USMLE QUESTIONS BANK 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moreGeneral Pediatric-related - MCQs 1-10Page 1 of 66 Loading...1. Which one of the following drugs is a 2nd generation Cephalosporin? Cefdinir All of the above Cefaclor Cefprozil A & B Loading...2. 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 DiphenhydramineRead moreThe following represents an essential element to an effective quality council? Loading...3. Which one of the following is the adverse effect of ACE inhibitors? All of the above Skin rashes Dry cough A & B hypokalaemia Loading...4. Which of the following characterizes intravenous (IV) route of administration? Maximum bioavailability Rabidly excreted Undergo first pass metabolism Efficacy is affected by liver disorders Loading...5. A 21 year-old college student complains of the appearance of yellowish coloration on her sclera. She mentions that she had been dizzy and weak for the last 3 days but did not feel any pain or fever and no change in stool color. Abdominal examination reveals normal bowel sounds and no tenderness or organomegaly. Laboratory tests show normal levels of liver enzymes and serum bilirubin. Which is the most likely initial diagnosis? Pancreatic cancer Obstructive jaundice Gallstones Hemolysis Hepatocellular disease Loading...6. 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 2 years in 3 years in 1 year in 6 months During this visit Loading...7. Which of the following locations is the most common site of mural thrombus following myocardial infarction? Right atrium Right ventricle Left ventricle Aorta Loading...8. An enolic acid derivative of Nonsteroidal anti-inflammatory drugs also called? Salicylates Propionic acid Oxicam derivative N-arylanthranilic acids Acetic acid Loading...9. Which of the following tests is the most accurate for diagnosis of herpes encephalitis? MRI of the brain Serological studies for herpes Viral culture of CSF PCR of CSF Loading...10. Which of the following is the target LDL in a patient with diabetes? 100-130 70-100 More than 130 Less than 70 Loading...11. Drug-to-drug interaction based on absorption, transformation, distribution and excretion is considered which one of the following types of interaction? Pharmaceutical interaction Pharmacokinetic interaction Chemical interaction Pharmacodynamic interaction Loading...12. Pins and needles and numbness is the adverse effect of the following drug? Streptomycin Ethambutol Isoniazid Nystatin Loading...13. Which of the following drug is belong to the dihydropyridines class of antihypertension? Amlodipine Diltiazem Losartan Verapamil Amiloride Loading...14. Autoantibodies to pancreatic islets Beta cells and insulin are found in one of the following types of Diabetes? Pseudo hypoglycemia Gestational Diabetes mellitus Type 1 Diabetes mellitus Type 2 Diabetes mellitus Loading...15. What is the antidote to organophosphates toxicity? Atropine All of above Pralidoxime B & C Dimercaprol Loading...16. Which of the following side effects is the most common after prolonged use of SSRIs? Sexual dysfunction Nausea Insomnia Headache Loading...17. Mechanism of action of repaglinide? DPP-IV inhibitor A-glucosidase inhibitor Insulin sensitiser GLP-1 agonist Insulin secretagogue Loading...18. Which one of the following tests is recommended in follow up for a patient receiving anti-tuberculous treatment (isoniazid and rifampin)? Renal function tests Amylase and lipase tests Liver function tests Blood glucose test Loading...19. What is the mechanism of action of zileuton? Inhibition of muscarinic receptor action Inhibition of cytokine production Inhibition of calcium (Ca2+) channel activity Inhibition of leukotriene production Inhibition of mediator release Loading...20. 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? Coarctation of the aorta Atrial septal defect Ventricular septal defect Tetralogy of Fallot Transposition of great vessels Loading...21. 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? Ampicillin and gentamicin Ampicillin Ceftazidime and gentamicin Vancomycin Ceftazidime Loading...22. A patient is diagnosed with posterior dislocation of the hip. Which one of the following ligaments is most likely torn? Sacrotuberous ligament Ischiofemoral ligament Iliofemoral ligament Lacunar ligament Loading...23. A 58-year-old man presents to the clinic with sudden weakness of his right arm. He also complains of progressive difficulty breathing on exertion, palpitations and a low grade fever during the last month. Examination reveals elevated jugular venous pressure, a loud S1 and mid-diastolic rumbling murmur hard on fifth intercostal space. Transesophageal echocardiography (TEE) confirms the diagnosis. What is the most likely diagnosis? Vegetative valvular lesions Left ventricular wall aneurysm Atrial thrombus Atrial myxoma Loading...24. Which of the following drug is a PGF2-Alpha analog? Treprostinil Misoprostol Epoprostenol Dinoprostone Carboprost Loading...25. 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? NSAID-induced esophagitis Staphylococcal food poisoning Bulimia nervosa CREST syndrome Mallory-Weiss syndromePage 2 of 66 Loading...26. Which of the following is the most likely cause of sudden death in a case of portal hypertension? Hepatic encephalopathy Congestive heart failure Ventricular fibrillation Rupture of esophageal varices Loading...27. 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? Aniridia Heterochromia iridis Anisocoria Coloboma Loading...28. Which one of the following medical conditions is associated with an arthritis that resembles ankylosing spondylitis? Whipple disease Celiac disease Peptic ulcer Crohn’s disease Loading...29. 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? Tissue plasminogen activator (tPA) Cardiac catheterization Coronary angioplasty Ibuprofen Enoxaparin Loading...30. 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? Facial nerve Trigeminal nerve Oculomotor nerve Orbital nerve Vagus nerve Loading...31. Which one of the following glucocorticoids is long acting? Amiloride Cortisone Prednisolone A & B Dexamethasone Loading...32. 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? Cocaine Albuterol Epinephrine Atenolol Phenylephrine Loading...33. Which one of the following neoplasms is the most likely related to HIV infection? Hodgkin’s lymphoma Burkitt’s lymphoma Kaposi sarcoma Myelocytic leukemia Loading...34. The therapeutic indication of Clomiphene drug specifically is to treat the following disease? Thromboembolic disease Treat osteoporosis Fluid retention Estrogen-dependent Breast Cancer Induce ovulation Loading...35. Which of the following types of sensations is carried to the thalamus by the anterolateral tracts after crossing the spinal cord? Vibrations Fine touch Position Crude touch Loading...36. Which of the following drug is Propionic acid derivative NSAID? Diclofenac Piroxicam Mefenamic Acid Naproxen Aspirin Loading...37. Which of the following is the classic electrocardiogram (ECG) finding in pericarditis? S-T segment elevation in leads II. III and aVF Sawtooth P waves S-T segment elevation in anterior leads (V1-V4) Diffuse S-T segment elevation Loading...38. Which test of the following is used to evaluate acute exacerbation of asthma? Pulse oximetry Chest x-ray Pulmonary function tests Complete blood count Loading...39. Which one of the following conditions is characterized by high blood pressure, hypokalemia and elevated renal potassium? Fanconi syndrome Tay-sachs disease Waardenburg syndrome Liddle syndrome Loading...40. What is the pKa of a drug? The pH at which 100% drug becomes completely ionized The pH at which 100% drug becomes completely unionized The pH at which 50% of the drug is ionized and 50% unionized Loading...41. Purple toe syndrome is caused by using the therapy of which drug? Cyclosporine Phenytoin Digoxin Amikacin Warfarin Loading...42. A 50 year-old man presents to the clinic with a long history of heartburn after eating, exaggerated when he is lying down and lessened when he takes antacids. Endoscopy reveals a large irregular, erythematous area in the lower esophagus. Esophageal motility studies reveal dysfunction of the lower esophageal sphincter (LES). Which of the following most likely leads to increase in the resting pressure of LES? Chocolate Protein Caffeine Fat Alcohol Loading...43. Prazosin blocks which of the following actions of epinephrine? Mydriasis Tachycardia High stroke volume Bronchodilation Loading...44. 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? Amphotericin B Ampicillin Ceftazidime Acyclovir Vancomycin Loading...45. A 78 year-old patient is admitted to the hospital for treatment of pneumonia. On the third day, the nurse noticed that his heart rate is 150/min. and blood pressure is 116/86 mmHg. The patient is stable with no chest pain or shortness of breath. His ECG shows saw tooth pattern with no other abnormalities. What is the most appropriate next step of management of this patient? Start heparin Perform electric cardioversion Start metoprolol Refer to a cardiologist Order cardiac enzymes Loading...46. Which one of the following enzymes catalyzes the transformation of testosterone into DHT? Aromatase Cholesterol side chain cleavage enzyme (CYP11A1) 17α-hydroxylase 5 α-reductase Loading...47. Which one of these drugs is more beneficial to treat hypertension in diabetic patients? Verapamil Enalapril Furosemide Amlodipine Loading...48. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Acetylcholine Benztropine Tamsulosin Atropine Succinylcholine Loading...49. Which one of the following drugs is used to treat helminthic infections for cestodes? Albendazole Mebendazole Thiabendazole Praziquantel Ivermectin Loading...50. Which of the following drug belongs to H2 histamine receptor blocker? Glimepiride Cefoxitin Oxacillin Niacin NizatidinePage 3 of 66 Loading...51. Which of the following is the drug of choice of anaphylactic shock? Adrenaline Diphenhydramine Dopamine Phenylephrine Loading...52. A 56 year old man is taken to the emergency room after having grand mal seizure during a staff meeting. He has no history of seizure but he complains lately of recurrent headaches on the morning and decrease in intensity later in the day. Laboratory investigations and imaging studies are performed. Which of these tests will confirm the diagnosis of glioblastoma multiform? Head CT scan Brain biopsy MRI of the brain CSF analysis Loading...53. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Ethambutol A & B Ibandronate Furosemide Amphotericin B Loading...54. Which of the following is the most abused drug for all ages in the United States? Alcohol Cocaine Marijuana Methamphetamine Loading...55. Which of the following laboratory tests could be slightly increased in Gilbert’s syndrome? Haptoglobin Bilirubin, indirect Bilirubin, direct Triglyceride Loading...56. Which of the following effects is caused by alcohol intake? Increased body temperature Increased body heat loss No effect on body temperature or body heat loss Decreased body heat loss Loading...57. Which one of the following oral hypoglycemic drugs is the initial therapy for patients with type 2 diabetes? Glyburide Acarbose Repaglinide Metformin Loading...58. 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 Lipoma Dermoid cyst Branchial cleft cyst Thyroglossal duct cyst Loading...59. Which one of the following parts of the heart is the major consumer of oxygen and requires the best blood supply? Left atrium Right ventricle Right atrium Left ventricle Loading...60. 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 penicillin IV ceftriaxone and oral doxycycline IM ampicillin IV ceftriaxone Oral doxycycline Loading...61. 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? Right coronary artery Anterior interventricular artery Circumflex artery Posterior interventricular artery Left coronary artery Loading...62. A drug that act as laxative is one of the following? Sulbactam A & B Furosemide Castor oil Bumetanide Loading...63. Which one of the following medications inhibits fibrinolysis? Heparin Rifampin Lepirudin Aminocaproic acid Loading...64. 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? Argatroban Aspirin Ticlopidine Tissue plasminogen activator (tPA) Loading...65. Type of hypoglycemia in which patient feels hypoglycemic symptoms but the blood glucose level is normal or slightly above normal? Gestational Diabetes mellitus Pseudo hypoglycemia Type 1 diabetes Mellitus Type 2. Diabetic mellitus Loading...66. Which of the following medications may cause acquired angioedema within days to weeks after starting it? Propranolol Benazepril Clopidogrel Aspirin Loading...67. Drug distribution into tissues depends mostly on which of the following? Rate of absorption Tissue receptors Interaction with other drugs Binding to plasma protein Loading...68. Which one of the following is most likely normal in duodenal ulcer? Response of gastrin to food Pepsin secretion Parietal cell mass Fasting serum gastrin Loading...69. 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? Single blind clinical trial Double blind clinical trial Cross sectional study Randomized controlled trial Case-control study Loading...70. Which of the following conditions is considered a physiological change for normal pregnancy? Decreased respiratory tidal volume Decreased blood volume Decreased body weight Decreased GI tone and motility Loading...71. 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? Sodium nitrite Flumazenil Atropine Ethyl alcohol Activated charcoal Loading...72. A 52-year-old alcoholic man complains of painful lesions on his tongue and inside his mouth. He also has hyper-pigmented scales on his face and both hands. He is weak, forgetful and suffers of burning sensation in several parts of his body. He mentions that he has diarrhea for the last two months. Deficiency of which of these vitamins is responsible for this patient’s condition? Folic acid Vitamin A Vitamin C Vitamin D Vitamin B3 (niacin) Loading...73. Reversible neutropenia and thrombocytopenia is the adverse effect of following drug? Flucytosine Amphotericin B Ketoconazole Nystatin Loading...74. Primitive spermatogenic germ cells are located in which one of the following sites? Vas deferens Seminal vesicles Seminiferous tubules Interstitium of the testes Loading...75. 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 folic acid synthesis Inhibition of bacterial wall synthesis Inhibition of bacterial protein synthesis Inactivation of bacterial toxins Inhibition of mycolic acid synthesisPage 4 of 66 Loading...76. Which of the following is considered a limiting adverse effect of ACE inhibitors? Hypokalemia Hyponatremia Hyperkalemia Acidosis Loading...77. What is the most likely explanation of this finding? Metabolism of beta-naphthylamine by human cytochrome 450 system in the liver Human urinary glucuronidase splits beta-naphthylamine into glucuronic acid and a toxic metabolite. Detoxification of beta-naphthylamine by glucuronic acid conjugation. Beta-naphthylamine is directly carcinogenic to human bladder Loading...78. Which of the following statements is true about live attenuated vaccine? They only induce humoral immunity No booster is needed for live attenuated vaccines Close contacts of influenza patients can be safely vaccinated with live attenuated vaccine It is mainly used for immunocompromised patients Loading...79. Which of the following drug is a part of proton pump inhibitors? A & B Pantoprazole Furosemide Mannitol Acetazolamide Loading...80. Organophosphorus poisoning can be treated with which of the following agents? Ipratropium bromide Atropine Physostigmine Atenolol Loading...81. Which of the following is the most common cause of congestive heart failure associated with systolic impairment in the United States? Rheumatic heart disease Atherosclerosis Diabetes Alcohol Loading...82. 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? Alpha adrenergic antagonist Direct smooth muscle vasodilator ACE inhibitor Beta adrenergic antagonist Ganglion blocker Loading...83. Which one of the following fungistatic drugs has a half-life of 30 hours? Fluconazole Ketoconazole Voriconazole Posaconazole Loading...84. Griseofulvin belongs to the following drugs class? Antipyretic Antifungal Antibiotics Antiviral Antiprotozoal Loading...85. Which of the following type of virus causes influenza? Varicella zoster Orthomyxoviruses Cytomegalovirus Herpesvirus A & B Loading...86. A drug that Increases the cell permeability allowing more Flucytosine to penetrate the cell? Amphotericin B Caspofungin Nystatin Ketoconazole Loading...87. Beta-Blocker drug is following? Atropine Nicotine Mecamylamine Atracurium Pindolol Loading...88. Which of the following drug is commonly used for the Reactivation of inhibited Acetylcholine esterase? Echothiophate Pralidoxime Edrophonium Bethanechol Carbachol Loading...89. Which of the following autoantibodies is associated with diffuse scleroderma? Anti-SSB Anti-histone Anti-SSA Anti-DNA topoisomerase 1 Loading...90. Which one of the following drugs prevents the release of Renin and increase in heart rate from sympathetic stimulation? Digoxin Dobutamine Metoprolol Enalapril Loading...91. Which one of the following actions is produced by muscarinic cholinergic agonists? Decreased release of intracellular calcium Inhibition of phospholipase C Activation of inhibitory G protein Decreased IP3 production Loading...92. Which one of the following fetal structures transfer oxygenated blood from the umbilical vein to the inferior vena cava and becomes ligamentum venosum after birth? Umbilical artery Ductus arteriosus Ductus venosus Azygous vein Loading...93. Which of the following drug is Leukotriene Antagonist? Ipratropium Bromide Terbutaline Montelukast Salbutamol Sodium Cromoglycate Loading...94. 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? Refer to cardiologist Metoprolol Heparin Aspirin Cardioversion Loading...95. 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? Pneumonitis aeruginosa Streptococcus viridans Bacillus anthracis Staphylococcus aureus Loading...96. Anemia occurs in cases of multiple myeloma most likely results from which one of the following factors? Loss of blood due to gastrointestinal bleeding Low production of hemopoietin Defective absorption of urine Infiltration of bone marrow with massive numbers of plasma cells Loading...97. A 21-year-old medical student with a history of asthma presents to the clinic for medication refill. He discussed with his physician the pros and cons of treatment with theophylline. One of the disadvantages of using theophylline is low toxic threshold. Which of these drugs is used to treat theophylline toxicity? Atenolol Albuterol Epinephrine Furosemide Digoxin Loading...98. Which one of the following conditions is characterized by painless blisters on the back of the hands and hyperpigmentation of the face? Herpes zoster Dermatitis herpetiformis Contact dermatitis Porphyria cutanea tarda Loading...99. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefaclor Ceftizoxime Cefepime Cefadroxil Loading...100. Rapid Acting Insulin is one of the following? Glargine Regular NPH GlulisinePage 5 of 66 Loading...101. 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 Decreased production of cAMP Increased production of cAMP Increased motility of the small intestine Deficiency in the brush border enzymes Loading...102. 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? Immobilization Septicemia Effect of medications Surgical complication Loading...103. Which of the following hormone belongs to the posterior pituitary? Somatrem Desmopressin Urofollitropin A & B Furosemide Loading...104. 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? Orlistat Fenofibrate Lovastatin Niacin Atenolol Loading...105. Which substance is degraded by COMT (Catechol-O-Methyl transferase)? All of these Catechol estrogens Norepinephrine Dopamine Epinephrine Loading...106. Ceftriaxone belongs to the one of the following generation of the cephalosporin? 4th generation 3rd generation 1st generation 2nd generation Loading...107. An antihyperlipidemic drug that consists of a closed six-membered lactone ring in the structural formula? Pravastatin Atorvastatin Rosuvastatin Fluvastatin Simvastatin Loading...108. Which one of the following drugs treatment usually causes a decrease in intestinal flora? Calcium supplements Diuretics Antibiotics A & B All of the above Loading...109. A young adult complains of fever, sore throat and lymphadenopathy for 5 days. Examination reveals bilateral enlarged tender cervical lymph nodes and enlarged spleen. Which of the following organisms is most likely responsible for this patient’s condition? Epstein-Barr virus Cytomegalovirus Human immunodeficiency virus (HIV) Human papillomavirus Loading...110. Which of the following is the most likely cause of death in cases of overdose of hypnotics? Hypothermia Status epilepticus Cerebral edema Depression of the medullary respiratory center Loading...111. Peripheral resistance is linked with one of the following issues? Blood pressure Headache Fever Aids Loading...112. 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 esophagus Injury to the myocardium Injury to the right bronchus Injury to the lung tissue Loading...113. 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 low molecular weight heparin and warfarin Assurance and follow up in 3 months Start warfarin Start aspirin Loading...114. Which one of the following statements about the functions of histamine is incorrect? Stimulate gastric acid secretion Cause itching and pain increase peripheral resistance Constriction of bronchioles Loading...115. Control of diabetes is most likely determined by which one of the following laboratory tests? Hemoglobin A1C Urinary glucose content Fasting blood glucose Random blood glucose Loading...116. Which one of the following parts of fallopian tube is the widest and the most common site for fertilization? Isthmus Ampulla Infundibulum Loading...117. The only type of insulin that should be given intravenously is one of the following? Lispro A & B Regular Detemir Glargine Loading...118. Which of the following statements is true about warfarin? Liver is the main site of action of warfarin Warfarin acts by activation of antithrombin Warfarin is monitored by PTT Toxicity of warfarin is treated by protamine sulfate Loading...119. Which of the following is the common cause of secondary dyslipidemia? Familial combined hyperlipidemia Apo C-II deficiency Familial hypercholesterolemia Diabetes mellitus Loading...120. Which one of the following drugs is associated with peripheral neuropathy? Isoniazid Capreomycin Rifampin Ethambutol Loading...121. Which of the following hormone belongs to the posterior pituitary? Urofollitropin A & B Somatrem Oxytocin Furosemide Loading...122. Which of the following is the best immediate treatment for unresponsive patient with diabetic ketoacidosis? Insulin and glucose Metformin Bicarbonate Observation and hospitalization Loading...123. Which of the following drugs should NOT be initiated in case of acute decompensated heart failure? Lisinopril Metoprolol Potassium supplements Digoxin Loading...124. Imidazoline derivative drug with Alpha1 adrenoceptors effect? Apraclonidine Oxymetazoline Brimonidine Clonidine Phenylephrine Loading...125. Which of the following is the mechanism of action of pioglitazone in diabetic patients? Increases insulin release Increases glucose excretion Decreases insulin breakdown Increases glucose uptake in muscle cellsPage 6 of 66 Loading...126. 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? Cytotoxic agents Lobectomy Progestin therapy Radiotherapy Loading...127. Which one of the following types of cell secretions involves exocytosis? Holocrine secretion Merocrine secretion Apocrine secretion Loading...128. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Nizatidine Aluminium hydroxide Indanyl carbenicillin Macrolides Ezetimibe Loading...129. Which of the following hormone belongs to the oral diabetic agent? Pioglitazone Oxytocin Furosemide A & B Somatrem Loading...130. 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? Acute glomerulonephritis Wegener granulomatosis Miliary tuberculosis Systemic lupus erythematosus Rheumatoid arthritis Loading...131. Which one of the following is an anterior pituitary hormone? Torsemide Somatostatin Fenofibrate Corticotropin Atorvastatin Loading...132. Which of the following explains the reason for the formation of atheroma at the bifurcations of arteries such as aorta and carotid? Hypoxemia Cholesterol breakdown Endothelial dysfunction Regular blood flow Loading...133. Which one of the following is the adverse effect of Heparin? Bleeding All of the above Osteoporosis Thrombocytopenia Hypersensitivity Loading...134. 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? Tadalafil Flutamide Finasteride Abiraterone Pergolide Loading...135. The drug which inhibits the action of histamine at parietal cells results in a reduction of hydrogen ions concentration and volume of gastric acid? Cimetidine Omeprazole Sucralfate Rabeprazole Loading...136. A crescendo-decrescendo murmur is heard during systole at the second right intercostal space and radiates to the carotid artery. Which one of the following findings is most likely seen on the chest X-ray? Right ventricular hypertrophy Left ventricular hypertrophy Enlarged cardiac shadow in both directions Boot-shaped heart Loading...137. Which one of the following drugs is effective only for the influenza A virus? None of these Zanamivir Oseltamivir A & B Rimantadine Loading...138. Which one of the following medications effectively lowers intraocular pressure? Morphine Atropine Latanoprost Ergonovine Loading...139. 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? Pulmonary embolism Reye syndrome Atherosclerosis Ductus arteriosus Hypotrichosis Loading...140. Which of the following is the mechanism of action of selegiline in treating Parkinson’s disease? Precursor of dopamine Agonist at dopamine receptors Inhibition of MAO type B to reserve dopamine Blocks catechol-O-methyltransferase (COMT) Loading...141. 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? Mitral stenosis Tricuspid regurgitation Aortic stenosis Mitral valve prolapse Dilated cardiomyopathy Loading...142. Which of the following groups of drugs are useful for night terrors and sleepwalking? Benzodiazepines Tricyclic anti-depressants Barbiturates Alcohols Loading...143. Which of the following medications is the most effective immunosuppressant in cases of organ transplantation? Cyclophosphamide Vinblastine Azathioprine Cyclosporine Loading...144. Which of the following activity of Acetaminophen is weak? Anti inflammatory Antipyretic Analgesic A & C A & B Loading...145. 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? Aortic dissection Hypertrophic cardiomyopathy Myocardial infarction Pericarditis Loading...146. 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? Skeletal muscles Brain Liver Small intestine Retina Loading...147. 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? NSAID-induced esophagitis Mallory-Weiss syndrome Bulimia nervosa Staphylococcal food poisoning CREST syndrome Loading...148. Which one of the following drugs causes teratogenic effect? Amantadine Zanamavir Oseltamivir Ribavirin Rimantadine Loading...149. 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 amoxicillin Topical betamethasone Topical mupirocin Oral acetaminophen Loading...150. Which of the following is the most common complication of otitis media? Meningitis Brain abscess Drum perforation Hearing lossPage 7 of 66 Loading...151. What is the proper treatment of adrenal insufficiency? Fludrocortisone Prednisone and fludrocortisone Prednisone Adrenaline Loading...152. Which of the following medications is useful to distinguish nephrogenic from neurogenic diabetes insipidus? Desmopressin Acetazolamide Demeclocycline Hydrochlorothiazide Loading...153. 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 Reducing bile synthesis Dissolving cholesterol form the stone Dissolving calcium from the stone Loading...154. 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? Promethazine Trazodone Buspirone Lorazepam Midazolam Loading...155. 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? Azithromycin Amoxicillin Ampicillin No medication Loading...156. Infection in body causes one of the following issue? Headache High Blood pressure Aids Fever Loading...157. 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 Fasciotomy and tissue perfusion Intravenous broad-spectrum antibiotics Loading...158. Which of the following is the enzyme responsible for conversion of testosterone into dihydrotestosterone (DHT)? Aromatase 17 alpha-hydroxylase 3-beta-hydroxylase 5-alpha-reductase Loading...159. Which one of the following autoantibodies is associated with Goodpasture syndrome? Anti-histone Anti-centromere Anti-Ach receptor Anti-basement membrane Loading...160. Which one of the following studies measures heritability and influence of environmental factors? Cross-sectional study Case-control study Adoption study Cohort study Loading...161. Which of the following is a serious complication of ergotamine? Headache Prolonged vasospasm Hypotension Depression Loading...162. Which of the following is the most effective treatment of a case of an old man with benign prostatic hypertrophy (BPH)? Finasteride Propranolol Doxazosin and finasteride Doxazosin Loading...163. A 2-year old girl is presented with rectal bleeding. Her mom noticed blood in her BM yesterday and was worried about it and she decided to go to your clinic to examine her daughter. There is mild pain, not related to meals. No nausea or vomiting. The girl is healthy and her routine physical examination 2 months ago was normal. You perform a biopsy and the histopathology of the affected part shows mixed gastric and intestinal tissues. Which of the following is the most likely diagnosis? Diverticulitis Appendicitis Intussusception Meckel’s diverticulum Volvulus Loading...164. Which one of the following medications is used for cases of Parkinson’s disease and influenza type A? Ribavirin Bromocriptine Amantadine Benztropine Loading...165. 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? Pancreatic cancer Gall bladder stones Hemolytic anemia Acute hepatitis Loading...166. Which one of the following conditions is NOT a common cause of vitamin B12 deficiency? Diet deficiency of vitamin B12 Intrinsic factor deficiency Gastric bypass Malabsorption syndrome Loading...167. Which of the following is the most likely mechanism of action of hydralazine in treating cardiovascular disorders? Decreased cardiac preload Sympathetic antagonism Parasympathetic stimulation Relaxation of arterial smooth muscle Loading...168. 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? Reaction formation Projection Splitting Regression Repression Loading...169. 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 Colonoscopy MRI of the brain Cosyntropin stimulation test Serum Thyroid Stimulation Hormone (TSH) level Loading...170. Which one of the following results of Tensilon test confirms the diagnosis myasthenia gravis Rapid amelioration of symptoms Exaggeration of weakness No effect Slow and gradual amelioration of symptoms Loading...171. 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? Hydrochlorothiazide Verapamil Captopril Metoprolol Loading...172. Which one of the following types of cells myelinates axons of neurons of CNS? Microglia Schwann cells Astrocytes Oligodendroglia Loading...173. Which one of the following drugs works through inhibition of acetyl-cholinesterase enzyme and used in myasthenia gravis? Neostigmine Noradrenaline Montelukast Atropine Loading...174. 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 immunoglobulin Tetanus toxoid No further therapy Tetanus toxoid followed by tetanus immunoglobulin after 5 days Tetanus toxoid and tetanus immunoglobulin Loading...175. 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 APage 8 of 66 Loading...176. 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? Why don’t you like to take this medication? I am afraid, you have to take this antibiotic otherwise, you will have more complications of the condition. Loading...177. A 22-year-old man presents to the clinic due to excessive urination. He goes to the restroom almost every 15 minutes. His physical examination is otherwise normal. Laboratory tests show Serum Na: 140 mEq/L Psychogenic polydipsiaine Na: 18 mEq/L Urine osmolality: 260 mOsm/kg after 4h fluid deprivation. Urinary tract infection Solute diuresisat is the most likely diagnosis? Diabetes insipidus Diabetes mellitus Loading...178. Which one of the following medications enters the cell and acts on a cytoplasmic receptor? Propranolol Dexamethasone Insulin Adrenaline Loading...179. Which of the following is the most common cause of acute mesenteric ischemia? Embolism Mesenteric vein thrombosis Vascular autoimmune disease Abdominal aortic aneurysm Loading...180. 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? Isolated premature thelarche Pituitary adenoma Precocious puberty Congenital adrenal hyperplasia Androgen insensitivity syndrome Loading...181. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Ethionamide Nizatidine Aluminium hydroxide Indanyl carbenicillin Ezetimibe Loading...182. Which one the following parts of the large intestine is extraperitoneal? Transverse colon Cecum Sigmoid colon Descending colon Loading...183. 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? Cavernous sinus Superior cerebellar artery Middle meningeal artery Inferior cerebral artery Loading...184. 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...185. Which of the following is the most common cause of sudden death in patients with diabetes mellitus? Cerebral hemorrhage Hyperosmolar coma Gangrene Myocardial infarction Loading...186. A 29-year-old man is brought to the ER by a policeman. He was driving his car under the influence of alcohol. The policeman asks the ER physician to get a sample of this patient’s gastric contents for analysis. The physician explains the procedure to him but the patient refuses to go through it. What is the best next action? Inject the patient with anesthesia and do the procedure Respect the patient’s wishes and don’t do this procedure Force the patient to do the procedure Convince the patient falsely that this procedure is part of treatment and do it Loading...187. Concurrent therapy of digitalis with the following drugs enhance the potential for cardiotoxicity? Amiodarone Quinidine Erythromycin All of the above Tetracycline Loading...188. A drug that effects the thyroid hormone is one of the following ? Bumetanide A & B Levothyroxine Sulbactam Furosemide Loading...189. 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 Shingles (herpes zoster) Rosacea Psoriasis Seborrheic keratosis Loading...190. 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? Pemphigus vulgaris Dermatitis herpetiformis Cicatricial pemphigoid Scabies Bullous pemphigoid Loading...191. Which of the following drugs has the least CNS side effects? Acyclovir Ganciclovir Amantadine Zidovudine Rimantadine Loading...192. Intramuscular vitamin B12 should be prescribed after gastrectomy. Which of the following gastric cells is responsible for this replacement treatment? G cells Goblet cells Parietal cells Chief cells Loading...193. 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 Administer flu vaccine plus oseltamivir for 2 weeks to all residents Administer flu vaccine to all residents Treat only patients with oseltamivir until their symptoms subside Loading...194. Which of the following is the percentage of thymine in a DsDNA if it contains 20% guanine? 30% 50% 20% 40% Loading...195. 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 Arrange nursing and supportive assistance Discontinue atenolol Further investigations including liver function test Begin anti-depressive medication Loading...196. Which one of the following medications has a significant alpha-adrenergic blocking activity? Clozapine Chlorpromazine Haloperidol Risperidone Loading...197. One of the following statements is not right about the production of Acetylcholine? Uptake of choline is a rate-limiting step Acetylcholine is metabolized by COMT Acetylcholine released by an increase in calcium level Acetylcholine rapidly hydrolyzed by Acetylcholinesterase Neurotransmitter in vesicles are called varicosities Loading...198. Which of the following is the initial treatment of asymptomatic aortic stenosis? Valve replacement Balloon valvuloplasty Hydrochlorothiazide Furosemide Loading...199. The anterior pituitary is derived from which of the following structures? Third pharyngeal arch Infundibulum Rathke’s pouch Neurohypophysis Loading...200. Lactic acidosis is the adverse effect of one of the following drugs? Glyburide All of the above Aspirin MetforminPage 9 of 66 Loading...201. 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 Vitamin K deficiency Hemophilia A Disseminated intravascular coagulopathy Loading...202. 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 Hyperglycemia Constipation Diarrhea Loading...203. Which one of the following drugs is a loop Diuretics drug? Bumetanide Amiloride Acetazolamide Chlorthalidone Loading...204. 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? Acid perfusion test Motility studies Barium swallow Endoscopy Loading...205. 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? Alanine aminotransferase (ALT) Serum creatinine Blood glucose Urinary sodium Loading...206. Which one of the following drugs is a H² receptor Antagonist? Omeprazole Rabeprazole Cimetidine Sucralfate Loading...207. Alcohol is oxidized in the liver by which one of the following enzymes? Alcohol dehydrogenase Alcohol decarboxylase Alcohol oxidase Alcohol reductase Loading...208. Which of the following drug prevents bacterial protein synthesis by binding to the 30s ribosomal subunit tetracyclin lincosamine macrolides penicillin Loading...209. 