhibit the enzyme phosphodiesterase which inactivate the cAMP? Aminocaproic acid Argatroban Warfarin Dipyridamole Loading...1039. A patient represents with a neck mass. Which of the following suggests the possibility of cancer? Recent complaint of toothache History of hoarseness of voice for 3 months History of hypothyroidism Pain or tenderness Loading...1040. 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? Intravenous levothyroxine and glucocorticoid Obtain T4 and TSH and wait for results Begin intravenous fluids Rapid rewarming Loading...1041. Which of the following is an indandione analog Anticoagulant agent? Warfarin Clopidogrel Abciximab Heparin Anisindione Loading...1042. Which of the following is the most likely developmental defect associated with tetralogy of Fallot? Bicuspid pulmonary artery Patent ductus arteriosus Anterosuperior displacement of the infundibular septum Transportation of the great vessels Loading...1043. 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? Enoxaparin Coronary angioplasty Cardiac catheterization Tissue plasminogen activator (tPA) Ibuprofen Loading...1044. 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? Excessive salivation Dilation of the pupils Dry skin Delirium Tachycardia Loading...1045. An anticancer agent 6-mercaptopurine metabolism disturbed by following drug due to which dose is reduced? Colchicine Sulfinpyrazone Allopurinol Probenecid Loading...1046. 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? Lamotrigine Chlorpromazine Benztropine Sertraline Loading...1047. Dose related bone marrow depression is the adverse effect of following drug? Probenecid Caspofungin Ketoconazole Flucytosine Loading...1048. Autonomic nervous system is the part of? Spinal cord Central nervous system Peripheral nervous system Brain Somatic nervous system Loading...1049. 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...1050. Which one of the following anti-depressant drugs is contraindicated if the patient has a history of seizures? Venlafaxine Fluoxetine Bupropion ImipraminePage 43 of 66 Loading...1051. Dry or “sandy eyes” is seen after administration of large doses of which one of the following medications? Pilocarpine Carbacho Atropine Timolol Loading...1052. 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? An observable physical or biochemical trait on an organism DNA structure that determines the expression of a trait Genetic constitution of an organism Physical location of a trait on a DNA molecule Loading...1053. Which of the following is the most likely mechanism of action of hydralazine in treating cardiovascular disorders? Relaxation of arterial smooth muscle Sympathetic antagonism Decreased cardiac preload Parasympathetic stimulation Loading...1054. 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? Complex focal seizure Tonic-clonic seizure Simple focal seizure Myoclonic seizure Absence seizure Loading...1055. 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.ich of the following drugs is most likely responsible for this condition? Verapamil Sotalol Metoprolol Hydralazine Propranolol Loading...1056. Which one of the following medications inhibits protein synthesis by binding to 50S subunit and preventing the formation of the initiation complex? Azithromycin Clindamycin Minocycline Linezolid Loading...1057. 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 She does not need a consent Her boyfriend The ER physician Loading...1058. 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 Atenolol Epinephrine Albuterol Cocaine Loading...1059. Which one of the following structures provides the majority of noradrenergic innervation to the cerebral cortex? Caudate nucleus Substantia nigra Locus coeruleus Raphe nucleus Loading...1060. Nabumetone is a prodrug derived from which of the following class? Propionic acid derivative Enolic acid derivative Fenamic acid derivative Salicylic Acid derivatives Acetic acid derivative Loading...1061. A drug that effects the thyroid hormone is one of the following ? Furosemide Bumetanide A & B Triiodothyronine Sulbactam Loading...1062. Which one of the following medications stimulates muscarinic receptors in airways when inhaled? Carbachol Pilocarpine Bethanechol Methacholine Loading...1063. Which of the following endocrine disorders is characterized by high blood pressure, sodium and water retention, low potassium level and decreased renin activity? Primary hyperaldosteronism Secondary hyperaldosteronism Pheochromocytoma Addison’s disease Loading...1064. Which of the following side effects is the most common after prolonged use of SSRIs? Nausea Headache Insomnia Sexual dysfunction Loading...1065. 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 Arsenic Lead Copper Loading...1066. Which one of the following substances is used to acidify the urine? Sodium bicarbonate Ammonium chloride Acetazolamide Loading...1067. 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 Depression screening test Prostate specific antigen (PSA) Erythrocyte sedimentation rate ECG stress test Loading...1068. 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? 14 hours 1/2 an hour 18 hours 12 hours 6 hours Loading...1069. What are the 5 Ps of ischemia due to peripheral vascular disease? Pain-Pallor-Paralysis-Paresthesia-Poikilothermia Pain-Pallor-Proteinuria-Paresthesia-Paralysis Pain-Pallor-Paralysis-Polycythemia-Proteinuria Pain-Pallor-Paresthesia-Proteinuria-Poikilothermia Loading...1070. Which one of the following drugs is a 2nd generation Cephalosporin? Cefepime Cefadroxil Cefoxitin Cefdinir Loading...1071. Which of the following is the diagnostic test used when ultrasound is equivocal for cholecystitis? Abdominal x-ray Liver function tests CT scan HIDA scan Loading...1072. Which of the following is a characteristic finding in isopropanol poisoning? Elevated anion gap Elevated serum BUN and creatinine Blindness due to ocular accumulation Ketosis without acidosis Loading...1073. 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 history of an organism 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 Loading...1074. Which one of the following contraceptive methods is contraindicated in women with a history of deep venous thrombosis (DVT)? Intrauterine contraceptive device (IUD) Norplant Combined oral contraceptive Depo-Provera injections Loading...1075. 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 Osteomalacia Osteitis fibrosa cystica OsteoporosisPage 44 of 66 Loading...1076. 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? Prostatic cancer Renal cell carcinoma Hodgkin’s lymphoma Chronic lymphocytic leukemia Thyroid follicular carcinoma Loading...1077. A neonate presents by renal failure and pulmonary hypoplasia. What is your diagnosis? Recessive polycystic kidney disease Pompe disease Niemann-Pick disease Phenylketonuria Loading...1078. Which one of the following drugs mediates histamine release from mast cells causing flushing? Caspofungin Griseofulvin Terbinafine Nystatin Loading...1079. 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? Anterior cord syndrome Central cord syndrome Conus medullaris syndrome Brown-Sequard syndrome Transverse myopathy Loading...1080. 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? Rickettsia Mycobacteria Streptococci Mycoplasma Fungi Loading...1081. Beta-Blocker drug is following? Acetylcholine Tamsulosin Succinylcholine Esmolol Atropine Loading...1082. Which one of the following drugs is associated with elevated liver function test results? Ethambutol Isoniazid Capreomycin Rifampin Loading...1083. 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...1084. Which of the following is the initial treatment of asymptomatic aortic stenosis? Balloon valvuloplasty Furosemide Valve replacement Hydrochlorothiazide Loading...1085. 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? Ciprofloxacin Ampicillin Tobramycin Gentamicin Vancomycin Loading...1086. Which one of the following drugs belongs to inhibitors of viral coating? Nevirapine Oseltamivir Amantadine Acyclovir Zidovudine Loading...1087. Following drug is a phenylalanine derivative? Metformin Repaglinide Pioglitazone Nateglinide Loading...1088. Administration of clopidogrel with aspirin is an example of which of the following drug interactions? Additive Tachyphylactic Synergistic Permissive Loading...1089. Which of the following organisms is associated with toxic shock syndrome due to exotoxin A? Clostridium perfringens Streptococcus pyogenes Vibrio cholera Staphylococcus aureus Loading...1090. 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? Inhibition of mycolic acid synthesis Inhibition of bacterial protein synthesis Inhibition of folic acid synthesis Inactivation of bacterial toxins Inhibition of bacterial wall synthesis Loading...1091. Which one of the following antipsychotics has higher affinity to both dopamine and serotonin receptors? Fluphenazine Clozapine Thioridazine Haloperidol Loading...1092. A patient comes to the emergency ward with recent organophosphorus compound poisoning. He will have all of the following signs & symptoms except: Muscle Weakness Diarrhea Increased salivation Bronchodilatation Increased lacrimation Loading...1093. Which of the following layers of the heart forms the cardiac valves and continues with the intima of the aorta? Pericardium Myocardium Epicardium Endocardium Loading...1094. 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? Amoxicillin Ampicillin Azithromycin No medication Loading...1095. Which one of the following drugs is a neuromuscular blocker drug? Nicotine Benztropine Neostigmine Atracurium Atropine Loading...1096. A female patient is found to have an absent right kidney. Which of the following may also be found in this patient? Imperforate hymen Pelvic testis Absent right ovary Unicornuate uterus Loading...1097. 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 Osteitis fibrosa cystica Osteoporosis Osteomalacia Loading...1098. Which of the following factors most likely affects the result of a study due to awareness of study subjects that they are being studied? Hawthorne effect Pygmalion effect Berkson’s bias Recall bias Loading...1099. 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...1100. Sulindac belongs to one of the following class? Acetic acid derivative Fenamates Oxicam derivative Propionic acidPage 45 of 66 Loading...1101. Which one of the following liver disorders occurs due to hepatic vein thrombosis? Fatty liver Alcoholic hepatitis Budd-Chiari syndrome Pyogenic liver abscess Loading...1102. Which of the following laboratory tests is diagnostic for adrenal insufficiency? Serum cortisol Serum ACTH CT scan of adrenal gland ACTH stimulation test Loading...1103. A young man complains of little finger numbness and difficulty gripping things. Which of the following is the affected nerve root? Cervical 5 Cervical 8 Cervical 7 Cervical 6 Loading...1104. Ganglion blocker drug is following? Atracurium Atropine Nicotine B & C Mecamylamine Loading...1105. Infection in body causes one of the following issue? High Blood pressure Fever Aids Headache Loading...1106. Antimuscarinic agent is following? Nicotine Tacrine Atropine Physostigmine Acetylcholine Loading...1107. 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? Fibrillin and elastin Myosin and actin Myosin and fibrin Fibrin and actin Loading...1108. Epinephrine acts to dilate bronchial smooth muscle through which one of the following receptors? Alpha-1-adrenoreceptors Beta-2-adrenoreceptors Beta-1-adrenoreceptors Alpha-2-adrenoreceptors Loading...1109. Which of the following drugs has/have beneficial role in Torsades de pointes ? b & c Magnesium Sulfate Eplerinone Amiodarone Propranolol Loading...1110. 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? Boot-shaped heart Enlarged cardiac shadow in both directions Right ventricular hypertrophy Left ventricular hypertrophy Loading...1111. Which of the following is the earliest abnormal test after infection with hepatitis B? Anti-hepatitis B antibodies Surface antigen ALT Serum bilirubin Loading...1112. A drug that is more effective in combination with itraconazole to treat chromoblastomycosis? Amphotericin B Griseofulvin Flucytosine Nystatin Loading...1113. 