April 16, 2021

Q257

A 35-year-old woman notices a change in the appearance of a mole on her neck. Physical examination reveals that the lesion is an irregular, nodular, superficial mass with a variegated appearance. Biopsy demonstrates a primary malignant tumor. Which of the following factors is most predictive of the patient's long term prognosis?
April 16, 2021

Q258

A 43-year-old, insulin-dependent diabetic patient is diagnosed with hypertension and begins therapy with an antihypertensive agent. Three days later, he measures his blood glucose at home and finds that it is 53 mg/dL. He recalibrates his glucose testing apparatus and repeats the test, only to find that the first reading was accurate. He is concerned that his hypoglycemia did not produce the normal premonitory signs and symptoms. Which of the following medications was most likely prescribed to treat his hypertension?
April 16, 2021

Q259

A 33-year-old woman presents with fever, vomiting, severe irritative voiding symptoms, and pronounced costovertebral angle tenderness. Laboratory evaluation reveals leukocytosis with a left shift; blood cultures indicate bacteremia. Urinalysis shows pyuria, mild hematuria, and gram-negative bacteria. Which of the following drugs would besttreat this patient's infection?
April 16, 2021

Q240

A 55-year-old man had been in good health since receiving a heart transplant for severe atherosclerotic disease. Five years after transplantation, the patient died suddenly, without any premonitory symptoms, while working in his garden. He had been maintained on cyclosporin since his transplant. Which of the following complications would most likely be found at autopsy in the transplanted heart?
April 16, 2021

Q241

An elderly lady is brought to the emergency room after drinking insecticide that she thought was tea. After her stomach is pumped, her sense of smell is tested and it is found that she can not distinguish common smells (e.g., an orange, coffee). CT scan of the head demonstrates a mass in the olfactory groove area. The axons likely compressed by this mass project to which of the following structures?
April 16, 2021

Q242

A 27-year-old man develops bilateral parotid gland swelling and orchitis, and is generally ill with fever of 102° F. Which of the following substances is most likely to be significantly elevated in the patient's serum?
April 16, 2021

Q243

A 55-year-old man presents to the emergency room with crushing substernal pain and left shoulder pain of 2 hours duration. The pain is not relieved by sublingual nitroglycerin, and the electrocardiogram shows ST elevation in several leads. Aspirin and streptokinase therapy are initiated, and the patient is admitted to the intensive care unit. The next morning, serum cardiac enzymes are elevated to 4 times the upper limit of normal, and the electrocardiographic changes are still present. Which of the following is the most likely diagnosis?
April 16, 2021

Q244

Which of the following amino acids is post-translationally hydroxylated in the cytoplasm of fibroblasts?
April 16, 2021

Q245

Microscopic examination of a cancer cell reveals a cell in an abnormal telophase in which three clusters of chromosomes are seen. An abnormality of which of the following would be most likely to produce this alteration?
April 16, 2021

Q246

A 58-year-old man with fainting spells and exercise intolerance is found to have a bicuspid aortic valve with marked aortic stenosis. Which of the following physical findings would be prominent in this patient?
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