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 Cholesterol reduction Weight loss Blood pressure control Loading...210. 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? Cystic fibrosis Congenital annular pancreas Gallstones Trauma Viral infection Loading...211. 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...212. What is the most appropriate treatment of organophosphate poisoning? Pralidoxime Morphine Pyridostigmine Hexamethonium Loading...213. A) Atropine Flumazenil Dimercaprol Penicillamine Loading...214. Which one of the following metals is the most likely cause of allergic contact dermatitis especially in females? Nickel Copper Gold Silver Loading...215. A drug induces rapid depolarization of the membrane inhibiting the intracellular synthesis of DNA, RNA, and protein? Daptomycin Imipenem Vancomycin Aztreonam Loading...216. 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 Carbon monoxide Reduced hemoglobin Decreased oxygen affinity Loading...217. Which of the following organisms is responsible for the development of oral hairy leukoplakia in HIV patients? Human papilloma virus Candida albicans Epstein-Barr virus Bartonella henselae Loading...218. Which of the following receptors is the most likely affected in patients with diabetes mellitus? Ruffini’s end organ Pacinian corpuscle Meissner’s corpuscle End-bulbs of Krause Loading...219. What is the best first step of action for a case of posterior myocardial infarction? Tissue plasminogen activator Metoprolol 60 mg administration Aspirin 325 mg administration Stress test Loading...220. Which one of the following dermatologic disorders presents with a herald batch and a Christmas tree pattern? Bullous pemphigoid Pemphigus vulgaris Psoriasis Pityriasis rosea Loading...221. 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 Inflammatory carcinoma Milk engorgement Loading...222. Which one of the following is the effect of metoprolol on cardiac ejection time? Decreased Increased No effect Loading...223. 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 Measles Smallpox Chicken pox German measles Loading...224. Which of the following is the earliest abnormal test after infection with hepatitis B? Surface antigen Serum bilirubin Anti-hepatitis B antibodies ALT Loading...225. Which of the following drug is a part of proton pump inhibitors? A & B Acetazolamide Rabeprazole Furosemide MannitolPage 10 of 66 Loading...226. Which of the following group of medications prolongs GABA activity in the brain? Benzodiazepines Methamphetamines Alcohols Barbiturates Loading...227. Which one of the following antihypertensive medications is directly acting vasodilator? Labetalol Clonidine Nifedipine Enalapril Loading...228. Pemphigus is an autoimmune skin disease associated with which of the following structures? , Desmosomes Gap junctions Cell matrix junctions Tight junctions 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) Rheumatoid factor Anti-cyclic citrullinated peptide Cervical spine x-ray Loading...230. One of the following statements about the sympathetic neurons is wrong? Postganglionic neurons innervate tissues Preganglionic neurons originated from Lumber Originated from Efferent autonomic system Preganglionic neurons are Long Preganglionic neurons originated from thoracic Loading...231. Which of the following is a frequent side effect of amphetamine? Diarrhea Hair loss Constipation Depression Loading...232. Which one of the following drugs is commonly contributing to hypokalemia? Verapamil Lisinopril Spironolactone Furosemide Loading...233. 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? ECG stress test Prostate specific antigen (PSA) Erythrocyte sedimentation rate Depression screening test Colonoscopy Loading...234. Which of the following drug belongs to lincosamide antibiotics? Ciprofloxacin Clindamycin Oxytetracycline Sulbactam Linezolid Loading...235. Gynecomastia is the adverse effect of the following drug? Griseofulvin Flucytosine Fluconazole Ketoconazole Loading...236. A drug that is used to treat leprosy is one of the following? Magnesium hydroxide Etidronate Clofazimine A & B Furosemide Loading...237. 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? Myocardial infarction Hypertrophic cardiomyopathy Mitral stenosis Aortic stenosis Loading...238. 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? Exercise Weight Age Family history of breast cancer Blood pressure Loading...239. 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. Metabolism of beta-naphthylamine by human cytochrome 450 system in the liver Human urinary glucuronidase splits beta-naphthylamine into glucuronic acid and a toxic metabolite. Loading...240. 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? Biopsy of the anal lesions VDRL for syphilis Stool and urine analysis Nucleic acid amplification test for chlamydia Serology for Human papilloma virus Loading...241. Which one of the following disorders is accompanied by blue sclera? Systemic lupus erythematosus Duchenne muscular dystrophy Neurofibromatosis type 2 Osteogenesis imperfecta Loading...242. A 55-year-old woman visits her physician to consult about hormone replacement therapy (HRT).Her physician discuss with her the pros and cons of using HRT. Which one of these benefits is gained by the use of HRT? HRT decrease the risk of hot flashes and vaginal dryness HRT decrease the risk of stroke HRT decrease the risk of coronary artery disease HRT decrease the risk of deep venous thrombosis HRT decrease the risk of breast cancer Loading...243. Which one of the following drugs form insoluble chelates that are not absorbed? Rabeprazole & Sitaglipton Levofloxacin & magnesium All of the above Pioglitazone & Calcium A & B Loading...244. Which one of the following reactions occurs between five days and three months after transplant? Chronic rejection Acute rejection Delayed rejection Hyperacute rejection Loading...245. Which of the following agents should a patient take for a stuffy, runny nose? Albuterol Terbutaline Clonidine Metoprolol Oxymetazoline Loading...246. Which of the following drug is a derivative of Propionic acid? Mefenamic Acid ketorolac Piroxicam Diflunisal Etodolac Loading...247. 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 Transabdominal ultrasonography Vaginal examination Immediate delivery Loading...248. Absorption of levodopa-carbidopa is reduced when taken with meals rich in which of the following nutrients? Fat Carbohydrate Protein Loading...249. Which of the following drug has Ocular effects like mydriasis and fixed far vision? Mecamylamine Phenylephrine Neostigmine Timolol Phentolamine Loading...250. Which of the following are the major sites for heme synthesis? Kidney and spleen Bone marrow and kidney Bone marrow and liver Bone marrow and spleen Kidney and liverPage 11 of 66 Loading...251. Which one of the following types of drug interactions occurs when aspirin is given with acetaminophen? Additive Permissive Tachyphylactic Synergistic Loading...252. Which of the following is most likely characteristic of oral route of administration? 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 It is the most appropriate route to interact with most of the emergencies Loading...253. Which one of the following antihypertensive medications is appropriate to use for an asthmatic patient? Timolol Metoprolol Propranolol Labetalol Loading...254. Which one of the following drugs is the most effective in improvement of ascites? Digoxin Lisinopril Hydrochlorothiazide Spironolactone Loading...255. Which of the following is the LEAST factor can lead to urinary tract infection? Prolonged tetracycline therapy Pregnancy Diabetes mellitus Urinary tract obstruction Loading...256. Which of the following treatments should be used in cases of methanol or ethylene glycol poisoning? Pyridoxine Sodium bicarbonate Ethanol Glucagon Loading...257. Which of the following characteristics differentiates cephalohematoma from caput succedaneum in newborn? Cephalohematoma disappears in the first few days Cephalohematoma crosses suture lines Cephalohematoma will never calcify Cephalohematoma does not cross suture lines Loading...258. 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? Ethosuximide Felbamate Phenytoin Topiramate Loading...259. 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. Gallstones Congenital annular pancreas Cystic fibrosis Viral infection Traumaat is the most likely etiology of this boy’s condition? Loading...260. Which one of the following drugs is a inhibitors of the P-GP (glycoprotein) efflux pumps? A & B Amiodarone All of the above Digoxin Linezolid Loading...261. 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 Deletion of VHL gene on chromosome 3 Defective DNA repair mechanisms Mutation in PKD1 on chromosome 16 Mutation in the NF1 gene on chromosome 17 Loading...262. Which of the following conditions is an indication for interferon gamma? Chronic granulomatous disease Glomerulonephritis Chronic myeloblastic leukemia Hepatitis A Loading...263. In which of the following Diuretic, cyclic sulfonamide is replaced by an Amide? Hydrochlorothiazide Chlorothiazide Chlorthalidone Methylchlorothiazide Bendroflumethiazide Loading...264. A patient with HIV history develops fecal urgency and bloody diarrhea. Which of the following is the most likely causative organism? Clostridium difficile Entamoeba histolytica Cytomegalovirus Giardia lamblia Loading...265. 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? Non-keratinized squamous epithelium Keratinized squamous epithelium Ciliated columnar epithelium Non-ciliated columnar epithelium Loading...266. Achilles tendon xanthoma is most likely characteristic of which one of the following conditions? Familial hypercholesterolemia Systemic lupus erythematosus Diabetes mellitus Pseudogout Loading...267. Histamine Receptor found on the mucus layer causing the production of gastric acid secretion is the following? H² histamine receptor H⁴ histamine receptor H¹ histamine receptor H³ histamine receptor H⁵ Histamine receptor Loading...268. 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 Donepezil Fluoxetine Citalopram Diazepam Loading...269. Duration of action of nitroprusside is following? 1 to 2 minutes 30 minutes 15 to 30 minutes 3 to 6 hours Loading...270. Which one of the following is the most common etiology of abdominal aortic aneurysm in the United States? Turner syndrome Rheumatic heart disease Cystic medial necrosis Atherosclerosis Loading...271. Which of the following types of protein is encoded by the P53 gene? Tyrosine kinase DNA repair enzyme Transcription factor Caspase Loading...272. A drug that belongs to Loop Diuretics is one of the following? Cefazolin Sulbactam Bumetanide Furosemide A & B Loading...273. A 45-year-old man who was diagnosed with malaria and received anti-malarial medication presents to the office with progressive fatigue and loss of appetite. He also mentions that he noticed that his urine has become dark lately. Urinalysis is positive for both bilirubin and urobilinogen. Blood studies show serum total bilirubin of 4.3 mg/dL, hemoglobin concentration of 8.5 g/dL and hematocrit of 30%. Which medication is used to treat this patient? Primaquine Doxycycline Chloroquine Atovaquone Loading...274. What is the antidote of theophylline? Activated charcoal Esmolol A & B All of the above Pralidoxime Loading...275. 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 termPage 12 of 66 Loading...276. Which one of these medication groups is contraindicated in a patient with narrow-angle glaucoma? Muscarinic-receptor antagonists Beta blockers Diuretics Cholinomimetics Loading...277. Atropine is often used prior to administration of inhalant anesthetics to reduce which of the following? Muscle tone Secretions Vomiting Heart rate Loading...278. Which one of the following local anesthetics can NOT be given parenterally due to its physicochemical properties? Mepivacaine Procaine Etidocaine Benzocaine Loading...279. Which one of the following cells secretes glycosaminoglycans and found in the in the terminal and respiratory bronchioles? K cells Pneumocytes type I Clara cells Macrophages Pneumocytes type II Loading...280. A drug that inhibits xanthine oxidase through the formation of a stable complex with xanthine oxidase is the following? Pegloticase Colchicine Allopurinol Probenecid Febuxostate Loading...281. A patient requires quinidine to treat his atrial arrhythmia, which of the following drugs should be administered prior to it to prevent the deleterious effects? Acetaminophen Amiodarone Digoxin Mexalitine Loading...282. 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? Endocrine Infection Trauma Vascular Pure psychogenic Loading...283. A 68-year-old man presents to the emergency room complaining of multiple episodes of fainting since he woke up today. His fainting mainly occurs when he stands up. He has a history of coronary artery disease, diabetes, high cholesterol and hypertension. He takes atenolol, metformin, lovastatin and lisinopril. On physical examination, his blood pressure is 120/75, pulse is 55/min. and irregular, heart sounds are normal and lungs are clear on auscultation. ECG shows dropped beat after progressive lengthening of the PR interval. What is the most likely initial diagnosis? Atrial fibrillation Atrial flutter Third degree atrioventricular block Mobitz type II second degree AV block Mobitz type I (Wenckebach) second degree AV block Loading...284. A 37-year-old woman complains of watery diarrhea, abdominal cramps and periodic facial flushing for the last six months. Examination reveals bilateral wheezing and slightly enlarged liver. Urine analysis shows high levels of 5-hydroxyindoleacetic acid (5-HIAA). Multiple tumors are detected by a CT scan. What is the most likely primary site of these tumors? Colon Small Intestine Stomach Esophagus Loading...285. A patient is given epinephrine and an agonistic effect is produced on a certain organ. But when he is given Norepinephrine no such effect is produced. Which one of the following organs is it? It has no direct neural control. Cutaneous blood vessels Respiratory smooth muscle Splanchnic blood vessels SA Node Radial muscle of the iris Loading...286. Combination of levodopa and carbidopa is recommended. Which of the following explains the significance of this combination? Carbidopa enhances the conversion of peripheral levodopa into dopamine Unknown mechanism Carbidopa enhances the absorption of levodopa Carbidopa enhances the entry of levodopa into brain Loading...287. 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 Radial nerve Ulnar nerve Axillary nerve Loading...288. What is the most common cause of epididymitis in males older than 35 years of age? Streptococci Gonococci E Coli Chlamydia Loading...289. Which of the following is the currently drug of choice for the treatment of cutaneous anthrax? Ciprofloxacin Gentamicin Azithromycin Penicillin Loading...290. Amnestic syndrome due to thiamine deficiency is caused by lesions of which one of the following structures? Temporal lobe Cerebellum Limbic system Parietal lobe Loading...291. Sjögren syndrome is characterized by a dry mouth and lack of tears. what is the recommended drug for this syndrome? Tropicamide Cyclopentolate Bethanechol Atropine Pilocarpine Loading...292. A 72- year old man with a long history of hypertension and coronary artery disease presents for follow up examination. He takes metoprolol for many years. He started taking enalapril last week. His blood pressure is now under control. Physical and laboratory examinations are unremarkable except for slight increase in serum creatinine. What is the best explanation for this abnormality? Increased glomerular filtration rate (GFR) Blocking of efferent arteriole vasoconstriction Drug-induced tubular obstruction Increase absorption of water in the proximal convoluted tubules Renal interstitial nephritis Loading...293. 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? Embolism Thrombosis Atherosclerosis Arteriosclerosis Loading...294. Which one of the following drugs mediates histamine release from mast cells causing flushing? Griseofulvin Nystatin Caspofungin Terbinafine Loading...295. Which of the following is the most common cause of adverse drug reactions? Allergic reaction Dosage discrepancy Idiosyncrasy Non-compliance Loading...296. Which one of the following medications is a non-selective beta receptor agonist? Phenylephrine Epinephrine Ephedrine Isoproterenol Loading...297. Bulging of anterior fontanelle is considered after examination of which one of the following anatomic landmarks? Bregma Pterion Lambda Sagittal suture Loading...298. A 4-year-old boy is brought to his physician by his mother. She is worried and tells you that her son is weak and not growing properly. He chews his fingers and lips constantly and seems to enjoy it. On examination, there is marked loss of tissues on his fingers and lips. His serum and urine levels of uric acid are both high. What is the most likely diagnosis of this condition? Hurler syndrome Tay-sachs disease Galactosemia Lesch-Nyhan syndrome Gaucher disease Loading...299. What is the most common cause of chronic chest pain? Gastrointestinal Musculoskeletal Cardiac Malignant Loading...300. Which one of these drugs is associated with aplastic anemia? Nitrofurantoin Penicillin Metronidazole ChloramphenicolPage 13 of 66 Loading...301. Which of the following defense mechanisms is most likely associated with paranoia? Projection Superego lacunae Undoing Splitting Loading...302. A cytokine that induces proliferation of antigen-primed T cells along with enhancing the activity of NK cells? Tissue necrosis factor-alpha Interleukin-1 (IL-1) Interleukin-2 (IL-2) Interferon-gamma Loading...303. A patient with a recent history of meningitis develops headache, blurred vision and cognitive decline. CT scan shows enlarged ventricles. Which of the following is most likely responsible for this condition? Impaired CSF resorption Excessive CSF production Destruction of the gray matter Obstruction of cerebral aqueduct Loading...304. Which one of the following drugs is the most effective for nausea and vomiting of pregnancy? Cimetidine Meclizine Ondansetron Loratadine Loading...305. Which one of the following medications acts at the proximal tubule of the kidney? Spironolactone Acetazolamide Furosemide Hydrochlorothiazide Loading...306. Which one of the following medications inhibits protein synthesis by binding to 50S subunit and preventing the formation of the initiation complex? Minocycline Clindamycin Linezolid Azithromycin Loading...307. Deficiency of the enzyme argininosuccinate in urea cycle leads to the accumulation of which one of the following? Citrulline Arginine Ornithine Argininosuccinate Loading...308. A 32-year-old woman with a history of generalized anxiety disorder develops numbness of her face particularly around her mouth. Physical examination and x-ray show no abnormalities other than markedly increased respiratory rate. Laboratory investigations are as follows: Elevated hydrogen ion concentration Elevated hydrogen ion excretion Elevated bicarbonate excretion Elevated arterial PO22: 100 mmHg PCO2: 30 mmHgich of these findings shows that the body is compensating to this condition? Elevated respiratory rate Loading...309. 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? Rhabditiform larvae Cyst Ovum Encysted larvae Loading...310. 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? HBV vaccine Supportive treatment Famciclovir Interferon alfa Acyclovir Loading...311. Which of the following correctly describes permissive drug interaction? Effect of drug A and drug B is equal to the sum of their individual effectsich of the following drugs is the effective treatment of benzodiazepines toxicity? Decrease in response of a drug after repeated administration Effect of drug A and drug B is greater than the sum of their individual effects Presence of drug A is required for full effect of drug B Loading...312. 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? Methotrexate Vincristine Cyclophosphamide Daunorubicin Cisplatin Loading...313. Which one of the following gout treatments lowers serum uric acid? Indomethacin Allopurinol Colchicine Probenecid Loading...314. During normal inspiration, the diaphragm: Contracts Does not move Relaxes Loading...315. Canal of Schlemm is located at which one of the following junctions? Ciliary body and iris Cornea and iris Cornea and sclera Cornea and ciliary body Loading...316. 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? Chlorpromazine Benztropine Lamotrigine Sertraline Loading...317. The vitreous chamber of the eye is located between which of the following structures of the eye? The cornea and the retina The iris and the lens The cornea and the iris The lens and the retina Loading...318. Albumin quantitatively a primary protein in serum is synthesized by? Kidney Brain Lungs Intestine Liver Loading...319. Which one of the following agents is used to eradicate the organism's (Phthisis pubis) extraerythrocytic phase? Chloroquine Chloroguanide Primaquine Pyrimethamine Quinacrine Loading...320. Abacavir belongs to the class of following drugs? Antiviral Antibiotics Anti malaria Antiprotozoal Antipyretic Loading...321. 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...322. Which one of the following drugs associated with nephrotoxicity? Capreomycin Ethambutol Rifampin Isoniazid Loading...323. Which of the following is the most likely developmental defect associated with tetralogy of Fallot? Anterosuperior displacement of the infundibular septum Bicuspid pulmonary artery Patent ductus arteriosus Transportation of the great vessels Loading...324. Which one of the following agents prolongs the duration of nerve block when combined with a local anesthetic? Isoproterenol Epinephrine Atropine Dobutamine Loading...325. Which one of the following statements about the use of Diclofenac is incorrect? Accumulate in synovial fluid Excrete out by the kidney Also used for ankylosis spondylitis Less potent than NaproxenPage 14 of 66 Loading...326. Which of the following drug belongs to Carbonic anhydrase inhibitors? Acetazolamide Mannitol Furosemide A & B Urea Loading...327. Cortisol is released from which part of the adrenal medulla? Zona fasciculate All of these A & B Zona glomerulosa Zona reticularis Loading...328. Acute decrease in response to a drug after initial or repeated intake is known as which of the following drug interactions? Synergetic Additive Permissive Tachyphylactic Loading...329. As physicians, we need to know some definitions in Genetics, which are related directly to our practice and guide us to diagnose and treat many genetic disorders. These items include genome, genotype, phenotype, genetic code, gene expression, etc. Which one of the following choices describes the definition of a phenotype? Physical location of a trait on a DNA molecule An observable physical or biochemical trait on an organism DNA structure that determines the expression of a trait Genetic history of an organism Loading...330. Which of the following is a characteristic finding in isopropanol poisoning? Blindness due to ocular accumulation Elevated serum BUN and creatinine Ketosis without acidosis Elevated anion gap Loading...331. Gray baby syndrome is the adverse effect of the following drug? Linezolid Chloramphenicol Quinupristin Clindamycin Loading...332. During newspaper delivery, a boy walked into the Out Patient Department (OPD) with a history of having palpitations since morning. His pulse and heart rate were difficult to count. He was immediately shifted to the Intensive Care Unit (ICU) and an urgent electrocardiogram (ECG) was taken which showed narrow complex tachycardia with a heart rate of 194 per min and absence of P waves. His blood pressure was 100/73 mmHg. He was comfortable at rest with no distress and not in cardiac failure. Carotid sinus massage was tried, which failed to convert Supraventricular Tachycardia. He was diagnosed with paroxysmal supraventricular tachycardia. Which of the following drugs would you think is the drug of the first choice in this situation? Amiodarone Verapamil Lidocaine Propranolol Adenosine Loading...333. Which of the following medications may cause acute cholestatic hepatitis? Erythromycin Colchicine Acarbose Metformin Loading...334. Which of the following characterizes syndrome of inappropriate antidiuretic hormone secretion? Serum osmolality is greater than urine osmolality Recommended treatment is desmopressin acetate and hydration Euvolemic hyponatremia with continued Na excretion Hyperosmotic volume contraction Loading...335. 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? Initiation of left myringotomy and induction of topical treatment Antibiotic ear drops and follow up in three days Hospitalization for intravenous antibiotics and control of diabetes Empiric oral antibiotic therapy and follow up in one week Loading...336. One of the following statements is false about the functions of epinephrine? Increased blood supply to the kidney Increase in systolic blood pressure Bronchodilation Strengthen the contractility of the myocardium Hyperglycemic effect Loading...337. 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? Propranolol Verapamil Quinidine Amiodarone Loading...338. Which one of the following medications stimulates muscarinic receptors in airways when inhaled? Methacholine Carbachol Bethanechol Pilocarpine Loading...339. Acetazolamide and other carbonic anhydrase inhibitors act at which part of the kidney? Distal tubule Descending loop of Henle Collecting duct Proximal tubule Loading...340. 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 Aplastic anemia Vitamin B12 deficiency Loading...341. Which of the following is most likely to occur with carbonic anhydrase inhibitors? Alkalosis Hyperkalemia Hyperuricemia Acidic urine Hyperchloremia Loading...342. Which of the following is considered an indication of first-generation histamine H1-receptor blockers? Cough Apoplexy Allergy Peptic ulcer Loading...343. Which one of the following is characteristic of Chlamydia? Facultative intracellular Gram-negative diplococci Obligate intracellular Anaerobic bacteria Loading...344. Which of the following is the substance released from the parietal cells of the stomach? Gastrin Pepsinogen Mucus Hydrochloric acid Loading...345. If a dose of the following drug is not properly adjusted it accumulates in neonates that interfere with the function of mitochondrial ribosomes? Erythromycin Chloramphenicol Amikacin Clindamycin Loading...346. What is the genetic abnormality related to Cri-du-chat-syndrome? Mutations of the fibrillin gene on chromosome 15 Trisomy 18 Deletion of phenylalanine in position 508 Deletion of short arm of chromosome 5 Loading...347. 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? Diarrheal diseases Ischemic heart disease HIV/AIDS Stroke Lower respiratory tract infections Loading...348. Zalcitabine belongs to the class of following drugs? Antiprotozoal Anti malaria Antifungal Antipyretic Antiviral Loading...349. Beta-Blocker drug is following? Esmolol Atropine Acetylcholine Succinylcholine Tamsulosin Loading...350. Amylin hormone is released from one of the following cells? juxtaglomerular cells Pancreatic Delta cells Pancreatic Alpha cells Pancreatic Beta cellsPage 15 of 66 Loading...351. 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 Gaucher’s disease Fabry’s disease Niemann-Pick disease Loading...352. Which one of the following agents is insulin? Desmopressin Somatostatin Torsemide Glargine Atorvastatin Loading...353. Which one of the following agent is a insulin? Torsemide Somatostatin Aspart Atorvastatin Desmopressin Loading...354. 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 Nucleus Ambiguus Lateral spinothalamic tract Inferior cerebellar peduncle Loading...355. Which one of the following drugs is used to treat hyperphosphatemia? A & B Sodium polystyrene sulfonate Sevelamer Metamucil Alendronate Loading...356. A 22-year- old man presents to the emergency room complaining of sudden onset of shortness of breath and palpitation for 2 hours. He had similar episodes in the past which resolved by breath holding. His past medical, surgical and family histories are unremarkable. He takes no medication. ECG reveals supraventricular tachycardia. Carotid massage on the right side fails to subside this attack. What is the most likely next step in management? IV lidocaine Try carotid massage on the left side IV succinylcholine IV procainamide IV adenosine Loading...357. 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 Femoral hernia Hiatal hernia Direct inguinal hernia Loading...358. 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 Albuterol inhaler as needed Continuous supplemental oxygen Loading...359. A drugs inhibit the urate-anion exchanger in the proximal tubules that mediates urate reabsorption? Colchicine Allopurinol Sulindac Probenecid Loading...360. Which one of the following drugs is a calcium channel blocker (Class IV)? Procainamide Carvedilol Verapamil Amiodarone Loading...361. Which of the following is the best treatment of genuine stress incontinence? Urethropexy Surgical repair Intermittent self-catheterization Anticholinergic Loading...362. Loss of individual cells by fragmentation of nuclei and cytoplasm caused by a chemotherapeutic agent is produced through which one of the following mechanisms? Acute inflammation Apoptosis Phagocytosis Mitochondrial poisoning Loading...363. 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? Epithelial cells of the retina Endothelial cells of the cornea Epithelia cells of the cornea Epithelial cells of the ciliary body Loading...364. Which one of the following drugs causes inhibition of viral neuraminidase? Oseltamivir A & B A & C Ribavirin Zanamivir Amantadine Loading...365. 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? Malignant melanoma Langerhans cell histiocytosis Squamous cell carcinoma Basal cell carcinoma Mycosis fungoides Loading...366. Which of the following drug is a part of drugs for osteoporosis? Alendronate A & B Furosemide Rabeprazole Acetazolamide Loading...367. CLASS II drugs of the Antiarrhythmic drugs interfere with one of the following options? Beta adrenoceptors Blockers Na+ channel blockers Ca+ channel blockers K+ channel blockers Loading...368. Which of the following in the mode of inheritance of glucose-6-phosphate dehydrogenase deficiency? X-linked dominant Autosomal dominant Autosomal recessive X-linked recessive Loading...369. 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 Imperforate anus Tracheomalacia Loading...370. Which of the following drug is Antiprogestrin?ich one of the following drugs Increases Glucose-dependent insulin release and decreases secretion of glucagon? Acarbose Bicalutamide Metformin Sitagliptin Pioglitazone Loading...371. 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 difficile Clostridium butyricum Clostridium botulinum Clostridium Septicum Clostridium histolyticum Loading...372. Which of the following is the diagnostic test used when ultrasound is equivocal for cholecystitis? Liver function tests CT scan Abdominal x-ray HIDA scan Loading...373. Varicella zoster vaccine is not recommended if an elderly patient already developed shingles. False True Loading...374. 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? Erythromycin Cephalexin Ampicillin Chloramphenicol Tetracycline Loading...375. Counterregulatory hormone in diabetes that works against insulin include the following? Glucagon Cortisol Catecholamines Growth hormone All of the abovePage 16 of 66 Loading...376. A drug used in severe DIGITALIS toxicity is the following drug? DIGIBIND Fomepizole Amyl Nitrate Calcium Gluconate Loading...377. 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 Polycystic kidney disease Irritable bowel syndrome Ulcerative colitis Loading...378. Which one of the following oral anti-diabetic drugs is associated with lactic acidosis? Metformin Glipizide Pioglitazone Nateglinide Loading...379. A drug that belongs to proton pump inhibitor is one of the following? A & B Omeprazole Sulbactam Rosiglitazone Ethacrynic Acid Loading...380. Which of the following substances is used in mercury poisoning? Flumazenil Succimer Methylene blue Fomepizole Loading...381. Mafenamic acid belongs to following class? Oxicam Acetic acid Fenamates Propionic acid Salicylic acid Loading...382. Which one of the following is the most appropriate next step in suspected scaphoid fracture (with normal radiology)? Thumb spica splint Assurance and follow up in 2 weeks Emergent orthopedic consultation Admission and observation Loading...383. Which one of the following fractures is incomplete and involving the cortex of only one side of the bone? Osgood-Schlatter disease Greenstick fracture Nursemaid’s elbow Torus fracture Loading...384. Which of the following drugs should NOT be initiated in case of acute decompensated heart failure? Digoxin Lisinopril Potassium supplements Metoprolol Loading...385. Which one of the following drugs is a Alpha Glucosidase inhibitors? Hydrochlorothiazide Repaglinide Ezetimibe Indanyl carbenicillin Acarbose Loading...386. Which one of the following medications increases the threshold for angina? Digoxin Furosemide Benazepril Metoprolol Loading...387. A drug that belongs to DPP-IV inhibitors is one of the following? A & B Sitagliptin Sulbactam Rosiglitazone Ethacrynic Acid Loading...388. 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 Foreign body stuck in the main bronchus Bronchiolitis Loading...389. 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 Rapid urease test Stool analysis and culture Serum test for IgG antibodies against H. Pylori Examination and culture of gastric contents Loading...390. 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 Warfarin Dipyridamole Streptokinase Aspirin Loading...391. Which of the following substances is responsible for growth of the prostate at puberty? Estrogen Testosterone Dihydrotestosterone Progesterone Loading...392. 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 Gallstones Hemolysis Hepatocellular disease Loading...393. 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 Staphylococcus aureus Trichophyton rubrum Trypanosoma cruzi Ascaris lumbricoides Loading...394. A patient with cystic fibrosis is treated by gene therapy. Which of the following types of cells should be targeted as host cells? Hemopoietic stem cells Epithelial cells Germ cells T-cells Loading...395. 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? Myasthenia gravis Meningitis Spinal cord compression Peripheral neuropathy Loading...396. In high doses, Aspirin lacks anti-platelet activity by which of the following phenomena Stimulates leukotrienes Stimulates thromboxanes Inhibits leukotrienes Stimulates prostacyclins Inhibits prostacyclins Loading...397. Which of the following drug is a part of drugs for osteoporosis? Furosemide Acetazolamide A & B Calcitonin Rabeprazole Loading...398. The effect of medications on parasympathetic function declines slowly in which one of the following organs? Heart Glands Eye Smooth muscles Loading...399. Which of the following is the most likely rout of transmission of herpes simplex virus-1? Congenital transfusion Respiratory secretions and saliva Food contamination Sexual contact and perinatal Loading...400. A direct-acting adrenergic agonist is following? Clonidine Albuterol A & B Amphetamine AcetylcholinePage 17 of 66 Loading...401. In which one of the following locations a mural thrombus commonly occurs following myocardial infarction? Left ventricle Left atrium Right ventricle Thoracic aorta Right atrium Loading...402. Indapamide belongs to the one of the following class of diuretics? Carbonic anhydrase inhibitors Thiazide Diuretic Potassium sparing diuretics Loop Diuretics Loading...403. Hydralazine is used to treat one of the following disease? High Blood pressure Malaria Viral infection Diabetes Stomach Ulcer Loading...404. 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? Atropine Timolol Pilocarpine Acetazolamide Neomycin Loading...405. 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...406. Select Dihydropyridines Calcium channel blocker drug? Verapamil Acetazolamide Diltiazam Amiloride Nifedipine Loading...407. Which of the following is the mechanism of action of flumazenil in the treatment of lorazepam toxicity? Stimulation of dopamine receptors Competitive inhibition at benzodiazepine receptors Noncompetitive inhibition of benzodiazepine receptors Inhibition of alpha adrenoceptors Loading...408. Which one of the following drugs is associated with optic neuritis? Ethambutol Capreomycin Rifampin Isoniazid Loading...409. A drug that belongs to Loop Diuretics is one of the following? A & B All of the following Bumetanide Bumetanide Furosemide Loading...410. 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? Aspirin Hydrocodone Vitamin C Acetaminophen Loading...411. A 54-year-old woman with a 6-year history of type 2 diabetes visits her physician for a regular examination. She was initially treated with oral hypoglycemic but her HbA1c had gotten worse so, her physician switched to insulin last year. Six-month ago, she had surgery in her wrist to release compression caused by carpal tunnel syndrome. Now, she complains of progressive increase in her feet size. Examination reveals coarse facial features with prominent supraorbital ridge. What is the most appropriate test to help reach the diagnosis of this case? Fasting serum glucose test Dexamethasone suppression test Measurement of thyroid stimulating hormone (TSH) Measurement of HbA1c Assessment of insulin-like growth factor 1 (IGF-1) Loading...412. Which one of the following antihypertensive medications is NOT safe in pregnancy? Methyldopa Lisinopril Nifedipine Labetalol Loading...413. 