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? Perform nerve conduction studies Start duloxetine Perform electromyogram (EMG) Start hydrocodone Start prednisone Loading...1114. A drug that inhibits replication of the influenza A virus by interfering with viral attachment and uncoating? Oseltamivir Rimantadine Nevirapine Acyclovir Zidovudine Loading...1115. Extrapyramidal side effects develop after the use of haloperidol due to its effect on which of the following receptors? Dopamine receptors Nicotinic receptors Muscarinic receptors Alpha-adrenergic receptors Loading...1116. Which of the following medications is the most effective immunosuppressant in cases of organ transplantation? Vinblastine Cyclosporine Cyclophosphamide Azathioprine Loading...1117. Which of the following effects is caused by alcohol intake? No effect on body temperature or body heat loss Decreased body heat loss Increased body heat loss Increased body temperature Loading...1118. 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? Protein Alcohol Fat Chocolate Caffeine Loading...1119. 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? Normal pressure hydrocephalus Alzheimer’s disease Middle cerebral artery stroke Trauma to the head due to elderly abuse Anterior pituitary adenoma Loading...1120. 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 Stickler syndrome Turner’s syndrome Down syndrome Loading...1121. Which of the following esophageal disorders is the most likely a complication of HIV infection? Adenocarcinoma Esophageal varices Candida esophagitis Achalasia Loading...1122. A liposomal preparation of which one of the following medications may reduce the incidence of renal toxicity? Acyclovir Amphotericin B Vancomycin Ketoconazole Loading...1123. 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? Heterochromia iridis Aniridia Anisocoria Coloboma Loading...1124. 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 Ventricular septal defect Transposition of great vessels Coarctation of the aorta Atrial septal defect Loading...1125. Which of the following disorders is most likely related to body dysmorphic disorder? Post-traumatic stress disorder Obsessive compulsive disorder Generalized anxiety disorder MalingeringPage 46 of 66 Loading...1126. Which of the following drugs is beneficial in treatment of glaucoma through increased outflow of aqueous fluid by causing contraction of ciliary muscle? Cholinomimetics Beta blockers Alpha agonists Diuretics Loading...1127. Which one of the following types of cells is involved in foreign body reaction? Giant cell Plasma cell Neutrophil Eosinophil Loading...1128. Which of the following is the most common etiology of type II diabetes? Insulin receptor deficiency Low insulin production Altered hormone-receptor complex Increased hepatic glycogen breakdown Loading...1129. 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? Cyst Rhabditiform larvae Ovum Encysted larvae Loading...1130. 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? You have to sign consent to leave You can leave anytime if you want We cannot release you before you become sober We will call the police if you don’t take treatment Loading...1131. In a case of methemoglobinemia, which one of the following is the most likely cause of the brown color of the patient’s blood? Oxidized hemoglobin Decreased oxygen affinity Reduced hemoglobin Carbon monoxide Loading...1132. A patient presents with painless scrotal mass and increased thyroid panel. Which of the following markers would be elevated in this patient? Follicle stimulating hormone Lactate dehydrogenase Human chorionic gonadotropin Alpha-fetoprotein Loading...1133. A drug that inhibits the ergosterol synthesis causing disruption of membrane function and Increase permeability? Flucytosine Nystatin Ketoconazole Amphotericin B Loading...1134. 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 Ethosuximide Phenytoin Loading...1135. Canrenone is an active metabolite of one of the following Diuretic drug? Furosemide Spironolactone Acetazolamide Triamterene Bumetanide Loading...1136. Which one of the following drugs treatment usually causes a decrease in intestinal flora? All of the above Calcium supplements A & B Antibiotics Diuretics Loading...1137. Which of the following drugs improves skeletal muscle spasm by acting inside the muscle cell? Dantrolene Diazepam Botulinum toxin Tubocurarine Loading...1138. Which of the following drug belongs to Sulfonylureas? Urae Oxacillin Cefoxitin Niacin Glyburide Loading...1139. Which of the following receptors is inhibited by ondansetron to treat nausea following chemotherapy? Muscarinic receptors Serotonin 5-HT receptors Dopamine receptors Nicotinic receptors Loading...1140. Which of the following is the classic electrocardiogram (ECG) finding in inferior myocardial infarction (MI)? Diffuse S-T segment elevation S-T segment elevation in anterior leads (V1-V4) Sawtooth P waves S-T segment elevation in leads II. III and aVF Loading...1141. Which of the following drugs is most likely protective against the toxicity of doxorubicin? Leucovorin Dexrazoxane Vitamin C Mensa Loading...1142. Which one of the following drugs is Nonsteroidal antiestrogens? Estradiol acetate Estradiol Exemestane Tamoxifen Estrogen Loading...1143. Which one of the following conditions is the most likely cause of acute lower gastrointestinal bleeding in patients older than 40? Colorectal cancer Ulcerative colitis Varicose veins Diverticulosis Loading...1144. Which of the following procedures is used in case of Barrett esophagus without dysplasia? Endoscopy and biopsy every 3 months Endoscopy and biopsy every 3 years Endoscopic eradication Endoscopy and biopsy every 6 months Loading...1145. 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. Serum cortisol Serum thyroid stimulating hormone Blood glucose and serum lipidsat is the most appropriate lab test you should order on this visit? Blood urea nitrogen and serum creatinine Loading...1146. Which one of the following drugs is a Tetracycline? Cefepime Cefadroxil Doxycycline Cefdinir Loading...1147. Type of hypoglycemia in which patient feels hypoglycemic symptoms but the blood glucose level is normal or slightly above normal? Gestational Diabetes mellitus Type 1 diabetes Mellitus Pseudo hypoglycemia Type 2. Diabetic mellitus Loading...1148. Which of the following statements correctly describes the therapeutic dose of medication? The amount of medication that produces minimal biological effect 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 Loading...1149. Which of the following drug belongs to Sulfonylureas? Urae Tolbutamide Niacin Oxacillin Cefoxitin Loading...1150. Which one of the following antihypertensive medications is appropriate to use for an asthmatic patient? Metoprolol Labetalol Timolol PropranololPage 47 of 66 Loading...1151. A drug that is used to treat HIV infections is one of the following? Cladribine Niclosamide Praziquantel Etidronate Tenofovir Loading...1152. Which of the following organs is the most commonly affected one by a blunt trauma to the abdomen? Spleen Large intestine Small intestine Liver Loading...1153. 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? Embolism Atherosclerosis Inflammation Thrombosis Loading...1154. A drug that belongs to proton pump inhibitor is one of the following? Omeprazole A & B Rosiglitazone Sulbactam Ethacrynic Acid Loading...1155. The drug that produces dilation of the pupil (mydriasis) for 6 hours is one of the following drugs? Physostigmine Ipratropium Atropine Cyclopentolate Tropicamide Loading...1156. Which of the following cell types is responsible for forming the blood brain barrier (BBB)? Microglia Astrocytes Schwann cells Oligodendrocytes Loading...1157. About Nateglinide; All are true, except? decrease postprandial hypoglycemia Hypoglycemia less common than with Sulfonylureas Decrease insulin resistance release insulin Loading...1158. Which one of the following statements about the use of Diclofenac is incorrect? Also used for ankylosis spondylitis Accumulate in synovial fluid Less potent than Naproxen Excrete out by the kidney Loading...1159. What is the antidote to snake bites? Pralidoxime Antivenin Vitamin K A & B Nalmefene Loading...1160. Adrenal insufficiency is commonly combined with which one of the following findings? Hypernatremia Hyperglycemia Hypercalcemia Hyperkalemia Loading...1161. NucleoSide Reverse Transcriptase inhibitors(NRTIs) drug in Antiviral class? Amprenavir Acyclovir Saquinavir Zidovudine Nevirapine Loading...1162. 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? 5 hours 10 hours 15 hours 7.5 hours Loading...1163. Penicillin type antibiotics half-life is increased due to inhibition of tubular secretion by which of the following drug? Aspirin Colchicine Pegloticase Celecoxib Probenecid Loading...1164. Which of the following is a frequent side effect of amphetamine? Depression Constipation Diarrhea Hair loss Loading...1165. Which of the following conditions is an indication for interferon gamma? Hepatitis A Chronic granulomatous disease Glomerulonephritis Chronic myeloblastic leukemia Loading...1166. Bioavailability of a medication is maximal when it has which of the following factors? High plasma binding High lipid solubility High ionization High water solubility Loading...1167. 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? Atherosclerosis Steven-johnson syndrome Reye syndrome Ductus arteriosus Hypotrichosis Loading...1168. 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 distal convoluted tubules The proximal convoluted tubules The collecting tubule and duct The ascending loop of Henle Loading...1169. Which of the following is the major indication of ondansetron in patients receiving chemotherapy? Headache GERD Nausea and vomiting Hair loss Loading...1170. 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 IV hydration and antibiotics Contrast enema MRI of the abdomen Refer to surgery for bowel resection Loading...1171. Atropine causes:? Tachycardia followed by bradycardia Bradycardia followed by tachycardia Only tachycardia Only bradycardia No effect on Heart Loading...1172. A) Atropine Flumazenil Dimercaprol Penicillamine Loading...1173. Which of the following drug is a derivative of salicylic acid? Etodolac Mefenamic Acid ketorolac Piroxicam Diflunisal Loading...1174. Which one of the following can be found in sickle cell disease? Bite cells Schistocytes Howell-Jolly bodies Spherocytes Loading...1175. 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? T-helper cells B Lymphocytes Fibrocytes Plasma cells Cytotoxic T cellsPage 48 of 66 Loading...1176. Which of the following group of medications prolongs GABA activity in the brain? Methamphetamines Alcohols Benzodiazepines Barbiturates Loading...1177. 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...1178. Which one of the following is NOT a factor in Apgar Scoring System? Respiration Heart rate Skull dimensions Reflex irritability Loading...1179. 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? Refer to a cardiologist Pacemaker implantation Repeat Holter monitor examination Perform exercise stress test Reassurance and follow up visits Loading...1180. An organophosphate drug that has a side effect of cataracts? Neostigmine Edrophonium Acetylcholine Donepezil Echothiophate Loading...1181. Which of the following disorders is considered a nephrotic syndrome? IgA nephropathy (Berger disease) Minimal change disease Alport syndrome Goodpasture syndrome Loading...1182. 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? Fenofibrate Atenolol Orlistat Niacin Lovastatin Loading...1183. 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? Gangliocytoma Germinoma Craniopharyngioma Choriocarcinoma Teratoma Loading...1184. Which of the following types of protein is encoded by the P53 gene? Transcription factor Caspase DNA repair enzyme Tyrosine kinase Loading...1185. Which of the following drug is Phenoxy acetic acid derivative diuretic? Chlorthalidone Ethacrynic acid Benzthiazide Torasemide Furosemide Loading...1186. Which of the following is the most common complication of otitis media? Hearing loss Brain abscess Meningitis Drum perforation Loading...1187. 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 Aspirin Refer to cardiologist Heparin Metoprolol Loading...1188. 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? Urea breath test Stool analysis and culture Rapid urease test Examination and culture of gastric contents Serum test for IgG antibodies against H. Pylori Loading...1189. Which of the following medications is a non-drowsy anti-allergic medication? Chlorpheniramine Loratadine Diphenhydramine Cetirizine Loading...1190. 