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 2 carbon ring 6 carbon ring 5 carbon ring Loading...414. Which of the following is absolute contraindication of fibrinolytic therapy in MI? History of diabetes History of hemorrhagic stroke 9 years ago History of hypertension History of ischemic stroke 4 years ago Loading...415. A female patient presents to the emergency room with a suspicious ruptured abdominal aortic aneurysm. Which of the following is the appropriate test needed at this situation? Abdominal CT scan Abdominal ultrasonography Abdominal X-ray Abdominal MRI Loading...416. 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? Promethazine Ondansetron Ranitidine Hydroxyzine Diphenhydramine Loading...417. A 77-year-old man presents to the emergency room with a complaint of retention of urine. Carbachol is administered to stimulate bladder emptying. Which of the following is a prominent side effect of carbachol? Dilation of the pupils Excessive salivation Dry skin Tachycardia Delirium Loading...418. Which of the following drug is used as a cervical ripening agent to induce labor? Dinoprostone Ketorolac Celecoxib Etodolac Nubemetone Loading...419. Which one of the following is a fat-soluble vitamin? Riboflavin Retinoid Thiamine Ascorbic acid Loading...420. A young man complains of syncope, dyspnea and chest pain after exercise. A crescendo-decrescendo systolic murmur is heard over the left sternal border without radiation. What is the most likely etiology? Hypertrophic cardiomyopathy Aortic stenosis Aortic dissection Aortic regurgitation Loading...421. Which of the following drugs appears unchanged in the urine? A & B Amantadine All of the above Zanamivir Oseltamivir Loading...422. Alendronate is effective in which one of the following conditions? Hyperthyroidism Spinal cord lesions Osteoporosis Hypoparathyroidism Loading...423. What is the most common cause of abdominal aortic aneurysm? Post-inflammatory Post-operative Atherosclerosis Complication of coronary artery disease Loading...424. Which of the following is a major complication of central retinal veins occlusion? Lens subluxation Glaucoma Retinal detachment Cataract Loading...425. Which one of the following drugs is a microtubule inhibitor chemotherapeutic drug? Methotrexate Vincristine Dactinomycin BusulfanPage 18 of 66 Loading...426. Which one of the following drugs is 2nd generation flouroquinolone? Nalidixic acid Ciprofloxacin Moxifloxacin Levofloxacin Loading...427. In case of transposition of the great arteries, the pulmonary artery arises from which one of the following parts of the heart? Right atrium Right ventricle Left ventricle Left atrium Loading...428. Which of the following is the main step in treating alcoholic liver disease? Baclofen Naltrexone Disulfiram Abstinence Loading...429. 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? Pompe disease Von Gierke disease Gaucher disease Niemann-Pick disease Loading...430. Which one of the following medications should be taken on an empty stomach and at least one hour before meals? Prednisone Propranolol Aspirin Levothyroxine Loading...431. Administration of clopidogrel with aspirin is an example of which of the following drug interactions? Permissive Additive Tachyphylactic Synergistic Loading...432. Which one of the following cholinomimetic agents is used in the challenge test for diagnosis of asthma? Methacholine Bethanechol Carbachol Pilocarpine Loading...433. A patient comes to the emergency ward with recent organophosphorus compound poisoning. He will have all of the following signs & symptoms except: Muscle Weakness Increased salivation Bronchodilatation Diarrhea Increased lacrimation Loading...434. 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? Acute myocardial infarction Pericardial effusion Hypertrophic cardiomyopathy Septic shock Left bundle branch block Loading...435. Which of the following should be added to premature infants of breast-feeding mothers after 2 month of age? Zink Vitamin C Copper Iron Loading...436. 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? Trigeminal nerve Facial nerve Oculomotor nerve Optic nerve Loading...437. PITUITARY HORMONE is synthesized in the pituitary gland. The pituitary gland is divided into two anatomical lobes, one of these lobes is called the Anterior lobe. The anterior lobe is also called as following? Adenohypophysis Neurohypophysis Adenohyperphysis Uterohypophysis Neurohyperphysis Loading...438. 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 Berkson’s bias Recall bias Pygmalion effect Loading...439. Which one of these drugs reverses both muscarinic and nicotinic effects of organophosphorus compounds by restoring cholinesterase? Physostigmine Atracurium Pralidoxime Atropine Loading...440. An 80 mg dose of a drug was administered to a patient. 40 mg was eliminated during the first hour. This drug follows first-order elimination kinetics. Which of the following is the amount of the drug remains 3 hours after administration? None 20 mg 30 mg 10 mg Loading...441. High levels of which one of the following substances signals the initiation of gluconeogenesis? Citrate Oxalate Acetyl CoA Adenosine triphosphate (ATP) Loading...442. Which of the following drugs acts directly on dopamine receptors to improve the effects of Parkinson’s disease? Bromocriptine Carbidopa Amantadine Selegiline Loading...443. Which one of the following drugs is used to treat constipation? A & B Alendronate Metamucil Sevelamer Sodium polystyrene sulfonate Loading...444. Which of the following management plans is recommended for a case of myocardial infarction with 70% main left stenosis? Percutaneous coronary intervention (PCI) Pharmacotherapy and observation Coronary artery bypass graft (CABG) Percutaneous transluminal coronary angiography (PTCA) Loading...445. Which of the following is an epithelial tumor with a “stuck-on” appearance? Squamous cell carcinoma Actinic keratosis Basal cell carcinoma Seborrheic keratosis Loading...446. Ibuprofen belongs to one of the following class? Propionic acid Fenamates Oxicam derivative Acetic acid derivative Loading...447. Which of the following drug belongs to Osmotic Diuretic? Cefoxitin Niacin Urae Ampicillin Oxacillin Loading...448. Erythema infectiosum (Fifth disease) is caused by which of the following organism? Parvovirus B19 Rubella virus Coxsackie A virus Paramyxovirus Loading...449. Bones of calvarium and facial bones are formed by which one of the following types of ossification? Endochondral ossification Membranous ossification Loading...450. Which one of the following effects is caused by administration of mecamylamine? Tremors Tachycardia Hypertension Pupillary constrictionPage 19 of 66 Loading...451. 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? Formation of a protective coating of the ulcer beds Suppression of secretory responses to food stimulation Direct inhibition of the proton pump Increased mucus and bicarbonates secretion and decreased HCL secretion Loading...452. Which of the following is the appropriate treatment of a moderate case of acne vulgaris? Oral antibiotic and topical therapy Topical antibiotic Benzyl peroxide Oral isotretinoin Loading...453. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Furosemide Ibandronate Rifamycins A & B Rabeprazole Loading...454. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Isoniazid Rabeprazole Furosemide Ibandronate A & B Loading...455. Which of the following explains the higher incidence of sickle cell disease in African Americans more than other races? Increased mutation rate Natural selection Increased gene flow Genetic drift Loading...456. Which of the following benefits is achieved as a result of adding progesterone to estrogen in HRT? Increase the effect of estrogen on the heart Decrease bone resorption Decrease the occurrence of endometrial cancer Decrease the effect of estrogen on the breast Loading...457. Which one of the following drugs inhibits ribonucleotide reductase? 5-Fluorouracil Hydroxyurea Mycophenolate Ribavirin Loading...458. The tracheal tube is originated from which of the following structures? Foregut Fourth pharyngeal arch Ductus arteriosus Third pharyngeal arch Loading...459. Which of the following organisms is associated with toxic shock syndrome due to exotoxin A? Staphylococcus aureus Vibrio cholera Streptococcus pyogenes Clostridium perfringens Loading...460. Which of the following drugs is an ergosterol synthesis inhibitor? Acyclovir Ritonavir Ketoconazole Ampicillin Loading...461. Antihyperlipidemic drugs which consist of open hydroxy acid lactone ring in the structural formula except? Fluvastatin Atorvastatin Pravastatin Rosuvastatin Simvastatin Loading...462. 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? MMR Varicella Oral polio vaccine DTaP Loading...463. Which of the following drugs is used for respiratory virus infections? Capecitabine Naftifine Miconazole Ibandronate Zanamivir Loading...464. 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...465. Which of the following anti-retroviral treatments is a non-competitive reverse transcriptase inhibitor? Nevirapine Didanosine Saquinavir Zidovudine Loading...466. Deferoxamine is an antidote used for toxicity of the following? Isoniazid Iron Calcium bicarbonate Atropine Loading...467. An 80-year-old woman develops chest pain on second day after hysterectomy. Which of the following is the most likely diagnosis? Pulmonary infarction Myocardial infarction Right bundle branch block Acute pericarditis Loading...468. 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 Reactive hypoglycemia Insulinoma Pheochromocytoma Loading...469. 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? Restrain in bed and lorazepam administration Diphenhydramine to enhance sleeping Sleep enhancement protocol and family support as well as haloperidol administration Refer to psychiatry department Restrain in bed and haloperidol administration Loading...470. Which of the following differentiates physiologic jaundice from pathologic jaundice? Bilirubin in physiologic jaundice rises higher than 5 mg/dL/day Direct bilirubin is lower than 10% of total bilirubin in physiologic jaundice Bilirubin peaks at higher levels (> 15 mg/dL) in physiologic jaundice Physiologic jaundice is present in the first 24 hours of life Loading...471. 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 Streptococcus pneumoniae Candida albicans Moraxella catarrhalis Pseudomonas aeruginosa Loading...472. Epinephrine acts to dilate bronchial smooth muscle through which one of the following receptors? Beta-2-adrenoreceptors Beta-1-adrenoreceptors Alpha-2-adrenoreceptors Alpha-1-adrenoreceptors Loading...473. Which of the following agents reduce the blood levels of certain drugs through its action on hepatic P450 system? Guava juice St. John’s wart Grapefruit juice Kava Loading...474. A drug that blocks the glycoprotein GP IIb/IIIa receptors of platelets? Clopidogrel Aspirin Ticlopidine Tirofiban Dipyridamole Loading...475. 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? Oral ampicillin and gentamicin Blood samples and intravenous antibiotics CT scans of the abdomen and pelvis Observation and waiting for the results of blood culture MRI of the pelvisPage 20 of 66 Loading...476. Which of the following medications is most likely prescribed in cases of asthma associated with chronic environmental allergies? Albuterol inhaler Oral montelukast Fluticasone nasal spray Oral fexofenadine Loading...477. Reye syndrome causes brain and liver damage in children with viral infections like chickenpox and flu. this disease is linked with the following drug? Aspirin None of these Acetaminophen Mefenamic acid Ketorolac Loading...478. 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...479. Which of the following is the most frequent and irreversible side effect of typical anti-psychotics? Tardive dyskinesia Dystonia Akathisia Anxiety Loading...480. Which one of the following conditions is a long term complication of cystic fibrosis? Emphysema Adenocarcinoma of the lung Bronchiectasis Pneumothorax Loading...481. 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? Hydralazine Propranolol Sotalol Metoprolol Verapamil Loading...482. Which one of the following macrolide drugs has a half-life of >40 hours? Erythromycin Telithromycin Azithromycin Clarithromycin Loading...483. Which of the following drugs is beneficial in treatment of glaucoma through increased outflow of aqueous fluid by causing contraction of ciliary muscle? Diuretics Cholinomimetics Beta blockers Alpha agonists Loading...484. Chronic use of which of the following drugs may increase the toxicity of acetaminophen? Ethanol Cimetidine Ketoconazole Verapamil Loading...485. Which of the following medications reduces the effectiveness of oral contraceptives? Ritonavirich of the following medications is the best treatment of absence seizures? Carbamazepine Ketoconazole Omeprazole Loading...486. A college student visits the clinic for pruritic maculopapular rash on abdomen, trunk, and palms of the hands and soles of the foot. Generalized lymphadenopathy and wart-like lesions are seen around anal area. Which of the following laboratory tests is the most useful for this patient? Chlamydia titer Blood culture of gonococci Weil-Felix titer Venereal Disease Research Laboratory (VDRL) test Loading...487. Which one of the following enzymes is extremely important in muscle energy metabolism through its role in purine nucleotide cycle? Hypoxanthine-guanine phosphoribosyltransferase (HGPRT) Myoadenylate deaminase Myo-inositol monophosphatase Adenosine deaminase Loading...488. - - - disease is inherited disorder of copper metabolism characterized by reduced serum copper & increased cincentration of copper in brain & viscera wilsons disorder Gout restless legs syndrome parkinsons disorder Loading...489. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Nizatidine Ezetimibe Capreomycin Indanyl carbenicillin Aluminium hydroxide Loading...490. A drug that is a part of Macrolide is following? Azithromycin Cefaclor Cefdinir Cefepime Loading...491. Following are the 17 alpha-Hydroxyprogesterone derivatives Having a pregnane nucleus in the structural formula? Hydroxyzine Promethazine Cyproheptadine Fexofenadine Cetirizine Loading...492. 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? Caspofungin Amphotericin B Metronidazole Fluconazole Loading...493. A 19-year-old man is referred to the clinic for a positive purified protein derivative (PPD) test for tuberculosis. He moved to the United States from Egypt 2 years ago and has been in a good health. He has no history of fever, cough, weight loss or night sweats. He has no family history or contacts with tuberculosis. His physical examination is normal. His chest x-ray shows no cavitation or hilar adenopathy. What is the appropriate next step in management for this patient? Start treatment with multiple drug- antituberculosis therapy Repeat the PPD test and x-ray after 6 months Start treatment with isoniazid for 9 months Isolation and full antituberculous therapy for 6 months Loading...494. Which of the following is Sulphamoyl Derivative diuretic drug? Chlorthalidone Metolazone Bumetanide Hydrochlorothiazide Ethacrynic Acid Loading...495. 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? Verapamil Propranolol Quinidine Amiodarone Aspirin Loading...496. Which of the following characterized by painless blisters on the back of the hands with friable surrounding skin and hyperpigmentation of the face? Herpes Zoster Contact dermatitis Dermatitis herpetiformis Porphyria cutanea tarda Loading...497. 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? 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. Ask the patient for the reason of refusal and don’t force her to take her medications Call her family and address this issue with them to find the best way to solve this problem to avoid any blame if something happens to her Tell the patient that if she doesn’t take her medications then, there is no need to take any future appointments Loading...498. 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? Inhibition of H+/K+ ATPase pump Anti-cholinergic effect Blocking of H2 receptor Neutralization of gastric acid Forming a layer to protect gastric mucosa Loading...499. 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 Amiodarone Quinidine Bretylium Sotalol Loading...500. 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 Supportive treatment until it resolves Begin radioactive iodine Life-long levothyroxinePage 21 of 66 Loading...501. Injury of the C8 and T1 at the lower portion of the brachial plexus most likely affects which one of the following nerves? Axillary nerve Median nerve Ulnar nerve Radial nerve Loading...502. Which one of the following blotting procedures is the best for studying mRNA levels? Southwestern blot Southern blot Northern blot Western blot Loading...503. Which one of these conditions is most likely associated with peripheral lymphocytosis? Viral hepatitis Myocardial infarction Pyogenic bacterial infections Inflammatory bowel syndrome Loading...504. Which of the following screening tests should be recommended for a patient taking olanzapine for schizophrenia? Hemochromatosis Cancer Diabetes Hemolysis Loading...505. 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? MRI of the kidney Administration of wide spectrum antibiotics CT scan of abdomen and pelvis Admission to the intensive care unit (ICU) Collection of urine and blood cultures Loading...506. Which one of the following drugs causes cyanide toxicity? Minoxidil Clonidine Nicardipine Sodium nitroprusside Loading...507. Liposomal preparation of one of the following drugs decreases the risk of nephrotoxicity? Nystatin Ethambutol Amphotericin B Isoniazid Loading...508. Which one of the following glucocorticoids can cause sodium and water retention? Cortisol Triamcinolone Betamethasone Dexamethasone Loading...509. In case of constrictive pericarditis, examination reveals increased jugular venous pressure with inspiration. Which of the following is considered positive in this patient? Kussmaul sign Hepatojugular reflux S3 gallop Raynaud’s phenomenon Loading...510. A 15-year-old boy is diagnosed with “Walking pneumonia”. Which of the following is the most effective treatment of this condition? Tetracycline Azithromycin Vancomycin Ampicillin Loading...511. Which of the following hormone belongs to the oral diabetic agent? Acarbose A & B Somatrem Oxytocin Furosemide Loading...512. Which one of the following drugs is a potassium channel blocker (Class III)? Verapamil Procainamide Amiodarone Carvedilol Loading...513. The structural formula of epinephrine and Norepinephrine called? Catechol Pyrocatechol 1,2-dihydroxybenzene All of these Loading...514. 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 levels of HbF in red blood cells Increase ability of HbS to bind 2.3-bisphosphoglycerate Loading...515. Gonadotropin-releasing hormones are synthesized by which of the following nuclei of the hypothalamus? Ventromedial nuclei Anterior nuclei Arcuate nuclei Dorsomedial nuclei Loading...516. 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? Extension of the knee joint Adduction of the hip joint Abduction of the hip joint Dorsiflexion of the ankle joint Flexion of the knee joint Loading...517. Mullerian-inhibitory factor plays a major rule in development of the male reproductive system. Which type of cells secrets it? Sertoli cells Leydig cells Loading...518. 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...519. A 68 year-old woman complains of fever, anorexia and right flank pain for 2 days. She vomited twice today. On physical examination, her temperature is 101.3 F and there is moderate tenderness on the right costovertebral angle. Her urinalysis shows leukocytes and pus cells. What is the most appropriate next step of management? Schedule Intravenous pyelogram 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 Hospitalization and intravenous antibiotics Loading...520. Outpatient prophylaxis of superior ventricular tachycardia (SVT) is best accomplished by which of the following medications? Diltiazem Lidocaine Procainamide Adenosine Loading...521. Which one of the following macrolide drugs has a short half-life of 2 hours? Erythromycin Telithromycin Clarithromycin Azithromycin Loading...522. A child presents with low body weight, edema of lower extremities, enlarged abdomen with ascites and desquamating skin and areas of depigmentation and hyperpigmentation. Which of the following is the most likely diagnosis? Marasmus Scurvy Kwashiorkor Pellagra Loading...523. The structural formula of the following drugs contains the Biphenyl methyl group except? Candesartan Eprosartan Losartan Olmesartan Valsartan Loading...524. Which one of the following drugs acts mainly by blocking the synthesis of leukotrienes? Cromolyn Ipratropium Zileuton Montelukast Loading...525. A 29-year-old man underwent bone marrow transplantation two weeks ago. Yesterday he developed diarrhea with occult blood and rashes all over his face, hands and feet. Examination reveals jaundice and maculopapular rashes on his face, palms and soles. What are the most likely cells activated in this case? Host B-lymphocytes Donor B-lymphocytes Host T-lymphocytes Donor T-lymphocytesPage 22 of 66 Loading...526. Which one of the following drugs can be used as a patch to avoid sea sickness? Adrenaline Digoxin Nicotine Scopolamine Loading...527. A drug that blocks the viral membrane matrix protein M2 and its ability to modulate intracellular PH? Zanamivir Oseltamivir Ribavirin Acyclovir Rimantadine Loading...528. Which of the following pathological terms describes the disordered, non-neoplastic cell growth? Metaplasia Dysplasia Neoplasia Anaplasia Loading...529. Misoprostol is an analog of the following type of prostaglandin? PGB PGE1 PGE PGI2 PGA Loading...530. 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? Turner’s syndrome Down syndrome DiGeorge Syndrome Stickler syndrome Loading...531. Risk of rupture of abdominal aortic aneurysm (AAA) is increased by all the following factors EXCEPT? Male gender Increased aortic wall stress Smoking Uncontrolled hypertension Loading...532. 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 Bladder hemorrhage Hemolytic anemia Cardiomyopathy Loading...533. 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 Cocaine Morphine Heroin Loading...534. Which of these medications is contraindicated in a case of cardiogenic shock? Metoprolol Intravenous fluids Norepinephrine Dopamine Loading...535. Which of the following leads to toxic reactions when a drug is taken repeatedly? Tachyphylaxis Cumulative action Tolerance Absorption disorder Loading...536. Which of the following drug contain the Sulfahydril group in the structural formula? Ramipril Quinapril Enalapril Lisinopril Captopril Loading...537. Coagulation factor VIII is produced by which of the following cells? Splenic macrophages Juxtaglomerular cells Hepatic cells Endothelial cells Loading...538. A group of drugs bind to a receptor but do not produce any pharmacological effect is called: Antagonist Agonist Partial agonist Loading...539. 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 7.60, bicarbonate 24, Pco2 60 and Po2 90 pH 7.05, bicarbonate 15, Pco2 30 and Po2 90 pH 7.00, bicarbonate 15, Pco2 60 and Po2 90 pH 7.47, bicarbonate 15, Pco2 30 and Po2 90 pH 7.50, bicarbonate 24, Pco2 40 and Po2 90 Loading...540. One of the OATPs (Organic anion transporting polypeptides) drugs transporters OATP4C1 has a mainly limited distribution to the following? Heart Kidney Liver Skin Stomach Loading...541. Which one of the following drugs is used to treat asthma? Indanyl carbenicillin Ezetimibe Hydrochlorothiazide Ipratropium Repaglinide Loading...542. 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? Kaposi’s sarcoma of the palate Malignant melanoma of the palate Lymphoproliferative disease Torus palatinus Palatal abscess Loading...543. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Ethambutol Furosemide A & B Ibandronate Caspofungin Loading...544. Which one of the following factors stimulates the renal secretion of renin? Decreased serum sodium ion concentration Increased chloride ion concentration in the renal distal tubules Decreased pressure in the afferent glomerular arterioles Increased pressure in the afferent glomerular arterioles Loading...545. 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? Check carboxyhemoglobin level Obtain EKG Obtain MRI of the brain Obtain CT scan of the head Loading...546. Oxytocin is an agent used to increase uterine contractions during labor and also control postpartum bleeding and hemorrhage has the following adverse effects except? Phlebitis Uterine Hypertonicity Hyponatremia Neonatal jaundice Bradycardia Loading...547. A 10-year-old boy is brought to the emergency room by his mother due to a long active seizure. He was hospitalized two months ago for status epilepticus and was prescribed valproic acid. What is the first step of action? Intravenous fluids Intravenous injection of haloperidol Gastric lavage Airway stabilization and 100% oxygen Electroencephalogram (EEG) Loading...548. Which one of the following drugs is used for subcutaneous and systemic mycoses? Butoconazole Griseofulvin Itraconazole Econazole Loading...549. Which one of the following enzymes catalyzes the rate limiting step in glycolysis? 6-Phosphofructo-1 kinase Phosphofructokinase-2 Pyruvate kinase Glyceraldehyde-3-phosphate dehydrogenase Loading...550. Which of the following drug is the Antidote of Isoniazid? N-acetyl-cysteine Amyl Nitrate Digibind PyridoxinePage 23 of 66 Loading...551. 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? Osteitis fibrosa cystica Osteomalacia Osteopetrosis Osteoporosis Loading...552. Bioavailability of a medication is maximal when it has which of the following factors? High water solubility High plasma binding High ionization High lipid solubility Loading...553. Which one of the following medications act as bacteriostatic by inhibiting bacterial dihydrofolate reductase? Ciprofloxacin Trimethoprim Dapsone Sulfamethoxazole Loading...554. Which of the following statements about the use of aminoglycoside is wrong? Accumulate in renal cortex cross the placental barrier Causes ototoxicity Bind to 50S subunit Accumulate in endolymph and perilymph Loading...555. 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 Reye syndrome Hypotrichosis Churg Strauss syndrome Steven-johnson syndrome Loading...556. 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 Family history of inflammatory bowel syndrome Having first attack in his twenties Smoking cessation History of diarrhea and weight loss Loading...557. Which of the following proteins in the serum transport drugs? Albumin Alpha-1 acid glycoprotein A & B Organic anion polypeptides All of the above Loading...558. Which of the following drugs has/have beneficial role in Torsades de pointes ? Amiodarone Magnesium Sulfate Eplerinone b & c Propranolol Loading...559. A 45-year-old man is rushed to the emergency room having severe headaches and recurrent fever started 1 week ago, a week after he came back from a trip to Africa. Physical examination reveals high fever and splenomegaly. Brain imaging reveals signs of cerebral involvement. Which of these following parasites is likely causing the patient’s symptoms? Plasmodium malariae Plasmodium vivax Plasmodium falciparum Babesia microti Loading...560. Which one of the following drugs is a Tetracycline? Cefepime Cefdinir Cefadroxil Doxycycline Loading...561. 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 succinyl-CoA to fumarate Conversion of propionyl –CoA to methylmalonyl –CoA Conversion of malonyl-CoA to palmitate Loading...562. Which of the following cellular pathological changes affects myocardial fibers in a case of irreversible myocardial infarction? Decreased intracellular pH Increased cytoplasmic sodium Depletion of myoglobin stores Karyorrhexis of the nuclei Loading...563. A 30-year-old man tells you that when he carries a heavy lift, his muscle gives up all of a sudden. Which of the following actions is responsible for abrupt cessation of skeletal muscle contraction? Activation of muscle spindles Lower blood supply to the muscle Activation of lower motor neuron Activation of Golgi tendon organs Loading...564. What is the correct match regarding the genetic transmission of the following diseases? Leber hereditary optic neuropathy- Mitochondrial inheritance Hypophosphatemic rickets- X-link recessive Huntington’s disease- Autosomal recessive Duchenne muscular dystrophy- X-link dominant Loading...565. 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 oculomotor nerve Right optic nerve Left optic nerve Right oculomotor nerve Loading...566. Which of the following laboratory tests is diagnostic for adrenal insufficiency? CT scan of adrenal gland Serum cortisol ACTH stimulation test Serum ACTH Loading...567. Which one of the following drugs blocks the urinary excretion of penicillin which leads to prolonged high serum concentration? Rifampicin Chloramphenicol Probenecid Cimetidine Loading...568. In which one of the following parts of the GIT most of the ingested iron is absorbed? Duodenum Descending colon Ileum Stomach Ascending colon Loading...569. Which of the following is calculated by dividing the incidence rate of a disease in exposed by the incident rate of unexposed? Relative risk Positive predictive value Attributable risk Odds ratio Loading...570. Which of the following is the mechanism of action of digoxin to increase cardiac contractility? Inhibition of K/Ca ATPase Inhibition of phosphodiesterase Inhibition of Na/Ca ATPase Inhibition of Na/K ATPase Loading...571. Which of the following drug are indandione derivative oral anticoagulants? Heparin Menadione Phytonadione Dicumarol Phenindione Loading...572. Which one of the following drugs is a Thiazide Diuretic? Indanyl carbenicillin Fenofibrate Ezetimibe Torsemide Atorvastatin Loading...573. 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 Neisseria Meningitidis Staphylococcus Aureus Streptococcus Pneumonia Echovirus Loading...574. Which one of the following cells is neuroendocrine and found within the epithelium of the bronchi? K cells Macrophages Clara cells Pneumocytes type I Pneumocytes type II Loading...575. Which one of the following types of necrosis is most likely associated with myocardial infarction? Fibrinoid Liquefactive Caseous CoagulativePage 24 of 66 Loading...576. 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 Epinephrine Methoxamine Clonidine Metaproterenol Loading...577. Which one of the following liver disorders occurs due to hepatic vein thrombosis? Alcoholic hepatitis Budd-Chiari syndrome Fatty liver Pyogenic liver abscess Loading...578. 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? Digital pelvic examination Stabilize the patient Admit the patient Ultrasound examination of the pelvis Loading...579. Amoxicillin inhibits which one of the following enzymes? Squalene epoxidase Transpeptidase Beta lactamase Transglycosylase Loading...580. Uric acid excretion is Increased by using one of the following options? Sulfinpyrazone A & B Allopurinol Probenecid All of the above Loading...581. What is the meaning of Dose Dumping phenomenon? Excess release of gastric acid Excess release of Insulin Excess release of glucose Excess release of control released drugs High dose of IV drugs Loading...582. Which one of the following statements about the Digoxin is wrong? None of these Positive Inotropic drug Has a half-life of 36 hours Inhibit Na+/K+ exchange A cardiac glycosides Loading...583. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Indanyl carbenicillin Aluminium hydroxide Ezetimibe Cycloserine Nizatidine Loading...584. Which of the following factors directly stimulates the release of antidiuretic hormone (ADH)? Decreased temperature Decreased extracellular fluid osmolality Increased blood volume Increased extracellular fluid osmolality Loading...585. ADP-mediated platelets aggregation is inhibited by? Dipyridamole Ticlopidine Tirofiban Abciximab Aspirin Loading...586. Which one of the following drugs belongs to drugs for hepatic viral infections? Indanyl carbenicillin Entecavir Ezetimibe Capreomycin Aluminium hydroxide Loading...587. Which of the following types of sensations is carried to the thalamus by the anterolateral tracts after crossing the spinal cord? Fine touch Position Crude touch Vibrations Loading...588. Which one of the following intravenous anesthesia has antiemetic action? Propofol Ketamine Fentanyl Thiopental Loading...589. Which one of the following statements about the use of Celecoxib is wrong? Selective inhibitor of COX-2 Causes kidney toxicity Inhibition is irreversible Half-life of 11 hours Loading...590. A drug has black box warning due to severe hematologic ADRs? Aspirin Digoxin Ticlopidine Clopidogrel Dipyridamole Loading...591. A drug that act as laxative is one of the following? A & B Sulbactam Furosemide Magnesium hydroxide Bumetanide Loading...592. Which of the following drug can disrupt the enteric coating by increasing the Gastric PH? Sitagliptin Glimepiride Omeprazole Oxacillin Cefoxitin Loading...593. 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 Refer to surgery for urgent reduction Urine culture MRI of the pelvis Assurance and follow up in 2 weeks Loading...594. Ranitidine is used to treat one of the following diseases? Malaria Diabetes Blood pressure Viral infection Stomach Ulcer Loading...595. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Tacrine Atracurium Metoprolol Mecamylamine Phenoxybenzamine Loading...596. Megaloblastic anemia is caused by folic acid or Vitamin B12 deficiency. Which of these reactions is directly affected by vitamin B12 deficiency? Methylmalonyl CoA >> succinyl CoA Propionyl CoA >> methylmalonyl CoA Malonyl CoA >> palmitate Succinyl CoA >> fumarate Loading...597. 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 Cocaine addiction HIV infection Simvastatin Zidovudine Alcohol abuse Loading...598. Which of the following drugs is used to inhibit viral neuraminidase? Naftifine Oseltamivir Capecitabine Acyclovir Ibandronate Loading...599. Gonadotropin-releasing hormone is produced by which of the following nuclei of hypothalamus? Arcuate nucleus Anterior nucleus Dorsomedial nucleus Ventromedial nucleus Loading...600. The functions of insulin include the following except one? inhibit the production of glucose from the liver Uptake of Amino acids into a cell increase breakdown of fat to Ketone bodies Cellular Uptake of plasma glucosePage 25 of 66 Loading...601. 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 smaller at the apex than at the base Alveoli are more compliant at the apex than at the base Loading...602. Your 8-year-old daughter wakes you up in the middle of the night complaining of severe coughing. You bring the child to the doctor the next day and upon examination, the following is revealed: noisy breathing on inspiration, flaring of the nostrils, marked retractions of the chest wall, and a severe barking cough. She has also developed an upper respiratory tract infection. What would be the best diagnosis for the patient? Bronchiolitis Foreign body stuck in the main bronchus Asthma Viral croup Loading...603. Which of the following are the primary vessels responsible for the regulation of blood pressure? Venuses Arteries Capillaries Arterioles Veins Loading...604. 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? Monosodium urate crystals Copper Hemosiderin Negatively birefringent particles Loading...605. Which of the following is the most important risk factor for coronary artery disease? Obesity High LDL cholesterol Low HDL cholesterol High total cholesterol Loading...606. A drug that belongs to Loop Diuretics is one of the following? Bumetanide Cefazolin Sulbactam Doripenem A & B Loading...607. Which of the following is the best next step for a suspicious malignant melanoma? Excision with a safety margin Shave biopsy Excisional biopsy Observation Loading...608. 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...609. What is the best treatment of gastroparesis in a diabetic patient? Vagotomy Omeprazole Metoclopramide Gastric resection Loading...610. 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 Sickle cell anemia Paroxysmal nocturnal hemoglobinuria Hereditary spherocytosis Loading...611. Deficiency of which of the following enzymes is associated with von Gierke’s disease? Phosphofructokinase-1 Glucose-6-phosphatase Hexosaminidase A α-1,4-phosphorylase Loading...612. Ethacrynic acid belongs to one of the following classes of diuretics? Loop Diuretics Thiazide Diuretic Carbonic anhydrase inhibitors Potassium-sparing diuretics Loading...613. Clopidogrel belongs to which of the following class of antiplatelet agents? Dipyridamole Fabric acid derivatives Theinopyridines Glycoproteins inhibitors Polyamines Loading...614. Which of the following types of necrosis occurs in abscesses and brain infarcts? Coagulative necrosis Fibrinoid necrosis Caseous necrosis Liquefaction necrosis Loading...615. A patient with hyperthyroidism develops a cardiac arrhythmia, the most suitable drug to treat his arrhythmia would include: Propranolol Digoxin Bretylium Amiodarone Loading...616. 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 concentration of the drug in plasma at a certain time It is a kinetic parameter that correlates dose with plasma level of a drug at zero time It is the capacity of a drug to attach to plasma protein Loading...617. Which of the following is responsible for the wrinkled appearance of the scrotum? Dartos fascia Pampiniform plexus Thickened keratinized epithelium Tunica albuginea Loading...618. Ganglion blocker drug is following? Mecamylamine Benztropine Atracurium Atropine Neostigmine Loading...619. Which of the following medications inhibits folic acid synthesis through its effect on dihydropteroate synthetase enzyme? Pyrimethamine Sulfonamides Methotrexate Trimethoprim Loading...620. Which of the following drug contain sulfonamide structure in the structural formula? Mefenamic acid None of these Celecoxib Acetaminophen Meloxicam Loading...621. Which of the following types of receptors are associated with the slowest response time? G-protein coupled receptors Ion channel receptors Transmembrane enzyme receptors Steroid receptors Loading...622. 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% 88% 84% 90% 92% Loading...623. Which one of the following may precipitate to an acute porphyria attack? Vegetarian diet Low carbohydrate diet High carbohydrate diet Mediterranean diet Loading...624. Following drug causes Systemic acidosis by binding with cations in antacid? Metamucil Sevelamer Alendronate A & B Sodium polystyrene sulfonate Loading...625. 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 Nicotinic receptors Beta-adrenoceptors Alpha-adrenoceptorsPage 26 of 66 Loading...626. Which one of the following drugs belongs to 3st generation Cephalosporins? Cefadroxil Cefepime Cefdinir Cefaclor Loading...627. Which one of the following cells secretes glycosaminoglycan and is found in the terminal and respiratory bronchioles? Pneumocytes type Clara cells K cells Macrophages Loading...628. Which of the following is NOT an adverse effect of aspirin? Gastritis Tolerance Renal problems Bleeding Loading...629. A 57 year-old man presents to the ER complaining of sudden dizziness and heart racing for 2 hours. He is a CEO of a big corporation and those symptoms started during a stressful meeting. At first, he felt irregular heartbeats and ignored it but he felt dizzy soon after and his staff drove him to the ER. There is NO chest pain, shortness of breath or loss of consciousness. His vital signs are temp 97.8 F, Pulse 138/min and irregular, blood pressure 107/60 and oxygen saturation is 96% on room air. His ECG shows irregular irregularity with absence of P waves. What is the appropriate treatment to improve his symptoms in this current situation? Cardioversion Heparin Aspirin Metoprolol Refer to cardiologist Loading...630. Which of the following is the cellular mechanism of epinephrine? Inhibition of adenylyl cyclase Activation of phospholipase Activation of acetylcholinesterase Activation of adenylyl cyclase Loading...631. Which of the following is the most sensitive test for myocardial infarction? Creatine kinase myocardial fraction (CK-MB) Lactose dehydrogenase (LDH) Troponin-1 Troponin-C Loading...632. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Ibandronate Ethambutol Anidulafungin A & B Furosemide Loading...633. A drug that act as laxative is one of the following? Furosemide Bumetanide A & B Sodium phosphate Sulbactam Loading...634. A 17-year-old girl visits the clinic with her mother who is concerned that her daughter had not menstruated yet and her breast had not been significantly developed. She also notes that her daughter is color blind. The girl denies any sexual relationship or using any recreational drugs. Examination reveals normally appearing girl with small non-developed breasts. There is lack of pubic hair and her vagina and cervix are not fully developed. She is 5f5in tall and weighs 130 Ib. Cardiac, chest and abdominal examinations are unremarkable. What is the most likely initial diagnosis? Early pregnancy Kallmann’s syndrome Turner’s syndrome Kartagener’s syndrome Androgen insensitivity disorder Loading...635. Regulation of which of the following regions is mostly dependent on extrinsic nerves? Upper esophagus Small intestine Large intestine Lower esophagus Loading...636. Mechanism of action of Abciximab is following? Inhibit COX-1 Inhibit glycoprotein receptors Inhibit ADP mediation Decrease Calcium levels Inhibit COX-2 Loading...637. A thiophene-containing agent that blocks the synthesis of leukotrienes by inhibiting 5_ lipoxygenase is the following? Acetaminophen Zileuton Montelukast Zafirlukast Loading...638. Which of the following is the nonessential amino acid? Alanine Histidine Leucine Methionine Lycine Loading...639. 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 Urgent surgical interference Broad spectrum antibiotics to avoid meningitis Manual compression of the lesion Loading...640. 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 Urinalysis Serum electrolytes Beta-HCG Loading...641. A 27 year old man presents with a 3 month history of heartburn and epigastric discomfort. His symptoms are exaggerated after meals especially if he eats spicy food. He takes no medications, doesn’t smoke or drink alcohol. He exercises regularly and has an active lifestyle. On physical examination, he has slight epigastric tenderness. His routine lab tests are normal What is the most appropriate intervention at this time? Barium swallow Upper endoscopy Trial of a proton-pump inhibitor Esophageal manometry 24-hour pH monitoring Loading...642. Which one of the following drugs is the most effective in midazolam paradoxical reaction? Albuterol Protamine Flumazenil Adrenaline Loading...643. Which form of dosage has a high rate of bioavailability? Capsules Suspension Syrup Tablet Control released drugs Loading...644. Anterior spinal artery arises from which of the following arteries? Internal carotid artery External carotid artery Vertebral artery Basilar artery Loading...645. Which one of the following is NOT a factor in Apgar Scoring System? Heart rate Respiration Skull dimensions Reflex irritability Loading...646. 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? Iron supplement Vitamin D supplement Milk formula instead of breastfeeding Vitamin C supplement Loading...647. 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? Hypospadias Agenesis Undescended testis Hypopituitarism Loading...648. Which one of the following urine electrolytes in the best to estimate extracellular fluid (ECF) volume in metabolic alkalosis? Urine anion gap Urine chloride Urine urea Urine sodium Loading...649. A drug that effects the thyroid hormone is one of the following ? Bumetanide Furosemide Sulbactam Triiodothyronine A & B Loading...650. Which of the following medications is considered irreversible alpha receptor antagonist? Tolazoline Labetalol Phenoxybenzamine PrazosinPage 27 of 66 Loading...651. 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? Hyperacute rejection Chronic rejection Normal reaction Acute pyelonephritis Acute rejection Loading...652. Which of the following drug is a derivative of Fenamic acid? ketorolac Piroxicam Mefenamic Acid Etodolac Diflunisal Loading...653. Which of the following organisms is responsible for antibiotic-associated colitis? Clostridium tetani Clostridium difficile Clostridium perfringens Clostridium botulinum Loading...654. Which of the following locations is the most common for Koplik’s spots of measles? Hard palate Buccal mucosa Soft palate Tongue Loading...655. A 45-year-old man is rushed to the emergency room having severe headaches and recurrent fever started 1 week ago, a week after he came back from a trip to Africa. Physical examination reveals high fever and splenomegaly. Brain imaging reveals signs of cerebral involvement. Which of these following parasites is likely causing the patient’s symptoms? Plasmodium malariae Plasmodium vivax Babesia microti Plasmodium falciparum Loading...656. When a blood clot adhere to vessel wall this is called as one of the following? Thrombus Embolus All of the above Coagulation Loading...657. A drug that is used for Hypotrichosis of the eyelashes? Epoprostenol Carboprost Bimatoprost Dinoprostone Treprostinil Loading...658. Maraviroc belongs to the class of following drugs? Antiprotozoal Antipyretic Anti malaria Antiviral Antifungal Loading...659. Immune related problem is one of the following? Aids High Blood pressure Fever Headache Loading...660. 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 Huntington disease Tourette syndrome Epilepsy Loading...661. The mechanism of action of etidronate disodium is most likely related to Hyperphosphatemia Excretion unchanged in the urine An unusual form of phosphorus (P) Inhibition of both normal and abnormal bone resorptions Inhibition of the formation of hydroxyapatite crystals Loading...662. 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 Psychotherapy and alprazolam 12-Lead ECG, random blood glucose and thyroid panel Loading...663. 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? Diffuse esophageal spasm Lower esophageal ring Achalasia Peptic esophageal stricture Cancer esophagus Loading...664. Penicillin type antibiotics half-life is increased due to inhibition of tubular secretion by which of the following drug? Aspirin Probenecid Celecoxib Colchicine Pegloticase Loading...665. Thrombocytopenic purpura (TTP) is the adverse effect of the following drug? Both A & B Ticlopidine All of the above Abciximab Clopidogrel Loading...666. Proliferation of endometrial glands results from stimulation by which one of the following hormones? Progesterone Follicle stimulating hormone Estrogen Androgen Loading...667. The antimuscarinic drug used for motion sickness as well as for blockage of short-term memory? Pirenzepine Phenylephrine Scopolamine Physostigmine Atropine Loading...668. Which one of the following drugs is the first line medication in transplant immunopharmacology? Methotrexate Sulfasalazine Cyclosporine Thalidomide Loading...669. Prolonged vomiting results in which one of the following findings? Metabolic alkalosis with hypokalemia Metabolic acidosis with hyperkalemia Metabolic acidosis with hypernatremia Metabolic alkalosis with hyperkalemia Loading...670. 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? Vitamin D Levothyroxine Calcitonin Parathyroid hormone Calcium gluconate Loading...671. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Ezetimibe Lamivudine Indanyl carbenicillin Capreomycin Capecitabine Loading...672. All of the following are currently used in hyperthyroidism EXCEPT? Methimazole Diatrizoate sodium Potassium perchlorate Propylthiouracil Loading...673. Which of the following layers of the heart forms the cardiac valves and continues with the intima of the aorta? Pericardium Myocardium Endocardium Epicardium Loading...674. Which of the following findings distinguishes chronic renal failure from acute renal failure? History of elevated serum creatinine High serum sodium High serum calcium History of elevated BUN Loading...675. 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? Transposition of the great arteries Truncus arteriosus Total anomalous pulmonary venous return Tetralogy of Fallot Tricuspid atresiaPage 28 of 66 Loading...676. Which one of the following drugs belongs to an alkylating agent? Lamivudine Fludarabine Cladribine Melphalan Gemcitabine Loading...677. Which one of the following substances induces the closure of patent ductus arteriosus? Prostaglandin E Indomethacin Ibuprofen Estradiol Loading...678. A 30-year-old man with a history of recurrent generalized tonic-clonic seizures visits his psychiatrist to refill his prescriptions. He complains of recent diplopia and ataxia. His doctor thinks that these new symptoms are related to one of his medications. Which of these drugs is most likely responsible for these new symptoms? Ethosuximide Clonazepam Gabapentin Acetazolamide Carbamazepine Loading...679. 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...680. Indirectly acting reversible cholinergic agonist drug? Tacrine Acetylcholine Pilocarpine Echothiophate Loading...681. Which one of the following anti-arrhythmic drugs may lead the development of torsade de pointes at therapeutic doses? Adenosine Quinidine Propranolol Lidocaine Loading...682. Which of the following cells of the ovary secretes inhibin, follistatin and activin? Theca interna cells Surface epithelial cells Theca externa cells Granulosa cells Loading...683. A patient presents with vomiting, diarrhea and abdominal cramps a few hours after a picnic. Which is the causative organism? Clostridium difficile Streptococcus pyogenes Staphylococcus aureus E-coli Loading...684. Which of these drugs inhibits epoxide reductase? Aspirin Heparin Warfarin Streptokinase Loading...685. Ingestion of which of the following products may cause hypertensive crisis in patients taking MAO inhibitors? Gluten-rich food Vitamin D and calcium Tyramine-rich food Carbohydrates such as starch Loading...686. Which one of the following parts of lymph nodes has T lymphocyte as the predominate cell? Paracortex Cortex Germinal center Medulla Loading...687. 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? Nitrogen Sulfur dioxide Ozone Carbon monoxide (CO) Loading...688. A young man complains of daytime sleeping, cataplexy and sleep paralysis. Which of the following is the best treatment? Modafinil Diazepam Zolpidem Hydroxyzine Loading...689. Prophylaxis in HIV patients with TMP-SMX should be initiated at which of the following CD4 counts? Under 50 Under 300 Under 200 Under 100 Loading...690. A 54 year-old man with a history of chronic obstructive pulmonary disease (COPD) presents by his son to the emergency room semi-unconscious with shortness of breath. He has nausea, diarrhea and restlessness for the last four hours. His arterial oxygen saturation is 88% with room air. His ECG shows normal sinus rhythm with non-specific changes in lateral leads. The patient uses albuterol inhalation, ipratropium bromide, theophylline and Lisinopril. Three days ago, he had an exacerbation of his COPD and was prescribed ciprofloxacin and supplemental oxygen at night and during ambulation. What is the most likely cause of this patient presentation to the ER? Interaction of ciprofloxacin to Lisinopril Interaction of ciprofloxacin to theophylline Interaction of ciprofloxacin to ipratropium bromide Interaction of ciprofloxacin to oxygen Interaction of ciprofloxacin to albuterol Loading...691. Which one of the following drugs is a thiazide diuretic drug? Chlorthalidone Amiloride Acetazolamide Bumetanide Loading...692. Which one of the following substances is released by sympathetic postganglionic neurons which innervate renal vascular smooth muscle? Epinephrine Acetyl choline Norepinephrine Dopamine Loading...693. Which one of the following medications inhibits HMG-CoA reductase? Simvastatin Digoxin Tacrolimus Aspirin Loading...694. Which one of the following complications is the common cause of death in acromegaly? Splenic infarction Hepatic failure Heart failure Renal failure Loading...695. Which one of the following cranial openings is located at the greater wing of sphenoid and contains the middle meningeal artery? Foramen rotundum Foramen lacerum Foramen ovale Foramen spinosum Loading...696. Ca+ channel blockers belongs to the one of the following CLASS of Antiarrhythmic drugs? CLASS II CLASS I CLASS III CLASS IV Loading...697. Which one of the following factors is the most accurate measure for the severity of diabetic ketoacidosis? Urine ketones Serum glucose level Serum bicarbonate level Blood ketones Loading...698. Intermediate Acting Insulin is one of the following? Lispro Detemir NPH (neutral Protamine hagedorn) Glargine Loading...699. Which one of the following drugs blocks dopamine uptake transporter? Cocaine Marijuana Alcohol Nicotine Loading...700. 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? Lisinopril Furosemide Digoxin AtenololPage 29 of 66 Loading...701. Which one of the following glucocorticoids is long acting? Amiloride Cortisone Prednisone Betamethasone A & B Loading...702. Which of the following is the most common cancer of the lower third of esophagus in non-alcoholic, non-smoker patients? Sarcoma Melanoma Adenocarcinoma Squamous cell carcinoma Loading...703. Which of the following tests is the most accurate one to confirm the diagnosis of achalasia? Chest-x-ray Upper endoscopy Barium esophagram Manometry Loading...704. Which one of the following agent is a insulin? Desmopressin Atorvastatin Torsemide Glulisine Somatostatin Loading...705. Which of the following esophageal disorders is the most likely a complication of HIV infection? Adenocarcinoma Candida esophagitis Achalasia Esophageal varices Loading...706. Ganglion blocker drug is following? B & C Nicotine Mecamylamine Atropine Atracurium Loading...707. Mechanism of action of Aspirin is following? Inhibit COX-1 Decrease Calcium levels Inhibit ADP mediation Inhibit glycoprotein receptors Inhibit COX-2 Loading...708. Elevation of which one of the following substances in blood occurs due to reduced renal blood flow? Renin Ammonia Cholesterol Calcium Loading...709. A 58-year-old woman is brought to the emergency room complaining of lightheadedness for 4 hours. She has diarrhea with loose stool for 2 days. She explains her symptoms as flu and she drinks lots of water as her neighbor advised her to avoid dehydration. Her physician told her that she should take combined solution of sodium chloride (NaCl) and glucose to prevent dehydration. What is the mechanism of action of this mixture to improve dehydration? Glucose provides energy for NaCl to increase gastric emptiness The mixture helps to increase secretion of water and Na through the large intestine It reduces bowel contractions and consequently improves diarrhea Cotransport of glucose and NaCl across the intestinal membrane facilitates absorption of water and Na. Loading...710. Which of the following is the checkpoint in cell development that is affected by ionizing radiation? G2/M S/G2 G0/G1 G1/S Loading...711. 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? Fumarate Alpha-ketoglutarate Oxaloacetate Acetyl CoA Succinyl CoA Loading...712. A) Bupropion Ethosuximide Haloperidol Methylphenidate Loading...713. Which of the following is the main reason that acetylcholine not used in clinical practice? It is hydrolyzed very quickly It is expensive It has a long half-life It is toxic Loading...714. 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? Age of the patient Depth of the lesion Diameter of the lesion Color of the lesion Loading...715. Which one of the following drugs is a Thiazide Diuretic? Ezetimibe Atorvastatin Indanyl carbenicillin Chlorthalidone Fenofibrate Loading...716. 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 incident and decreased prevalence Both incident and prevalence decrease No change in both Incident decreases with no change in prevalence Loading...717. 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 Liver cirrhosis Cervical cancer Lung cancer Loading...718. Which one of the following defines the drug efficacy? The impact of the drug on a wide range of patients The minimal amount of drug administered that leads to toxicity The dose of a drug needed to produce a maximal effect The capacity a drug to affect a condition irrespective of the dose Loading...719. 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? Renal cell carcinoma Prostatic cancer Hodgkin’s lymphoma Thyroid follicular carcinoma Chronic lymphocytic leukemia Loading...720. 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 Immobilization Alcohol abuse Hypertension Hypothyroidism Loading...721. Which one of the following conditions most likely shows lower than normal erythrocyte sedimentation rate (ESR)? Polycythemia Pregnancy Multiple myeloma Giant cell arteritis Loading...722. Which of the following are the characteristics of Virchow’s triad? Stasis, hypercoagulability and endothelial damage Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) Hypotension, distant heart sounds and jugular vein distention (JVD) Loading...723. Which one of the following medications is the best recommended for induction of medical abortion? Estrogen Progesterone Mifepristone Ergotamine Loading...724. 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? Efavirenz Etravirine Zidovudine Indinavir Saquinavir Loading...725. Select Phenyl Alkylamine Calcium channel blocker drug? Diltiazem Nifedipine Verapamil Triamterene TriamcinolonePage 30 of 66 Loading...726. Which one of the following features characterizes Crohn’s disease from ulcerative colitis? Bloody diarrhea Colectomy is curative Perineal fissures and fistulas Continuous disease beginning at rectum and extending without skipped areas Loading...727. 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? Acyclovir HBV vaccine Famciclovir Supportive treatment Interferon alfa Loading...728. Which of the following is the most effective role of probenecid in treating gout? Probenecid decreases production of uric acid Probenecid decreases inflammation of affected joints Probenecid decreases secretion of uric acid Probenecid decreases reabsorption of uric acid Loading...729. A patient presents with pruritic rash on his face, palms and soles, bloody diarrhea and abnormal liver tests two weeks after bone marrow transplantation. Which of the following is the mechanism of this condition? Activation of the donor B-lymphocytes Activation of the host T-lymphocytes Development of liver failure Activation of the donor T -lymphocytes Loading...730. 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? Phencyclidine Cocaine Alcohol Lysergic acid diethylamide Loading...731. Which of the following is the best initial management of esophageal candidiasis in an HIV patient? Oral fluconazole Upper endoscopy Oral nystatin Intravenous amphotericin Loading...732. Administration of which one of the following medications can lead to the development of hemolytic anemia? Hydralazine Propranolol Verapamil Quinidine Loading...733. Which of the following features are most likely seen in a case of Takayasu arteritis? Febrile lymphadenopathy with rah Blindness and pulseless upper extremities Blanching and cyanosis of the fingers and toes Major organ failures Loading...734. Which of the following is the role of infliximab in the management of rheumatoid arthritis? Inhibition of dihydrofolate reductase It is a TNF-alpha receptor agonist It is a TNF-alpha receptor antagonist It neutralizes the activity of TNF-alpha by binding to soluble forms of it Loading...735. Cardiac glycosides are used in the treatment of congestive heart failure and atrial fibrillation. Given the differences between the cardiac glycosides in their length of action and organs of major excretion, the correct statement concerning the use of digitoxin is: digitoxin has a much higher incidence of toxicity in patients with renal disease 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 is highly protein-bound in the serum Loading...736. Which of the following drug belongs to Osmotic Diuretic? Niacin Oxacillin Mannitol Ampicillin Cefoxitin Loading...737. Chronic Daily ingestion of 5 g or more acetaminophen for longer than 1 month causes? GI disturbance Hypersensitivity to Salicylates Hypersensitivity to NSAIDs Liver damage Bleeding compilations Loading...738. 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? Levothyroxine Amitriptyline Hydralazine Ibuprofen Loading...739. 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? Gentamycin Trimethoprim Tetracycline Nalidixic acid Metronidazole Loading...740. 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? Point mutation Thymidine dimers Missense mutation Nonsense mutation Loading...741. 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 another appointment whenever she has symptoms Obtain CT scan of the head Schedule carotid duplex ultrasonography Schedule transesophageal echocardiography Loading...742. Which one of the following statements about the platelets is wrong? Can't synthesize the new enzyme Platelet have nuclei PG2 decrease aggregation Life of platelet 3-7 days TXA2 enhance aggregation Loading...743. Indomethacin belongs to one of the following class? Propionic acid Acetic acid derivative Oxicam derivative Fenamates Loading...744. Cholestatic Jaundice is the adverse effect of the following drug? Erythromycin Chloramphenicol Cefepime Clindamycin Loading...745. An old man presents with acute severe back pain, tachycardia, hypotension and syncope. Which of the following is the most likely diagnosis? Acute myocardial infarction Rupture of abdominal aortic aneurysm Pulmonary embolism Acute mesenteric ischemia Loading...746. 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? Broad spectrum antibiotics Cleaning, dressing and analgesics Surgical debridement and grafting Admission to hospital Loading...747. Which one of the following antibiotics is the empiric treatment of cellulitis in a diabetic patient? Vancomycin Imipenem Neomycin Amoxicillin Loading...748. Which of the following options is the adverse effect of Vancomycin? All of the above Fever Chill's Phlebitis Redman syndrome Loading...749. Thyroid hormone can cause which one of the following effects? Lowers blood cholesterol Hypoglycemia Lowers body temperature Lowers oxygen consumption Loading...750. Which one of the following statements correctly describes the inspiratory reserve volume? Volume of air that can still be inhaled in after a normal inspiration Volume of air that remains in the lung after a normal expiration Volume of air that moves into the lung with each normal inspiration Volume of air that present in the lung after maximal inspirationPage 31 of 66 Loading...751. Which of the following is the mechanism of action of misoprostol for the treatment of peptic ulcer? Formation of a protective coating of the ulcer beds Suppression of secretory responses to food stimulation Increased mucus and bicarbonates secretion and decreased HCL secretion Direct inhibition of the proton pump Loading...752. Cefaclor belongs to one of the following generations of the cephalosporin? 1st generation 3rd generation 2nd generation 4th generation Loading...753. 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 Streptococci Mycobacteria Mycoplasma Loading...754. Which of the following disorders is most likely related to body dysmorphic disorder? Post-traumatic stress disorder Generalized anxiety disorder Obsessive compulsive disorder Malingering Loading...755. Which one of the following gastrointestinal conditions is NOT associated with blood in stools? Irritable bowel syndrome Diverticulosis Cancer colon Ulcerative colitis Loading...756. Bicornuate uterus results from failure of the fusion of which of the following structures? Nephrogenic ridges Urogenital sinus Paramesonephric ducts Mesonephric ducts Loading...757. Which of the following drug is Cholinergic agonist used for diagnosis of myasthenia gravis as well as an antidote for tubocurarine? Atracurium Tyramine Edrophonium Atropine Piruterol Loading...758. Which statement about the use of pilocarpine is wrong? Lack of selectivity relaxation of Ciliary muscles Used for Xerostomia Used for Sjögren syndrome Produce rapid miosis Loading...759. 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 Primary osteosarcoma Paraneoplastic disease Metastases to the vertebral column Loading...760. Which of the following medications is used in opioid overdose? Naloxone Phencyclidine Flumazenil Norepinephrine Loading...761. Which of the following drug is a Non-dihydropyridine antihypertensive drug? Carvedilol Amlodipine Bumetanide Diltiazem Nifedipine Loading...762. 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? Neuropsychiatric disturbances Polyphagia Stiff neck Hypotension Loading...763. 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. Sotalol Propranolol Verapamilich of the following drugs is most likely responsible for this condition? Hydralazine Metoprolol Loading...764. 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? First lumbar Second cervical Fifth thoracic Seventh cervical Third lumbar Loading...765. A 33-year-old man presents to his physician to discuss his plans for treatment of hyperthyroidism. One of the options is potassium perchlorate. What is the mechanism of action of potassium perchlorate as anti-thyroid? Blocking of coupling of iodotyrosines Competitive inhibition of iodide transport mechanism Blocking of peroxidase catalyzed reactions Inhibition of the release of thyroid hormone from the thyroid gland Blocking of peripheral deiodination of T3 and T4 Loading...766. 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? 6 hours 1/2 an hour 12 hours 18 hours 14 hours Loading...767. Terbinafine blood levels are decreased by the following the drug? Griseofulvin Caspofungin Rifampin Cimetidine Loading...768. The binding of a drug to plasma proteins will tend to: Decrease half-life. Decrease its rate of glomerular filtration. Increase its pharmacological activity Increase its rate of biotransformation. Increase its concentration in the plasma. Loading...769. 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 Lewy body dementia Vascular dementia Creutzfeldt-Jakob disease Alzheimer’s disease Loading...770. Alkylating agents are associated with bone marrow depression and for this reason they are inappropriate for this patient. Missing of a chromosome Duplication of a gene on the affected chromosome Deletion of a gene on the affected chromosome Presence of an extra chromosome Replication of a chromosome Loading...771. Which of the following is the main reaction of hepatic cytochrome P-450 in metabolism? Hydroxylation Binding with glutathione Methylation Binding with glucuronic acid Loading...772. Serotonin Receptor which acts presynaptically at Serotonergic and adrenergic neurons to reduce neurotransmitter release is following? 5HT4 5HT¹ 5HT² 5HT5 5HT³ Loading...773. Which one of the following tests can be used to distinguish between Folic acid and vitamin B12 deficiencies? Serum methylmalonate level Serum methionine level Serum homocysteine level Serum cystathionine level Loading...774. Which of the following locations is the most common site of gastrinoma? Ileum Liver Pancreas Stomach Loading...775. Which of the following cell types is responsible for forming the blood brain barrier (BBB)? Oligodendrocytes Microglia Schwann cells AstrocytesPage 32 of 66 Loading...776. Erythromycin belongs to the class of following drugs? Antipyretic Anti-malaria Antiprotozoal Antibiotics Antiviral Loading...777. Which of the following is the most common etiology of type II diabetes? Increased hepatic glycogen breakdown Altered hormone-receptor complex Low insulin production Insulin receptor deficiency Loading...778. 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 Fluid retention Paresthesia Hepatic Adenoma Thromboembolic disease Loading...779. Which of the following is the leading cause of blindness in the USA? Macular degeneration Cataract Diabetic retinopathy Glaucoma Loading...780. Which one of the following antibiotics has NO effect on anaerobes? Metronidazole Clindamycin Tobramycin Ampicillin Loading...781. 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...782. Which of the following statements correctly describe the lag time of a drug? Time from administration of the drug to reaching minimal effect concentration Time in which plasma concentration remains the same Time from administration of the drug to appearance in blood Time from administration of the drug to reaching maximal effect concentration. Loading...783. 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? Craniopharyngioma Germinoma Teratoma Choriocarcinoma Gangliocytoma Loading...784. Which one of the following drugs decreases endogenous hepatic production of glucose? Acarbose Sitagliptin Pioglitazone Metformin Loading...785. Which of the following drugs has the longest duration of bronchodilation? Albuterol Metaproterenol Epinephrine Isoproterenol Salmeterol Loading...786. 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...787. 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 arterial CO2 partial pressure Increased pulmonary venous pressure Normal respiratory function tests Decreased pulmonary artery pressure Loading...788. 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? Conn syndrome C-11 hydroxylase deficiency C-21 hydroxylase deficiency C-17 hydroxylase deficiency Loading...789. Rocky mountain spotted fever is caused by following? Clostridium tetani Spirochetes Chlamydia trachomatis Rickettsia Rickettsii Loading...790. Which one of the following medications can be used safely in cases of lack of liver function? Lorazepam Midazolam Clonazepam Diazepam Loading...791. A 1-year-old girl is brought to the pediatrician by her parents due to poor growth and skeletal abnormalities. Laboratory investigations show microcytic anemia and higher concentration of hemoglobin A2. Which is the most likely diagnosis? Iron deficiency β-thalassemia Lead poisoning Sickle cell anemia Loading...792. Autonomic nervous system is the part of? Brain Spinal cord Somatic nervous system Central nervous system Peripheral nervous system Loading...793. Which of the following substances increases absorption of iron in the intestine? Riboflavin Folic acid Ascorbic acid Cyanocobalamin Loading...794. Which of the following procedures is used in case of Barrett esophagus without dysplasia? Endoscopic eradication Endoscopy and biopsy every 3 years Endoscopy and biopsy every 3 months Endoscopy and biopsy every 6 months Loading...795. 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 Broad spectrum antibiotics Oral lorazepam Intravenous thiamine Loading...796. Which of the following is the mode of inheritance of cystic fibrosis? Autosomal recessive Autosomal dominant X-linked recessive X-linked dominant Loading...797. Which of the following drug is Phenoxy acetic acid derivative diuretic? Chlorthalidone Furosemide Ethacrynic acid Torasemide Benzthiazide Loading...798. 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...799. Amylin analog is one of the following? Bumetanide A & B Levothyroxine Furosemide Pramlintide Loading...800. 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 Inhibits H+,K+-ATPase Adds a protective membrane to gastric mucosaPage 33 of 66 Loading...801. Androgen is released from which part of the adrenal medulla? Zona glomerulosa Zona fasciculate All of these Zona reticularis A & B Loading...802. Receptors have a high sensitivity for which of the following drug? Norepinephrine Epinephrine A & B All of these Isoproterenol Loading...803. Taste and visual disturbance is the adverse effect of the following drug? Miconazole Nystatin Griseofulvin Terbinafine Loading...804. Which of the following is the classic electrocardiogram (ECG) finding in inferior myocardial infarction (MI)? Diffuse S-T segment elevation Sawtooth P waves S-T segment elevation in anterior leads (V1-V4) S-T segment elevation in leads II. III and aVF Loading...805. Which of the following substances is responsible for growth of the prostate at puberty? Progesterone Estrogen Dihydrotestosterone Testosterone Loading...806. A 35-year-old office worker complains of pain and numbness over the lateral side of the hand. It is worse at night and may awaken her from sleep. Examination reveals tingling over the median nerve distribution by compressing the opposing dorsal surface of the hand with the wrist flexed. Which of the following is the correct term of this test? Phalen test ELISA test Coombs test Tinel test Loading...807. Naloxone is the treatment of choice of which one of the following toxicities? Hydrocodone toxicity Citalopram overdose Methylphenidate overdose Amitriptyline toxicity Loading...808. Which one of the following drugs is a proton pump inhibitor drug? Cimetidine Rabeprazole Sucralfate Misoprostol Loading...809. 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...810. A drug inhibit the human gonadal and adrenal steroids synthesis along with fungistatic property? Ketoconazole Nystatin Flucytosine Caspofungin Loading...811. 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? Budd-Chiari syndrome Acetaminophen toxicity Fatty liver Alcoholic hepatitis Loading...812. A fenamic acid derivative of Nonsteroidal anti-inflammatory drugs also called? Salicylates Acetic acid Oxicam N-arylanthranilic acids Propionic acid Loading...813. 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 Highly specific and refined over time Its main secreted proteins are immunoglobulins Loading...814. Which of the following side effects occurs with both tricyclic antidepressants and phenothiazines? Orthostatic hypotension Weight loss Seizures Excessive salivation Loading...815. Aspirin is contraindicated in following disease? Bleeding disorder Peptic ulcer Reye's syndrome A & B All of these Loading...816. Which of the following drug belongs to Osmotic Diuretic? Mannitol A & B Furosemide Urea Ampicillin Loading...817. Which one of the following glucocorticoids is a short acting? Amiloride Betamethasone Hydrocortisone A & B Prednisone Loading...818. Atropine causes:? No effect on Heart Bradycardia followed by tachycardia Only bradycardia Tachycardia followed by bradycardia Only tachycardia Loading...819. Gingival hyperplasia, granulocytopenia and facial hirsutism are possible side effects of which one of the following medications? Valproic acid Phenytoin Phenobarbital Carbamazepine Loading...820. Which one of the following medications inhibits protein synthesis by binding to 50S subunit and preventing the formation of the initiation complex? Minocycline Linezolid Azithromycin Clindamycin Loading...821. 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: Longitudinal study Cross-sectional study Case-control study Double-blind study Cohort study Loading...822. Phentolamine and Tolazoline have similar structures to imidazoline Alpha Agonists due to lack of? Lipophilic substitutions on the aromatic ring Hydrophilic substitutions on the aromatic ring None of these Lipophilic substitutions on the Cyclic ring Hydrophilic substitutions on the Cyclic ring Loading...823. Following drug has a low therapeutic index? Ticlopidine Digoxin Clopidogrel Aspirin Abciximab Loading...824. Reflex tachycardia caused by systemic albuterol can be blocked by which of the following medications? Prazosin Dobutamine Phenylephrine Metoprolol Loading...825. Which one of the following tests is performed to determine if a fetus develops hemolytic disease of the newborn? Osmotic fragility test Hemoglobin electrophoresis Radioimmunoassay Direct Coombs testPage 34 of 66 Loading...826. Which one of the following viruses is responsible for the development of viral myocarditis? Mumps virus Coxsackie B virus Adenovirus Rhinovirus Loading...827. The sympathomimetic which may promote diuresis by a direct effect on the kidney is: norepinephrine dobutamine epinephrine dopamine Isoproterenol Loading...828. Vertebral artery arises from which one of the following arteries? Internal carotid artery Common carotid artery Subclavian artery External carotid artery Loading...829. Incretin mimetic is one of the following? Exenatide Bumetanide Pramlintide A & B Furosemide Loading...830. A 2-month-old child is brought to the clinic by his parents with a complaint of failure to thrive. During an examination, the baby suffers a seizure. Test of stat serum chemistries indicates hyperlipidemia, severe hypoglycemia, ketosis, and lactic acidosis. Hepatomegaly is also confirmed by both physical examination and CT scan. Which of the following conditions is the child suffering from based on these findings? Von Gierke disease Niemann-Pick disease Pompe disease Gaucher disease Loading...831. A patient is suffering from gouty arthritis along with hyperuricemia, which of the following drugs is indicated to give relief to this patient? Probenecid Pegloticase Febuxostate Colchicine Allopurinol Loading...832. Which one of the following drugs belongs to 1st generation Cephalosporins? A & B Cefazolin Cefdinir All of the above Cefadroxil Loading...833. 