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 Negatively birefringent urate crystals Cholesterol crystals Cloudy, reddish fluid, with leucocytes’ count equal to the blood count Calcium oxalate crystals Loading...1191. Didanosine belongs to the class of the following drugs? Antibiotics Antiprotozoal Antiviral Anti-malaria Antipyretic Loading...1192. Which one of the following drugs belongs to an alkylating agent? Capreomycin Indanyl carbenicillin Streptozocin Lamivudine Gemcitabine Loading...1193. 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? Weil-Felix titer Blood culture of gonococci Venereal Disease Research Laboratory (VDRL) test Chlamydia titer Loading...1194. Select Phenyl Alkylamine Calcium channel blocker drug? Diltiazem Triamcinolone Verapamil Nifedipine Triamterene Loading...1195. Which one of the following statements about the use of Aspirin is wrong? Repress the sensation of pain Causes Interstitial nephritis Increases alveolar ventilation Inhibit inflammation Loading...1196. A 9-month-child who was delivered after premature labor and is feeding on cow milk and orange juice. What is the predicted deficiency? Vitamin C Iron CalciumVitamin D Loading...1197. Which one of the following medications effectively lowers intraocular pressure? Ergonovine Morphine Latanoprost Atropine Loading...1198. 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 MRI Abdominal X-ray Abdominal ultrasonography Loading...1199. Which of the following substances increases absorption of iron in the intestine? Folic acid Ascorbic acid Riboflavin Cyanocobalamin Loading...1200. A 69-year-old male with angina develops severe constipation following treatment with: Captopril Nitroglycerin Dobutamine Propranolol VerapamilPage 49 of 66 Loading...1201. Lactic acidosis is the adverse effect of one of the following drugs? Aspirin All of the above Metformin Glyburide Loading...1202. 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 and oral doxycycline IM ampicillin IV ceftriaxone IV penicillin Oral doxycycline Loading...1203. 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? Phosphoribosylpyrophosphate synthase Hypoxanthine guanine phosphoribosyltransferase Xanthine oxidase Guanase Loading...1204. Peripheral resistance is linked with one of the following issues? Fever Aids Headache Blood pressure Loading...1205. What is the antidote of Verapamil? Both C & D can be used Atropine Calcium Pyridostigmine Epinephrine Loading...1206. A patient with cystic fibrosis is treated by gene therapy. Which of the following types of cells should be targeted as host cells? T-cells Hemopoietic stem cells Epithelial cells Germ cells Loading...1207. Which of the following organisms is responsible for antibiotic-associated colitis? Clostridium difficile Clostridium tetani Clostridium perfringens Clostridium botulinum Loading...1208. 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? Direct inhibition of the proton pump Suppression of secretory responses to food stimulation Increased mucus and bicarbonates secretion and decreased HCL secretion Formation of a protective coating of the ulcer beds Loading...1209. Which of the following substances is used in mercury poisoning? Fomepizole Succimer Methylene blue Flumazenil Loading...1210. In a case of esophageal dysphagia, which one of the following is considered a mechanical obstruction versus motility disorder? Diffuse esophageal spasm Extrinsic compression Chagas disease Achalasia Loading...1211. Which one of the following agents is a muscarinic cholinomimetic? Tubocurarine Atropine Pilocarpine Hexamethonium Loading...1212. A drug that is used for Hypotrichosis of the eyelashes? Bimatoprost Dinoprostone Treprostinil Epoprostenol Carboprost Loading...1213. 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 Rubella Adenovirus Measles Loading...1214. 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 Acetaminophen Ketorolac Aspirin Loading...1215. 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? 0.1 0.001 0.0.1 0.0001 Loading...1216. Which of the following is the appropriate treatment of amoebic liver abscess? Surgical drainage Amikacin Metronidazole Amoxicillin Vancomycin Loading...1217. Which of the following locations is the most common site of gastrinoma? Ileum Stomach Liver Pancreas Loading...1218. Which of the following differentiate neostigmine from pilocarpine? Stimulation of salivary glands Stimulation of bowel motility Prolonged skeletal muscle contraction Acceleration of heart rate Loading...1219. Which of the following drugs are highly bound to albumin? Ibuprofen All of the above Warfarin Digoxin A & B Loading...1220. Which one of these conditions is most likely associated with peripheral lymphocytosis? Pyogenic bacterial infections Viral hepatitis Myocardial infarction Inflammatory bowel syndrome Loading...1221. 5-FdUMP a false nucleotide inhibits thymidylate synthetase decreasing thymidylic acid(an essential DNA component) is MOA of following drug? Flucytosine Nystatin Amphotericin B Ketoconazole Loading...1222. Which one of the following is a fat-soluble vitamin? Thiamine Retinoid Ascorbic acid Riboflavin Loading...1223. A young man complains of daytime sleeping, cataplexy and sleep paralysis. Which of the following is the best treatment? Diazepam Zolpidem Modafinil Hydroxyzine Loading...1224. Deficiency of which of the following enzymes most likely result in the development of Cori disease? Lysosomal alpha-1,4 glucosidase Muscle glycogen phosphorylase Glucose-6-phosphatase Debranching enzyme (alpha-1,6-glucoside) Loading...1225. Phentolamine and Tolazoline have similar structures to imidazoline Alpha Agonists due to lack of? Lipophilic substitutions on the Cyclic ring Hydrophilic substitutions on the aromatic ring None of these Hydrophilic substitutions on the Cyclic ring Lipophilic substitutions on the aromatic ringPage 50 of 66 Loading...1226. Which one of the following agent is a insulin? Atorvastatin Somatostatin Glulisine Desmopressin Torsemide Loading...1227. 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 Prescribe tolterodine therapy Discontinue metoprolol Try timed voiding Discontinue hydrochlorothiazide Loading...1228. Which one of the following adverse effects of calcium channel blockers is wrong? Vertigo Hypotension Fatigue Diarrhea Loading...1229. Increased level of bradykinin causes? Headache Fever Fatigue Dry cough Vertigo Loading...1230. 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? Folic acid derivatives Ferrous sulfate Wide spectrum antibiotics Rh (D) immune globulin Loading...1231. Which of the following drugs is an ergosterol synthesis inhibitor? Ketoconazole Ritonavir Acyclovir Ampicillin Loading...1232. 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? Scaphoid fracture Colles fracture First metacarpal bone fracture Tear of opponens pollicis Loading...1233. 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...1234. Which one of the following phases of the cell cycle is affected by binding p53 to DNA? G1 M G0 G2 Loading...1235. 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? Normal reaction Acute pyelonephritis Acute rejection Chronic rejection Hyperacute rejection Loading...1236. 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:ich of these findings shows that the body is compensating to this condition? Elevated bicarbonate excretion2: 100 mmHg PCO2: 30 mmHg Elevated arterial PO2 Elevated hydrogen ion concentration Elevated respiratory rate Elevated hydrogen ion excretion Loading...1237. 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? Having to undergo a cesarean section Spontaneous abortions in the first trimester Fetal malformations Preterm labor Loading...1238. 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? Diazepam Metoclopramide Fluoxetine Citalopram Donepezil Loading...1239. Which one of the following drugs is the most effective for nausea and vomiting of pregnancy? Meclizine Cimetidine Loratadine Ondansetron Loading...1240. Which one of the following agent is a insulin? Torsemide Aspart Somatostatin Desmopressin Atorvastatin Loading...1241. Which of the following indicates the probability that a person who has a positive test result actually has the disease? Positive predictive value Sensitivity Specificity Attributable risk Loading...1242. 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 Reye syndrome Hypotrichosis Pulmonary embolism Atherosclerosis Loading...1243. 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? Vitamin C Vitamin B3 (niacin) Vitamin D Vitamin A Folic acid Loading...1244. Gonadotropin-releasing hormone is produced by which of the following nuclei of hypothalamus? Anterior nucleus Dorsomedial nucleus Arcuate nucleus Ventromedial nucleus Loading...1245. Which one of the following statements about the platelets is wrong? TXA2 enhance aggregation Life of platelet 3-7 days Platelet have nuclei Can't synthesize the new enzyme PG2 decrease aggregation Loading...1246. Which of the following drug belongs to H2 histamine receptor blocker? Cefoxitin Glimepiride Oxacillin Niacin Famotidine Loading...1247. Which one of the following is the most common cause of non-adherence to administration of prescribed drugs? Food restrictions Fear of addiction Frequent dosing Forgetfulness Loading...1248. Which one of the following factors stimulates the renal secretion of renin? Increased chloride ion concentration in the renal distal tubules Decreased pressure in the afferent glomerular arterioles Decreased serum sodium ion concentration Increased pressure in the afferent glomerular arterioles Loading...1249. 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? Crohn’s disease Irritable bowel syndrome Polycystic kidney disease Ulcerative colitis Loading...1250. Which of the following drug is Leukotriene Antagonist? Sodium Cromoglycate Terbutaline Montelukast Salbutamol Ipratropium BromidePage 51 of 66 Loading...1251. 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 optic nerve Right oculomotor nerve Loading...1252. 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 CT scan of abdomen and pelvis Admission to the intensive care unit (ICU) MRI of the kidney Collection of urine and blood cultures Loading...1253. Which of the following esophageal disorders is the most likely a complication of HIV infection? Candida esophagitis Adenocarcinoma Achalasia Esophageal varices Loading...1254. Which one of the following urine electrolytes in the best to estimate extracellular fluid (ECF) volume in metabolic alkalosis? Urine sodium Urine urea Urine anion gap Urine chloride Loading...1255. 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) Cocaine Barbiturates Amphetamines Loading...1256. 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 Diarrheal diseases HIV/AIDS Ischemic heart disease Lower respiratory tract infections Loading...1257. The tracheal tube is originated from which of the following structures? Fourth pharyngeal arch Third pharyngeal arch Foregut Ductus arteriosus Loading...1258. Which 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...1259. Which of the following medications may cause acquired angioedema within days to weeks after starting it? Clopidogrel Aspirin Propranolol Benazepril Loading...1260. Which one of the following drugs is the best treatment for seizures of eclampsia? Haloperidol Phenobarbital Carbamazepine Magnesium sulfate Loading...1261. Which one of the following drugs belongs to an alkylating agent? Lamivudine Gemcitabine Melphalan Cladribine Fludarabine Loading...1262. 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? 88% 84% 90% 92% 86% Loading...1263. 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? Tracheomalacia Pyloric stenosis Tetralogy of Fallot Tracheoesophageal fistula Imperforate anus Loading...1264. Release of which of the following chemical mediators results in pain in cases of acute inflammation? Complement C3b Prostaglandin Histamine Serotonin Loading...1265. Which of the following types of sensations is carried to the thalamus by the anterolateral tracts after crossing the spinal cord? Crude touch Vibrations Position Fine touch Loading...1266. A drug that act as laxative is one of the following? Furosemide Magnesium hydroxide A & B Bumetanide Sulbactam Loading...1267. Atropine is often used prior to administration of inhalant anesthetics to reduce which of the following? Muscle tone Vomiting Heart rate Secretions Loading...1268. 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? Osteoarthritis Side effect of one of her medications Alzheimer’s disease Postural hypotension Old age Loading...1269. 