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? Smoking Chronic hypertension Lyme disease High cholesterol Alcohol Loading...834. 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 Frontal lobe Ankle and elbow joints Parietal lobe Loading...835. 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? Old age Postural hypotension Alzheimer’s disease Osteoarthritis Side effect of one of her medications Loading...836. Which one of the following antibiotics is the most appropriate treatment of chancroid, a bacterial infection caused by Haemophilus ducreyi? Ciprofloxacin Vancomycin Ampicillin Ceftriaxone Loading...837. Which of the following is the most accurate test for multiple myeloma? 24-hour urine calculation Bone marrow biopsy Urine electrophoresis Brain MRI Loading...838. The therapeutic indication of Tamoxifen Drug specifically is to treat one of the following diseases? Induce ovulation Treat osteoporosis Thromboembolic disease Fluid retention Estrogen-dependent Breast Cancer Loading...839. Which of the following is the active form of vitamin D? 1,25-dihydroxycholecalciferol 25-hydroxycholecalciferol 1-dihydroxycholecalciferol Cholecalciferol Loading...840. Which statement about the Actions of the incretin hormone Glucagon-like peptide-1 is wrong? Inhibit inappropriate Glucagon secretion Suppress appetite Increase Glucose-dependent insulin secretion Decrease Beta cells growth Loading...841. Antipseudomonal penicillin is one of the following? Carbenicillin Penicillin G Methicillin Amoxicillin Loading...842. 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? Metoclopramide Sodium bicarbonate Clindamycin Omeprazole Ondansetron Loading...843. 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? Vincristine Cisplatin Ifosfamide Procarbazine Chlorambucil Loading...844. 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? Hydralazine 50 mg daily Continue lifestyle modification for 3 months Lisinopril 10 mg daily Minoxidil 30 mg daily Metoprolol 25 mg daily Loading...845. Which of the following local anesthetics causes vasoconstriction and may lead to an increase of blood pressure? Benzocaine Lidocaine Cocaine Tetracaine Loading...846. Which of the following medications increases cardiac output in pulmonary edema following myocardial infarction? Lisinopril Dobutamine Verapamil Metoprolol Loading...847. 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 Conduct disorder Attention-deficit hyperactivity disorder (ADHD) Bipolar disorder Loading...848. Which of the following conditions is associated with the presence of non-inflammatory follicular papules (comedones)? Atopic dermatitis Pemphigus vulgaris Acne vulgaris Bullous pemphigoid Loading...849. A 62 year-old man complains of fever and diminished consciousness for 2 days. He has been healthy all his life and he doesn’t take any medications. On examination, he responds inconsistently to commands. His temperature is 103 F, pulse 110/min and blood pressure is 80/56 mmHg. His physical examination is otherwise normal. There is no bleeding. Laboratory test are as follows: Hemoglobin: 12 g/dlat is the most likely diagnosis?ukocyte count: 25,000 – 80% neutrophils Platelet count: 20,000 Hemophilia b Idiopathic thrombocytopenic purpura Disseminated intravascular coagulation Hemophilia a Thrombotic thrombocytopenic purpura Loading...850. 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 Transposition of great vessels Atrial septal defect Coarctation of the aorta Ventricular septal defectPage 35 of 66 Loading...851. A drug that belongs to proton pump inhibitor is one of the following? Ethacrynic Acid A & B Lansoprazole Sulbactam Rosiglitazone Loading...852. One of the following statements about the Parasympathetic neurons is wrong? Postganglionic fibers are long Preganglionic fibers arise from cranial nerves Originated from Efferent autonomic system Preganglionic fibers are long Preganglionic neurons originated from the Sacral region Loading...853. Amphotericin B exerts its anti-fungal effect by which of the following mechanisms? Inhibition of cell wall synthesis Inhibition of fungal protein synthesis Inhibition of DNA synthesis Alteration of cell membrane permeability Inhibition of fungal cell wall synthesis Loading...854. As physicians, we need to know some definitions in Genetics, which are related directly to our practice and guide us to diagnose and treat many genetic disorders. These items include genome, genotype, phenotype, genetic code, gene expression, etc. Which one of the following choices describes the definition of a phenotype? DNA structure that determines the expression of a trait An observable physical or biochemical trait on an organism Genetic history of an organism Physical location of a trait on a DNA molecule Loading...855. Which one of the following conditions is associated with Acanthosis Nigricans? Diabetes mellitus Diabetes insipidus Hemochromatosis Amyloidosis Loading...856. Receptors that produce the most rapid response: Cytokine receptors Ion channel linked receptors G-protein linked receptors Intracellular Receptors Tyrosine-Kinase Receptors Loading...857. Which one of the following medications inhibits cell wall synthesis of bacteria? Clindamycin Aminoglycoside. Carbapenem Erythromycinotein Synthesis Inhibitors: Aminoglycosides, Tetracyclines, Spectinomycin, Erythromycin, Lincomycin, Clindamycin and Chloramphenicol. Loading...858. 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? Confounding bias Information bias Sample distortion bias Hawthorne effect Loading...859. Which one of the following is the most common cause of ruptured aortic aneurysm? Hypertension History of intravenous drug use Cardiomyopathy Atherosclerosis Loading...860. 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? Parkinson’s disease Huntington’s disease Tourette’s syndrome Creutzfeldt-Jakob disease Drug-induced tremors Loading...861. Which one of the following conditions is the most likely cause of acute lower gastrointestinal bleeding in patients older than 40? Varicose veins Colorectal cancer Diverticulosis Ulcerative colitis Loading...862. 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...863. 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? Ovarian cyst Acute appendicitis Endometriosis Ectopic pregnancy Pelvic abscess Loading...864. Which of the following conditions may occur as a result of a long umbilical cord? Amnion nodosum Placenta previa Abruptio placenta Nuchal cord Loading...865. Which of the following is the epithelial covering of vocal cords? Stratified squamous Simple columnar Simple squamous Simple cuboidal Loading...866. Which one of the following neurologic drugs can cause diplopia, thickened gums and hirsutism? Phenytoin Valproic acid Phenobarbital Carbamazepine Loading...867. Which of the following differentiates Dubin-Johnson syndrome from Rotor syndrome? Level of liver enzymes Mode of inheritance Black pigmentation of the liver Conjugated hyperbilirubinemia Loading...868. Echothiophate, which is used mainly for ophthalmic actions inhibits: Acetylcholinesterase DOPA decarboxylase Monoamine Oxidase Catechol-O-methyltransferase (COMT) Tyrosine hydroxylase Loading...869. Carbonic anhydrase enzyme is present in the epithelial cells of one of the following part functional zones of the nephron? The ascending loop of Henle The distal convoluted tubules The descending loop of Henle The collecting tubule and duct The proximal convoluted tubules Loading...870. Which of the following drug belongs to H2 histamine receptor blocker? Niacin Glimepiride Famotidine Cefoxitin Oxacillin Loading...871. A drug that belongs to thiazolidinediones is one of the following? Rosiglitazone Cefazolin Sulbactam Ethacrynic Acid A & B Loading...872. Which of the following is the most common cause of nasal obstruction and bleeding in adolescents? Nasal cancer Nasal polyps Papilloma Angiofibroma Loading...873. When a intravascular clot started floating in the blood termed as one of the following option? Thrombus Embolus All of above Coagulation Loading...874. Which of the following is characteristic of Hodgkin lymphoma and differentiates it from non-Hodgkin lymphoma? Associated with HIV and autoimmune disease Affects mostly old age Reed-Sternberg cells Peripheral nodes are most likely involved Loading...875. 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? Cocaine Phencyclidine (PCP) Amphetamines BarbituratesPage 36 of 66 Loading...876. Which one of the following conditions most likely shows lower than normal erythrocyte sedimentation rate (ESR)? Multiple myeloma Polycythemia Pregnancy Giant cell arteritis Loading...877. NucleoSide Reverse Transcriptase inhibitors(NRTIs) drug in Antiviral class? Nevirapine Zidovudine Amprenavir Acyclovir Saquinavir Loading...878. 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? CD4 lymphocyte count HIV p24 antigen HIV antibody test HIV RT PCR Loading...879. A drug that elevate bronchial smooth muscle cAMP leading to decreased intracellular calcium and prompt bronchodilation. Epinephrine Phenylephrine Dipivefrin Clonidine Albuterol Loading...880. 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 dobutamine IV fluids stat IV calcium gluconate Sublingual glyceryl nitrate (GTN) IV heparin Loading...881. Administration of which one of the following can increase the excretion of a weak acid i.e. Aspirin toxicity? A weak base A strong acid A weak acid A neutral salt Loading...882. 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...883. Which of the following is characteristic of Alzheimer’s disease? Neurofibrillary tangles Nuclear atypia Negri bodies Lewy bodies Loading...884. 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 increase Both of them decrease EDV increases and ET decreases EDV decreases and ET increases Loading...885. Which of the following is the mechanism of action of ciprofloxacin? Interferes with bacterial cell wall synthesis Inhibits DNA gyrase and relaxation of DNA Interferes with bacterial metabolic production Inhibits bacterial protein synthesis through binding with 30 S Loading...886. Antimuscarinic agent is following? Atropine Nicotine Tacrine Acetylcholine Physostigmine Loading...887. Which of the following is the best therapy for essential tremors? Propranolol Metoclopramide Haloperidol Physiotherapy Loading...888. Which of the following substances lines the vesicles that involved in LDL uptake by hepatocytes? Chylomicrons Laminin Transferrin Clathrin Loading...889. 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...890. Which one of the following statements about dobutamine is incorrect? Treat acute heart failure Decrease myocardial cAMP Positive inotropic effect Increase contractility Loading...891. Which of the following conditions could be a serious side effect of sumatriptan? Dilated cardiomyopathy Cutaneous flushing Coronary vasospasm Torsades de pointes Loading...892. Which of the following drug belongs to potassium sparing Diuretics? Urea A & B Furosemide Acetazolamide Amiloride Loading...893. 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? Subcutaneous Oral Intramuscular Sublingual Intravenous Loading...894. A 6 year old girl presents to the emergency room with her mother for a deep wound on her right forearm. Her mother tells you that her daughter was playing at school today and wounded herself when she fell on a big rock. When you ask her about her vaccination, she tells you that her daughter had all her vaccinations before the school started this year. What is the most appropriate therapy for this girl? Both tetanus toxoid and antitoxin Tetanus antitoxin Neither tetanus toxoid or antitoxin Tetanus toxoid Loading...895. Which one of the following drugs is a selective Beta-2 adrenergic long-acting bronchodilator? Albuterol Formoterol Pirbuterol Terbutaline Metaproterenol Loading...896. Which of the following anticoagulant medications works by binding to thrombin and inhibiting it? Heparin Ticlopidine Warfarin Hirudin Loading...897. Which of the following signs of infective endocarditis appears as small, tender nodules on the finger and toe pads? Roth’s spots Osler nodes Janeway lesions Splinter hemorrhages Loading...898. Which one of the following drugs belongs to H2 histamine receptor blocker? Ranitidine Atorvastatin Torsemide Indanyl carbenicillin Ezetimibe Loading...899. 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 B6 (Pyridoxine) Vitamin B3 (Niacin) Vitamin D (Cholecalciferol) Vitamin C (Ascorbic Acid) Vitamin A (Retinol) Loading...900. A drug causes accumulation of fat in the abdomen and the base of the neck on chronic administration? Ritonavir Vidarabine Lamivudine Zanamavir AmantadinePage 37 of 66 Loading...901. A 4-year old girl is brought to the clinic by her mother complaining of fever and abdominal pain since yesterday. Today, she looks uncomfortable during micturition. On examination, her temperature is 99.4, her pulse is 100/min. and her suprapubic area is soft and tender. Her blood analysis shows increased neutrophils. Her urinalysis is positive for organisms and leukocytes. What is the drug of choice for this condition? Chloramphenicol Rifampin Ciprofloxacin C0-trimoxazole Loading...902. 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. Osteoarthritis Baker cyst Hydrarthrosis Acute arthritis Tear of posterior collateral ligamentat is the most likely diagnosis? Loading...903. Which one of the following analgesics inhibits COX in CNS and can be used safely for pregnant women? Naproxen Ibuprofen Acetylsalicylic acid Acetaminophen Loading...904. A drug that effects the thyroid hormone is one of the following? A & B Sulbactam Thyroxine Bumetanide Furosemide Loading...905. Which one of the following statements about dobutamine is incorrect? Increase myocardial cAMP Increase contractility Positive inotropic effect Avoid in acute heart failure Loading...906. Which of the following drug is Non-NucleoSide Reverse Transcriptase inhibitors(NNRTIs)? Nevirapine Saquinavir Zidovudine Acyclovir Amprenavir Loading...907. 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? Ultrasonography of the neck Serology for infectious mononucleosis Throat swab and culture Admit to the intensive care unit Prescribe broad spectrum antibiotic Loading...908. Long Acting Insulin is one of the following? Aspart Glargine NPH Glulisine Loading...909. Which of the following in the most likely cause of spontaneous abortion in the first trimester? Maternal drug use Chromosomal abnormalities Congenital infection Toxemia of pregnancy Loading...910. Which of the following amino acids is a non essential? Alanine Histidine Aspartic acid Glutamic acid Asparagine Loading...911. Decreased production of which type of collagen may result in osteogenesis imperfecta? Type IV Type I Type II Type III Loading...912. Which of the following cell types is responsible for forming the blood brain barrier (BBB)? Microglia Oligodendrocytes Schwann cells Astrocytes Loading...913. Aminoglycosides inhibit protein synthesis through targeting which of the following? RNA polymerase mRNA 30S ribosomal subunits Peptidoglycan units Loading...914. Which of the following is the classic electrocardiogram (ECG) finding in atrial flutter? S-T segment elevation in anterior leads (V1-V4) Diffuse S-T segment elevation S-T segment elevation in leads II. III and aVF Sawtooth P waves Loading...915. Miconazole belongs to the following type of drugs class? Antibiotics Antiviral Antipyretic Antifungal Anti malaria Loading...916. 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...917. Pancreatic exocrine secretions empty into the duodenum through which one of the following? Accessory pancreatic duct Duct of Wirsung Common bile duct Duct of Santorini Loading...918. Which one of the following antibacterial drugs is a protein synthesis inhibitor drug? Cefuroxime Aztreonam Vancomycin Chloramphenicol Loading...919. Which one of the following tests is diagnostic for acromegaly? Serum insulin-like growth factor-1 (IGF-1) Serum cortisol level Fasting blood glucose level Serum growth hormone level Loading...920. Onychomycoses is the fungal infection of one of the following? Skin Teeth Hair Nails Loading...921. Which one of the following differentiates exudate from transudate? Few leukocytes High specific gravity High osmotic pressure Low protein content Loading...922. Which one of the following statements about the digoxin is incorrect? Low therapeutic index Increase contractility Indicated for diastolic HF None of these 36 hours half-life Loading...923. 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 beta1 blocker while labetalol is a beta 2 blocker Atenolol is both beta and alpha-blocker while labetalol is a beta-blocker only 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 a beta1 blocker while labetalol is both alpha and beta-blocker Loading...924. Which one of the following drugs belongs to Antidiarreals? Nizatidine Ezetimibe Methyl cellulose Indanyl carbenicillin Atorvastatin Loading...925. A 40-year-old man who works in a manufacture of explosives presents to the clinic for a routine physical examination. Medical history reveals that the patient experiences episodes of headache and palpitation every Monday. Physical examination, laboratory tests and ECG show normal results. The patient questions if the chemicals related to his job could be responsible for his symptoms. Which is the appropriate response for this question? Yes. They are related to withdrawal of chemical and may lead to massive heart attack No. They are not related to exposure because they are episodic 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 weekendPage 38 of 66 Loading...926. Mechanism of action of Ticlopidine is following? Inhibit COX-1 Inhibit ADP mediation Inhibit glycoprotein receptors Inhibit COX-2 Decrease Calcium levels Loading...927. Stimulation of muscarinic receptors by pilocarpine is competitively inhibited by which of the following medications? Edrophonium Physostigmine Atropine Pralidoxime Loading...928. Which one of the following drugs is a beta blocker (Class II)? Procainamide Amiodarone Verapamil Carvedilol Loading...929. 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...930. Which of the following differentiate neostigmine from pilocarpine? Stimulation of salivary glands Acceleration of heart rate Prolonged skeletal muscle contraction Stimulation of bowel motility Loading...931. Heteroaryl acetic acid drug is following? Diclofenac Ibuprofen Nabumetone Indomethacine Piroxicam Loading...932. 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? Clostridium difficile Giardia lamblia cytomegalovirus Entamoeba histolytica Loading...933. Amiodarone is considered one of which of the following classes of anti-arrhythmic drugs? Class III Class IV Class II Class I Loading...934. Which of the following medications should be given to a patient that exhibits severe adverse reactions after administration of IV midazolam? Flumazenil Glucagon Protamine Naloxone Loading...935. Which one of the following drugs is a Substrate of the P-GP (glycoprotein) efflux pumps? All of the above A & B Amiodarone Digoxin Erythromycin Loading...936. A drug that belongs to proton pump inhibitor is one of the following? Esomeprazole Rosiglitazone A & B Sulbactam Ethacrynic Acid Loading...937. A 1-year-old boy with a diagnosis of stable small ventricular septal defect is scheduled for a dental procedure. Which of the following medications should be administered prior to this procedure? No medication Ampicillin Azithromycin Amoxicillin Loading...938. At which of these vertebral levels does the trachea bifurcate? Seventh cervical First thoracic Sixth thoracic Fourth thoracic Loading...939. 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? Copper Arsenic Lead Iron Zinc Loading...940. 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...941. 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? Negatively birefringent urate crystals Cloudy, reddish fluid, with leucocytes’ count equal to the blood count Calcium oxalate crystals Calcium pyrophosphate dehydrate crystals Cholesterol crystals Loading...942. 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 50 mg 0 mg Loading...943. A drug causes Blockage of the M2 protein ion channel and it's ability to modulate intracellular PH? Acyclovir Zanamavir Vidarabine Amantadine Lamivudine Loading...944. Action of incretin hormone GLP-1 is following except? Inhibit inappropriate glucagon secretion Enhance appetite slow gastric emptying Increase beta-cell growth Increase glucose-dependent insulin secretion Loading...945. 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 Binasal hemianopsia Homonymous hemianopsia Bitemporal hemianopsia Loading...946. Two sisters, aged 40 and 45 years old, are brought to the emergency room presenting with severely dramatic pneumonia. When the lungs are examined, doctors are able to easily hear rales. The chest x-rays reveal that both sisters have bilateral and diffuse infiltrates. On taking down their history, it was observed that 2 weeks ago both sisters went hiking to a mountainous area where they explored a dusty cave. What would be the most likely causative agent of their condition? Blastomyces dermatitidis Coxsackie A virus Hemophilic influenzae Histoplasma capsulatum Loading...947. 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 Mycoplasma Streptococci Mycobacteria Fungi Loading...948. During development, hypothalamus arises from which one of the following structures? Metencephalon Telencephalon Diencephalon Mesencephalon Loading...949. Which one of the following phases of the cell cycle is affected by binding p53 to DNA? G0 G1 G2 M Loading...950. Which of the following antibiotics is the most appropriate one to treat a case of Legionella pneumonia? Erythromycin Vancomycin Clindamycin MetronidazolePage 39 of 66 Loading...951. Which one of the following structures is involved in a case of tarsal tunnel syndrome? Peroneal artery Deep peroneal nerve Tibial nerve Anterior tibial artery Loading...952. Autoantibodies to pancreatic islets Beta cells and insulin are found in the following types of Diabetes? A & C Type 2 Diabetes mellitus All of the above Latent autoimmune diabetes of the adults Type 1 Diabetes mellitus Loading...953. Which one of the following treatment most likely prevents meningeal leukemia in a young boy diagnosed with acute lymphoblastic leukemia? Radiotherapy High dose of cortisone Intrathecal methotrexate Cyclophosphamide Loading...954. 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? Coronary angiography Thallium stress test Echocardiography Aspirin Loading...955. Extrapyramidal side effects develop after the use of haloperidol due to its effect on which of the following receptors? Muscarinic receptors Alpha-adrenergic receptors Dopamine receptors Nicotinic receptors Loading...956. A neonate presents by renal failure and pulmonary hypoplasia. What is your diagnosis? Niemann-Pick disease Pompe disease Phenylketonuria Recessive polycystic kidney disease Loading...957. A liposomal preparation of which one of the following medications may reduce the incidence of renal toxicity? Ketoconazole Amphotericin B Vancomycin Acyclovir Loading...958. 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 3 Branchial Arch 2 Branchial Arch 5 Branchial Arch 1 Branchial Arch 4 Loading...959. 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? Shoulder dystocia Rotator cuff tear Tendinitis Frozen shoulder Loading...960. 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 Decrease parathormone activity Increase osteoblast activity Increase vitamin D absorption Loading...961. Cephalexin belongs to the class of following drugs? Anti malaria Antibiotics Antipyretic Antiprotozoal Antiviral Loading...962. Which of the following groups are found in the structural formula of Angiotensin-converting enzyme inhibitors Except? Imidazole ring Phosphinic acid group Sulfahydril group Thiol group Carboxylate group Loading...963. Which one of the following effects is correlated to direct beta1-adrenoreceptor stimulation? Vasoconstriction Tachycardia Bradycardia Bronchodilation Loading...964. 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 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 HPV vaccine is essential to treat the current infection No need for the vaccine as long as Pap smear is normal Loading...965. Which of the following antibiotics is the most appropriate treatment of mycoplasma pneumonia? Gentamicin Doxycycline Ampicillin Azithromycin Loading...966. Deficiency of which of the following enzymes most likely result in the development of Cori disease? Debranching enzyme (alpha-1,6-glucoside) Glucose-6-phosphatase Lysosomal alpha-1,4 glucosidase Muscle glycogen phosphorylase Loading...967. 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? Chandler sign Tinel sign Wonder sign Phalen sign Loading...968. Which of the following conditions could be a serious side effect of sumatriptan? Coronary vasospasm Cutaneous flushing Dilated cardiomyopathy Torsades de pointes Loading...969. Which one of the following drugs increase survival in patients with MI? Digoxin Verapamil Atenolol Furosemide Loading...970. Carbonic anhydrase enzyme is present in the epithelial cells of one of the following part functional zones of the nephron? The ascending loop of Henle The proximal convoluted tubules The collecting tubule and duct The distal convoluted tubules The descending loop of Henle Loading...971. Which of the following tests would most likely indicates the etiology of vitamin B12 deficiency anemia? Complete blood count (CBC) Coomb’s test Schilling test Osmotic fragility test Loading...972. Which one of the following naturally occurring penicillins has a higher minimum bactericidal concentration and can't be used for bacteremia? Penicillin G Amoxicillin Methicillin Penicillin V Loading...973. Which of the following is a major complication of central retinal veins occlusion? Glaucoma Retinal detachment Cataract Lens subluxation Loading...974. Which of the following conditions is most likely caused by over-secretion of growth hormone in adults (acromegaly)? Hypothyroidism Gastric adenocarcinoma Carpal tunnel syndrome Malignant melanoma Loading...975. 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. Barium swallow Esophageal manometry Upper endoscopy CT body screening Trial of proton pump inhibitorPage 40 of 66 Loading...976. Which of the following is the most significant action of monoamine oxidase A? Metabolism of serotonin and dopamine Metabolism of dopamine Metabolism of serotonin and epinephrine Metabolism of norepinephrine, serotonin and tyramine Loading...977. Which of the following drug are Nonsteroidal antiestrogens? Estradiol Tamoxifen Estrogen Estradiol acetate Exemestane Loading...978. Which one of the following drugs has irritation of the respiratory tract and should avoid in severe reactive asthma? Zanamivir Amantadine None of these Oseltamivir Rimantadine Loading...979. Which of the following is the effect of digoxin on a case of heart failure? Decreased stroke volume and vagal activity Increased sympathetic tone and decreased vagal activity Rapid conduction through AV node Increased stroke volume and cardiac output Loading...980. 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 Prescribe antidepressant and follow up in a week Admit to the hospital Refer to the social worker Advise family that it is a normal reaction and keep an eye on her Loading...981. Which drug belongs to the Quinoline methanol antimalarial class? Mefloquine Pyrimethamine Quinine Quinidine Chloroquine Loading...982. Which of the following are the characteristics of Beck’s triad? Stasis, hypercoagulability and endothelial damage Hypotension, distant heart sounds and jugular vein distention (JVD) Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) Loading...983. Na+ channel blockers belongs to the one of the following CLASS of Antiarrhythmic drugs? CLASS IV CLASS II CLASS III CLASS I Loading...984. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Miconazole Flucytosine Ethambutol Ibandronate A & B Loading...985. A drug that is a part of Aminoglycosides is following? Cefaclor Tobramycin Cefepime Cefdinir Loading...986. Administration of spironolactone and furosemide leads to which of the following? Reduce sodium loss Increase potassium loss Reduce potassium loss Reduce magnesium loss Loading...987. 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? Osteitis fibrosa cystica Osteomalacia Osteopetrosis Osteoporosis Loading...988. Which of the following enzymes is markedly elevated in primary biliary cirrhosis? Acid phosphatase Alkaline phosphatase Alanine aminotransferase (ALT) Aspartate aminotransferase (AST) Loading...989. 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 Leucovorin Amitriptyline Penicillamine Loading...990. Which of the following drug is a derivative of N- arylanthranilic acid? Diflunisal Piroxicam Etodolac Mefenamic Acid ketorolac Loading...991. Nabumetone is a prodrug derived from which of the following class? Fenamic acid derivative Enolic acid derivative Propionic acid derivative Acetic acid derivative Salicylic Acid derivatives Loading...992. 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...993. 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 immunoglobulin Tetanus toxoid followed by tetanus immunoglobulin after 5 days Tetanus toxoid No further therapy Tetanus toxoid and tetanus immunoglobulin Loading...994. 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...995. 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? Order cardiac enzymes Start heparin Perform electric cardioversion Refer to a cardiologist Start metoprolol Loading...996. 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? Ascending colon Ileum Left kidney Tonsils Gall bladder Loading...997. Which one of the following antipsychotics has higher affinity to both dopamine and serotonin receptors? Fluphenazine Clozapine Haloperidol Thioridazine Loading...998. Which of the following statements correctly describes the therapeutic dose of medication? The amount of medication that produces maximal rate of distribution The amount of medication that produces the highest plasma concentration of the drug The amount of medication that produces minimal biological effect The amount of medication that produces the required effect in the majority of patients Loading...999. Which of the following medications acts to prevent cholesterol absorption at small intestine brush border? Cholestyramine Ezetimibe Gemfibrozil Colestipol Loading...1000. Which of the following correctly describes unstable angina? Angina following strenuous exercise Angina relieved by rest Angina occurs at restPage 41 of 66 Loading...1001. Which of the following prostaglandin type also called prostacyclin? PGE PGI2 PGA PGB PGE1 Loading...1002. Serotonin Receptor linked with nausea and emesis? 5HT4 5HT¹ 5HT5 5HT³ 5HT² Loading...1003. 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 Niacin Acetaminophen Lactase Loading...1004. 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...1005. 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) Acute myocardial infarction Hypertrophic cardiomyopathy Pericardial effusion Septic shock Loading...1006. 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? Immobilization Alcohol abuse Hypertension Daily aspirin Hypothyroidism Loading...1007. A 70-year-old man develops chest pain 2 days after hip replacement. Which is the most likely diagnosis? Bundle branch block Cor pulmonale Myocardial infarction Pulmonary embolism Loading...1008. 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...1009. 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? Myoclonic seizure Tonic-clonic seizure Simple focal seizure Complex focal seizure Absence seizure Loading...1010. 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 no chance to be a carrier The baby has 100% chance to clinically have the disease The baby has 50% chance to clinically have the disease The baby has 50% chance to be a carrier Loading...1011. Which one of the following drugs is a Tetracycline? Cefdinir Demeclocycline Cefepime Cefadroxil Loading...1012. Which one of the following causes induction of cellular enzymes that interfere with viral protein synthesis? Interferon-alpha Ribavirin Zanamavir Amantadine Gancyclovir Loading...1013. Which of the following hormone belongs to the oral diabetic agent? Glimepiride Somatrem Furosemide Oxytocin A & B Loading...1014. Which one of the following drugs is Nonsteroidal antiestrogens? Exemestane Estradiol acetate Estradiol Tamoxifen Estrogen Loading...1015. Consumption of which of the following products most likely reduces the risk for coronary heart disease in susceptible patients? Saturated fat Fish oils Sugar-free snacks Beef products Loading...1016. Which one of the following drugs is a neuromuscular blocker drug? Pancuronium Mecamylamine Neostigmine Atropine Benztropine Loading...1017. Which of the following is the major indication of ondansetron in patients receiving chemotherapy? GERD Headache Hair loss Nausea and vomiting Loading...1018. All of the following drugs have anti-inflammatory effects except? Piroxicam ketorolac Mefenamic acid Acetaminophen Naproxen Loading...1019. 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...1020. Which of the following explains the benefit of lactulose in hepatic encephalopathy? Lactulose decreases stress of the liver to produce glucose Lactulose removes circulating toxins from the blood Lactulose converts to lactic acid by intestinal bacteria which decreases ammonia Lactulose antagonize the action of ammonia on hepatic cells Loading...1021. Which one of the following drugs is a Thiazide Diuretic? Indapamide Fenofibrate Ezetimibe Indanyl carbenicillin Atorvastatin Loading...1022. Fluconazole belongs to the class of following drugs? Antiprotozoal Antipyretic Antibiotics Antifungal Antiviral Loading...1023. Which one of the following conditions is characterized by joint space narrowing and osteophyte formation while bone density appears normal? Pseudogout Osteoarthritis Rheumatoid arthritis Gout Loading...1024. Which of the following chemotherapeutic agents is specific for the M phase of the cell cycle? Cytarabine Daunorubicin Mechlorethamine Vincristine Hydroxyurea Loading...1025. A 43-year-old man presents to your clinic for a follow up after colon biopsy taken last week. He has a history of constipation and blood in stools for 6 months. Biopsy reveals colon cancer. After you told him the bad news, he looked down and told you that constipation was not that bad. He seeks more investigations because he does not think that he has cancer. What is the emotional stage experienced by this patient at this time? Denial Anger Acceptance Depression BargainingPage 42 of 66 Loading...1026. 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...1027. 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...1028. Which of the following drug belongs to the Nonnucleoside reverse transcriptase inhibitor? Indanyl carbenicillin Maraviroc Abacavir Atazanavir Efavirenz Loading...1029. A cytokine that enhances the activity of NK cells and attracts neutrophils and macrophages? Interferon gamma Tissue necrosis factor-alpha Interleukin-2 Interleukin-1 Loading...1030. 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? Undescended testis Defect in the pelvic floor Defective closure of tunica vaginalis Defect in the inguinal canal Patent processus vaginalis Loading...1031. Which one of the following statements about the use of Labetalol is incorrect? 3-6 hours duration of action Doesn't cause reflex tachycardia Used as I.V infusion in emergency Selective Beta-1 blocker Loading...1032. 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? Acute cholecystitis Pyelonephritis Necrotizing pancreatitis Appendicitis Loading...1033. Which of the following drug is a derivative of salicylic acid? Etodolac Diflunisal ketorolac Mefenamic Acid Piroxicam Loading...1034. Which of the following is the most common primary disturbance of acid-base balance in pregnant women? Metabolic alkalosis Metabolic acidosis Respiratory acidosis Respiratory alkalosis Loading...1035. A patient is suffering from xerostomia due to the Sjogren’s syndrome he has been afflicted with for the last few months. Which one of the following is the best for treating xerostomia? Bethanechol Methacholine Scopolamine Carbachol Cevimeline Loading...1036. Meissner’s plexus of nerves is located within which layer of the gastrointestinal tract? Muscularis Externa Submucosa Mucosa External layer Loading...1037. Which of the following organisms is associated with pneumonia precipitated by aerosolized water (air conditions)? Pneumocystis jirovecii Mycoplasma pneumonia Legionella pneumophila Chlamydophila pneumonia Loading...1038. Which one of the following indicates drug resistance? Response to a drug decreases after repeated use Altered effect of the drug when used with another drug No or minimum effect on a microorganism due to genetic mutation Induction of liver metabolism Loading...1039. Which one of the following drugs is a Inducer of the P-GP (glycoprotein) efflux pumps? Digoxin Amiodarone Erythromycin Rifampin All of the above Loading...1040. Which one of the following structures provides the majority of noradrenergic innervation to the cerebral cortex? Caudate nucleus Raphe nucleus Locus coeruleus Substantia nigra Loading...1041. Which one of the following drugs is a Proteas inhibitor? Abacavir Delavirdine Maraviroc Indanyl carbenicillin Atazanavir Loading...1042. 