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? Ultrasound guided biopsy Mammography MRI of the chest Whole body CT scan X-Ray of the chest Loading...1270. Which one of the following drugs is a H² receptor Antagonist? Sucralfate Cimetidine Rabeprazole Omeprazole Loading...1271. Serotonin Receptor linked with nausea and emesis? 5HT³ 5HT4 5HT5 5HT² 5HT¹ Loading...1272. Which of the following is the mechanism of action of zileuton for asthma? Inhibition of 5-lipoxygenase Inhibition of phosphodiesterase Stimulation of beta-2 receptors Inhibition of Phospholipase A Loading...1273. One of the following statements is false about the functions of epinephrine? Hyperglycemic effect Increase in systolic blood pressure Bronchodilation Increased blood supply to the kidney Strengthen the contractility of the myocardium Loading...1274. Which of the following amino acids is a non essential? Histidine Alanine Glutamic acid Asparagine Aspartic acid Loading...1275. Which of the following conditions could be a serious side effect of sumatriptan? Torsades de pointes Coronary vasospasm Cutaneous flushing Dilated cardiomyopathyPage 52 of 66 Loading...1276. Which of the following enzymes is markedly elevated in primary biliary cirrhosis? Aspartate aminotransferase (AST) Alkaline phosphatase Alanine aminotransferase (ALT) Acid phosphatase Loading...1277. Beta-Blocker drug is following? Atracurium Atropine Nicotine Pindolol Mecamylamine Loading...1278. Amiodarone is considered one of which of the following classes of anti-arrhythmic drugs? Class IV Class I Class III Class II Loading...1279. Which one of the following drugs is used to treat asthma? Montelukast Ezetimibe Hydrochlorothiazide Repaglinide Indanyl carbenicillin Loading...1280. 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? Milk formula instead of breastfeeding Vitamin C supplement Iron supplement Vitamin D supplement Loading...1281. Which of the following ligaments is most likely torn in a case of posterior dislocation of the hip? Sacrotuberous ligament Ischiofemoral ligament Iliofemoral ligament Loading...1282. Which of the following is absolute contraindication of fibrinolytic therapy in MI? History of ischemic stroke 4 years ago History of hemorrhagic stroke 9 years ago History of diabetes History of hypertension Loading...1283. What is the antidote to Atenolol? Pyridoxine atropine Glucagon Flumazenil Loading...1284. 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. Respiratory smooth muscle Cutaneous blood vessels SA Node Splanchnic blood vessels Radial muscle of the iris Loading...1285. Which one of the following drugs decreases Glucose absorption? Glipizide Metformin Miglitol Rasagiline Loading...1286. 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 Colorectal adenocarcinoma Small cell carcinoma of the lung Loading...1287. Which one of the following antibacterial drugs is a protein synthesis inhibitor drug? Cefuroxime Vancomycin Aztreonam Chloramphenicol Loading...1288. A drug has a large volume of distribution because it accumulates in muscles? Clopidogrel Digoxin Acetaminophen Nitroglycerin Aspirin Loading...1289. What is the best treatment of gastroparesis in a diabetic patient? Metoclopramide Gastric resection Omeprazole Vagotomy Loading...1290. Which of the following is the cellular mechanism of epinephrine? Activation of adenylyl cyclase Activation of acetylcholinesterase Inhibition of adenylyl cyclase Activation of phospholipase Loading...1291. Outpatient prophylaxis of superior ventricular tachycardia (SVT) is best accomplished by which of the following medications? Diltiazem Procainamide Lidocaine Adenosine Loading...1292. Torsades de pointes may occur after the use of which one of the following medications? Sotalol Propranolol Lidocaine Rifampin Loading...1293. 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...1294. Which one of the following types of cell secretions involves exocytosis? Holocrine secretion Merocrine secretion Apocrine secretion Loading...1295. Cholestatic Jaundice is the adverse effect of the following drug? Clindamycin Cefepime Erythromycin Chloramphenicol Loading...1296. 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? Sulfur dioxide Carbon monoxide (CO) Nitrogen Ozone Loading...1297. Which one of the following drugs is a Substrate of the P-GP (glycoprotein) efflux pumps? Digoxin All of the above Erythromycin A & B Amiodarone Loading...1298. 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? Verapamil Propranolol Quinidine Amiodarone Loading...1299. 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? Superior mesenteric artery Celiac trunk Left gastric artery Splenic artery Right gastric artery Loading...1300. Which one of the following drugs can be used as a patch to avoid sea sickness? Nicotine Adrenaline Scopolamine DigoxinPage 53 of 66 Loading...1301. Which one of the following intravenous anesthesia has antiemetic action? Fentanyl Thiopental Ketamine Propofol Loading...1302. 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 Superior, middle and inferior rectal veins Splenic and external iliac veins Azygos and hemiazygos veins Paraumbilical and epigastric veins Loading...1303. Which of the following is the best next step for a suspicious malignant melanoma? Excisional biopsy Shave biopsy Observation Excision with a safety margin Loading...1304. Which of the following is the best screening test for colon cancer? Barium enema Colonoscopy Blood in stool (FOBT) Sigmoidoscopy Loading...1305. Which of the following is the most effective treatment of a case of an old man with benign prostatic hypertrophy (BPH)? Doxazosin Finasteride Doxazosin and finasteride Propranolol Loading...1306. Elevation of which one of the following substances in blood occurs due to reduced renal blood flow? Renin Ammonia Cholesterol Calcium Loading...1307. One of the following statements about the Parasympathetic neurons is wrong? Preganglionic fibers arise from cranial nerves Preganglionic neurons originated from the Sacral region Preganglionic fibers are long Originated from Efferent autonomic system Postganglionic fibers are long Loading...1308. Which one of the following drugs prevents the release of Renin and increase in heart rate from sympathetic stimulation? Digoxin Metoprolol Dobutamine Enalapril Loading...1309. 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? Sodium bicarbonate Omeprazole Ondansetron Metoclopramide Clindamycin Loading...1310. Which of the following conditions is associated with the presence of non-inflammatory follicular papules (comedones)? Atopic dermatitis Acne vulgaris Bullous pemphigoid Pemphigus vulgaris Loading...1311. A drug that belongs to Loop Diuretics is one of the following? Bumetanide Sulbactam A & B Cefazolin Doripenem Loading...1312. Serotonin Receptor which acts presynaptically at Serotonergic and adrenergic neurons to reduce neurotransmitter release is following? 5HT¹ 5HT4 5HT³ 5HT5 5HT² Loading...1313. Which of the following locations is the most common for Koplik’s spots of measles? Tongue Hard palate Buccal mucosa Soft palate Loading...1314. Which of the following hormone belongs to the oral diabetic agent? Somatrem Glimepiride Furosemide A & B Oxytocin Loading...1315. 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? Respect the patient’s wishes and don’t do this procedure Convince the patient falsely that this procedure is part of treatment and do it Force the patient to do the procedure Inject the patient with anesthesia and do the procedure Loading...1316. 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? Acute glomerulonephritis Traumatic avulsion of the ureter Acute tubular necrosis Interstitial nephritis Loading...1317. What is the proper treatment of ventricular fibrillation? Metoprolol and heparin Immediate cardioversion Morphine and nitroglycerin Digoxin and verapamil Loading...1318. 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? Small Intestine Stomach Colon Esophagus Loading...1319. Which of the following conditions is caused by a frameshift mutation? Becker muscular dystrophy Hereditary nonpolyposis colorectal cancer Sickle cell disease Duchenne muscular dystrophy Loading...1320. A patient is diagnosed with posterior dislocation of the hip. Which one of the following ligaments is most likely torn? Lacunar ligament Sacrotuberous ligament Ischiofemoral ligament Iliofemoral ligament Loading...1321. Which of the following is the main site of action of HMG-CoA reductase inhibitors? GI tract Kidney Blood Liver Loading...1322. 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 lactulose Oral lorazepam Broad spectrum antibiotics Intravenous thiamine Loading...1323. 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 osteoclast activity Increase urinary calcium reabsorption Increase vitamin D absorption Increase osteoblast activity Decrease parathormone activity Loading...1324. 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? Assurance and follow up in 2 weeks Urine culture MRI of the pelvis Refer to surgery for urgent reduction Abdominal CT scan Loading...1325. Which of the following parts of the stomach has a dome-shaped appearance and lies superior to the lower end of esophagus? Pylorus Body Fundus AntrumPage 54 of 66 Loading...1326. 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 heparin Start warfarin Start low molecular weight heparin and warfarin Assurance and follow up in 3 months Start aspirin Loading...1327. Which one of the following neurologic drugs can cause diplopia, thickened gums and hirsutism? Phenobarbital Valproic acid Phenytoin Carbamazepine Loading...1328. Which of the following is the most common inherited cause of hypercoagulability? Prothrombin gene mutation Factor V Leiden mutation Protein C deficiency Congenital antithrombin III deficiency Loading...1329. 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? No. They are not related to exposure because they are episodic 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 Loading...1330. A cytokine that induces proliferation of antigen-primed T cells along with enhancing the activity of NK cells? Interleukin-2 (IL-2) Interleukin-1 (IL-1) Tissue necrosis factor-alpha Interferon-gamma Loading...1331. 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 Exercise Age Blood pressure Weight Loading...1332. Peripheral resistance is linked with one of the following issue? Fever Aids Blood pressure Headache Loading...1333. 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? Primary adrenal insufficiency Tanner syndrome Hashimoto’s disease Post-traumatic hypopituitarism Loading...1334. 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? Hawthorne effect Information bias Sample distortion bias Confounding bias Loading...1335. 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? Verapamil Captopril Hydrochlorothiazide Metoprolol Loading...1336. Which one of the following drugs belongs to drugs for hepatic viral infections? Capreomycin Ezetimibe Aluminium hydroxide Indanyl carbenicillin Lamivudine Loading...1337. Which one of the following parts of the cell is the site of steroid synthesis? Golgi apparatus Rough endoplasmic reticulum Peroxisome Smooth endoplasmic reticulum Loading...1338. 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? Bumetanide Furosemide Acetazolamide Spironolactone Chlorothiazide Loading...1339. Which one of the following cardiac conditions occurs in about 25% of patients with systemic lupus erythematosus (SLE)? Aortic stenosis Atrial hypertrophy Ventricular myxoma Pericarditis Loading...1340. Which of the following is the mechanism of action of vinblastine? Interferes with purine synthesis Interferes with DNA mobilization and replication Interferes with microtubule assembly Interferes with microtubule disassembly Loading...1341. Which of the following drug causes Calcium reabsorption that leads to hypercalcemia? Spironolactone Triamterene Hydrochlorothiazide Acetazolamide Furosemide Loading...1342. A drug that belongs to Loop Diuretics is one of the following? A & B Bumetanide All of the following Bumetanide Furosemide Loading...1343. Which one of the following viruses is responsible for the development of viral myocarditis? Mumps virus Adenovirus Coxsackie B virus Rhinovirus Loading...1344. What is the most likely explanation of this finding? Beta-naphthylamine is directly carcinogenic to human bladder Human urinary glucuronidase splits beta-naphthylamine into glucuronic acid and a toxic metabolite. Detoxification of beta-naphthylamine by glucuronic acid conjugation. Metabolism of beta-naphthylamine by human cytochrome 450 system in the liver Loading...1345. 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? Transposition of great vessels Tetralogy of Fallot Coarctation of the aorta Atrial septal defect Ventricular septal defect Loading...1346. 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? Ciliated columnar epithelium Keratinized squamous epithelium Non-keratinized squamous epithelium Non-ciliated columnar epithelium Loading...1347. Which one of the following actions is produced by muscarinic cholinergic agonists? Decreased release of intracellular calcium Decreased IP3 production Inhibition of phospholipase C Activation of inhibitory G protein Loading...1348. Anterior spinal artery arises from which of the following arteries? Vertebral artery Basilar artery Internal carotid artery External carotid artery Loading...1349. Which of the following causes pancreatitis? All of the above Didanosine Azathioprine Exenatide L-asparaginase Loading...1350. Which one of the following is a anterior pituitary hormone? Desmopressin Somatostatin Atorvastatin Torsemide FenofibratePage 55 of 66 Loading...1351. Which of the following substances is responsible for growth of the prostate at puberty? Dihydrotestosterone Progesterone Testosterone Estrogen Loading...1352. Which of the following is Sulphamoyl Derivative diuretic drug? Bumetanide Metolazone Chlorthalidone Hydrochlorothiazide Ethacrynic Acid Loading...1353. Which one of the following drugs is first generation flouroquinolone? Levofloxacin Moxifloxacin Ciprofloxacin Nalidixic acid Loading...1354. Pemphigus is an autoimmune skin disease associated with which of the following structures? , Tight junctions Gap junctions Desmosomes Cell matrix junctions Loading...1355. Which of the following drug is the Antidote of Isoniazid? N-acetyl-cysteine Digibind Pyridoxine Amyl Nitrate Loading...1356. Which of the following drug belongs to Sulfonylureas? Glimepiride Niacin Urae Oxacillin Cefoxitin Loading...1357. What is the antidote to organophosphates toxicity? Atropine Pralidoxime Dimercaprol B & C All of above Loading...1358. Which one of the following anti-acne drugs act by induction of apoptosis in sebaceous glands? Tetracycline Benzoyl peroxide Isotretinoin Azelaic acid Loading...1359. 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? AVitamin K Deferoxamine Amitriptyline Penicillamine Leucovorin Loading...1360. 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? 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 Ask the patient for the reason of refusal and don’t force her to take her medications Tell the patient that if she doesn’t take her medications then, there is no need to take any future appointments 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...1361. Which of the following is the best therapy for essential tremors? Physiotherapy Haloperidol Propranolol Metoclopramide Loading...1362. 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? Vincristine Daunorubicin Cisplatin Methotrexate Cyclophosphamide Loading...1363. 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 Ampicillin Methicillin Ciprofloxacin Loading...1364. Which one of the following drugs causes a non-productive cough? Atorvastatin Desmopressin Torsemide Somatostatin Captopril Loading...1365. 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 Administer metoprolol Initiate perfusion therapy Send for echocardiography Loading...1366. Which of these drugs inhibits epoxide reductase? Aspirin Heparin Streptokinase Warfarin Loading...1367. Which of the following groups are found in the structural formula of Angiotensin-converting enzyme inhibitors Except? Sulfahydril group Imidazole ring Carboxylate group Phosphinic acid group Thiol group Loading...1368. Following statements about the use of the Metformin is incorrect? Hypoglycaemia risk is low A biguanide Insulin sensitiser Requires insulin for action Promotes insulin secretion Loading...1369. Verapamil, a calcium channel antagonist: Decreases myocardial contractility Increases intracellular cAMP Increases conduction velocity Increases reactivation of sodium channels Decreases intracellular K Loading...1370. 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? Antibody to hepatitis B surface antigen DNA for Epstein-Burr virus Serum anti-mitochondrial antibodies Antibody to hepatitis C virus IgM antibody to hepatitis A virus Loading...1371. A drugs decrease the migration of granulocytes into the effected area Also Block cell division by binding to mitotic spindles? Sulindac Allopurinol Probenecid Colchicine Loading...1372. Hemorrhagic cystitis may develop after the use of cyclophosphamide. Which one of the following drugs can reduce this risk? Vitamin K Infliximab Mensa Ampicillin Loading...1373. 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? Schizophrenia Bipolar disorder Attention-deficit hyperactivity disorder (ADHD) Conduct disorder Loading...1374. Which test of the following is used to evaluate acute exacerbation of asthma? Pulmonary function tests Pulse oximetry Chest x-ray Complete blood count Loading...1375. 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? Glipizide Glyclopyramide Carbetamide Tolazamide MetforminPage 56 of 66 Loading...1376. 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? Amoxicillin No medication Azithromycin Ampicillin Loading...1377. Which one of the following drugs is a Tetracycline? Cefdinir Cefepime Demeclocycline Cefadroxil Loading...1378. 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? Decreased gastrointestinal motility Mydriasis Constipation Bronchial smooth muscle dilation Dilation of blood vessels Loading...1379. Which one of the following glucocorticoids is short acting? Betamethasone Cortisone Amiloride Prednisone A & B Loading...1380. Which of the following in the mode of inheritance of glucose-6-phosphate dehydrogenase deficiency? X-linked dominant Autosomal recessive X-linked recessive Autosomal dominant Loading...1381. 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 Nystatin Amphotericin B Ampicillin Acyclovir Loading...1382. Which of the following characteristics differentiates cephalohematoma from caput succedaneum in newborn? Cephalohematoma crosses suture lines Cephalohematoma does not cross suture lines Cephalohematoma disappears in the first few days Cephalohematoma will never calcify Loading...1383. 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...1384. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Ibandronate Capecitabine Voriconazole Naftifine Miconazole Loading...1385. Which one of the following drugs is a selective beta-1 agonist? Amrinone Digoxin Dobutamine Dopamine Loading...1386. Which one of the following drugs is a 2nd generation Cephalosporin? Cefprozil Cefdinir All of the above A & B Cefaclor Loading...1387. Which one of the following effects is correlated to direct beta1-adrenoreceptor stimulation? Bradycardia Vasoconstriction Bronchodilation Tachycardia Loading...1388. Which of the following muscles are the primary abductors of the arm at the shoulder? Deltoid and infraspinatus Deltoid and coracobrachialis Deltoid and supraspinatus Deltoid and biceps Loading...1389. Alcohol is oxidized in the liver by which one of the following enzymes? Alcohol oxidase Alcohol dehydrogenase Alcohol decarboxylase Alcohol reductase Loading...1390. Which one of the following blotting procedures is the best for studying mRNA levels? Western blot Northern blot Southwestern blot Southern blot Loading...1391. Which of the following drug can disrupt the enteric coating by increasing the Gastric PH? Oxacillin Glimepiride Cefoxitin Omeprazole Sitagliptin Loading...1392. Which of the following drugs is used to treat pulmonary embolism? Oxacillin Niacin Dalteparin Cefoxitin Tolbutamide Loading...1393. 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? Left ventricular wall aneurysm Atrial myxoma Vegetative valvular lesions Atrial thrombus Loading...1394. 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...1395. 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? Candida albicans Streptococcus pneumoniae Moraxella catarrhalis Pseudomonas aeruginosa Haemophilus influenzae Loading...1396. Which one of the following medications has a significant alpha-adrenergic blocking activity? Haloperidol Risperidone Chlorpromazine Clozapine Loading...1397. Which of the following arteries is the most common site of coronary artery occlusion? Posterior descending artery Left circumflex artery Left anterior descending artery Right coronary artery Loading...1398. Which of the following is NOT considered an indication for HIV testing? Patients with symptoms of AIDS Recent positive test of a partner Semen donor Homosexuality Loading...1399. The structural formula of epinephrine and Norepinephrine called? All of these Pyrocatechol 1,2-dihydroxybenzene Catechol Loading...1400. Which one of the following drugs belongs to drugs for hepatic viral infections? Aluminium hydroxide Ezetimibe Entecavir Capreomycin Indanyl carbenicillinPage 57 of 66 Loading...1401. 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? Depth of the lesion Diameter of the lesion Color of the lesion Age of the patient Loading...1402. Which of the following is the appropriate next step of action to parents who refuse to vaccinate their child? Obtain a court order Proceed with immunizations Explain the risks and benefits to them and document the conversation Report to Department of Health Services (DHS) Loading...1403. Deficiency of which of the following enzymes results in elevated serum levels of alanine and lactate? Lactate dehydrogenase Pyruvate dehydrogenase Alanine aminotransferase Glucose-6-phosphatase Loading...1404. A patient presents with vomiting, diarrhea and abdominal cramps a few hours after a picnic. Which is the causative organism? Staphylococcus aureus E-coli Streptococcus pyogenes Clostridium difficile Loading...1405. Which one of the following parts of the cell is the site of steroid synthesis? Rough endoplasmic reticulum Smooth endoplasmic reticulum Golgi apparatus Peroxisome Loading...1406. Which one of the following medications inhibits HMG-CoA reductase? Digoxin Aspirin Tacrolimus Simvastatin Loading...1407. What is the most appropriate next step in management of a patient complaining of symptoms of GERD? Barium swallow Endoscopy Ranitidine Omeprazole Loading...1408. Amylin analog is one of the following? A & B Furosemide Pramlintide Bumetanide Levothyroxine Loading...1409. Which one of the following drugs is a Thiazide Diuretic? Atorvastatin Indapamide Fenofibrate Indanyl carbenicillin Ezetimibe Loading...1410. Which of the following is the main reason that acetylcholine not used in clinical practice? It has a long half-life It is expensive It is toxic It is hydrolyzed very quickly Loading...1411. 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 MRI to the brain Schedule another appointment whenever she has symptoms Loading...1412. Which one of the following contraceptive methods is contraindicated in women with a history of deep venous thrombosis (DVT)? Depo-Provera injections Norplant Intrauterine contraceptive device (IUD) Combined oral contraceptive Loading...1413. Which one of the following is the most common cause of vitiligo? Chemical Autoimmune Trauma Infection Loading...1414. A disease that is characterized by the movement of gastric contents from the stomach into the esophagus? Peptic Ulcer disease A & B Dyspepsia GERD Loading...1415. Which of the following is Coumarin derivative Anticoagulant agent? Clopidogrel Abciximab Heparin Ticlopidine Warfarin Loading...1416. Secretion of which one of the following hormones is decreased due to renal failure? Glucagon Erythropoietin Thyroxin Insulin Loading...1417. Which of the following medications is selectively used in NSAID-induced gastric ulcer? Misoprostol Bismuth Famotidine Cimetidine Loading...1418. Which of the following drug is a Dihydropyridine antihypertensive drug? Ethacrynic Bumetanide Carvedilol Amlodipine Diltiazem Loading...1419. Which of the following drug is prototypical phenylalkylamine? Amiloride Diltiazem Verapamil Losartan Amlodipine Loading...1420. Which one of the following drugs is used to prevent acute mountain sickness? Furosemide Acetazolamide Chlorthalidone Spironolactone Mannitol Loading...1421. Which of the following are the most likely effects of beta blockers on the end-diastolic volume (EDV) and the ejection time (ET)? Both of them decrease Both of them increase EDV increases and ET decreases EDV decreases and ET increases Loading...1422. 