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? Preterm labor Having to undergo a cesarean section Spontaneous abortions in the first trimester Fetal malformations Loading...1043. Which one of the following drugs belongs to alkylating agent? Lamivudine Indanyl carbenicillin Dacarbazine Gemcitabine Capreomycin Loading...1044. Which one of the following cells is derived from monocytes and lying within the alveoli? K cells Pneumocytes type I Macrophages Clara cells Pneumocytes type II Loading...1045. Which one of the following drugs is a more effective drug and drug of choice for fungal infection with a shorter duration of therapy? Terbinafine Delavirdine Itraconazole Griseofulvin Loading...1046. A 35 woman undergoes a hysterectomy. A section of one of her fallopian tubes is shown on this picture. What is your diagnosis? Papillary carcinoma Ectopic pregnancy Endometriosis Chronic salpingitis Loading...1047. Which one of the following drugs is worst for causing gastric irritation? Sulindac Misoprostol Acetaminophen Diclofenac Aspirin Loading...1048. 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 Addison’s disease Pheochromocytoma Secondary hyperaldosteronism Loading...1049. Which of these conditions is known as pulsus paradoxus? A difference in blood pressure for more than 10 mmHg between both arms 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 of 10/min between radial and femoral pulse Loading...1050. 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? Turner’s syndrome Male pseudohermaphrodite Female pseudohermaphrodite True hermaphroditePage 43 of 66 Loading...1051. An anticancer agent 6-mercaptopurine metabolism disturbed by following drug due to which dose is reduced? Sulfinpyrazone Allopurinol Probenecid Colchicine Loading...1052. Which of the following is a characteristic finding in isopropanol poisoning? Ketosis without acidosis Elevated serum BUN and creatinine Blindness due to ocular accumulation Elevated anion gap Loading...1053. Which of the following is the correct statement about the difference between a strain and a sprain? Strain affects tendons and ligaments while sprain affects muscles Strain affects muscles or tendons while sprain affects ligaments Strain affects muscles or ligaments while sprain affects tendons Strain affects ligaments while sprain affects muscles and tendons Loading...1054. A drug has a large volume of distribution because it accumulates in muscles? Clopidogrel Acetaminophen Digoxin Nitroglycerin Aspirin Loading...1055. A 23-year-old man with a history of Marfan syndrome presents to the ER complaining of sharp pain on the upper back. He is admitted to intensive care unit (ICU) for the risk of aortic dissection. Which of the following proteins are responsible for the probable development of abdominal aortic aneurysm (AAA) in this patient? Myosin and actin Fibrin and actin Fibrillin and elastin Myosin and fibrin Loading...1056. 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. Rifampin Ethambutolich of these drugs acts by inhibition of formation of mycolic acid? Isoniazid Pyrazinamide Streptomycin Loading...1057. Which of the following drugs has the shortest half-life and used in acute anxiety? Chlordiazepoxide Flurazepam Alprazolam Clonazepam Loading...1058. Which one of the following drugs belongs to drugs for hepatic viral infections? Capreomycin Indanyl carbenicillin Interferon Aluminium hydroxide Ezetimibe Loading...1059. Which of the following insects is the victor responsible for transmission of Rocky Mountain spotted fever? Louse Flea Tick Mite Loading...1060. Which of the following drugs causes Rhabdomyolysis as an adverse effect? Warfarin Simvastatin Amikacin Digoxin Dronedarone Loading...1061. 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? 3.2 2.3 71 230 Loading...1062. During normal inspiration, the diaphragm: Contracts Relaxes Does not move Loading...1063. Which of the following drugs is used after chemotherapy to increase the leukocyte count if it drops? Interleukin-2 Filgrastim Dexamethasone Prednisone Loading...1064. What is the antidote to snake bites? A & B Pralidoxime Antivenin Vitamin K Nalmefene Loading...1065. Which of the following organs is the most commonly affected one by a blunt trauma to the abdomen? Large intestine Liver Spleen Small intestine Loading...1066. A drug that belongs to thiazolidinediones is one of the following? Ethacrynic Acid A & B Sulbactam Pioglitazone Cefazolin Loading...1067. Which of the following is the mechanism of action of benzodiazepines in the treatment of insomnia? Dopamine receptor agonist Binds to serotonin receptors Alpha adrenergic antagonist Binds to GABA receptors Loading...1068. Chemotherapeutic agents use may result in the loss of individual neoplastic cells through which of the following mechanisms? Coagulative necrosis Phagocytosis Apoptosis Acute inflammation Loading...1069. A 78-year-old woman presents to the office with her daughter. Last week, she fell twice while she was walking with her daughter. She was not shaking or lost her consciousness and she got up in a minute. Her medical history is significant for hypertension and osteoarthritis. She takes Lisinopril daily and ibuprofen as needed. She also takes diphenhydramine to help her sleeping during the night. Her vital signs are within normal limits on sitting and standing. All her laboratory tests are within normal ranges. Her mini-mental status test is normal. What is the best explanation for this patient’s fallings? Postural hypotension Osteoarthritis Alzheimer’s disease Old age Side effect of one of her medications Loading...1070. Which of the following receptors are membrane receptors (not intracellular)? The nicotinic receptors for acetylcholine Receptors for thyroid hormones Receptors for steroids Receptors for vitamin D Loading...1071. The following drug is a peripheral dopamine-1 receptor agonist? Hydralazine Minoxidil Fenoldopam Alpha-Methyldopa Loading...1072. An 80-year-old man is diagnosed with severe atherosclerosis. He has been a heavy smoker for 62 years and also has a long history of hypercholesterolemia. Atherosclerotic occlusion of which of these arteries will cause insufficient perfusion of the urinary bladder? Internal iliac Lateral sacral Inferior epigastric External iliac Loading...1073. Which of the following controls the secretion of thyrotropin? Concentration of thyrotropin in the pituitary gland Concentration of thyroid hormones in the blood Concentration of thyroid hormones in the thyroid gland Concentration of iodine in the thyroid gland Loading...1074. Which of the following findings is consistent with a case of right lung atelectasis? Trachea is deviated to the left Trachea is not deviated (normal location) Trachea is deviated to the right Loading...1075. Which of the following drug belongs to Sulfonylureas? Niacin Glyburide Urae Cefoxitin OxacillinPage 44 of 66 Loading...1076. A 58-year-old woman is brought to the emergency room complaining of lightheadedness for 4 hours. She has diarrhea with loose stool for 2 days. She explains her symptoms as flu and she drinks lots of water as her neighbor advised her to avoid dehydration. Her physician told her that she should take combined solution of sodium chloride (NaCl) and glucose to prevent dehydration. What is the mechanism of action of this mixture to improve dehydration? Glucose provides energy for NaCl to increase gastric emptiness Cotransport of glucose and NaCl across the intestinal membrane facilitates absorption of water The mixture helps to increase secretion of water and Na through the large intestine It reduces bowel contractions and consequently improves diarrhea Loading...1077. What is the antidote of Verapamil? Pyridostigmine Epinephrine Both C & D can be used Atropine Calcium Loading...1078. Which of the following locations is the site of action of furosemide to inhibit sodium reabsorption? Collecting tubules Distal convoluted tubules Descending limb of loop of Henle Ascending limb of loop of Henle Loading...1079. 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 Glyburide Rosiglitazone Metformin Glucagon Loading...1080. Which one of the following muscles is most likely at risk due to injury of the pelvic floor during delivery of a large-size baby? Pubococcygeus Coccygeus Iliococcygeus Loading...1081. Which of the following medications is a non-drowsy anti-allergic medication? Diphenhydramine Loratadine Cetirizine Chlorpheniramine Loading...1082. 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? Osmotic fragility test Schilling test Metabisulfite test Coomb’s test Acid hemolysis test Loading...1083. The gland responsible for secretion of prolactin is derived from which of the following structures? Neurohypophysis Rathke’s pouch Primordial follicle Infundibulum Loading...1084. Which one of the following is the most common cause of microcytic hypochromic anemia in a patient diagnosed with progressive renal failure? Erythropoietin deficiency Frequent hematuria Iron deficiency anemia Blood loss Loading...1085. 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? Treponema pallidum Rickettsia prowazekii Borrelia burgdorferi Staphylococcus aureus Meningococci Loading...1086. Generally, Passive diffusion of Water-soluble drugs inside the cell membrane occurs by one of the following processes? Readily move across by facilitated diffusion Readily move across by active transport Readily move due to lipid solubility Penetrate through aqueous pores Loading...1087. Bronchoconstriction results from stimulation of which one of the following receptor types? M3 cholinergic receptors Alpha-1- adrenergic receptors M2 cholinergic receptors Beta-2- adrenergic receptors Loading...1088. Gonadotropin-releasing hormones are synthesized by which of the following nuclei of the hypothalamus? Ventromedial nuclei Dorsomedial nuclei Anterior nuclei Arcuate nuclei Loading...1089. Which one of the following is a anterior pituitary hormone? Desmopressin Atorvastatin Torsemide Fenofibrate Somatostatin Loading...1090. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Furosemide Ibandronate Ethambutol A & B Rabeprazole Loading...1091. A single injection of leuprolide was given to a man 2 weeks ago. Which of the following changes could be revealed today? Increased FSH receptors Increased testosterone production Decreased testosterone production Increased LH receptors Loading...1092. Nelfinavir belongs to the class of following drugs? Anti-malaria Antiviral Antibiotics Antipyretic Antiprotozoal Loading...1093. Emotions, judgments and motor aspects of speech are controlled by which one of the following lobes of the brain? Temporal Occipital Parietal Frontal Loading...1094. Which one of the following drugs causes a non-productive cough? Desmopressin Somatostatin Atorvastatin Captopril Torsemide Loading...1095. Which one of the following drugs is effective against prolactin-secreting tumors? Chlorpromazine Adrenaline Bromocriptine Prazosin Loading...1096. Which of the following is the most likely finding on a biopsy of a case of chronic bronchitis? Caseating granuloma Abundant mucus with plugging of the bronchioles Non-caseating granuloma Interstitial fibrosis Loading...1097. Gastric inhibitory peptide (GIP) and Glucagon-like peptide-1 (GLP-1) are secreted by? Intestine's Liver Kidney Adrenal glands Loading...1098. Which one of the following drugs is Quaternary compound antispasmodic? Propantheline Dicyclomine Biperiden Cyclopentolate Oxybutynin Loading...1099. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Indanyl carbenicillin 6-thioguanine Ezetimibe Lamivudine Capreomycin Loading...1100. 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? Brown-Sequard syndrome Conus medullaris syndrome Transverse myopathy Central cord syndrome Anterior cord syndromePage 45 of 66 Loading...1101. A patient develops severe diarrhea after 2 weeks of treating pneumonia with broad spectrum antibiotics. Which of the following is the first line of treatment of this condition? Vancomycin Methicillin Ampicillin Ciprofloxacin Loading...1102. Amantadine belongs to the class of following drugs? Antipyretic Antiprotozoal Antibiotics Antiviral Anti malaria Loading...1103. Which one of the following medications causes black stools? Buspirone Iron Ampicillin Propranolol Loading...1104. Which of the following drug belongs to H2 histamine receptor blocker? Glimepiride Oxacillin Niacin Cefoxitin Cimetidine Loading...1105. 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 Carotid Doppler studies Refer to a neurologist Start prednisone CT scan of the head Loading...1106. A 32-year old diabetic woman delivered a large baby after difficult vaginal delivery. At labor, the head emerged first and then the shoulders were stuck behind the bony pelvis. The obstetrician had to use some tools and maneuvers to deliver the baby. The baby had a good cry and red pink color but his right arm was not moving. It was hanging on his side with medial rotation. Which of these nerve roots are most likely affected? C6 and C7 C5 and C6 C7 and C8 C8 and T1 Loading...1107. Blockage of ɑ1 and ɑ2 adrenergic receptors on the arteriolar beds lead to following? Increase peripheral resistance Reduce peripheral resistance Increase renin secretion None Increase renin secretion Loading...1108. 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 Child abuse Attention-deficit-hyperactive disorder (ADHD) Antisocial personality Oppositional defiant disorder (ODD) Loading...1109. Which of the following is the most dangerous adverse effect of chronic alcohol abuse? Respiratory depression Cutaneous vasodilation Live cirrhosis Impaired judgment Loading...1110. Epinephrine acts on which one of the following receptors to constrict vascular smooth muscle? α1-Adrenoceptors α2-Adrenoceptors β1-Adrenoceptors β2-Adrenoceptors Loading...1111. 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 Folic acid deficiency Thiamine deficiency Niacin deficiency Vitamin B12 deficiency Loading...1112. A 56- year-old man visits his physician complaining of lower back pain for 1 week. He was moving to a new house and carrying a lot of furniture during the last 2 weeks. He does not remember any injury or trauma to his back. His pain is not radiating, improving by rest and ibuprofen and worsening by movement. Medical, surgical and family histories are unremarkable. On examination, vital signs are within normal limits. There is a diffuse tenderness over the lumbar area. Neurological examination is normal. Laboratory tests are normal. What is the most appropriate next step of management for this patient? Complete bed rest with ibuprofen for 3 days Electromyography X-ray of lumbar spine HLA-B27 testing Refer to a rheumatologist Loading...1113. A drug that act as laxative is one of the following? Sulbactam Lactulose A & B Bumetanide Furosemide Loading...1114. Which one of the following adverse effects of calcium channel blockers is wrong? Diarrhea Hypotension Vertigo Fatigue Loading...1115. A 56-year-old man presents to the emergency room complaining of severe chest pain, nausea and excessive sweating for 30 minutes. ECG and laboratory tests confirm the diagnosis of acute myocardial infarction. What is the most likely reason of diaphoresis in this patient? Decreased sodium and water retention Parasympathetic stimulation Decreased peripheral resistance Elevated parathyroid hormone Sympathetic stimulation Loading...1116. Which one of the following viruses most likely causes aplastic crisis in sickle cell disease? Parvovirus B19 Herpes simplex virus Hepatitis C virus Rotavirus Loading...1117. Administration of which one of the following substances most likely reverses the course of Wernicke-Korsakoff syndrome? Niacin Vitamin K Riboflavin Thiamine Loading...1118. Conversion of ethanol to acetate will result in increase production of which of the following? Pyruvate NADH NAD Oxaloacetate Loading...1119. A 40-year-old woman complains of fatigue, headache and generalized pain for 9 months. She presented to the clinic several times and had multiple negative workups. Her pain started as localized to her head, neck and shoulder but now it is generalized. On physical examination, there are multiple points of tenderness on bony prominences. What is the most likely prognosis of this condition? Full recovery with radiation and chemotherapy Symptomatic improvement with supportive therapy Full recovery with multiple surgeries Full recovery with specific medical therapy Slow progression to permanent disability Loading...1120. Verapamil, a calcium channel antagonist: Decreases intracellular K Increases conduction velocity Increases reactivation of sodium channels Decreases myocardial contractility Increases intracellular cAMP Loading...1121. A young man complains of little finger numbness and difficulty gripping things. Which of the following is the affected nerve root? Cervical 7 Cervical 8 Cervical 5 Cervical 6 Loading...1122. 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:ctose dehydrogenase 267 U/L What is the most likely diagnosis of this patient condition? Stroke Heart attack Alcohol toxicity Alcohol withdrawal Loading...1123. A 2-week-old boy is brought for persistent vomiting of non-bilious material after feeding. The boy is lysergic and dehydrated. Examination reveals presence of an olive-sized mass in the epigastric area moving with peristalsis. What is the most likely diagnosis? Esophageal atresia Duodenal atresia Meckel’s diverticulum Pyloric stenosis Loading...1124. Which of the following is a poor prognostic sign of acute pancreatitis a day after initiation of hydration and appropriate treatment? Hematocrit drops by 4% Random serum glucose of 70 mg/dL Serum amylase of 900 IU/L Blood urea nitrogen (BUN) rises 6 mg/dL Loading...1125. Which one of the following drugs is a Meglitinide drug? Ezetimibe Repaglinide Fenofibrate Hydrochlorothiazide Indanyl carbenicillinPage 46 of 66 Loading...1126. Which one of the following statements about the use of Alpha-methyldopa is incorrect? Cardiac output is decreased Reduce peripheral resistance Alpha² agonist activity Causes Sedation and drowsiness Loading...1127. A 52-year-old man who is recently diagnosed with gout is presented to his physician to discuss his treatment plan. One of the treatments that will be taken is allopurinol. Which of these enzymes is targeted by this medication? Hypoxanthine guanine phosphoribosyltransferase Phosphoribosylpyrophosphate synthase Guanase Xanthine oxidase Loading...1128. A 69-year-old man presents to the clinic with his wife for evaluation of his memory problem. His wife tells you that her husband has begun to forget recent events insidiously since last year. He forgets recent conversations and recent appointments. He is no longer able to manage his checkbook and daily budget as he used to do. He has no history of general medical condition and he only takes baby aspirin daily. His examination is normal. Mini mental status examination reveals prominent memory loss. MRI shows a few areas of cerebral atrophy. Which of the following is the most likely diagnosis? Lewy body dementia Creutzfeldt-Jakob disease Old age dementia Vascular dementia Alzheimer’s disease Loading...1129. 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? Styloglossus muscle Hypoglossus muscle Palatoglossus muscle Genioglossus muscle Loading...1130. 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? Lateral sacral External iliac Inferior epigastric Internal iliac Loading...1131. Which one of the following is the most common cause of vitiligo? Chemical Autoimmune Infection Trauma Loading...1132. A disease characterized as recurrent and persistent abdominal discomfort and abdominal pain? Dyspepsia GERD Peptic Ulcer disease A & B Loading...1133. 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? Prolactinoma Metastatic carcinoma Pregnancy Intraductal papilloma Loading...1134. Which of the following tests is most likely used to rule out congestive heart failure in a case of cardiomegaly during pregnancy? Electrocardiogram (ECG) MRI of the chest Echocardiography Arterial blood gas Loading...1135. Which of the following joint conditions is characterized by narrowing of joint space and formation of osteophytes? Gouty arthritis Rheumatoid arthritis Pseudo-gout Osteoarthriti Loading...1136. A 26-year-old pregnant woman visits her primary care physician for routine examination. Her examination is normal. Her blood group is O, Rh-negative. Administration of which of the following should prevent the development of related fetal complications? Wide spectrum antibiotics Rh (D) immune globulin Ferrous sulfate Folic acid derivatives Loading...1137. Blanching and sloughing of skin is the adverse effect of one of the following Direct acting adrenergic agonists? Isoproterenol Dopamine Norepinephrine Dobutamine Epinephrine Loading...1138. Histamine Receptor found on eosinophils and mast cells having a chemotactic function also found on neutrophils and CD⁴ T cells are following? H² histamine receptor H⁵ Histamine receptor H³ histamine receptor H⁴ histamine receptor H¹ histamine receptor Loading...1139. Which one of the following enzymes is associated with Lyesh-Nyhan syndrome? Hypoxanthine-guanine phosphoribosyl transferase Adenosine deaminase Ribonucleotide reductase Xanthine oxidase Loading...1140. 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 Advise family that it is a normal reaction and keep an eye on her Prescribe antidepressant and follow up in a week Refer to the social worker Loading...1141. Which one of the following drugs is a Proteas inhibitor? Abacavir Maraviroc Darunavir Delavirdine Indanyl carbenicillin Loading...1142. Which one of the following amines is permanently charged? Tertiary Secondary Primary Quaternary Loading...1143. 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 lowers surface tension and increases compliance It elevates surface tension forces and decreases compliance Loading...1144. Which one of the following procoagulant factors is produced by the epithelial cells? Thromboxane A2 von Willebrand’s factor (vWF) Prostacyclin Fibrinogen Loading...1145. An agent that contains sulfonamide structure in structural formula and blocks cysLT¹ receptor thus blocking the effect of leukotrienes? Acetaminophen Zileuton Ergotamine Zafirlukast Loading...1146. Which one of the following joints is the only articulation between the upper limb and the trunk? Sternoclavicular joint Glenohumeral joint Coracoclavicular joint Acromioclavicular joint Loading...1147. 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? Psychogenic Inflammatory Osmotic Secretory Loading...1148. Which of the following drug contain the Carboxylic group, replaced with tetrazole ring in the structural formula? Valsratan Losartan Candesartan Irbesartan Telmisartan Loading...1149. Which one of the following drugs reduce the absorption of phosphate when taken with diet? Indanyl carbenicillin Hydrochlorothiazide Ezetimibe Sevelamer Montelukast Loading...1150. Which type of hypersensitivity reaction develops from Mycobacterium tuberculosis? Type III Type II Type I Type IVPage 47 of 66 Loading...1151. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Voriconazole Naftifine Miconazole Ibandronate Capecitabine Loading...1152. A drug increase cAMP results in activation of protein kinase? Clopidogrel Aspirin Ticlopidine Dobutamine Tirofiban Loading...1153. 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 Complement activity Immune complex deposition Cell mediated hypersensitivity Loading...1154. 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? Brain biopsy CSF analysis Head CT scan MRI of the brain Loading...1155. Reflex bradycardia caused by alpha-1-agonists is blocked by which of the following medications? Phenylephrine Adrenaline Metoprolol Atropine Loading...1156. 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 C virus DNA for Epstein-Burr virus Antibody to hepatitis B surface antigen IgM antibody to hepatitis A virus Serum anti-mitochondrial antibodies Loading...1157. Which one of the following valve abnormalities is related to intravenous drug abuse? Aortic stenosis Mitral stenosis Tricuspid regurgitation Aortic regurgitation Loading...1158. ADP mediated platelets aggregation is inhibited by? Eptifibatide Dipyridamole Tirofiban Aspirin Clopidogrel Loading...1159. Phenylephrine has the least affinity for following adrenoceptors type? All of these α2 Receptors α1 & B1 Receptors α1 Receptors Both A & B Loading...1160. Which one of the following drugs has a relatively lowest potential to induce drowsiness? Cetirizine Fexofenadine Loratadine Acrivastine Loading...1161. A 72-year-old woman presents to her physician complaining of abdominal pain and frequent episodes of burning micturition. After physical examination and laboratory tests, she is diagnosed with urinary tract infection. She is prescribed gentamicin in addition to other medications. What is the most likely complication attributed to this antibiotic? Thrombocytopenia Agranulocytosis Hepatic toxicity Hearing loss Loading...1162. Which one of the following drugs belongs to inhibitors of viral coating? Amantadine Acyclovir Oseltamivir Zidovudine Nevirapine Loading...1163. Which of the following is the main site of action of HMG-CoA reductase inhibitors? Liver GI tract Kidney Blood Loading...1164. Which one of the following drugs reverses the effects of heparin? Warfarin Epinephrine Chloroquine Protamine Loading...1165. A 40-year-old man with a long history of intravenous drug addiction presents to the emergency room complaining of fever, anorexia, malaise, shortness of breath, cough and chest pain for 2 days. On physical examination, temperature is 102.7 F, Pulse is 110/min. and blood pressure is 110/66. Irregular erythematous nodules are seen on his hands and feet. Which of the following is most likely valvular lesion associated with this infection? Mitral valve stenosis Mitral valve regurgitation Pulmonic valve stenosis Aortic valve stenosis Tricuspid valve regurgitation Loading...1166. The effect of two medications is greater than the sum of their individual effects explains which of the following drug interactions? Permissive Synergistic Additive Tachyphylaxis Loading...1167. Foci of hemorrhage and necrosis in which of the following parts of the brain is characteristic of Wernicke’s encephalopathy? Mamillary bodies Anterior pituitary Posterior pituitary Basal ganglia Loading...1168. In an acute attack of gout, Indomethacin is preferred over Colchicine because of which characteristic? Less likely to cause acute renal failure Less likely to cause diarrhea More likely to prevent further acute attacks More likely to reduce inflammation Less likely to cause GI bleeding Loading...1169. Which of the following conditions should be screened at the age of 50? Prostate cancer Colon cancer Lung cancer Adrenal insufficiency Loading...1170. The drug that produces dilation of the pupil (mydriasis) for 6 hours is one of the following drugs? Ipratropium Physostigmine Cyclopentolate Tropicamide Atropine Loading...1171. Which of the following is the mechanism of action of metoprolol in angina? Increases peripheral resistance Increases central venous pressure Reduces requirement of the heart for oxygen Reduces production of epinephrine Loading...1172. Which of these medications is the drug of choice in treatment of severe digitalis intoxication? Calcitonin Propranolol Bupropion Immune Fab Loading...1173. Laboratory tests for a patient are as follows: Plasma creatinine concentration is 0.8 mg/dL 100 ml/minine creatinine concentration is 80 mg/dL Urine volume is 1 ml/min 50 ml/minich of the following is the creatinine clearance? 300 ml/min 200 ml/min Loading...1174. Which one of the following cardiac conditions occurs in about 25% of patients with systemic lupus erythematosus (SLE)? Atrial hypertrophy Aortic stenosis Pericarditis Ventricular myxoma Loading...1175. 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 DepressionPage 48 of 66 Loading...1176. 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 heparin Start warfarin Start aspirin Loading...1177. Which of the following causes pancreatitis? All of the above Didanosine Azathioprine L-asparaginase Exenatide Loading...1178. 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? Anoscopy Colonoscopy Fecal occult blood test Barium enema Sigmoidoscopy Loading...1179. Ketorolac is derived from which of the following class? Salicylic Acid derivatives Acetic acid derivative Propionic acid derivative Enolic acid derivative Fenamic acid derivative Loading...1180. Which one of the following drugs is associated the most to tardive dyskinesia after use for years? Aripiprazole Olanzapine Chlorpromazine Risperidone Loading...1181. 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? Inhibits the production of prostaglandin E2 Stimulates the production of prostaglandin E2 Limits the production of histamine Interferes with the production of leukotrienes Inhibits the production of Phospholipase A2 Loading...1182. Which of the following is not a feature of Tetralogy of Fallot? Right ventricular hypertrophy Overriding aorta Pulmonary stenosis Atrial septal defect Loading...1183. Which of the following is the mechanism of action of metoclopramide? α-Adrenoceptor antagonist Nicotinic receptor antagonist Serotonin reuptake reuptake inhibitor (SSRI) Dopamine D2-receptor antagonist Loading...1184. Which of the following differentiates HIV virus from RNA tumor viruses? HIV virus has a cytolytic activity HIV virus is a retrovirus HIV virus contains the pol gene HIV virus contains 2 copies of RNA Loading...1185. Hemorrhagic cystitis may develop after the use of cyclophosphamide. Which one of the following drugs can reduce this risk? Mensa Ampicillin Vitamin K Infliximab Loading...1186. 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? Aortic insufficiency Mitral stenosis Mitral regurgitation Pulmonic stenosis Aortic stenosis Loading...1187. 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? Ampicillin Amphotericin B Nystatin Acyclovir Ciprofloxacin Loading...1188. Tazobactam belongs to the one of the following class? Cephalosporin Carbapenems Monobactams Beta lactamase inhibitor Penicillins Loading...1189. A 90-year-old man is hospitalized from falling and breaking his hip. He has been already in the hospital for 6 days when he developed a burning sensation upon urinating. An analysis of his urine shows plenty of gram positive cocci and leukocytosis. The attendant physician treats him with trimethoprim-sulfamethoxazole. However, the fever still persists. After 2 more days, the patient develops a diastolic murmur radiating to the axilla and a low-grade fever is still persisting. Out of the following, which would be the first line treatment for the cause of the possible infection? Piperacillin Vancomycin Gentamicin Ampicillin Loading...1190. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefadroxil Cefotaxime Cefaclor Cefepime Loading...1191. Which of the following drug is used as Mast Cell Stabilizers? Montelukast Terbutaline Ipratropium Bromide Salbutamol Sodium Cromoglycate Loading...1192. Release of which of the following chemical mediators results in pain in cases of acute inflammation? Complement C3b Prostaglandin Serotonin Histamine Loading...1193. 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? Pudendal nerve Ilioinguinal nerve Lateral cutaneous nerve Genitofemoral nerve Loading...1194. 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? Oral Sublingualugs administered by intramuscular, intravenous, subcutaneous and sublingual routes reach the blood stream first before they are metabolized by liver enzymes. Intravenous Intramuscular Loading...1195. A drug is more effective when combined with Flucytosine to treat candidiasis or cryptococcosis? Griseofulvin Caspofungin Itraconazole Amphotericin B Loading...1196. Which one of the following conditions most likely increases the risk for deep venous thrombosis (DVT)? Adenocarcinoma Pulmonary tuberculosis Crohn’s disease Coronary heart disease Loading...1197. Insulin dependent Diabetes mellitus? Type 1 diabetes Mellitus Gestational Diabetes mellitus A & D Type 2. Diabetic mellitus Pseudo hypoglycemia Loading...1198. 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? Thyroid hormone deficiency Progesterone deficiency Estrogen deficiency Testosterone deficiency Loading...1199. A drug that inhibit the guanosine triphosphate formation thus preventing viral mRNA capping and RNA dependent RNA polymerase blockage? Oseltamivir Ribavirin All of the above Both A & B Amantadine Loading...1200. Para-aminophenol derivative drug is the following? Mefenamic acid None of these Celecoxib Meloxicam AcetaminophenPage 49 of 66 Loading...1201. Amylin consecrated with insulin has the following actions except? Suppress appetite Delayed gastric emptying time Decrease postprandial glucagon secretion Increase beta-cell growth Loading...1202. Which of the following conditions most likely be presented with primary amenorrhea? Pituitary adenoma Pregnancy Turner syndrome Loading...1203. Which one of the following drugs induce Dose Dumping syndrome? Rifampin Erythromycin Amiodarone Digoxin Ethanol Loading...1204. A 30-year-old female after thyroidectomy needs replacement therapy. The preferred thyroid preparation for maintenance replacement therapy is which of the following drugs? Liotrix Protirelin Levothyroxine Desiccated thyroid Liothyronine Loading...1205. What is the mechanism of action of finasteride? Inhibition of 5-alpha-reductase Gonadotropin-releasing hormone analog Inhibition of testosterone negative feedback Stimulation of the posterior lobe of pituitary gland Loading...1206. Which of the following drugs is neuraminidase inhibitor drug? Capecitabine Zanamivir Ibandronate Naftifine Miconazole Loading...1207. 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? Dobutamine Levothyroxine Warfarin Propylthiouracil Iodine Loading...1208. Which of the following parts of the stomach has a dome-shaped appearance and lies superior to the lower end of esophagus? Body Fundus Antrum Pylorus Loading...1209. Which one of the following anti-acne drugs act by induction of apoptosis in sebaceous glands? Benzoyl peroxide Azelaic acid Tetracycline Isotretinoin Loading...1210. Which of these medications is the most appropriate treatment of malignant hyperthermia? Indomethacin Ibuprofen Dantrolene Acetaminophen Loading...1211. 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? quaternary charge glucuronidated form protein-bound ionized form unionized form Loading...1212. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Ibandronate A & B Pyrazinamide Rabeprazole Furosemide Loading...1213. A disease that is characterized by the movement of gastric contents from the stomach into the esophagus? A & B GERD Peptic Ulcer disease Dyspepsia Loading...1214. Cimetidine is used to treat one of the following diseases? Blood pressure Viral infection Malaria Diabetes Stomach Ulcer Loading...1215. 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 Conversion disorder Multiple sclerosis Transient ischemic attack Loading...1216. Which one of the following drugs belongs to drugs for hepatic viral infections? Indanyl carbenicillin Capreomycin Lamivudine Aluminium hydroxide Ezetimibe Loading...1217. Which of the following is Coumarin derivative Anticoagulant agent? Abciximab Warfarin Ticlopidine Heparin Clopidogrel Loading...1218. Hypertriglyceridemia and hypercholesterolemia are the adverse effects of following drugs? Integrase inhibitors Nucleoside analogs Protease inhibitors Entry inhibitors Loading...1219. Which of the following group is a compulsory part structural formula of Losartan? Phosphinic acid group Thiol group Imidazole ring Sulfahydril group Carboxylate group Loading...1220. What is the most common injury resulting from wearing a heavy backpack for a long time? Shoulder dislocation Costoclavicular syndrome Frozen shoulder Rotator cuff injury Loading...1221. Which of the following is the mechanism of action of vinblastine? Interferes with DNA mobilization and replication Interferes with microtubule disassembly Interferes with purine synthesis Interferes with microtubule assembly Loading...1222. Which one of the following can be found in sickle cell disease? Spherocytes Howell-Jolly bodies Bite cells Schistocytes Loading...1223. An old patient presents with multiple tumors on the liver. Which of the following is the most common site of the primary tumor? Breast Lung Kidney Colon Loading...1224. Which one of the following is an antimuscarinic agent? Tacrine Echothiophate Neostigmine Pralidoxime Scopolamine Loading...1225. Which of the following receptors is inhibited by ondansetron to treat nausea following chemotherapy? Muscarinic receptors Serotonin 5-HT receptors Dopamine receptors Nicotinic receptorsPage 50 of 66 Loading...1226. Cinchonism is a possible side effect of which one of the following drugs? Enflurane Metoclopramide Isoniazid Quinidine Loading...1227. Which of the following esophageal disorders is the most likely a complication of HIV infection? Achalasia Adenocarcinoma Esophageal varices Candida esophagitis Loading...1228. Which of the following leukocytes have nuclei of 3-5 lobes and azurophilic light-pink small granules in their cytoplasm? Plasma cells Basophils Monocytes Neutrophils Loading...1229. Which of the following drug belongs to Sulfonylureas? Niacin Tolbutamide Oxacillin Cefoxitin Urae Loading...1230. Which of the following markers identifies B lymphocytes in a blood sample treated with different fluorescent-labeled antibodies? CD8 CD4 CD19 CD3 Loading...1231. 