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 Simvastatin Cocaine addiction Zidovudine HIV infection Alcohol abuse Loading...1423. Which of the following medications is considered a selective beta-1 adrenergic agonist? Dobutamine Prazosin Dopamine Amrinone Loading...1424. Which one of the following medications inhibits protein synthesis by binding to 50S subunit and preventing the formation of the initiation complex? Linezolid Minocycline Azithromycin Clindamycin Loading...1425. Which one of the following is the most appropriate next step in suspected scaphoid fracture (with normal radiology)? Thumb spica splint Admission and observation Assurance and follow up in 2 weeks Emergent orthopedic consultationPage 58 of 66 Loading...1426. Which of the following characterized by painless blisters on the back of the hands with friable surrounding skin and hyperpigmentation of the face? Contact dermatitis Dermatitis herpetiformis Herpes Zoster Porphyria cutanea tarda Loading...1427. Which one of the following drugs is used to treat hyperphosphatemia? Sevelamer Sodium polystyrene sulfonate Alendronate Metamucil A & B Loading...1428. Which one of the following drugs is effective against prolactin-secreting tumors? Chlorpromazine Adrenaline Bromocriptine Prazosin Loading...1429. Which one of the following causes induction of cellular enzymes that interfere with viral protein synthesis? Amantadine Zanamavir Gancyclovir Interferon-alpha Ribavirin Loading...1430. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Furosemide A & B Ethambutol Rabeprazole Ibandronate Loading...1431. Aldosterone is released from which part of the adrenal medulla? Zona fasciculate Zona reticularis A & B Zona glomerulosa All of these Loading...1432. Which of the following correctly describes pleiotropy? Not all individuals with mutant genotype show the same mutant phenotype Phenotype is always the same among individuals having the same genotype One gene contributes to multiple phenotypic effects Increased severity of a disease in succeeding generations Loading...1433. 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 Hydrarthrosis Acute arthritis Osteoarthritis Tear of posterior collateral ligamentat is the most likely diagnosis? Loading...1434. Pharmacokinetics of a drug is defined as which one of the following? Amount of drug needed to produce an effect Effect of a drug on certain body systems Reaction of the body to a drug The movement of a drug within the body Loading...1435. In case of constrictive pericarditis, examination reveals increased jugular venous pressure with inspiration. Which of the following is considered positive in this patient? Hepatojugular reflux S3 gallop Raynaud’s phenomenon Kussmaul sign Loading...1436. A drug that is a part of Macrolide is following? Cefepime Cefaclor Clarithromycin Cefdinir Loading...1437. Which one of the following drugs is a Proteas inhibitor? Maraviroc Indanyl carbenicillin Delavirdine Darunavir Abacavir Loading...1438. Which of the following is the most likely finding on a biopsy of a case of chronic bronchitis? Non-caseating granuloma Abundant mucus with plugging of the bronchioles Caseating granuloma Interstitial fibrosis Loading...1439. 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? Cross sectional study Case-control study Double blind clinical trial Single blind clinical trial Randomized controlled trial Loading...1440. 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? Mastitis A breast abscess A clogged milk duct Milk engorgement Inflammatory carcinoma Loading...1441. 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...1442. Which one of the following cranial openings is located at the greater wing of sphenoid and contains the middle meningeal artery? Foramen lacerum Foramen spinosum Foramen ovale Foramen rotundum Loading...1443. Which one of the following cells is neuroendocrine and found within the epithelium of the bronchi? Macrophages Clara cells K cells Pneumocytes type I Pneumocytes type II Loading...1444. 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? Increased secretion of calcitonin Increased secretion of parathyroid hormone End-organ hyposensitivity to calcitonin Decreased secretion of parathyroid hormone End-organ hyposensitivity to parathyroid hormone Loading...1445. A drug increase cAMP results in activation of protein kinase? Dobutamine Tirofiban Clopidogrel Ticlopidine Aspirin Loading...1446. High levels of which one of the following substances signals the initiation of gluconeogenesis? Citrate Acetyl CoA Adenosine triphosphate (ATP) Oxalate Loading...1447. Prolonged vomiting results in which one of the following findings? Metabolic acidosis with hypernatremia Metabolic alkalosis with hypokalemia Metabolic alkalosis with hyperkalemia Metabolic acidosis with hyperkalemia Loading...1448. Following is the Structural analog of the aldosterone antagonist spironolactone with androgenic activity but to a little extent? Bicalutamide Megestrol Acetate Drospirenone Fluoxymesterone Mifepristone Loading...1449. 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? Acceptance Depression Bargaining Denial Anger Loading...1450. Which of the following is the most common cause of adverse drug reactions? Idiosyncrasy Non-compliance Dosage discrepancy Allergic reactionPage 59 of 66 Loading...1451. 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? Complete blood count Beta-HCG Serum electrolytes Urinalysis Loading...1452. Which of the following hormone belongs to the oral diabetic agent? Oxytocin Somatrem A & B Pioglitazone Furosemide Loading...1453. Which one of the following medications should be taken on an empty stomach and at least one hour before meals? Levothyroxine Propranolol Prednisone Aspirin Loading...1454. 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? Subcutaneous injection of epinephrine Intravenous injection of broad spectrum antibiotics Call the cardiology attendant Intravenous injection of heparin Electric cardioversion Loading...1455. 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 oseltamivir for 2 weeks to all residents Treat only patients with oseltamivir until their symptoms subside Administer flu vaccine plus oseltamivir for 2 weeks to all residents Administer flu vaccine to all residents Loading...1456. Ingestion of which of the following products may cause hypertensive crisis in patients taking MAO inhibitors? Carbohydrates such as starch Tyramine-rich food Gluten-rich food Vitamin D and calcium Loading...1457. 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? Hypertension Antihypertensive therapy Vasovagal reflex Aortic stenosis Loading...1458. 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.at is the most likely diagnosis? Hemolytic uremic syndrome Idiopathic thrombocytopenic purpura Thrombocytopenic thrombotic purpura Renal stones Henoch-Schonlein purpura Loading...1459. Chronic Daily ingestion of 5 g or more acetaminophen for longer than 1 month causes? Bleeding compilations GI disturbance Hypersensitivity to NSAIDs Liver damage Hypersensitivity to Salicylates Loading...1460. Which of the following characteristics is correct if the drug is highly tissue-bound? Low drug dilution Low volume of distribution High metabolic rate Low plasma concentration Loading...1461. 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 so, no need for the vaccine HPV vaccine is essential to treat the current infection She can only take the vaccine later after full recovery 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 Loading...1462. 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 antibody test HIV p24 antigen CD4 lymphocyte count HIV RT PCR Loading...1463. Which one of the following is an anterior pituitary hormone? Corticotropin Torsemide Somatostatin Fenofibrate Atorvastatin Loading...1464. 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? Rheumatoid arthritis Systemic lupus erythematosus Miliary tuberculosis Wegener granulomatosis Acute glomerulonephritis Loading...1465. Which of the following errors is considered if the researcher states that there is no difference when one exists? Type II error Type 1 error Loading...1466. Patients with genetic polymorphism have delay in metabolism of drugs by acetylation. Which one of the following drugs is most likely affected by that? Hydralazine Prazosin Nitroglycerin Clonidine Loading...1467. Which of the following is the main complication of sickle cell disease? Hepatic failure Autosplenectomy Cerebral hemorrhage Renal failure Loading...1468. To diagnose myasthenia gravis we use? Edrophonium Physostigmine Ambenonium Pralidoxim Malathion Loading...1469. 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 Cardioversion Metoprolol Refer to cardiologist Heparin Loading...1470. What is the most appropriate treatment of organophosphate poisoning? Pralidoxime Morphine Hexamethonium Pyridostigmine Loading...1471. 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? 30 mg None 20 mg 10 mg Loading...1472. Which of the following is an epithelial tumor with a “stuck-on” appearance? Basal cell carcinoma Squamous cell carcinoma Seborrheic keratosis Actinic keratosis Loading...1473. 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...1474. Which one of the following neoplasms is the most likely related to HIV infection? Myelocytic leukemia Kaposi sarcoma Hodgkin’s lymphoma Burkitt’s lymphoma Loading...1475. 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? Positive predictive value Specificity Relative risk Odds ratioPage 60 of 66 Loading...1476. Which one of the following drugs is a Meglitinide drug? Fenofibrate Indanyl carbenicillin Nateglinide Ezetimibe Hydrochlorothiazide Loading...1477. Which one of the following medications can be reversed by administration of vitamin K? Tirofiban Clopidogrel Heparin Warfarin Loading...1478. An agent that contains sulfonamide structure in structural formula and blocks cysLT¹ receptor thus blocking the effect of leukotrienes? Acetaminophen Zileuton Zafirlukast Ergotamine Loading...1479. Phenylephrine has the least affinity for following adrenoceptors type? α1 Receptors α1 & B1 Receptors α2 Receptors All of these Both A & B Loading...1480. Which one of the following drugs decreases endogenous hepatic production of glucose? Acarbose Pioglitazone Metformin Sitagliptin Loading...1481. Which one of the following features characterizes Crohn’s disease from ulcerative colitis? Perineal fissures and fistulas Continuous disease beginning at rectum and extending without skipped areas Bloody diarrhea Colectomy is curative Loading...1482. Following drug has a low therapeutic index? Digoxin Abciximab Clopidogrel Aspirin Ticlopidine Loading...1483. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? A & B Ethambutol Ibandronate Anidulafungin Furosemide Loading...1484. Generally, Passive diffusion of Water-soluble drugs inside the cell membrane occurs by one of the following processes? Penetrate through aqueous pores Readily move across by active transport Readily move across by facilitated diffusion Readily move due to lipid solubility Loading...1485. Antipseudomonal penicillin is one of the following? Amoxicillin Penicillin G Methicillin Carbenicillin Loading...1486. Terbinafine blood levels are decreased by the following the drug? Caspofungin Griseofulvin Rifampin Cimetidine Loading...1487. Which of the following pathological signs is the first visible one in atheroma formation? Hemorrhage Thrombus Fatty streak Calcification Loading...1488. Which one of the following metals is the most likely cause of allergic contact dermatitis especially in females? Silver Copper Gold Nickel Loading...1489. Which one of the following glucocorticoids is long acting? Dexamethasone Cortisone Prednisolone A & B Amiloride Loading...1490. Which of the following substances lines the vesicles that involved in LDL uptake by hepatocytes? Clathrin Laminin Transferrin Chylomicrons Loading...1491. Which of the following is the central action of cocaine? Inhibition of reuptake of serotonin Inhibition of phosphodiesterase Inhibition of reuptake of dopamine and epinephrine Stimulation of dopamine release Loading...1492. A drug induces rapid depolarization of the membrane inhibiting the intracellular synthesis of DNA, RNA, and protein? Imipenem Vancomycin Daptomycin Aztreonam Loading...1493. 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 Stimulates H2 receptors Adds a protective membrane to gastric mucosa Inhibits H+,K+-ATPase Loading...1494. Which of the following autoantibodies is associated with diffuse scleroderma? Anti-histone Anti-DNA topoisomerase 1 Anti-SSA Anti-SSB Loading...1495. Which of the following drugs has the longest duration of bronchodilation? Salmeterol Epinephrine Metaproterenol Albuterol Isoproterenol Loading...1496. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefepime Cefaclor Ceftizoxime Cefadroxil Loading...1497. A patient with HIV history develops fecal urgency and bloody diarrhea. Which of the following is the most likely causative organism? Clostridium difficile Giardia lamblia Cytomegalovirus Entamoeba histolytica Loading...1498. Which of the following activity of Acetaminophen is weak? A & B A & C Antipyretic Anti inflammatory Analgesic Loading...1499. Which one of the following is the main mechanism of absorption of most drugs in the gastrointestinal tract (GIT)? Passive diffusion Pinocytosis Facilitated transport Endocytosis and exocytosis Loading...1500. A drug has black box warning due to severe hematologic ADRs? Ticlopidine Clopidogrel Dipyridamole Digoxin AspirinPage 61 of 66 Loading...1501. 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 Asthma Bronchiolitis Foreign body stuck in the main bronchus Loading...1502. Which of the following is the best treatment of genuine stress incontinence? Intermittent self-catheterization Urethropexy Anticholinergic Surgical repair Loading...1503. Which one of the following statements about the use of Fenoldopam is wrong? Useful in Glaucoma Increase renal perfusion Dopamine-1 receptor agonist Lowers blood pressure Loading...1504. 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? Superior hemianopsia Homonymous hemianopsia Bitemporal hemianopsia Binasal hemianopsia Loading...1505. 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? Call cardiology department and prepare for PCI Assurance and send him home for the rest of the day 12-Lead ECG, random blood glucose and thyroid panel Psychotherapy and alprazolam Loading...1506. 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 Hypothyroidism Alcohol abuse Immobilization Hypertension Loading...1507. Which of the following medications should be given to a patient that exhibits severe adverse reactions after administration of IV midazolam? Glucagon Naloxone Protamine Flumazenil Loading...1508. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? A & B Flucytosine Ethambutol Miconazole Ibandronate Loading...1509. 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? Genitofemoral nerve Pudendal nerve Ilioinguinal nerve Lateral cutaneous nerve Loading...1510. A cytokine that enhances the activity of NK cells and attracts neutrophils and macrophages? Interferon gamma Interleukin-1 Interleukin-2 Tissue necrosis factor-alpha Loading...1511. Which of the following conditions is most likely caused by over-secretion of growth hormone in adults (acromegaly)? Gastric adenocarcinoma Malignant melanoma Hypothyroidism Carpal tunnel syndrome Loading...1512. 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? Glycine Phenylalanine Methionine Tryptophan Glutamate Loading...1513. Which of the following treatments should be used in cases of methanol or ethylene glycol poisoning? Pyridoxine Ethanol Glucagon Sodium bicarbonate Loading...1514. 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...1515. Dizziness, tinnitus, blurred vision, and headache are linked with the following drug? Quinidine Primaquine All of the above Quinine A & B Loading...1516. Which of the following drug is Pyrazolone Derivative NSAID? Indomethacin Ketorolac Phenylbutazone Nimesulide Diclofenac Loading...1517. A drug that Increases the cell permeability allowing more Flucytosine to penetrate the cell? Amphotericin B Caspofungin Ketoconazole Nystatin Loading...1518. Amnestic syndrome due to thiamine deficiency is caused by lesions of which one of the following structures? Temporal lobe Limbic system Parietal lobe Cerebellum Loading...1519. The anterior pituitary is derived from which of the following structures? Third pharyngeal arch Infundibulum Neurohypophysis Rathke’s pouch Loading...1520. 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? Intravenous Oralugs administered by intramuscular, intravenous, subcutaneous and sublingual routes reach the blood stream first before they are metabolized by liver enzymes. Sublingual Intramuscular Loading...1521. Which of the following leukocytes have nuclei of 3-5 lobes and azurophilic light-pink small granules in their cytoplasm? Neutrophils Basophils Monocytes Plasma cells Loading...1522. 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 MRI to the brain Schedule transesophageal echocardiography Schedule another appointment whenever she has symptoms Obtain CT scan of the head Schedule carotid duplex ultrasonography Loading...1523. 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? Ileum Tonsils Ascending colon Gall bladder Left kidney Loading...1524. Which of the following drugs has the shortest half-life and used in acute anxiety? Flurazepam Clonazepam Alprazolam Chlordiazepoxide Loading...1525. An old patient presents with multiple tumors on the liver. Which of the following is the most common site of the primary tumor? Kidney Breast Colon LungPage 62 of 66 Loading...1526. 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? Carbachol Cevimeline Scopolamine Bethanechol Methacholine Loading...1527. Which of the following is the mechanism of action of digoxin to increase cardiac contractility? Inhibition of Na/K ATPase Inhibition of phosphodiesterase Inhibition of K/Ca ATPase Inhibition of Na/Ca ATPase Loading...1528. Which of the following is a major complication of central retinal veins occlusion? Retinal detachment Glaucoma Lens subluxation Cataract Loading...1529. 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? Negative stool analysis Having first attack in his twenties Smoking cessation Family history of inflammatory bowel syndrome History of diarrhea and weight loss Loading...1530. - - - 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...1531. All of the following are currently used in hyperthyroidism EXCEPT? Propylthiouracil Potassium perchlorate Methimazole Diatrizoate sodium Loading...1532. A drug that belongs to proton pump inhibitor is one of the following? Lansoprazole Ethacrynic Acid A & B Rosiglitazone Sulbactam Loading...1533. Which one of the following conditions most likely increases the risk for deep venous thrombosis (DVT)? Pulmonary tuberculosis Adenocarcinoma Crohn’s disease Coronary heart disease Loading...1534. Stimulation of hepatic microsomal cytochrome p450 enzymes can cause which one of the following? Enhancement of excretion of some drugs Increased metabolism of certain drugs Decreased metabolism of certain drugs Increased intestinal absorption of certain drugs Loading...1535. What is the genetic abnormality related to Cri-du-chat-syndrome? Deletion of short arm of chromosome 5 Mutations of the fibrillin gene on chromosome 15 Trisomy 18 Deletion of phenylalanine in position 508 Loading...1536. 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? Serology for Human papilloma virus VDRL for syphilis Biopsy of the anal lesions Nucleic acid amplification test for chlamydia Stool and urine analysis Loading...1537. An indirect-acting adrenergic agonist is following? A & B Clonidine Acetylcholine Amphetamine Albuterol Loading...1538. A drug that act as laxative is one of the following? Furosemide Bumetanide Sulbactam A & B Lactulose Loading...1539. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Capecitabine Indanyl carbenicillin Ezetimibe Lamivudine Capreomycin Loading...1540. 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? Refer to the psychiatric clinic next day Admit to the hospital Prescribe antidepressant and follow up in a week Refer to the social worker Advise family that it is a normal reaction and keep an eye on her Loading...1541. Which of the following drug is commonly used for the Reactivation of inhibited Acetylcholine esterase? Pralidoxime Echothiophate Bethanechol Edrophonium Carbachol Loading...1542. A drug causes accumulation of fat in the abdomen and the base of the neck on chronic administration? Zanamavir Amantadine Lamivudine Vidarabine Ritonavir Loading...1543. Which of the following drug is a derivative of Acetic acid? Etodolac ketorolac Diflunisal Mefenamic Acid Piroxicam Loading...1544. Which one of the following drugs is used to treat asthma? Theophylline Indanyl carbenicillin Hydrochlorothiazide Repaglinide Ezetimibe Loading...1545. 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? Adductor pollicis Opponens pollicis Lumbricals Dorsal interossei Loading...1546. A 30-year-old man with hypertension is prescribed labetalol. It antagonizes which of the following receptors to be effective against hypertension? Both alpha and beta adrenoceptors Beta-adrenoceptors Nicotinic receptors Alpha-adrenoceptors Loading...1547. 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? Hemosiderin Negatively birefringent particles Copper Monosodium urate crystals Loading...1548. 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? Cleaning, dressing and analgesics Admission to hospital Surgical debridement and grafting Broad spectrum antibiotics Loading...1549. Which of the following predicts better prognosis in cases of breast cancer? Positive estrogen receptor No metastases in the nearest lymph nodes Tumor stage 2 Family history of breast cancer Loading...1550. Which of the following is the drug of choice of anaphylactic shock? Adrenaline Dopamine Diphenhydramine PhenylephrinePage 63 of 66 Loading...1551. What is the antidote of theophylline? All of the above A & B Pralidoxime Esmolol Activated charcoal Loading...1552. 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? Symptomatic improvement with supportive therapy Slow progression to permanent disability Full recovery with radiation and chemotherapy Full recovery with multiple surgeries Full recovery with specific medical therapy Loading...1553. Which one of the following cells lines the alveoli and secretes the surfactant? K cells Macrophages Pneumocytes type II Clara cells Pneumocytes type I Loading...1554. Which of the following is the most prominent side effect of scopolamine? Mydriasis Profuse sweating Miosis Bradycardia Loading...1555. 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...1556. An 80-year-old woman develops chest pain on second day after hysterectomy. Which of the following is the most likely diagnosis? Acute pericarditis Pulmonary infarction Right bundle branch block Myocardial infarction Loading...1557. 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 Case-control study Cross-sectional study Longitudinal study Cohort study Loading...1558. Administration of which one of the following medications can lead to the development of hemolytic anemia? Verapamil Hydralazine Propranolol Quinidine Loading...1559. Which one of the following enzymes catalyzes the rate limiting step in glycolysis? Glyceraldehyde-3-phosphate dehydrogenase Phosphofructokinase-2 6-Phosphofructo-1 kinase Pyruvate kinase Loading...1560. 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? Order hormonal assay to evaluate if the mass is functional or not Assure the patient and schedule another CT scan after 6 months Order MRI of the mass Refer to surgery for removal of the adrenal mass Perform a needle biopsy Loading...1561. ADP mediated platelets aggregation is inhibited by? Tirofiban Eptifibatide Dipyridamole Clopidogrel Aspirin Loading...1562. Paget disease of bone is characterized by which one of the following features? Increase osteoblastic activity only Increase osteoclastic activity only Increase both osteoblastic and osteoclastic activity Decrease osteoclastic activity Loading...1563. 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 HBV vaccine Famciclovir Interferon alfa Acyclovir Loading...1564. 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/dL Acute renal failure Leukemia Repeated doses due to repeated failuresr physician discusses advantages and disadvantages of all treatment options with the patient. What is the most important disadvantage of radioactive iodine therapy? Ablation of the gland and future hypothyroidism Anemia and agranulocytosis Loading...1565. 