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 She already has HPV infection so, no need for the vaccine 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...1232. Which one of the following antiretroviral drugs is a protease inhibitor? Tenofovir Ritonavir Etravirine Lamivudine Zidovudine Loading...1233. Which of the following muscles are the primary abductors of the arm at the shoulder? Deltoid and supraspinatus Deltoid and infraspinatus Deltoid and biceps Deltoid and coracobrachialis Loading...1234. Which of the following statements correctly describes the relative risk of a study? Odds that the group with a disease was exposed to a risk factor divided by odds that the group without the disease was exposed Risk of developing disease in the exposed group divided by risk in the unexposed group The difference in risk between exposed and unexposed groups The proportion of risk reduction attributable to the intervention as compared to a control Loading...1235. Which of the following regions of the brain is most likely affected in patients with Huntington’s disease? Temporal lobe Anterior frontal lobe Substantia nigra Caudate nucleus Loading...1236. 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 Clay colored stool Increased urobilinogen in urine Increased bilirubin in urine Dark brown urine Loading...1237. Directly acting cholinergic agonist drug? Pilocarpine A & B Tacrine Echothiophate Acetylcholine Loading...1238. 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? Melanin Bilirubin Lipofuscin Hemosiderin Loading...1239. Which one of the following anticonvulsant drugs in used only in the treatment of absence seizures? Carbamazepine Lorazepam Levetiracetam Ethosuximide Loading...1240. Dizziness, tinnitus, blurred vision, and headache are linked with the following drug? A & B All of the above Quinidine Quinine Primaquine Loading...1241. 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 History of diarrhea and weight loss Smoking cessation Family history of inflammatory bowel syndrome Having first attack in his twenties Loading...1242. Which of the following is the most likely cause of decreased visual acuity in pregnancy? Retinal detachment Thickening of the cornea Macular degeneration Optic nerve degeneration Loading...1243. Which one of the following is the most common cause of non-adherence to administration of prescribed drugs? Fear of addiction Forgetfulness Frequent dosing Food restrictions Loading...1244. 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? Acting out Transference Projection Countertransference Displacement Loading...1245. Amphotericin B belongs to the class of following drugs? Antipyretic Antifungal Antiviral Antibiotics Antiprotozoal Loading...1246. Which of the following is the earliest EKG sign of myocardial infarction? S-T elevation Large peaked T-wave Pathological Q –wave Inverted T-wave Loading...1247. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefadroxil Cefaclor Ceftazidine Cefepime Loading...1248. Which of the following is the most common complication of diverticulosis? Perforation Obstruction Diverticulitis Bleeding Loading...1249. Which of the following group of medications prolongs GABA activity in the brain? Methamphetamines Alcohols Benzodiazepines Barbiturates Loading...1250. 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 Dorsal interossei Opponens pollicis LumbricalsPage 51 of 66 Loading...1251. A drug that is a part of Macrolide is following? Cefaclor Cefdinir Cefepime Clarithromycin Loading...1252. A patient represents with a neck mass. Which of the following suggests the possibility of cancer? Recent complaint of toothache Pain or tenderness History of hoarseness of voice for 3 months History of hypothyroidism Loading...1253. Canrenone is an active metabolite of one of the following Diuretic drug? Acetazolamide Furosemide Bumetanide Spironolactone Triamterene Loading...1254. Which of the following is the most serious contraindication of electroconvulsive therapy? History of fracture Old age Meningioma History of seizures Loading...1255. 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 prednisone Start duloxetine Perform electromyogram (EMG) Start hydrocodone Loading...1256. 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? Celiac trunk Abdominal aorta Superior mesenteric artery Inferior mesenteric artery Loading...1257. 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? Heparin Cardioversion Metoprolol Refer to cardiologist Aspirin Loading...1258. Which of the following are side effects of Aspirin? Bronchoconstriction Metabolic acidosis Urticaria All of the above Peptic ulcer diseased Loading...1259. 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 Osteoarthritis Rheumatoid arthritis Gout Loading...1260. Which of the following side effect occurs in most of the patients when Alkylating agents and antimetabolites drugs are given in a therapeutically effective dose? Gastrointestinal toxicity Nausea Thinning of hair Myelosuppression Gonadal toxicity Loading...1261. Which of the following drug is a derivative of Acetic acid? Piroxicam ketorolac Etodolac Diflunisal Mefenamic Acid Loading...1262. 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? Explain to her with documentation the benefits and risks of immunization Obtain a court order Proceed with immunization Report her to health authorities Loading...1263. Drugs that show capacity-limited elimination have which of the following property? First-order elimination kinetics is followed by low and high doses both As the administered dose increases the elimination half-life (t½) increases A constant ratio of drug metabolites are formed as the administered dose increases The elimination half-life(t½) remains constant Loading...1264. Torsades de pointes may occur after the use of which one of the following medications? Propranolol Sotalol Lidocaine Rifampin Loading...1265. Niemann-Pick disease is characterized by deficiency of which one of the following enzymes? Arylsulfatase Alpha-glucosidase Sphingomyelinase Beta-glucosidase Loading...1266. Which of the following types of cells predominantly lines the conducting airways of the lung and is considered an important defense mechanism? Ciliated cells Basal cells Goblet cells Endocrine cells Loading...1267. Aspirin has anti-platelet effect that lasts for the life of the platelet. What is the average life of a platelet? 24 hours 2-4 days 7-10 days 120 days Loading...1268. Which one of the following agents is a muscarinic cholinomimetic? Atropine Tubocurarine Pilocarpine Hexamethonium Loading...1269. 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? Psoriasis Shingles (herpes zoster) Seborrheic keratosis Rosacea Dermatitis herpetiformis Loading...1270. Which one of the following lipid-lowering agents can cause skin flushing and pruritus? Gemfibrozil Cholestyramine Atorvastatin Niacin Loading...1271. 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? Pseudogout Osteoarthritis Osteosarcoma Gout Acute arthritis Loading...1272. Which of the following correctly describes pleiotropy? Increased severity of a disease in succeeding generations 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 Loading...1273. Low doses of one of the following drugs produce sedation, but at high doses it produces excitement? Pirenzepine Physostigmine Atropine Scopolamine Phenylephrine Loading...1274. A drug that is used to treat HIV infections is one of the following? Tenofovir Niclosamide Etidronate Cladribine Praziquantel Loading...1275. 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? Measles Adenovirus Coxsackie virus Echovirus RubellaPage 52 of 66 Loading...1276. Which one of the following drugs is a natural penicillin with a property of high acid stability than other naturally occurring penicillin? Methicillin Penicillin V Amoxicillin Penicillin G Loading...1277. Which one of the following disease is caused by bite of infected ticks? Mycoplasma Pneumonia Rocky mountain spotted fever Lyme disease Cholera Loading...1278. 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 Measure serum acetaminophen concentration Administer N-acetylcysteine Loading...1279. A drug that is more effective in combination with itraconazole to treat chromoblastomycosis? Griseofulvin Amphotericin B Nystatin Flucytosine Loading...1280. 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...1281. Heparin acts by binding to which of the following substances to achieve its anticoagulant activity? Factor V Prothrombin Factor VIII Antithrombin III Loading...1282. Which one of the following drugs results in disulfiram- like action when it is accompanied with alcohol? Cimetidine Dipyridamole Ampicillin Cefotetan Loading...1283. Which one of the following drugs is used to treat copper toxicity? Atropine Aminocaproic acid Penicillamine Protamine Loading...1284. 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? Ampicillin Vancomycin Azithromycin Amoxicillin Gentamicin Loading...1285. Disease prevalence can be measured by which one of the following studies? Cross-sectional study Cohort study Adoption study Case-control study Loading...1286. N-acetylcysteine is an antidote, which restores the glutathione levels in the hepatocytes decreased by the toxicity of which of the following specific drug? Acetaminophen Ketorolac Naproxen Mefenamic acid Meloxicam Loading...1287. 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? Streptococcus viridans Escherichia coli Campylobacter Staphylococcus aureus Loading...1288. 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? VI II I III Loading...1289. 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? Captopril Verapamil Diltiazem Metoprolol Atenolol Loading...1290. 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 MRI of the mass Refer to surgery for removal of the adrenal mass Assure the patient and schedule another CT scan after 6 months Order hormonal assay to evaluate if the mass is functional or not Perform a needle biopsy Loading...1291. Indirect acting irreversible cholinergic agonist drug? Neostigmine Echothiophate Tacrine Pilocarpine Loading...1292. Which of the following drugs is the initial therapy for Alzheimer disease? Methacholine Donepezil Carbachol Pilocarpine Loading...1293. Which one of the following medications binds tumor necrosis factor (TNF-α) and used in the treatment of rheumatoid arthritis? Infliximab Paclitaxel Trastuzumab Methotrexate Loading...1294. Which of the following is the central action of cocaine? Stimulation of dopamine release Inhibition of reuptake of dopamine and epinephrine Inhibition of phosphodiesterase Inhibition of reuptake of serotonin Loading...1295. 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 Freckles Melasma Benign lentigo Loading...1296. Lidocaine is an effective antiarrhythmic because of which of the following mechanisms? It block beta-receptors It suppresses excitability in ischemic areas of the heart It prolongs PR interval It blocks alpha-receptors It prolongs QT interval Loading...1297. 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 Tolazamide Glyclopyramide Metformin Carbetamide Loading...1298. Beta-Blocker drug is following? Metoprolol Mecamylamine Tacrine Atracurium Atropine Loading...1299. Which one of the following inhibit the excretion of Indomethacin, naproxen, and ketoprofen? Sulfinpyrazone Allopurinol Probenecid Colchicine Loading...1300. The cough associated with Captopril is most likely associated with? Increase in bradykinin levels Stimulation of adenosine receptors in the lungs Release of histamine Direct airway irritation Decrease in the metabolism of acetylcholinePage 53 of 66 Loading...1301. Which of the following is the first line therapy for gastroparesis in patients with diabetes? Ondansetron Metoclopramide Omeprazole Cimetidine Loading...1302. Which one of the following diuretics may elevate blood glucose level in some patients? Acetazolamide Triamterene Hydrochlorothiazide Spironolactone Loading...1303. What is the most appropriate next step in management of a patient complaining of symptoms of GERD? Ranitidine Omeprazole Endoscopy Barium swallow Loading...1304. To diagnose myasthenia gravis we use? Malathion Physostigmine Edrophonium Pralidoxim Ambenonium Loading...1305. Which of the following medications prevents cholesterol absorption at small intestine brush border? Niacin Fenofibrate Colestipol Ezetimibe Loading...1306. 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 parathyroid hormone End-organ hyposensitivity to parathyroid hormone Decreased secretion of parathyroid hormone Increased secretion of calcitonin End-organ hyposensitivity to calcitonin Loading...1307. Which of the following type of virus causes chickenpox? Varicella zoster Cytomegalovirus A & B Herpesvirus Orthomyxoviruses Loading...1308. 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 Vasovagal reflex Aortic stenosis Antihypertensive therapy Loading...1309. A 62-year-old woman visits her physician for a routine physical examination. She has a long history of lower back pain and she takes ibuprofen as needed. She also takes levothyroxine for hypothyroidism. She exercises daily for 30 minutes and follows a regular diet. On examination, her pulse is 45/min. Holter monitor reveals a regular pulse ranging from 40-80 pulse/min. Her thyroid-stimulating hormone is within normal limits. What is the best management for this patient at this point? Reassurance and follow up visits Repeat Holter monitor examination Pacemaker implantation Perform exercise stress test Refer to a cardiologist Loading...1310. 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 Median nerve Suprascapular nerve Ulnar nerve Axillary nerve Loading...1311. Which one of the following cephalosporins belongs to the third generation? Ceftin Cefixime Cefoxitin Cefaclor Loading...1312. N-Substitutions of the catecholamine pharmacophore with isopropyl groups or aryl-alkyl groups improve the selectivity of which receptor? Dopaminergic receptor Beta Receptor Alpha Receptor Muscarinic Receptor Neuromuscular Activity Loading...1313. Which of the following is the mechanism of action of cromolyn for asthmatic patients? Prevents degradation of mast cells Inhibits phosphodiesterase Blocks adenosine receptors in bronchial smooth muscle Inhibits COX 2 Loading...1314. If the prevalence of a disease is 10%, what is the chance that randomly selected 3 persons out of this population will all have the disease? 0.0001 0.001 0.1 0.0.1 Loading...1315. Which one of the following drugs is used to treat asthma? Repaglinide Ezetimibe Indanyl carbenicillin Hydrochlorothiazide Montelukast Loading...1316. 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 Acetazolamide Chlorothiazide Spironolactone Furosemide Loading...1317. A 62-year-old man who has a history of various drug overdose incidents presents to the emergency room after administration of a high dose of aspirin. Which set of these findings characterizes this condition? Metabolic alkalosis and respiratory alkalosis Metabolic alkalosis and respiratory acidosis Metabolic acidosis and respiratory alkalosis Metabolic acidosis and respiratory acidosis Loading...1318. Which one of the following drugs is a Tetracycline? Cefepime Cefdinir Minocycline Cefadroxil Loading...1319. A 26-year-old man with a history of HIV infection presents with fatigue and nuchal rigidity for 3 days. Lumber puncture shows increased leukocytes. India ink preparation detects which one of the following organisms? Aspergillus fumigatus Cryptococcus neoformans Toxoplasma gondii Streptococcus pneumonia Loading...1320. Which one of the following drugs is a sodium channel blocker (Class I)? Carvedilol Procainamide Amiodarone Verapamil Loading...1321. 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? Pyloric stenosis Tracheomalacia Imperforate anus Tracheoesophageal fistula Tetralogy of Fallot Loading...1322. 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? Mitochondrial Autosomal recessive Multifactorial Autosomal dominant X-linked recessive Loading...1323. A drug that belongs to Loop Diuretics is one of the following? Doripenem Cefazolin A & B Sulbactam Ethacrynic Acid Loading...1324. Terbinafine is a drug of choice for treating dermatophytoses, it's blood levels are Increased by following drug? Nystatin Caspofungin Rifampin Cimetidine Loading...1325. Which of the following medications is considered a selective beta-1 adrenergic agonist? Dobutamine Amrinone Prazosin DopaminePage 54 of 66 Loading...1326. Butoconazole belongs to the class of following drugs? Antiviral Antipyretic Antiprotozoal Antifungal Antibiotics Loading...1327. Which one of the following nerves would be likely affected if a stab injury is established to the lower brachial plexus (C8-T1)? Ulnar nerve Radial nerve Axillary nerve Musculocutaneous nerve Loading...1328. 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? Assessment of insulin-like growth factor 1 (IGF-1) Measurement of thyroid stimulating hormone (TSH) Dexamethasone suppression test Measurement of HbA1c Fasting serum glucose test Loading...1329. 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? Lung cancer Pneumonia Tuberculosis Sarcoidosis Asbestosis Loading...1330. Which of the following medications is the drug of choice for motion sickness? Dicyclomine Scopolamine Tolterodine Benztropine Loading...1331. Which of the following is the most prominent side effect of scopolamine? Miosis Profuse sweating Bradycardia Mydriasis Loading...1332. Which one of the following drugs is tertiary amine antispasmodic? Dicyclomine Propantheline Biperiden Cyclopentolate Oxybutynin Loading...1333. 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? Etoposide Cyclophosphamide Bleomycin Cisplatin Paclitaxel Loading...1334. 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? Refer to surgery for bowel resection Colonoscopy Contrast enema MRI of the abdomen IV hydration and antibiotics Loading...1335. During spermatogenesis, which type of cells enter meiosis 1 to from primary spermatocytes? Spermatids Type A spermatocytes Primordial germ cells Type B spermatocytes Loading...1336. A 9-month-child who was delivered after premature labor and is feeding on cow milk and orange juice. What is the predicted deficiency? Calcium Iron Vitamin CVitamin D Loading...1337. 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 Trauma to the head due to elderly abuse Middle cerebral artery stroke Alzheimer’s disease Anterior pituitary adenoma Loading...1338. 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? Osteomalacia Acute osteomyelitis Metastases Osteoporosis Loading...1339. Which one of the following drugs is most likely to cause severe bone marrow depression? Sirolimus Prednisone Tacrolimus Cyclosporine Loading...1340. 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? Enterovesical fistula Renal stones Pseudomembranous colitis Ulcerative colitis Loading...1341. Which one of the following is the main mechanism of absorption of most drugs in the gastrointestinal tract (GIT)? Passive diffusion Endocytosis and exocytosis Facilitated transport Pinocytosis Loading...1342. Which of the following is the main mechanism of action of methylergonovine in treating postpartum hemorrhage? Strong vasoconstriction Forceful contraction of myometrium Instant blood coagulation Blocking sympathetic stimulation Loading...1343. Pharmacokinetics of a drug is defined as which one of the following? Reaction of the body to a drug The movement of a drug within the body Amount of drug needed to produce an effect Effect of a drug on certain body systems Loading...1344. The binding of a drug to plasma proteins will tend to: Increase its pharmacological activity Increase its concentration in the plasma. Decrease its rate of glomerular filtration. Increase its rate of biotransformation. Decrease half-life. Loading...1345. Which of the following drugs are protein synthesis inhibitor? Erythromycin Tetracyclin All of the above Gentamicin Linezolid Loading...1346. What is the most common cause of hypertension in young women? Rheumatic heart disease Cardiomyopathy Oral contraceptive pills Atherosclerosis Loading...1347. 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 Triplodine Cyproheptadine Carbinoxamine Loratadine Loading...1348. Which of the following is an indandione analog Anticoagulant agent? Anisindione Heparin Warfarin Abciximab Clopidogrel Loading...1349. Which one of the following drugs belongs to drugs for hepatic viral infections? Adefovir Indanyl carbenicillin Ezetimibe Capreomycin Aluminium hydroxide Loading...1350. 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? Splenic artery Celiac trunk Right gastric artery Superior mesenteric artery Left gastric arteryPage 55 of 66 Loading...1351. Which one of the following medications can be reversed by administration of vitamin K? Tirofiban Warfarin Clopidogrel Heparin Loading...1352. A 47-year-old man with a history of chronic renal failure presents to the clinic for a follow up after a kidney transplant three weeks ago. His surgery was successful and his transplanted kidney started producing urine right after the operation. However, today his urine output drops and his serum creatinine begins to rise. There is no fever or dysuria. Urinalysis shows no abnormality. Biopsy from the transplanted kidney shows cellular infiltrate of cytotoxic cells (CD8). What is the most likely diagnosis of this condition? Acute pyelonephritis Chronic rejection Normal reaction Acute rejection Hyperacute rejection Loading...1353. Which of the following placental sites of insertion most likely predispose to an inverted uterus? Lower Posterior Fundal Anterior Loading...1354. Which one of the following drugs is a Thiazide Diuretic? Ezetimibe Hydrochlorothiazide Atorvastatin Indanyl carbenicillin Fenofibrate Loading...1355. Dry or “sandy eyes” is seen after administration of large doses of which one of the following medications? Carbacho Timolol Pilocarpine Atropine Loading...1356. Which of the following are the characteristics of Dressler’s syndrome? Stasis, hypercoagulability and endothelial damage Hypotension, distant heart sounds and jugular vein distention (JVD) Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) Loading...1357. 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? Bronchial smooth muscle dilation Mydriasis Dilation of blood vessels Constipation Decreased gastrointestinal motility Loading...1358. Dull, Persistent, and tightening is the characteristics of the following type of headache? Tension-Type Headache Cluster Headache A & B Migraine Headache Loading...1359. Unilateral or bilateral sweating is the symptom of one of the following types of headache? Cluster Headache Migraine Headache A & B Tension-Type Headache Loading...1360. A drug that inhibits replication of the influenza A virus by interfering with viral attachment and uncoating? Oseltamivir Nevirapine Acyclovir Rimantadine Zidovudine Loading...1361. What is the antidote to Atenolol? atropine Flumazenil Pyridoxine Glucagon Loading...1362. Stimulation of hepatic microsomal cytochrome p450 enzymes can cause which one of the following? Enhancement of excretion of some drugs Decreased metabolism of certain drugs Increased metabolism of certain drugs Increased intestinal absorption of certain drugs Loading...1363. One of the following statements about the use of scopolamine is wrong? produce excitement at high doses Used for Motion sickness Shorter duration of action as compared to atropine in CNS Short term memory blocker Belladonna Alkaloid Loading...1364. A 78- year-old-man who is recently diagnosed with a malignant brain tumor visits his physician with his wife to discuss his treatment options with radiotherapy and chemotherapy. When the physician explains the benefits and risks of each option, he notices that the patient does not understand everything he is saying. Meanwhile, his wife understands and asks questions. The physician knows them very well as they both share their own values and make their medical decisions together for a long time. They both agree to proceed with radiation and chemotherapy. What is the most appropriate next step in management? Refer the patient for psychiatric evaluation Seek guardianship through the court Schedule another appointment for the patient only to be sure of his own decision Start treatment immediately Start treatment after obtaining a written consent from his wife Loading...1365. 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? Sodium nitroprusside Clopidogrel Calcium gluconate Labetalol Heparin Loading...1366. A 12-year-old boy frequently experiences severe asthmatic attacks and becomes cyanotic, dyspneic, and agitated. Which of the following agents would be most likely used to prevent these attacks? Scopolamine Atropine Cromolyn sodium Epinephrine Loading...1367. 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 Ampicillin Cloxacillin Methicillin Loading...1368. 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 Cytotoxic T cells Fibrocytes Plasma cells Loading...1369. Aldosterone production is reduced by using one of the following drugs? Diltiazem Lisinopril Aspirin Erythromycin Loading...1370. Which of the following conditions is the most likely cause of development of velvety rash in the axilla? Insulin resistance Thyroid hormone deficiency Serotonin hypersecretion Testosterone hypersecretion Loading...1371. Which of the following methods is the most likely to demonstrate spores? India ink stain Malachite green stain Gram stain Acid-fast stain Loading...1372. 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? Schizophreniform disorder Schizophrenia Brief psychotic disorder Bipolar disorder Major depressive disorder Loading...1373. Measurement of the content of which one of the following could help to compare the collagen content of several tissues? Hydroxyproline Proline Cysteine Glycine Loading...1374. Which of the following needs to be added to a breast-fed 9-week-old premature infant to improve pallor? Iron supplements Vitamin C Orange juice Milk formula Loading...1375. Which one of the following cells lines the alveoli and secretes the surfactant? Clara cells K cells Pneumocytes type II Pneumocytes type I MacrophagesPage 56 of 66 Loading...1376. 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 Radial nerve Suprascapular nerve Loading...1377. What is the congenital heart disease most likely associated with Turner’s syndrome? Ventricular septal defect Atrial Septal defect Transposition of the great vessels Coarctation of the aorta Loading...1378. Which one of the following substances is used to differentiate between central and nephrogenic diabetes insipidus? Cortisol Dexamethasone Desmopressin Cosyntropin Loading...1379. Which of the following side effects is most likely associated to spironolactone? Metabolic alkalosis Hyperkalemia Hyperglycemia Hypercalcemia Loading...1380. 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? Tanner syndrome Primary adrenal insufficiency Hashimoto’s disease Post-traumatic hypopituitarism Loading...1381. Deficiency of which of the following enzymes results in elevated serum levels of alanine and lactate? Alanine aminotransferase Lactate dehydrogenase Pyruvate dehydrogenase Glucose-6-phosphatase Loading...1382. Which of the following is the appropriate next step of action to parents who refuse to vaccinate their child? Explain the risks and benefits to them and document the conversation Proceed with immunizations Report to Department of Health Services (DHS) Obtain a court order Loading...1383. As physicians, we need to know some definitions in Genetics, which are related directly to our practice and guide us to diagnose and treat many genetic disorders. These items include genome, genotype, phenotype, genetic code, gene expression, etc. Which one of the following choices describes the definition of a phenotype? Physical location of a trait on a DNA molecule DNA structure that determines the expression of a trait Genetic constitution of an organism An observable physical or biochemical trait on an organism Loading...1384. Imidazoline derivative drug with Alpha2 adrenoceptors effect? Albuterol Clonidine Dipivefrin Phentolamine Loading...1385. 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? Diffuse esophageal spasm Cancer esophagus Achalasia Peptic esophageal stricture Lower esophageal ring Loading...1386. 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 Subdural hematoma Epidural hematoma Cerebral contusion Loading...1387. A drug is used in severe alcohol poisoning is the following drug? DIGIBIND Fomepizole Amyl Nitrate Calcium Gluconate Loading...1388. 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 Tobramycin Ampicillin Vancomycin Gentamicin Loading...1389. Following is the Structural analog of the aldosterone antagonist spironolactone with androgenic activity but to a little extent? Mifepristone Drospirenone Fluoxymesterone Bicalutamide Megestrol Acetate Loading...1390. Following statements about the use of Metformin in wrong? Discontinued in women with a SCr> 1.4 Don't use in alcoholic patients Cause renal impairment Cause Vit. B12 depletion Loading...1391. Which one of the following is the class of aliskiren? Direct renin inhibitor Interior pituitary hormone Angiotensin receptor blocker Corticotropin ACE inhibitor Loading...1392. Which one of these apoproteins is associated with chylomicrons? Apo C-II Apo B-48 Apo A Apo E Apo D Loading...1393. Which one of the following drugs is used to prevent acute mountain sickness? Acetazolamide Chlorthalidone Spironolactone Mannitol Furosemide Loading...1394. An organophosphate drug that has a side effect of cataracts? Donepezil Neostigmine Echothiophate Edrophonium Acetylcholine Loading...1395. A patient with acute appendicitis complains of abdominal pain. Which of the following chemical mediators are responsible for this pain? Tumor necrosis factor and IgG Leukotriene and interlukin-1 Histamine and serotonin Prostaglandin and bradykinin Loading...1396. Which of the following drug resembles sex steroids and act at other receptors causing gynecomastia and menstrual irregularities at high doses? Spironolactone Acetazolamide Triamterene Furosemide Bumetanide Loading...1397. 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? Try timed voiding Discontinue metoprolol Prescribe tolterodine therapy Refer to a urologist Discontinue hydrochlorothiazide Loading...1398. A 5-year-old boy is brought to the emergency room for cough and trouble breathing. His parents mention that he was playing with some coins a short time ago. The coin is most likely lodged in which of the following lobar bronchi? Left middle lobar bronchus Left superior lobar bronchus Right middle lobar bronchus Right superior lobar bronchus Loading...1399. 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? Herpes simplex virus Toxoplasma gondii Treponema pallidum Togavirus Trypanosoma cruzi Loading...1400. Which of the following drug is Pyrazolone Derivative NSAID? Nimesulide Indomethacin Diclofenac Ketorolac PhenylbutazonePage 57 of 66 Loading...1401. Aztreonam belongs to the one of the following class? Monobactams Penicillins Cephalosporin Carbapenems Loading...1402. Which of the following conditions is characterized by the presence of periventricular calcified densities on brain imaging? Toxoplasmosis Huntington’s disease Cytomegalovirus infection Down syndrome Loading...1403. A hypoglycemic drug that decreases insulin resistance by binding with peroxisome proliferator-activated receptor gamma (PPAR-gamma) in muscles, fat, and liver? Pioglitazone Metformin Glyburide Sitagliptin Loading...1404. 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? Obsessive compulsive disorder Histrionic personality disorder Conduct disorder Antisocial personality disorder Borderline personality disorder Loading...1405. 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...1406. Which one of the following is a fatal complication of multiple long bone fractures in a young age? Thromboembolism Deep venous thrombosis Pericardial effusion Fat embolism Loading...1407. Which one of the following drugs is a Thiazide Diuretic? Metolazone Fenofibrate Ezetimibe Indanyl carbenicillin Atorvastatin Loading...1408. A 70-year-old woman, having had an appendectomy 25 years ago, is brought to the emergency room with severe abdominal pain. The patient describes the pain as being crampy and colicky. She also says that the pain seems to increase and then improve on its own. She has already vomited 10 times since the pain started in the morning. She has also not had a bowel movement since last 2 days or passed flatus in last couple of days. Physical examination shows that the abdomen is distended slightly. Auscultation of the abdomen shows peristaltic rushes and high-pitched bowel sounds. Tympanic abdomen is revealed during percussion. The patient is also diffusely tender with palpitation but there is no rebound tenderness. Rectal examination also shows an absence of stool. What would be the likely diagnosis? Intestinal obstruction Diverticulitis Pancreatitis Gastroenteritis Loading...1409. Which of the following is considered a dynamic stabilizer of the glenohumeral joint? Subscapularis muscle Coracohumeral ligament Inferior glenohumeral ligament Glenoid fossa Loading...1410. Which of the following is/are the most likely biopsy features seen in Celiac disease? Lack of ganglion cells Flattening of villi with excess lymphocytes Lymphoid aggregates with granulomas Crypt abscesses with excess neutrophils Loading...1411. One of the following statements about the use of succinylcholine is wrong? Malignant hyperthermia with halothane Act like Acetylcholine to depolarize junction prolonged apnea in patients deficient in cholinesterase Resistance to plasma cholinesterase causes Hyperkalemia Loading...1412. 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? Thrombosis Atherosclerosis Embolism Inflammation Loading...1413. Which of the following drug are coumarin derivative oral anticoagulants? Menadione Heparin Phenindione Dicumarol Phytonadione Loading...1414. 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 thyroid stimulating hormone Serum cortisol Blood urea nitrogen and serum creatinine Blood glucose and serum lipidsat is the most appropriate lab test you should order on this visit? Loading...1415. Which of the following drugs improves skeletal muscle spasm by acting inside the muscle cell? Dantrolene Tubocurarine Diazepam Botulinum toxin Loading...1416. Which of the following is the most common inherited cause of hypercoagulability? Protein C deficiency Factor V Leiden mutation Prothrombin gene mutation Congenital antithrombin III deficiency Loading...1417. Which of the following agents most likely causes vasoconstriction? Nitric oxide Histamine Bradykinin Norepinephrine Loading...1418. Peripheral resistance is linked with one of the following issue? Headache Fever Aids Blood pressure Loading...1419. A patient presents with persistent dry cough and high potassium. Which of the following medications is associated with these side effects? Digoxin Furosemide Albuterol Captopril Loading...1420. Which of the following is the most common cause of death in an old patient with uncontrolled diabetes? Cerebral hemorrhage Myocardial infarction Hyperosmolar coma Pulmonary embolism Loading...1421. A patient presents with painless scrotal mass and increased thyroid panel. Which of the following markers would be elevated in this patient? Alpha-fetoprotein Human chorionic gonadotropin Follicle stimulating hormone Lactate dehydrogenase Loading...1422. Which of the following medications is selectively used in NSAID-induced gastric ulcer? Cimetidine Bismuth Misoprostol Famotidine Loading...1423. Following drugs should be avoided in patients with heart failure? CCBs B-blocker Diuretic Inotropic drugs ACE inhibitors Loading...1424. 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 Anemia and agranulocytosisr physician discusses advantages and disadvantages of all treatment options with the patient. What is the most important disadvantage of radioactive iodine therapy? Leukemia Acute renal failure Repeated doses due to repeated failures Ablation of the gland and future hypothyroidism Loading...1425. A drug that belongs to Loop Diuretics is one of the following? Doripenem A & B Sulbactam Cefazolin FurosemidePage 58 of 66 Loading...1426. Which one of the following statements about the use of Leflunomide is incorrect? Immunomodulatory agent Inhibit Dihydroorotate dehydrogenase Reduce pain & inflammation Can't be used as monotherapy Loading...1427. A 37-week-pregnant woman is brought to the ER for fainting, severe abdominal pain and massive vaginal bleeding. She is pale, diaphoretic, her pulse is 130 and her blood pressure is 90/60. Which of the following is the most likely diagnosis? Abruptio placenta Pre-eclampsia Placenta previa Amniotic fluid embolism Loading...1428. 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. Hemolytic uremic syndrome Renal stonesat is the most likely diagnosis? Idiopathic thrombocytopenic purpura Henoch-Schonlein purpura Thrombocytopenic thrombotic purpura Loading...1429. 