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? Propranolol Quinidine Verapamil Amiodarone Aspirin Loading...1566. Bleeding and thrombocytopenia is an adverse effects of one of the following drugs? Aprotinin Heparin Vitamin K Protamine sulphate Loading...1567. Cortisol is released from which part of the adrenal medulla? Zona glomerulosa A & B Zona fasciculate All of these Zona reticularis Loading...1568. A 35 woman undergoes a hysterectomy. A section of one of her fallopian tubes is shown on this picture. What is your diagnosis? Endometriosis Papillary carcinoma Ectopic pregnancy Chronic salpingitis Loading...1569. Which of the following is the most likely cause of sudden death in a case of portal hypertension? Rupture of esophageal varices Ventricular fibrillation Hepatic encephalopathy Congestive heart failure Loading...1570. 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 Effect of medications Septicemia Immobilization Loading...1571. Which one of the following drugs is a Thiazide Diuretic? Indanyl carbenicillin Ezetimibe Fenofibrate Torsemide Atorvastatin Loading...1572. Which of the following is the indication for surgical repair of abdominal aortic aneurysm (AAA)? Larger than 3.5 cm Right after been diagnosed Located under the origin of renal arteries Larger than 5.5 cm Loading...1573. 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? Dexamethasone suppression test Measurement of thyroid stimulating hormone (TSH) Assessment of insulin-like growth factor 1 (IGF-1) Fasting serum glucose test Measurement of HbA1c Loading...1574. 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...1575. Blanching and sloughing of skin is the adverse effect of one of the following Direct acting adrenergic agonists? Dopamine Isoproterenol Epinephrine Dobutamine NorepinephrinePage 64 of 66 Loading...1576. Which of the following drug is a derivative of Fenamic acid? Mefenamic Acid ketorolac Piroxicam Etodolac Diflunisal Loading...1577. Which one of the following cells secretes glycosaminoglycan and is found in the terminal and respiratory bronchioles? Clara cells K cells Pneumocytes type Macrophages Loading...1578. 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? Excisional biopsy Fine needle aspiration Ultrasound of the thyroid T4 and TSH levels Loading...1579. Which of the following conditions should be screened at the age of 50? Lung cancer Prostate cancer Colon cancer Adrenal insufficiency Loading...1580. Reflex tachycardia caused by systemic albuterol can be blocked by which of the following medications? Phenylephrine Metoprolol Prazosin Dobutamine Loading...1581. 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 Cell mediated hypersensitivity Complement activity Immune complex deposition Loading...1582. 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 Agenesis Hypospadias Hypopituitarism Loading...1583. 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? Second cervical Third lumbar Fifth thoracic First lumbar Seventh cervical Loading...1584. Indomethacin belongs to one of the following class? Acetic acid derivative Oxicam derivative Propionic acid Fenamates Loading...1585. The vitreous chamber of the eye is located between which of the following structures of the eye? The iris and the lens The lens and the retina The cornea and the retina The cornea and the iris Loading...1586. 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? Mumps Chicken pox German measles Measles Smallpox Loading...1587. Indapamide belongs to the one of the following class of diuretics? Thiazide Diuretic Loop Diuretics Potassium sparing diuretics Carbonic anhydrase inhibitors Loading...1588. Which one of the following drugs has irritation of the respiratory tract and should avoid in severe reactive asthma? Oseltamivir Rimantadine None of these Zanamivir Amantadine Loading...1589. Amoxicillin inhibits which one of the following enzymes? Transpeptidase Transglycosylase Squalene epoxidase Beta lactamase Loading...1590. Which one of the following statements about the use of the metformin is incorrect? Inhibit hepatic glucose output Promote glucose uptake Decrease intestinal absorption of glucose Promote insulin secretion Potential for lactic acidosis Loading...1591. 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 Golgi tendon organs Activation of muscle spindles Activation of lower motor neuron Lower blood supply to the muscle Loading...1592. Which one of the following enzymes is associated with Lyesh-Nyhan syndrome? Adenosine deaminase Ribonucleotide reductase Hypoxanthine-guanine phosphoribosyl transferase Xanthine oxidase Loading...1593. What is the congenital heart disease most likely associated with Turner’s syndrome? Atrial Septal defect Coarctation of the aorta Ventricular septal defect Transposition of the great vessels Loading...1594. 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? Osteosarcoma Pseudogout Osteoarthritis Acute arthritis Gout Loading...1595. Which of the following screening tests should be recommended for a patient taking olanzapine for schizophrenia? Diabetes Hemochromatosis Hemolysis Cancer Loading...1596. Which of the following conditions is the most likely cause of development of velvety rash in the axilla? Testosterone hypersecretion Serotonin hypersecretion Insulin resistance Thyroid hormone deficiency Loading...1597. Mechanism of action of Ticlopidine is following? Inhibit COX-2 Decrease Calcium levels Inhibit glycoprotein receptors Inhibit COX-1 Inhibit ADP mediation Loading...1598. Gastric inhibitory peptide (GIP) and Glucagon-like peptide-1 (GLP-1) are secreted by? Liver Kidney Intestine's Adrenal glands Loading...1599. Which one of the following drugs reduce the absorption of phosphate when taken with diet? Ezetimibe Sevelamer Indanyl carbenicillin Hydrochlorothiazide Montelukast Loading...1600. A drugs inhibit the urate-anion exchanger in the proximal tubules that mediates urate reabsorption? Allopurinol Probenecid Colchicine SulindacPage 65 of 66 Loading...1601. 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? Indirect inguinal hernia Hiatal hernia Direct inguinal hernia Femoral hernia Loading...1602. Which substance is degraded by COMT (Catechol-O-Methyl transferase)? Catechol estrogens Dopamine Norepinephrine Epinephrine All of these Loading...1603. Which one of the following antibiotics has NO effect on anaerobes? Clindamycin Ampicillin Metronidazole Tobramycin Loading...1604. Which of the following is the most common cause of acute mesenteric ischemia? Embolism Mesenteric vein thrombosis Vascular autoimmune disease Abdominal aortic aneurysm Loading...1605. 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? Bulimia nervosa NSAID-induced esophagitis Staphylococcal food poisoning CREST syndrome Mallory-Weiss syndrome Loading...1606. 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? Median nerve Axillary nerve Ulnar nerve Radial nerve Loading...1607. Imidazoline derivative drug with Alpha1 adrenoceptors effect? Brimonidine Clonidine Apraclonidine Phenylephrine Oxymetazoline Loading...1608. Paraneoplastic hypercalcemia is most likely caused by tumor cells secreting which one of the following substances? Parathyroid hormone Calcitonin Parathyroid hormone-related peptide Calcitonin-related peptide Loading...1609. Which of the following medications acts to prevent cholesterol absorption at small intestine brush border? Gemfibrozil Colestipol Ezetimibe Cholestyramine Loading...1610. 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...1611. Which one of the following medications is a non-selective beta receptor agonist? Ephedrine Phenylephrine Isoproterenol Epinephrine Loading...1612. Which of the following groups of drugs are useful for night terrors and sleepwalking? Barbiturates Benzodiazepines Alcohols Tricyclic anti-depressants Loading...1613. One of the following statements about the use of scopolamine is wrong? Used for Motion sickness produce excitement at high doses Shorter duration of action as compared to atropine in CNS Belladonna Alkaloid Short term memory blocker Loading...1614. Following statements about the use of Metformin in wrong? Don't use in alcoholic patients Cause renal impairment Cause Vit. B12 depletion Discontinued in women with a SCr> 1.4 Loading...1615. Which of the following type of virus causes influenza? Cytomegalovirus Herpesvirus Varicella zoster Orthomyxoviruses A & B Loading...1616. Which one of the following drugs inhibits ribonucleotide reductase? Ribavirin Hydroxyurea 5-Fluorouracil Mycophenolate Loading...1617. During normal inspiration, the diaphragm: Contracts Does not move Relaxes Loading...1618. A drug that belongs to thiazolidinediones is one of the following? A & B Cefazolin Pioglitazone Ethacrynic Acid Sulbactam Loading...1619. Which of the following medications may cause acute cholestatic hepatitis? Colchicine Acarbose Metformin Erythromycin Loading...1620. ADP-mediated platelets aggregation is inhibited by? Abciximab Aspirin Tirofiban Ticlopidine Dipyridamole Loading...1621. 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? Mental retardation Antisocial personality Child abuse Oppositional defiant disorder (ODD) Attention-deficit-hyperactive disorder (ADHD) Loading...1622. 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 Babesia microti Plasmodium vivax Loading...1623. Which one of the following types of drug interactions occurs when aspirin is given with acetaminophen? Additive Permissive Tachyphylactic Synergistic Loading...1624. Which of the following drug resembles sex steroids and act at other receptors causing gynecomastia and menstrual irregularities at high doses? Furosemide Spironolactone Acetazolamide Triamterene Bumetanide Loading...1625. Which of the following correctly describes permissive drug interaction? Effect of drug A and drug B is greater than the sum of their individual effects Decrease in response of a drug after repeated administration 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? Presence of drug A is required for full effect of drug BPage 66 of 66 Loading...1626. 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 Axillary nerve Median nerve Loading...1627. Which of the following organisms is associated with pneumonia precipitated by aerosolized water (air conditions)? Chlamydophila pneumonia Pneumocystis jirovecii Legionella pneumophila Mycoplasma pneumonia Loading...1628. Which of the following cell types is responsible for forming the blood brain barrier (BBB)? Oligodendrocytes Astrocytes Microglia Schwann cells Loading...1629. Which of the following drug belongs to Osmotic Diuretic? Niacin Cefoxitin Oxacillin Ampicillin Mannitol Loading...1630. 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? Hypoglycemia Anemia Neutrophilia Hypoalbuminemia Loading...1631. Which one of the following drugs belongs to drugs for hepatic viral infections? Capreomycin Interferon Indanyl carbenicillin Aluminium hydroxide Ezetimibe Loading...1632. Following drugs should be avoided in patients with heart failure? B-blocker Diuretic Inotropic drugs ACE inhibitors CCBs Loading...1633. Hydralazine is used to treat one of the following disease? Diabetes Stomach Ulcer Viral infection High Blood pressure Malaria Loading...1634. Which one of the following agents is insulin? Torsemide Somatostatin Glargine Desmopressin Atorvastatin Loading...1635. Which one of the following drugs blocks the urinary excretion of penicillin which leads to prolonged high serum concentration? Chloramphenicol Rifampicin Probenecid Cimetidine Loading...1636. Periumbilical discoloration is found in a patient diagnosed with acute pancreatitis. Which of the following signs is considered positive in this patient? Murphy’s sign Cullen’s sign Nikolsky’s sign Grey Tunner sign Loading...1637. An antihyperlipidemic drug that consists of a closed six-membered lactone ring in the structural formula? Atorvastatin Fluvastatin Simvastatin Pravastatin Rosuvastatin Loading...1638. Which of the following anti-retroviral treatments is a non-competitive reverse transcriptase inhibitor? Didanosine Nevirapine Saquinavir Zidovudine Loading...1639. Mafenamic acid belongs to following class? Acetic acid Salicylic acid Fenamates Oxicam Propionic acid Loading...1640. 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 Empiric oral antibiotic therapy and follow up in one week Antibiotic ear drops and follow up in three days Loading...1641. Which of the following types of cells predominantly lines the conducting airways of the lung and is considered an important defense mechanism? Basal cells Endocrine cells Goblet cells Ciliated cells Loading...1642. 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? Third degree atrioventricular block Mobitz type I (Wenckebach) second degree AV block Atrial flutter Atrial fibrillation Mobitz type II second degree AV block 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.
Leave A Comment