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? Osteosarcoma Metastatic adenocarcinoma Osteoporosis Ewing sarcoma Loading...1430. Which one of the following statements of tetracycline is wrong? Bind with 50S ribosomal subunit Avoid in Pregnancy Deposition in bones and teeth Causes GIT disturbance Loading...1431. Which of the following substances is elevated due to vitamin B12 deficiency? Hemosiderin Homocysteine Cyanocobalamin Folic acid Loading...1432. M1 Receptors are primarily located in: Exocrine glands, vessels (smooth muscles & endothelium) Skeletal muscle neuromuscular endplates Postganglionic neurons Myocardium, smooth muscles Cerebral cortex, Sympathetic ganglia, myenteric ganglia Loading...1433. Which one of the following correctly describes nicotinic Ach receptors? Enzyme-linked receptors Ligand-gated Na+/K+ channels G-protein–coupled receptors Loading...1434. Which one of the following local anesthesia is mainly used for regional nerve block? Bupivacaine Dibucaine Cocaine Tetracaine Loading...1435. Which one of the following drugs is 4th generation cephalosporin drug? Cefixime Cefepime Cefadroxil Cefuroxime Loading...1436. Which one of the following tumors is commonly associated with mutations affecting tumor suppressor gene (APC) and TP 53? Hepatocellular carcinoma Invasive ductal carcinoma of the breast Small cell carcinoma of the lung Colorectal adenocarcinoma Loading...1437. Periumbilical discoloration is found in a patient diagnosed with acute pancreatitis. Which of the following signs is considered positive in this patient? Nikolsky’s sign Cullen’s sign Grey Tunner sign Murphy’s sign Loading...1438. A 30-year-old man is brought to the emergency room for alcohol intoxication. His blood alcohol level is 250 mg/dL. He refused to take any medications and insisted on leaving the hospital. What is the most appropriate response to this patient? We cannot release you before you become sober You can leave anytime if you want We will call the police if you don’t take treatment You have to sign consent to leave Loading...1439. A scientific researcher is classifying some drugs according to their actions on different receptors. One of these drugs binds to its receptor without producing any action. Agonist Antagonist Inverse agonistis drug should be classified as what? Partial agonist Loading...1440. 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 Toxoplasmosis Schistosomiasis Loading...1441. Which one of the following drugs is a 2nd generation Cephalosporin? Cefoxitin Cefdinir Cefadroxil Cefepime Loading...1442. Which one of the following drugs decreases Glucose absorption? Miglitol Metformin Rasagiline Glipizide Loading...1443. Which one of the following drugs is contraindicated in a case of osteoporosis? Albuterol Calcium oxalate Simvastatin Prednisone Loading...1444. Which one of the following drugs is a prostaglandin that suppresses gastric acid secretion? Rabeprazole Misoprostol Sucralfate Cimetidine Loading...1445. Polyuria is an adverse effect of which of the following drug? Oxytocin Desmopressin Vasopressin Conivaptan Loading...1446. 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...1447. Which one of the following drugs is a neuromuscular blocker drug? Benztropine Atropine Neostigmine Succinylcholine Mecamylamine Loading...1448. 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? Melanin Thromboplastin Hemosiderin Bilirubin Loading...1449. 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? Chemical Physiological Irreversible Competitive Loading...1450. Which one of the following drugs has a synergistic effect with Flucytosine? Nystatin Amphotericin B Griseofulvin CaspofunginPage 59 of 66 Loading...1451. Retention of sodium and water is decreased by using one of the following drugs? Methyldopa Enalapril Acetaminophen Diltiazem Loading...1452. 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? Heparin Aspirin Cardioversion Metoprolol Refer to cardiologist Loading...1453. 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? Metoprolol Digoxin Verapamil Procainamide Atropine Loading...1454. 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? Assurance and follow up on next visits Termination of pregnancy Wide spectrum antibiotics to prevent infection Surgical removal of the cyst Hormonal treatment Loading...1455. Antihistamine agent with nonsedative effect from the chemical class of piperazine is the following? Fexofenadine Cetirizine Hydroxyzine Promethazine Cyproheptadine Loading...1456. Which of the following physiological changes is expected in a person comping on a mountain at an altitude of 4500 meters? Decreased arterial Pco2 Decreased 2,3-diphosphoglycerate Increased renal excretion of H ion Decreased erythropoietin production Loading...1457. Which of the following drugs is used for respiratory virus infections? Oseltamivir Miconazole Capecitabine Ibandronate Naftifine Loading...1458. Which one of the following drugs is a calcium channel blocker (Class IV)? Procainamide Amiodarone Carvedilol Verapamil Loading...1459. A 30-year-old man presents to the emergency room with excruciating chest pain and shortness of breath for an hour. Past, surgical and familial histories are unremarkable except that his father died of heart attack at the age of 32. Imaging studies and laboratory tests confirm the diagnosis of myocardial infarction. What is the most likely precipitation factor contributing to his condition? Atherosclerosis Familial hypercholesterolemia Type II diabetes Alcohol abuse Loading...1460. Which one of the following drugs inhibit the enzyme phosphodiesterase which inactivate the cAMP? Dipyridamole Argatroban Warfarin Aminocaproic acid Loading...1461. Adrenal insufficiency is commonly combined with which one of the following findings? Hyperglycemia Hypercalcemia Hyperkalemia Hypernatremia Loading...1462. Which of the following pathological signs is the first visible one in atheroma formation? Calcification Hemorrhage Thrombus Fatty streak Loading...1463. Which one of the following conditions is most likely affects the lungs of a patient with Parkinsonism? Arteriosclerosis Thrombosis Embolism Atherosclerosis Loading...1464. Which one of the following drugs belongs to Antidiarreals? Atorvastatin Ezetimibe Indanyl carbenicillin Nizatidine Aluminium hydroxide Loading...1465. Naphthalene ring containing Antihyperlipidemic drug in the structural formula is the following? Fluvastatin Colestipol Rosuvastatin Atorvastatin Simvastatin Loading...1466. 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 Ductus arteriosus Steven-johnson syndrome Hypotrichosis Reye syndrome Loading...1467. Interferon alpha is indicated for the treatment of which one of the following conditions? Kidney transplantation Rheumatoid arthritis Hepatitis C virus infection Bullous pemphigoid Loading...1468. Following statements about the use of the Metformin is incorrect? Hypoglycaemia risk is low Insulin sensitiser Promotes insulin secretion A biguanide Requires insulin for action Loading...1469. Which one of the following hypertensive drug is poisonous when given orally? Hydralazine Minoxidil Fenoldopam Sodium nitroprusside Loading...1470. Which of the following conditions is caused by a frameshift mutation? Becker muscular dystrophy Duchenne muscular dystrophy Hereditary nonpolyposis colorectal cancer Sickle cell disease Loading...1471. A 60-year-old man complains of shortness of breath. Examination reveals bilateral pleural effusions and pitting edema up to the thighs’ level. Which of the following is the most likely laboratory finding in this patient? Hypoalbuminemia Anemia Neutrophilia Hypoglycemia Loading...1472. Which one of the following conditions is the most common cause of aortic stenosis in the the elderly patients? Bicuspid aorta Subacute bacterial endocarditis Calcification of the aortic valve Rheumatic fever Loading...1473. A drug that is used to treat HIV infections is one of the following? Niclosamide Praziquantel Cladribine Etidronate Atazanavir Loading...1474. A young woman presents with chronic diarrhea found to have rectovaginal fistula. Which of the following is most likely her diagnosis? Ulcerative colitis Celiac disease Crohn’s disease Ischemic colitis Loading...1475. 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? Exploratory laparotomy Ultrasound Laparoscopy Amylase and lipase levelsPage 60 of 66 Loading...1476. A drug that inhibits the fungal squalene epoxidase thus decreasing the synthesis of ergosterol? Terbinafine Griseofulvin Nystatin Itraconazole Loading...1477. Which one of the following symptoms is most likely found in Parkinson’s disease? Chorea Cogwheel rigidity Visual hallucinations Intention tremors Loading...1478. Food allergies are typically causing which one of the following immunologic abnormalities? Complement activation Cell-mediated hypersensitivity Immune-complex deposition Localized anaphylaxis Loading...1479. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Succinylcholine Atropine Neostigmine Prazosin Benztropine Loading...1480. Which of the following drugs is used to treat pulmonary embolism? Cefoxitin Oxacillin Dalteparin Niacin Tolbutamide Loading...1481. A drug that causes REACTIVATION OF ACETYLCHOLINESTERASE? Neostigmine Pralidoxime Echothiophate Tacrine Loading...1482. Which of the following is higher in athletics than in non-athletics in resting conditions? Stroke volume Oxygen consumption Heart rate Cardiac output Loading...1483. Which of the following conditions is characterized by the presence of smooth, painless, wart-like lesions on genital organs? Chlamydia infection Secondary syphilis Candida infection Gonococcal infection Loading...1484. Which of the following drug is a derivative of Enolic acid? ketorolac Etodolac Diflunisal Piroxicam Mefenamic Acid Loading...1485. Indinavir belongs to the class of following drugs? Antiprotozoal Antiviral Antipyretic Anti malaria Antibiotics Loading...1486. Congenital heart diseases are defects of the heart and/or great arteries that are present at birth. They may be manifested at birth or hidden until later in life. Cyanosis is an important sign to diagnose and differentiate between types of congenital heart disease. What is the most common congenital heart disease? Atrial septal defect Patent ductus arteriosus Transposition of the great arteries Tetralogy of Fallot Ventricular septal defect Loading...1487. Which one of the following substances is used to acidify the urine? Sodium bicarbonate Acetazolamide Ammonium chloride Loading...1488. Which one of the following anti-hypertensive medications is contraindicated in pregnancy? Labetalol Ramipril Methyldopa Nifedipine Loading...1489. Which of the following is the coagulation parameter affected by warfarin? Bleeding time Prothrombin time (PT) Partial thromboplastin time (PTT) Loading...1490. 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 Colonoscopy MRI of the abdomen Refer to surgery for bowel resection IV hydration and antibiotics Loading...1491. Which one of the following proteins surrounds the nuclear envelope? Vimentin Tropomyosin Actin Enkephalin Loading...1492. Which one of the following drugs is a selective beta-1 agonist? Dobutamine Digoxin Amrinone Dopamine Loading...1493. Which one of the following statements about the use of Aspirin is wrong? Causes Interstitial nephritis Repress the sensation of pain Inhibit inflammation Increases alveolar ventilation Loading...1494. Which one of the following anti-depressants is most likely effective in bulimia nervosa? Imipramine Fluoxetine Tranylcypromine Amitriptyline Loading...1495. Which one of the following is the best treatment of trigeminal neuralgia? Fluoxetine Riboflavin Methylphenidate Carbamazepine Loading...1496. 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? Fine needle aspiration Excisional biopsy Ultrasound of the thyroid T4 and TSH levels Loading...1497. Dose related bone marrow depression is the adverse effect of following drug? Ketoconazole Probenecid Caspofungin Flucytosine Loading...1498. 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? Prolonged standing Excessive sweating Alcohol intake Prolonged exposure to the sun Strenuous exercise Loading...1499. What are the 5 Ps of ischemia due to peripheral vascular disease? Pain-Pallor-Paresthesia-Proteinuria-Poikilothermia Pain-Pallor-Paralysis-Paresthesia-Poikilothermia Pain-Pallor-Paralysis-Polycythemia-Proteinuria Pain-Pallor-Proteinuria-Paresthesia-Paralysis Loading...1500. A drug that inhibits the M2 protein ion channel and its ability to modulate intracellular PH? Rimantadine Zanamivir Ribavirin AcyclovirPage 61 of 66 Loading...1501. Sensations to the external auditory meatus is innervated by which of the following nerves? Vagus nerve Great auricular nerve Facial nerve Auriculotemporal nerve Loading...1502. 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? Call the cardiology attendant Subcutaneous injection of epinephrine Intravenous injection of broad spectrum antibiotics Electric cardioversion Intravenous injection of heparin Loading...1503. 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 Transient ischemic attack Conversion disorder Multiple sclerosis Loading...1504. 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.ich of the following is the most likely vascular abnormality involved in this condition? Atherosclerosis Medical calcific sclerosis Deep venous thrombosis Hyperplastic arteriosclerosis Loading...1505. Sulindac belongs to one of the following class? Fenamates Acetic acid derivative Propionic acid Oxicam derivative Loading...1506. A 57-year-old man with a history of bleeding per rectum visits his physician to discuss the results of his recent CT colpography test. The test was positive for the presence of a colorectal polyp. The sensitivity and specificity of this test to detect a colorectal polyp is 75% and 90% respectively. What is the probability that this patient indeed has a colorectal polyp? 90% 88% 86% 84% 92% Loading...1507. Which one of the following drugs is a neuromuscular blocker drug? Nicotine Atracurium Atropine Neostigmine Benztropine Loading...1508. Red man syndrome is caused by lincosamine cephalosporin vancomycin penicilin Loading...1509. A 65 year old man presents to the clinic complaining of weakness and recurrent infections for 6 months. He has no significant medical, surgical or family history. Physical examination reveals multiple enlarged lymph nodes. Histopathology reveals excessive mature B cells that mark strongly with CD5 and CD23 and weekly with CD22. They also have weak expression of kappa chains on the plasma membrane. What is the most likely diagnosis? Chronic lymphocytic leukemia Chronic myeloid leukemia Sezary syndrome Acute lymphatic leukemia Hairy cell leukemia Loading...1510. 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 Teratoma Craniopharyngioma Germinoma Choriocarcinoma Loading...1511. Which one of the following is a anterior pituitary hormone? Atorvastatin Torsemide Desmopressin Urofollitropin Fenofibrate Loading...1512. A 35-year-old man complains of pain and swelling in the sacro-coccygeal region. Which of the following is the most likely diagnosis? Perianal abscess Liposarcoma Pilonidal abscess Suppurative hidradenitis Loading...1513. Which of the following is the next step to investigate oliguria in a catheterized patient? Measure serum creatinine Measure urine specific gravity Irrigate the catheter Start intravenous fluids Loading...1514. Which one of the following drugs is used to treat asthma? Ezetimibe Indanyl carbenicillin Theophylline Hydrochlorothiazide Repaglinide Loading...1515. Which of the following indicates the probability that a person who has a positive test result actually has the disease? Sensitivity Positive predictive value Attributable risk Specificity Loading...1516. Which of the following muscles are responsible for primary abduction of the arm at the shoulder joint? Deltoid and supraspinatus Deltoid and infraspinatus Supraspinatus and infraspinatus Coracobrachialis and deltoid Loading...1517. Which one of the following drugs is a Meglitinide drug? Fenofibrate Hydrochlorothiazide Indanyl carbenicillin Nateglinide Ezetimibe Loading...1518. 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? Advise her to keep breastfeeding her child as there is no risk of the drug on breast feeding Stop breast feeding and replace it with formula for 3 months Stop breast feeding indefinitely Stop metronidazole and choose another less effective drug as you weigh the benefits and the risks Advise her to use the pump to collect her breast milk every 24 hours right before she takes daily metronidazole Loading...1519. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Indanyl carbenicillin Lamivudine Gemcitabine Ezetimibe Capreomycin Loading...1520. An indirect-acting adrenergic agonist is following? Acetylcholine Albuterol A & B Amphetamine Clonidine Loading...1521. 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...1522. Which of the following substances is the risk factor in developing mesothelioma? Asbestos Silica Lead Copper Loading...1523. About Nateglinide; All are true, except? Decrease insulin resistance release insulin decrease postprandial hypoglycemia Hypoglycemia less common than with Sulfonylureas Loading...1524. Secretion of which one of the following hormones is decreased due to renal failure? Insulin Glucagon Thyroxin Erythropoietin Loading...1525. Which type of bias is reflected when individuals with severe disease are uncovered because they die first? Selection bias Confounding bias Late-look bias Measurement biasPage 62 of 66 Loading...1526. Which of the following is the best screening test for colon cancer? Blood in stool (FOBT) Sigmoidoscopy Colonoscopy Barium enema Loading...1527. Which one of the following drugs is often added to nasal decongestants? Norepinephrine Phenylephrine Epinephrine Albuterol Loading...1528. 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? Refer to surgery for urgent reduction Abdominal CT scan Urine culture MRI of the pelvis Assurance and follow up in 2 weeks Loading...1529. 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 father She does not need a consent Her boyfriend The ER physician Her regular physician Loading...1530. Thrombosis of the appendicular artery is significant due to compression by inflammatory edema. This artery arises directly from which of the following arteries? Inferior mesenteric artery Superior mesenteric artery Ileocolic artery Right colic artery Loading...1531. Which of the following statements about ACh release and deactivation is true? 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 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 Uptake of ACh into the presynaptic receptor is the most important mechanism in terminating the ACh signal Loading...1532. A 90-year-old man is hospitalized from falling and breaking his hip. He has been already in the hospital for 6 days when he developed a burning sensation upon urinating. An analysis of his urine shows plenty of gram positive cocci and leukocytosis. The attendant physician treats him with trimethoprim-sulfamethoxazole. However, the fever still persists. After 2 more days, the patient develops a diastolic murmur radiating to the axilla and a low-grade fever is still persisting. Out of the following, which would be the first line treatment for the cause of the possible infection? Vancomycin Gentamicin Piperacillin Ampicillin Loading...1533. 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 Try your best to explain the treatment plan to them Speak to the boy to find out if he speaks English, and if he does, explain the instructions to him. Find any Spanish-speaking person in the clinic to interpret the instructions Loading...1534. Which of the following drugs causes peripheral edema? Amlodipine A & B Oxytocin Somatrem Labetalol Loading...1535. A group of researchers investigate the effect of daily intake of baby aspirin on the development of coronary artery diseases. They are observing two groups of people divided according to intake of aspirin or not and how many develop CHD on each group. The results are listed on a chart. Which of the following is the correct measure to make an assumption? Specificity Positive predictive value Relative risk Odds ratio Loading...1536. Which of the following drug causes Calcium reabsorption that leads to hypercalcemia? Triamterene Spironolactone Acetazolamide Hydrochlorothiazide Furosemide Loading...1537. 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? Splenic and external iliac veins Azygos and hemiazygos veins Superior, middle and inferior rectal veins Esophageal venous plexus Paraumbilical and epigastric veins Loading...1538. A 69-year-old male with angina develops severe constipation following treatment with: Propranolol Nitroglycerin Dobutamine Captopril Verapamil Loading...1539. Which of the following drug is a Dihydropyridine antihypertensive drug? Amlodipine Carvedilol Diltiazem Ethacrynic Bumetanide Loading...1540. Which one of the following drugs belongs to an alkylating agent? Indanyl carbenicillin Streptozocin Capreomycin Lamivudine Gemcitabine Loading...1541. Which one of the following local anesthetics that causes local vasoconstriction and may leads to hypertension? Tetracaine Etidocaine Lidocaine Cocaine Loading...1542. Which one of the following drugs is the best treatment for seizures of eclampsia? Carbamazepine Haloperidol Magnesium sulfate Phenobarbital Loading...1543. 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? Nortriptyline Morphine Ibuprofen Carbamazepine Loading...1544. What is the proper treatment of ventricular fibrillation? Digoxin and verapamil Immediate cardioversion Morphine and nitroglycerin Metoprolol and heparin Loading...1545. Which of the following drug belongs to Sulfonylureas? Glimepiride Oxacillin Urae Cefoxitin Niacin Loading...1546. 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 Inhibition of HMG-CoA reductase Breakdown of adipose tissues Decreased synthesis of LDL receptors Loading...1547. Which of the following is the main complication of sickle cell disease? Hepatic failure Renal failure Cerebral hemorrhage Autosplenectomy Loading...1548. Didanosine belongs to the class of the following drugs? Antiprotozoal Antiviral Antipyretic Anti-malaria Antibiotics Loading...1549. Which of the following histamine H1 antagonists is identified for its serotonin-blocking effect? Loratadine Desloratadine Fexofenadine Cyproheptadine Loading...1550. Which one of the following statements about the use of the metformin is incorrect? Potential for lactic acidosis Decrease intestinal absorption of glucose Promote insulin secretion Inhibit hepatic glucose output Promote glucose uptakePage 63 of 66 Loading...1551. Which one of the following anti-Parkinsonism medications should be avoided in patients with glaucoma? Bromocriptine Trihexyphenidyl Levodopa Selegiline Loading...1552. Acyclovir belongs to one of the following classes of drugs? Antibiotics Antipyretic Antifungal Antiprotozoal Antiviral Loading...1553. Which one of the following types of cells is programmed to destroy cells the fail to display MHC class 1 antigen properly? B lymphocyte Natural killer cells CD8 lymphocyte CD4 lymphocyte Loading...1554. A decrease of J chain due to a genetic defect will cause a decrease of the which of the following? Mature B lymphocytes Mature T lymphocytes Serum IgM Serum IgE Loading...1555. Patients with genetic polymorphism have delay in metabolism of drugs by acetylation. Which one of the following drugs is most likely affected by that? Nitroglycerin Clonidine Prazosin Hydralazine Loading...1556. Which of the following hormone belongs to the posterior pituitary? Vasopressin A & B Urofollitropin Furosemide Somatrem Loading...1557. 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 Direct inguinal hernia Femoral hernia Hiatal hernia Loading...1558. Which one of the following agent is a insulin? Atorvastatin Torsemide Desmopressin Detemir Somatostatin Loading...1559. Which one of the following nicotinic antagonist drugs has the ability to lower blood pressure, a vasodilator? Succinylcholine Ipratropium Trimethaphan Tubocurarine Loading...1560. A-62-old woman presents to the ER in coma. Examination reveals temp of 90 F, pulse of 50, blood pressure of 100/60 and diffuse hyporeflexia. Thyroid gland is enlarged. What is the best next step? Rapid rewarming Intravenous levothyroxine and glucocorticoid Begin intravenous fluids Obtain T4 and TSH and wait for results Loading...1561. Which one of the following contraceptive methods is contraindicated in women with a history of deep venous thrombosis (DVT)? Intrauterine contraceptive device (IUD) Depo-Provera injections Norplant Combined oral contraceptive Loading...1562. Which of the following Diuretic drugs contain cyclic sulfonamide Except? Methylchlorothiazide Indapamide Chlorothiazide Hydrochlorothiazide Bendroflumethiazide Loading...1563. Which one of the following contraceptive methods is contraindicated in women with a history of deep venous thrombosis (DVT)? Combined oral contraceptive Depo-Provera injections Norplant Intrauterine contraceptive device (IUD) Loading...1564. Which of the following arteries is the most common site of coronary artery occlusion? Right coronary artery Left circumflex artery Posterior descending artery Left anterior descending artery Loading...1565. 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 Fluoxetine Donepezil Citalopram Diazepam Loading...1566. Which one of the following drugs is a 4th generation Cephalosporin? Cefdinir Cefaclor Cefepime Cefadroxil Loading...1567. 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 prolonged second stage Previous CS is performed due to unknown cause Loading...1568. 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 Collect blood and urine samples for culture Outpatient wide spectrum antibiotics and schedule a visit after 3 days Schedule MRI of the abdomen and pelvis Schedule Intravenous pyelogram Loading...1569. Which of the following drugs are highly bound to albumin? A & B Warfarin All of the above Digoxin Ibuprofen Loading...1570. Which one of the following enzyme deficiencies is related to Tay-Sachs disease? Arylsulfatase A deficiency Glucocerebrosidase deficiency Hexosaminidase A deficiency Sphingomyelinase deficiency Loading...1571. 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? Glutamate Methionine Glycine Phenylalanine Tryptophan Loading...1572. Which one of these drugs can lead to weight gain and constipation? Clozapine Ziprasidone Pimozide Bromocriptine Loading...1573. Which one of the following arteries is most likely affected in a case of expressive aphasia? Middle cerebral Anterior cerebral Posterior cerebral Vertebral Loading...1574. A 21-year-old pregnant woman visits her physician for a prenatal visit. Ultrasonography shows neural tube defects. The patient was not compliant with her medications. Assuming that the condition is caused by deficiency of a certain nutrient, which one of these abnormalities would be seen as well? Macrocytic anemia with neurological signs Microcytic anemia Macrocytic anemia Coagulation disorder Normochromic normocytic anemia Loading...1575. 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. Radioactive induced thyrotoxicosisat is the most likely diagnosis? Incomplete ablation of thyroid gland Cancer thyroid Ectopic thyroid tissue Hashimoto’s diseasePage 64 of 66 Loading...1576. 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 Left ventricular hypertrophy Dilated cardiomyopathy Mitral stenosis Loading...1577. Which of the following is NOT considered an indication for HIV testing? Recent positive test of a partner Patients with symptoms of AIDS Semen donor Homosexuality Loading...1578. Which one of the following maneuvers is recommended to deliver the baby arms in breech delivery? Pinard maneuver Mauriceau-Smellie-Veit maneuver Lovest maneuver Prague maneuver Loading...1579. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefaclor Ceftibuten Cefadroxil Cefepime Loading...1580. Which of the following tests is diagnostic in case of a 2-week old boy with persistent vomiting of non-bilious material after feeding? Abdominal ultrasound Chest x-ray Esophagostomy Barium studies Loading...1581. Which one of the following stain is most likely relevant to diagnose Cryptococcus neoformans? Ziehl-Neelsen stain Giemsa stain India ink stain Silver stain Loading...1582. 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? Neostigmine Physostigmine Flumazenil Nalaxone Fomepizole Loading...1583. Prolonged use of which one of the following diuretics can lead to hyperkalemia and gynecomastia? Furosemide Hydrochlorothiazide Spironolactone Acetazolamide Loading...1584. Which of the following beta blockers has the longest duration of action? Sotalol Propranolol Metoprolol Nadolol Loading...1585. Which of the following drug belongs to the Oxazolidinone class of Antibiotics? Erythromycin Sulbactam Linezolid Ciprofloxacin Oxytetracycline Loading...1586. Paraneoplastic hypercalcemia is most likely caused by tumor cells secreting which one of the following substances? Parathyroid hormone-related peptide Calcitonin-related peptide Calcitonin Parathyroid hormone Loading...1587. Which of the following disorders is considered a nephrotic syndrome? Goodpasture syndrome IgA nephropathy (Berger disease) Alport syndrome Minimal change disease Loading...1588. A drugs interfere with metabolism of azathioprine requiring a reduction in dosage? Allopurinol Sulfinpyrazone Probenecid Colchicine Loading...1589. 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 German measles Measles Chicken pox Smallpox Loading...1590. Which one of the following drugs belongs to H2 histamine receptor blocker? Nizatidine Indanyl carbenicillin Atorvastatin Torsemide Ezetimibe Loading...1591. Which of the following drug belongs to the Nonnucleoside reverse transcriptase inhibitor? Atazanavir Indanyl carbenicillin Delavirdine Maraviroc Abacavir Loading...1592. A female patient is found to have an absent right kidney. Which of the following may also be found in this patient? Unicornuate uterus Absent right ovary Imperforate hymen Pelvic testis Loading...1593. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Ibandronate Ethambutol A & B Furosemide Fluconazole Loading...1594. Which one of the following actions of epinephrine is blocked by prazosin? Pupil dilation High stroke volume Bronchial dilation Tachycardia Loading...1595. 5-FdUMP a false nucleotide inhibits thymidylate synthetase decreasing thymidylic acid(an essential DNA component) is MOA of following drug? Ketoconazole Nystatin Flucytosine Amphotericin B Loading...1596. A 76 year old woman comes to your office for a consultation. Yesterday, she had left hemiparesis for 30 minutes. She thought it was a stroke but now she is completely asymptomatic. She has a history of atrial fibrillation, angina and hypertension. She takes aspirin 81 mg and propranolol 80 mg. What is your appropriate initial management for this patient? Schedule carotid duplex ultrasonography Schedule MRI to the brain Obtain CT scan of the head Schedule another appointment whenever she has symptoms Schedule transesophageal echocardiography Loading...1597. Bleeding and thrombocytopenia is an adverse effects of one of the following drugs? Protamine sulphate Vitamin K Heparin Aprotinin Loading...1598. Which one of the following drugs is the most fatal in suicidal overdose? Citalopram Phenelzine Imipramine Bupropion Loading...1599. Which one of the following drugs binds with dietary phosphate & prevents its absorption? Furosemide Sevelamer Acetazolamide Calcitonin Rabeprazole Loading...1600. Heteroaryl acetic acid drug is following? Piroxicam Indomethacine Nabumetone Tolmetin IbuprofenPage 65 of 66 Loading...1601. Which one of the following glucocorticoids is short acting? Cortisone Betamethasone Amiloride A & B Prednisone Loading...1602. Which of the following is a contraindication of use of benzodiazepines in anxiety disorder? Smoking Sleep apnea Seizures Diabetes mellitus Loading...1603. Which of the following drugs is used to inhibit viral neuraminidase? Zanamivir Acyclovir Ibandronate Naftifine Capecitabine Loading...1604. Which one of the following drugs is first generation flouroquinolone? Levofloxacin Moxifloxacin Nalidixic acid Ciprofloxacin Loading...1605. 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 warfarin Start heparin Start low molecular weight heparin and warfarin Start aspirin Assurance and follow up in 3 months Loading...1606. Following is the 2nd generation cephalosporin drug? Cefepime Cefaclor Cefdinir Cefadroxil Cephalexin Loading...1607. 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 purpuraat is the most likely diagnosis? Hemophilia a Thrombotic thrombocytopenic purpura Hemophilia b Loading...1608. Which of the following is the appropriate treatment of amoebic liver abscess? Surgical drainage Vancomycin Amoxicillin Amikacin Metronidazole Loading...1609. Which one of the following is the wrong statement about the use of Acetylcholine as a neurotransmitter? Acetylcholine has a positive chronotropic effect Rapidly inactivated by cholinesterase In preganglionic fibers terminated at the adrenal medulla Neurotransmitter of parasympathetic nerves Neurotransmitter of somatic nerves Loading...1610. A patient comes to a rural hospital one hour after he experienced excruciating chest pain. After workup, you diagnose his case as myocardial infarction. The nearest hospital is 2-hour away. What is the best next step? Transfer to the nearest hospital Administer thrombolytic now Consult a cardiologist Loading...1611. Which of the following drugs is most likely protective against the toxicity of doxorubicin? Vitamin C Mensa Dexrazoxane Leucovorin Loading...1612. Which one of the following drugs is associated with elevated liver function test results? Isoniazid Ethambutol Capreomycin Rifampin Loading...1613. Immune-related problem is one of the following? Fever Headache Aids High Blood pressure Loading...1614. Propranolol is used to treat one of the following diseases? Viral infection Diabetes High Blood pressure Malaria Stomach Ulcer Loading...1615. 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? Tricuspid valve regurgitation Pulmonic valve stenosis Mitral valve regurgitation Aortic valve stenosis Mitral valve stenosis Loading...1616. Mitochondria are NOT found in which of the following organisms? Protozoa Fungi Yeasts Viruses Loading...1617. Which of the following characteristics is correct if the drug is highly tissue-bound? High metabolic rate Low drug dilution Low plasma concentration Low volume of distribution Loading...1618. Which of the following medications is a non-drowsy anti-allergic medication? Chlorpheniramine Loratadine Cetirizine Diphenhydramine Loading...1619. Aldosterone is released from which part of the adrenal medulla? Zona reticularis A & B Zona fasciculate All of these Zona glomerulosa Loading...1620. A 24-year-old woman visits her physician for consultation about human papillomavirus (HPV) vaccine. She has been sexually active since she was a senior in high school with multiple partners. She had her last Pap smear last year and it was normal. On examination, there are multiple vaginal non-tender wart-like projections. What is the best advice concerning HPV vaccine to this patient? She already has HPV infection but she should take the vaccine for other strains of HPV HPV vaccine is essential to treat the current infection No need for the vaccine as long as Pap smear is normal She already has HPV infection so, no need for the vaccine She can only take the vaccine later after full recovery Loading...1621. Which of the following types of rashes characterizes Lyme disease? Erythema migrans Erythema multiform Erythematous maculopapular rash Erythema marginatum Loading...1622. Which of the following is the reason that nitroglycerin is given sublingually? It improves patient compliance It has less reflex tachycardia than other routes It diminishes the odds of developing methemoglobinemia It avoids first pass metabolism Loading...1623. Which of the following is the indication for surgical repair of abdominal aortic aneurysm (AAA)? Right after been diagnosed Larger than 5.5 cm Larger than 3.5 cm Located under the origin of renal arteries Loading...1624. 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? Obsessive compulsive disorder Conduct disorder Antisocial personality disorder Borderline personality disorder Histrionic personality disorder Loading...1625. What is the mechanism of action of aminoglycosides? Disruption of cell wall hemostasis Inhibition of general metabolic pathways Disruption of ribosomal protein synthesis Blocking pathogens recognition of the hostPage 66 of 66 Loading...1626. Which one of the following drugs may cause parkinsonism-like adverse effect? Olanzapine Quetiapine Haloperidol Clozapine Loading...1627. 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? Flexor retinaculum Extensor retinaculum Palmer aponeurosis Skin Superficial fascia Loading...1628. Which of the following drugs are carboxylate derivatives of ACEIs except? Fosinopril Enalapril Quinapril Ramipril Lisinopril Loading...1629. Increased level of bradykinin causes? Headache Fatigue Vertigo Fever Dry cough Loading...1630. Which one of the following cell markers is unique for NK cells? CD14 CD16 CD40 CD56 Loading...1631. A drug that inhibits the ergosterol synthesis causing disruption of membrane function and Increase permeability? Ketoconazole Flucytosine Amphotericin B Nystatin Loading...1632. Which one of the following anti-depressant drugs is contraindicated if the patient has a history of seizures? Venlafaxine Bupropion Imipramine Fluoxetine Loading...1633. Following drug is a phenylalanine derivative? Nateglinide Metformin Pioglitazone Repaglinide Loading...1634. In a case of esophageal dysphagia, which one of the following is considered a mechanical obstruction versus motility disorder? Diffuse esophageal spasm Achalasia Extrinsic compression Chagas disease Loading...1635. Failure of degeneration of the urachus may lead to which of the following defects? Bladder adenocarcinoma Polycystic kidney disease Bladder exstrophy Renal agenesis Loading...1636. Following drug consists of an aromatic derivative ring in the structural formula? Simvastatin Colestipol Pravastatin Atorvastatin Lovastatin Loading...1637. Which of the following virus infections mostly develops chronic hepatitis? Hepatitis A Hepatitis B Hepatitis C Loading...1638. Which of the following drug is prototypical phenylalkylamine? Losartan Amiloride Verapamil Diltiazem Amlodipine Loading...1639. 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...1640. Which of the following substances is used in mercury poisoning? Flumazenil Fomepizole Methylene blue Succimer Loading...1641. Which one of the following types of cells is involved in foreign body reaction? Giant cell Eosinophil Neutrophil Plasma cell Loading...1642. 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 First metacarpal bone fracture Tear of opponens pollicis Colles fracture 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. Hover or click the text box below or Type/Enter: med2020
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